Ethical Issues In Physical Therapy

One important role massage therapist has, is to make the client feel comfortable. The more experience you have within this field, the more confident the therapist would be during a massage session. The idea of the client feeling safe, emotional and/or psychologically, is the a way to receive an effective session (Porcino,2014). The more the client feels complacent, the more the client will be willing to return. Also if the client feels safe, the number of lawsuits would decrease.The American Massage Therapy Association’s Rules of Ethics(2) states that practitioners shall be truthful in advertising and marketing, and refrain from misrepresenting his or her services, charges for services, credentials, training, experience, ability or results

As a New York Physical therapist, I urge you to veto measure AB 3551. This ill conceived legislation fails to understand the value of the current New York state law in curbing medical practices that may undermine the quality of care as it relates to physical therapists. As you are aware, Rep Jackie Spencer, the person who introduced the AB 3551, argued that self-referral by physicians increases cost (American Physical Therapy Association, 2014). He also stated that it encouraged an unnecessary use of services that do not promote the integrity of health care provision. If enacted, the law will eliminate financial incentives from the physician referral process. Rep Jackie Spencer is under the impression that the law will ensure that medical decisions will promote the patients’ interest. The lawmakers also have the impression that the financial incentives have encouraged physicians to expand the number of prescribed procedures, which is against the code of conduct of the profession. If enacted into law, it will complicate the work of physicians.

Code of Ethics is a written set of rules issued by an organization to its employees and administration to aid them provide treatment in accordance with its prime values and ethical standards.

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.

Under the old Georgia Physical Therapy Act, a physical therapist was allowed to examine and evaluate of patient or client without a referral source. The only treatment a physical therapist could provide without a referral source was in the area of fitness, wellness, or prevention that was not related to an injury. Effective July 1, 2015, the current Georgia Physical Therapy Act grants physical therapists limited direct access, or the terminology used in the act is self-referral. Under the new practice act a patient who self-refers can be seen by a physical therapist for a maximum of 21 days or eight visits before required to have a referral from the patient’s provider. (Georgia Physical Therapy Act, 2015). A stipulation is that a written disclosure must be provided to the patient that the physical therapy diagnosis is not a medical diagnosis. (Georgia Physical Therapy Act, 2015). Additionally, a provider referral is not required for patients who return for treatment within 90 days that have been previously diagnosed with a chronic musculoskeletal condition (Georgia Physical Therapy

As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).

So, I am going to clear up some of these myths. These myths are from a article I read called 7 Direct Access Myths Debunked. One topic is that it only applies to private outpatient Physical Therapy Practices. The truth is that is applies to many other areas as well like private pay home care or sports field and performing arts venues, etc. So it's not just applied for one group. If you really need serious go to a physical therapy clinic but you still might have to get approval from your primary care physician. Another Myth is that Direct access doesn’t exist in every state. That is somewhat true but there are different levels of direct access. A state my just limit the amount or put a limit on it. So a form of direct access does exist in every state so you just have to figure out what works best for you. Mississippi is one of the six states that has strict limitations that still require approval. Another myth is that allowing patients coming without a referral from their physician puts their health at risk. “Physical Therapist are doctoral-level medical professionals whose training and education make them more than qualified to not only conduct initial evaluations, but also recognize when a patient’s medical needs fall outside of their scope”(Andrus). Physical Therapist are doctors. They go to med-school like every other doctor does. They can see when a Patient needs therapy or not. According to Apta’s Guide of Professional Conduct it is required that PT’s should evaluate the patient for signs and symptoms of damage for therapy. A doctor would not just treat someone without evaluating

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,

As you posted the question regarding Illinois, more direct access, and the potential payers lack of recognition of PT’s as the practitioners of choice, I thought about our current practice challenges. Florida has direct access to physical therapists; however, we are still having battles with the commercial insurances not because they don’t recognize us as “the providers” but because they are in the business of denying services. We recently had an infant with a differential diagnosis of Spastic Cerebral Palsy and his insurance company approved a total of two (2) PT treatments. We appealed the case by requesting a peer review and the “peer” assigned to the case, was not a physical therapist; she was a speech language pathologist that

As a practicing physical therapist in the state of Georgia, and over 35 years of clinical experience in this healthcare field, I am writing to you today to gain the support of your insurance company, Blue Cross Blue Shield of Georgia (BCBSGA) in the recent achievement of direct access for physical therapists in Georgia. Currently, patients in the state of Georgia now have direct access to physical therapists without the requirement of a physician referral; however under the current health care system physical therapists are still prevented from providing necessary medical treatment to patients, on the account of that services rendered under direct access are not reimbursed by BCBSGA. This extra step places a burden to the consumer by increasing

The Texas Nurses Association is a strong proponent of permitting APRN’s to practice with full authority using their clinical skills and education to their fullest potential (Cates, 2017, p. 2)l. The TNA is a member of the APRN Alliance, which encompasses four statewide associations (Cates, 2017, p. 2). The APRN Alliance joined forces with the Coalition for Health Care Access (CHCA). This coalition is comprised of “over 20 business, consumer-advocacy, and health care stakeholder groups” (Cusack, 2017, p. 2). Currently, APRN’s barriers include expenses associated with partnering physicians (Holmes & Kinsey-Weathers, 2016). Granting APRN’s full practice authority would results in a monetary loss to these physicians. The AMA and AAFP oppose the passing of HB 1415 (Hooker & Muchow, 2015, p. 89). The pushback from these organizations stands regardless of strong evidence of the positive outcomes with allowing APRN’s full practice authority.

In 2010, The Affordable Care Act (ACA) was signed into law by President Barack Obama. The law was established in order to address essential issues within the US health system such as the high and rising cost of care, inadequate access to health insurance and health services and the diminished quality of care.1 Although this law was intended to help millions of Americans, many Americans are being effected by this same law. As a future physical therapist, there are many issues with this law that are bothersome in contemplating my future in a small outpatient privately owned clinic.

Physical therapy is the treatment of different physical issues by using physical methods rather than drugs or surgery. Physical therapy originally began in 1921 as the American Women’s Physical Association. The association was led by President Mary McMillan. An executive committee of elected officers governed the association. The executive committee included 274 charter members. In 1992, they changed their name to the American Physiotherapy Association (APA), and men were admitted. Within the 1930s, APA introduced its first “Code of Ethics”, and membership was just under 1,000. During WWII and the Polio epidemic (1940s-1950s) physical therapists were in high demand. As a result, membership grew to 8,000 and the number of education programs in the US increased from 16 to 39. In the late 40s the APA changed their name to the American Physical Therapy Association (APTA)

Physiotherapists were first able to serve as primary contact providers in Australia in 1976 with the lifting of the Australian Physiotherapy Association’s ethical principle stating “It is unethical for a member to act in a professional capacity except on referral by a registered medical or dental practitioner”. [1, pg 217] Although the change met much debate, the United Kingdom followed suit in 1978. [1] This legislation had yet to pass in all 50 American states, the District of Columbia, and the US Virgin Islands until July 1, 2014. [2]

According to Direct access utilization survey done by APTA in 2010 state with unrestricted direct access for more then 10 years 69% therapist report that their direct access patient contain only 10% of their patient population and this 10% consist of former patient, their relatives and friends. Even though most of the reimbursement companies including medicare doesn’t required initial referral from physician, 64.7% therapist identified reimbursements limitation is one of the primary reason behind lower number of direct access patient (APTA 2010). I work for one of the largest and lidding health care provider company in United state and company policy dictate that we have to have physician referral in order to evaluate and treat patient in all settings.