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PTA Blog Talk

On Duty

Published May 3, 2012 8:18 PM by Jason Marketti

The police, fire department, EMTs and MDs are a few of the professionals that seem to be on duty all the time. In therapy, we are not and in most cases we do not make truly independent decisions. This might be due to the training and thought processing that has been taught.

We consult with the nurse or other health professional before seeing patients in a hospital setting and a SNF. When X-ray and blood draws are needed, we are asked to step out of the room so they can do their procedure, and it seldom works the other way around. We cannot change a person's diet or medication, and in some cases we do not even have the authority to get him to participate in exercises.

In outpatient, a therapist cannot refer a patient to a different MD that might be better for the patient's condition. Therapists cannot write a prescription for an assistive device or adaptive equipment so insurance companies will pay for it. Yet insurance companies will require us to complete a wheelchair-seating assessment before they even think about providing one for a patient. Where is our authority to dictate to the insurance companies that we know what equipment the patient needs prior to discharge?

The higher education in therapy has given little credence to insurance companies and an LPN can still tell a DPT to leave a patient alone because the patient needs rest. Therapy does not dictate length of a patient stay and despite a therapist's knowledge and assessment of a patient diagnosis, we cannot act on that assessment unless we have approval from insurance and in some cases, the MD.

Other professions often go to court and have a legal precedence to what their profession can accomplish. I have met one therapist who went to court and was crucified because of poor handwriting in the chart. We do not even have a licensure compact agreement like nurses do where they can easily glide from state to state with limited interruption in their services. We are not on duty 24/7 and can relax on our days off. Officers, nurses, MDs and EMTs often have a duty to stop at an accident scene to render aid while those with a therapy degree can simply cruise on by listening to music. Even a lawyer would probably stop and pass out cards to secure clients, but not a therapist.


Too true, we did not take an oath to serve and protect or do no harm.  If a call goes out on an airplane for a doctor to assess a pateint who is in distress will the DPT's come running?  

Karen May 5, 2012 2:51 AM

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About this Blog

    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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