The Argument Against Direct Access
The campaign to bring direct access to physical therapy to every US state has been an ongoing challenge for the APTA and other professional organizations. A primary argument from opponents of direct access is the assertion that physical therapists lack the ability to properly diagnose patients, which carries potentially severe risks for both the patient and the practice. Failure to recognize a possibly fatal condition, opponents claim, is more likely as physical therapists lack proper diagnostic training.
While this may have been the case during the beginnings of modern physical therapy, it is most certainly not the case today. With stringent educational requirements to become a licensed physical therapist, the rise of DPTs and continuing education requirements for license renewal, PTs are now much better armed to recognize signs and symptoms that indicate a patient is not in need of a PT but of a physician.
Why Is Evaluative Procedure So Important?
As part of the ongoing effort to remove limitations to direct access in all states, it is vital that cases of misdiagnosis remain extremely rare. Even though textbooks authored by PTs on pathology, medical screening and differential diagnosis have been in existence for over fifteen years, physical therapists in direct access states can ensure that their diagnostic skills remain sharp and up to date with continuing education courses that focus directly on Evaluative Procedures. Evaluative procedures include orthopedic physical assessment, differential diagnosis and pathology.
Differential diagnosis provides therapists with a consistent way to screen for systemic diseases and medical conditions that can mimic neuromuscular and musculoskeletal problems. Orthopedic physical assessment is a systematic approach to performing a neuromusculoskeletal assessment. Pathology offers guidelines, precautions, and contraindications for interventions with patients who have musculoskeletal or neuromuscular problems as well as other conditions such as diabetes, heart disease, or pancreatitis.
Up to date and thorough knowledge of evaluative procedures reduces the chances of misdiagnosis and increases the confidence that unlimited direct access to physical therapy should be the norm in every state.
Maintaining EP Skills With Continuing Education
While evaluative procedure training is part of the mainstream curriculum in physical therapy education, continuing education courses are recommended for all therapists who practice direct access, and are mandatory in some states to maintain certification, including Pennsylvania and Virginia. Not sure if your state requires these courses to maintain Direct Access certification? Contact your state board for more information.
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