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Physical Therapists: Vital Role in Recovery

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Physical Therapists: Vital Role in Recovery

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pool therapyPhysical therapists often play a vital role in restoring an injured patient to a higher level of function. I recently learned more about their educational preparation and roles. The following is written by Gwen Simons:

To obtain a license to practice physical therapy, the physical therapist must graduate from a CAPTE accredited program or have equivalent foreign education. CAPTE accredited programs follow “The Normative Model of Physical Therapists Professional Education.” The entry level for physical therapy education has changed over the last twenty years from a bachelor’s degree to a doctorate in physical therapy (DPT) degree. Currently, physical therapy programs must offer a master’s degree to be accredited; however, more than 8 percent of the programs have converted or plan to convert to the entry-level DPT degree. Many practicing physical therapists are returning to “transitional” DPT programs to upgrade their degree to the doctorate degree merely because the DPT is becoming the recognized standard even though physical therapists with bachelor’s degrees had an equitable physical therapy education and still meet (or exceed) minimum licensure requirements.

Physical therapists often play a vital role in restoring an injured patient to a higher level of function. The following is written by Gwen Simons:

To obtain a license to practice physical therapy, the physical therapist must graduate from a CAPTE (Commission on Accreditation in Physical Therapy Education) accredited program or have equivalent foreign education. CAPTE accredited programs follow “The Normative Model of Physical Therapists Professional Education.” The entry level for physical therapy education has changed over the last twenty years from a bachelor’s degree to a doctorate in physical therapy (DPT) degree. Currently, physical therapy programs must offer a master’s degree to be accredited; however, more than 8 percent of the programs have converted or plan to convert to the entry-level DPT degree. Many practicing physical therapists are returning to “transitional” DPT programs to upgrade their degree to the doctorate degree merely because the DPT is becoming the recognized standard even though physical therapists with bachelor’s degrees had an equitable physical therapy education and still meet (or exceed) minimum licensure requirements.

The Federation of State Boards of Physical Therapy administers the only national licensure exam. Therefore, there is a national standard for entry level education and licensure even though each state licensure board sets its own passing criteria for the exam.

The physical therapist assistant (PTA) is a graduate of a physical therapist assistant associate degree program accredited by CAPTE. The PTA assists the physical therapist in providing physical therapy interventions to carry out the treatment plan. The PTA does not perform examinations or make decisions to change the treatment plan and functions under the direction of the physical therapist. In general, the PTA does not require on-site supervision unless it is required by the payer or the state licensure act. PTAs must be licensed or certified in most, but not all, states. In some settings, the physical therapist may be assisted by non-licensed personnel called physical therapy technicians (“techs”) or aides. Occasionally these support personnel have other degrees or certifications, such as an athletic training certification (ATC) or an exercise physiology degree.

The Physical Therapy Practice Act in each state governs the use of such non-licensed personnel when they are working in a physical therapy setting regardless of whether they have other degrees or certifications. In most states, non-licensed personnel have a very limited role in caring for the patient and are prohibited from independently performing or billing for physical therapy services. Documentation is not typically done by non-licensed support staff unless they are merely checking off flow sheets or exercise records. Therefore, each physical therapy note should be signed by either the physical therapist or the PTA. A red flag should go up about whether the licensure laws were complied with and the standard of care was met where documentation is done by non-licensed support staff.

Practice settings

Physical therapists provide services in a broad range of inpatient, outpatient, and community-based settings where physical therapists practice, including the following:

• Hospitals (for example, critical care, intensive care, acute care, and subacute care settings)

• Outpatient clinics or offices

• Rehabilitation facilities

• Skilled nursing, extended care, or subacute facilities

• Homes

• Education or research centers

• Schools and playgrounds (preschool, primary, and secondary)

• Hospices

• Corporate or industrial health centers

• Industrial, workplace, or other occupational environments

• Athletic facilities (collegiate, amateur, and professional)

• Fitness centers and sports training facilities

The physical therapist may play a slightly different role and have different responsibilities for the patient in each of these settings. For instance, in acute care and rehabilitation facilities, the physical therapist is one member of the patient care team. Care must be coordinated between multiple providers, and all team members have a responsibility for knowing what care the other team members are providing with regard to how it may impact their individual treatment plans.

In any inpatient setting (hospital, rehab, subacute, extended care or skilled nursing facility), it is generally the physical therapist who is responsible for teaching the patient how to safely transfer from the bed to the wheelchair and bedside commode or in and out of a car. They are also responsible for teaching the patient how to walk with assistive devices. The physical therapist assesses the patient’s need for assistance and documents it in the patient’s record. Other team members, such as nursing staff, may rely on this information to know how much assistance to give the patient and whether the patient requires the assistance of more than one person. Each facility will have policies and procedures about how this communication between team members should occur.

Source: Gwen Simons, PT, JD, OCS, FAAOMPT, “Physical Therapy Records”, Medical Legal Aspects of Medical Records, Second Edition.

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