Whose Profession Is It?
Two weeks ago I attended a Texas Physical Therapy Association meeting. The speaker was Mike Conners, president of the TPTA. Last week I discussed my belief the APTA is too focused on issues, such as direct access, that do not affect the majority of PTs and PTAs. Mike made another point that needs to be considered.
We all know that physician's orders are required for PTs to treat patients. Mike pointed out that none of the other disciplines competing for the same patients have that restriction. Anyone can be seen by a massage therapist, an athletic trainer or a personal trainer without having to see a physician first. None of these have the education we have but all practice without restriction.
In Texas, as in other states, there is stiff resistance from the physicians to remove the physician referral from the equation. They have described PTs as skilled technicians who require the direction of a physician to know what to do. Obviously some of this is financially driven. If they control the therapy, they control the money.
In the hospital setting, I need the physician to tell me the patient is medically stable enough to begin mobilization. This isn't true in skilled nursing. The majority of those patients are stable. In the school setting, it is easy to recognize those children who require intervention.
This problem is larger than the conflict between therapists and physicians over referrals. It is a mindset problem. There is a large scale belief that physical therapists are incapable of treating patients without first having the approval of someone else. Part of that belief arises from lack of understanding about what physical therapists do.
Once again we circle back to the APTA. Educating the public about who we are and what we do falls under their umbrella. I don't see anything out there on a large scale. Individuals and small groups are doing this but we need a large-scale, national educational push over a long period of time.
For example, the elder former President Bush is known to have Parkinson's disease and other chronic health problems. Somewhere along the line he received physical therapy. An ex-president would be a wonderful spokesperson. What about Gabrielle Giffords, the ex-congresswoman who was shot? She received inpatient rehab at a facility in Houston. She could speak firsthand as to the difference therapy made in her life. Somebody missed the boat.
Here's the problem. Neither received therapy for orthopedic problems, which is what drives the push for direct access. I hope there were other reasons not to approach those people rather than tunnel vision as to what physical therapy is and does.