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Toni Talks about PT Today

Is Diathermy a Skilled Therapy?

Published January 2, 2014 2:01 PM by Toni Patt

One of my OT coworkers and I have fallen into bicker back and forth in fun. We have an unspoken agreement to agree to disagree. Usually we find some middle ground until the topic of diathermy came up. We disagree about whether this is a skilled therapy or not.

I say it's not. To me this is like a neuro chair transfer. Just about anyone could perform one. The skill isn't in performing the transfer, it's in the clinical judgment as to appropriateness and patient tolerance. Nor is the transfer therapeutic. That comes from being out of bed. Except for the first treatment, I don't believe diathermy is skilled. I can easily train someone to use the machine. Some of the newer ones even come with recommended settings printed on them.

The OT says skilled. He holds that it requires skill before and after each treatment to determine whether the treatment is needed. Further skill is needed to choose the appropriate settings and position the head. He agrees I could train someone to set it up but only a therapist can make those decisions. Hot packs are not a skilled service but diathermy is.

The discussion is further complicated because diathermy is a skilled charge. I maintain being able to charge for it doesn't make it skilled. That just means someone successfully lobbied for it to be possible. My OT counterpart maintains that because it can be charged, it is skilled.

We're not debating whether diathermy is an effective treatment modality. Research exists that supports both positions. From what I can tell it works for some, not for others. I'm told that is due to user, I mean therapist, error. Set up properly with the correct settings, diathermy is an effective treatment.

We aren't going to find common ground on this one.

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Jason, I hear your opinion, however ultrasound does require the skill of the PT/PTA to set parameters. Do I need to spend my time moving the ultrasound head around on the patient? Not in my opinion, if I am watching the aide perform it correctly. Insurance requirements determine whether I will bill it, or choose to perform it myself.

Aubrey January 24, 2014 11:30 AM
Quinton VA

Is diathermy still used as a modality?  I haven't seen one since 1997.  

Saying "No" it is not skilled could lead to whether other modalities are skilled like a TENS unit.  The initial determination of whether a treatment is justified should be part of the skills and knowledge of a PT.  Continuation of the treatment is part of the assessment a PTA can discuss with the PT.  

The other argument is why do PT Aides do ultrasound if it is a billable service.  Shouldn't the skill of a therapist be involved somewhere in any billable service we provide.  

Jason Marketti January 3, 2014 9:49 AM

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