What Is a Physical Therapist Extender?
Reading Jason Marketti's blog last week reminded me of a discussion we're having here in Texas. It's called RC-3 and is an amendment to the Texas Physical Therapy Practice Act. It proposes unlicensed individuals such as athletic trainers and massage therapists be used as PT extenders. These extenders are to provide care as directed by the physical therapist.
That is pretty vague. Taken at face value, it implies non-licensed individuals be allowed to provide skill care under the direction of a physical therapist. Texas PTAs are viewing this as a threat to their profession and livelihood. Why would anyone pay a PTA salary when a much cheaper unlicensed individual could provide the same care?
Not only is such a thing scary, it's wrong in numerous ways. Equating the care provided by a PTA with that provided by an ATC or RMT completely discounts the education and training that goes into becoming a PTA. It assumes those individuals have the same clinical judgment as a PTA. I don't know about anyone else, but no way is a therapy extender touching one of my stroke patients.
A general consensus of PTAs attributes the measure to the OP ortho faction of our profession. Since RC-3 became general knowledge, I've heard horror stories of clinics where one or two PTs oversee as many as 19 patients at a time. I've also heard of clinics where double- and triple-booking is the norm. Having therapy extenders would increase the amount of one-on-one time between patients and staff without the expense of hiring more PTs.
It's a given facilities will jump at anything to cut costs. Maybe, just maybe, you might pull it off in an OP setting. What about a hospital? Hospital administrators aren't stupid. They're going to jump on the bandwagon of saving money. So will SNFs, LTACs and everyone else. The last thing a seriously ill patient needs is a therapy extender coming to exercise with them.
I'm not discounting the knowledge and skill of ATCs and RMTs. They're good at what they do. They studied to do what they do. But what they do isn't physical therapy. Saying those professions are capable of providing physical therapy care without additional and significant training is ridiculous.