Dry Needling

This frees up the physician’s schedule to see only the medically necessary patients, whereas PTs can share the load of musculoskeletal evaluations. Mitchell and Lissovoy published a study in 1994 on the cost effectiveness of direct access to PTs. They found that the costs for PT visits were 123% higher when patients were first seen by a physician as compared to when they were seen by a physical therapist directly. Establishing close working relationships between medical doctors and PTs, with a 2-way referral of patients, is essential to reduce not only unnecessary referrals, but also improve patient satisfaction and create an efficient process for reducing overall medical costs.

I believe that my personal and professional growth and behavior as a physical therapist is of utmost importance. I base this firstly on my strong connection to those in society who are disadvantaged when it comes to physical therapy, and also on the movement system, movement being “the key to optimal living and quality of life for all people that extends beyond health to every person’s ability to participate in and contribute to society” (American Physical Therapy Association, 2013). This perspective, I believe, is aligned perfectly with the vision statement for the physical therapy profession – to transform society through optimization of movement to improve the human experience (APTA, 2013). After reviewing the vision statement, I strongly believe it will act as my guide by strengthening compassion, reinforcing advocacy, improving quality of service, and strengthening cohesion.

As a PTA I have been given a breath of knowledge in regard to the profession of physical therapy. However, I am not satisfied with this breath of knowledge. I yearn for the opportunity to gain a further understanding in terms of “how and why” physical therapy is successful at restoring function to individuals seeking

The purpose of this research study is to determine through statistical evidence that physical therapist do or do not play a major role in helping patients with chronic diseases.

Conversely at SHU, I have visited our DPT students every year across the country as they interned in various clinical environments. Nevertheless, being rooted within the MSI, OMT, and bio-psychosocial framework would define my more than 25 years of (20 years in musculoskeletal) PT practice experience. Graduating with a DPT degree from USC, I am a fellowship-trained, board certified (OCS since 1999) Full Fellow of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT) since 2003, having graduated from the Southern California Kaiser Permanente Manual Therapy Fellowship program. Notwithstanding having an “in press” commentary and “under review” revised manuscript, I have 2 JOSPT (heralding 2 new techniques or treatment approach paradigms) and 1 Journal of Hand Therapy published journal articles and authored/co-authored almost 40 peer-reviewed orthopaedic and manual PT presentations nationally [Combined Sections Meeting (CSM) and AAOMPT] and internationally (World Confederation for Physical Therapy and the International Federation of Orthopaedic Manipulative Therapist). Anchored in clinical reasoning, OMT, MSI, bio-psychosocial

In regards to health care legislation, Ms. Rademeyer feels that the large restrictions and limitations on reimbursement has adversely affected the accessibility of comprehensive rehabilitation programs, thus putting more responsibility on the patients as well as the physical therapists (Rademeyer, 2015). She also feels that, even though the requirement for fees to be guided by outcome is a good opportunity for accountability in physical therapy services, there is a big need for balance between the limitations and the outcomes to avoid a negative impact on chances for full recovery of some patients (Rademeyer,

The scope of practice in the physical therapy profession is always changing and growing with new evidence, education, and social needs. The scope of practice is made up of three parts, professional, jurisdictional, and personal. The professional scope of practice is found upon the understanding, educational training, and evidence emerging from the therapy practice. The jurisdictional scope of practice is based on the particular state’s licensure procedures and policy. The personal scope of practice consists of the activities the therapist is familiar with and where they were trained to perform these activities expertly. (The Physical Therapist Scope of Practice.

The DPT physical therapy program at New York Medical College presents rigorous courses with a strong problem based curriculum. Facing challenges allow for personal growth and equips one with the tools needed to overcome more complex challenges in the future. Many unforeseen obstacles will be faced in this intense program, but I am willing to take the first step in overcoming this feat.

Authors Emma K. Stokes and Tracy J. Bury state "Attaining professional autonomy is a high priority for physical therapists and their professional organizations" (Global View 450). According to the World Confederation for Physical Therapy, it has been proven that patients are able to receive services from physical therapist without getting a referral from other healthcare professionals (450). This topic has not only raised concern within the country but also worldwide. Direct access to physical therapy is a concern to some legislators; however, forty-three out of the fifty states now allow direct access to physical therapists. Direct access not only decreases the cost for patients but is has an overall better outcome for patients as well. The World Confederation for Physical Therapy states "This diverse and highly specialized workforce provides opportunities for a variety of disciplines to function in primary care roles to improve access and reduce cost by eliminating unnecessary provider visits" (Challenges to Policy Adoption). Direct Access is the better and more efficient way for some people to go when seeking treatment. This is why direct access is becoming a leading benefit to human society today.

Dry needling is currently one of the “scope of practice” battles encountered in the physical therapy profession. The hot topic is extremely controversial and is not only debated by physical therapists, but by acupuncturists as well. The primary issue concerning dry needling is whether this technique fits within the Physical Therapist Scope of Practice. The controversial aspect emerges since dry needling is technically considered minimally invasive. Another issue that has appeared is the insufficient amount of research conducted. In addition, dry needling is not currently included in the DPT program curriculum. Therefore, physical therapists who want to acquire this skill are required to take a continuing education course. Furthermore, there are currently only 18 locations in the United States that offer dry needling education courses for physical therapists (APTA, 2012).

Physical therapy is always changing, evolving, improving, and becoming more effective (Scott). The way it is now is much improved from what

Strategies to facilitate the implementation of evidence-based physical therapy should emphasis on amending the barriers known in previous studies and confirmed in the future study. Certain solutions may be easy, such as improving access to journals, providing easily understandable summaries and training therapists in searching and appraisal (Iles & Davidson 2006).

Dry needling is recognized as an effective treatment of physical therapy because it helps in many ways. According to The American Academy of Orthopaedic Manual Physical Therapists, “Dry needling reduces pain and muscle tension” (qtd. in Amos). Alleviating pain in a number of patients attending a certain therapist or hospital is beneficial for that business. Successful treatments may bring more and more patients, therefore, creating more income for the hospital. Having many patients may then lead to an expansion of programs, specifically for dry needling, and opportunities for employees in the hospital. These programs will then need certified therapists to perform dry needling, thus, it may lead to training for current or new employees. Scott Malik, another physical therapist, explains that a patient who was unable to move his or her arm was unfortunately incapable of playing racquetball. The patient was then recommended for the treatment of dry needling in a study. Malik states, “After one session, he was able to compete in a

Physical therapy has grown increasing more useful as the years’ progress and more is learned about the human body and its movements, interactions, and mechanisms. Someone may go to physical therapy for injury, recovery, in order to maintain function, or even due to a stroke and is trying to work on walking again. Patients of a physical therapist can include, but is not limited to, elderly, children, accident victims, athletes, those with conditions such as arthritis or fractures, etc. The possibilities are endless for potential physical therapy patients (Mayo Clinic School of Health Sciences).

The best method to reach the targeted market is through referrals by word of mouth and by social media such as Facebook, Google reviews, Yelp, Twitter, and YouTube. Reviews help boost star-rating and most individuals will choose the highest rating, the best reviews, and overall the best physical therapy office. That’s how I chose RSM PT I wanted to be at the best physical therapy office in my area and I would assume the same for a patient. RSM PT uses external marketing by offering a reward when the consumer makes a review on Yelp. Using previous success stories (reviews) to allow others to read on their overall experience with therapy and satisfaction can help increase referrals. As well as using internal marketing with the staff in the break room; by having a chart with stars and a prize to the team who has the most reviews at the end of the month. Another form of promoting is offering direct access, as of January 1, 2015 patients can receive an evaluation and treatment without a physician prescription. At one point restrictions were placed on direct access that limited duration and visits, however state legislatures fought to amend these statutes (Gardner, 2015). Therefore, allowing physical therapists to deliver their level of expertise to access treatment more efficiently. RSM PT values the benefits direct access offers by providing 30-60 minute evaluation followed by treatment. A diagnosis will be needed from a physician to continue treatment if patients exceed 45 days or 12 visits with their