Contemporary Practice Issues

Elements of Vision 2020 of the APTA

Physical therapy will be provided by physical therapists who are
Doctors of physical therapy.

Board Certified Specialist.

Direct access to physical therapists. (Autonomous practice)

Assisted by Physical Therapist Assistants

Issues
Doctorate of physical therapy (DPT)degree.

Direct access by the public to physical therapy care.

The role of the PTA.

Doctorate of physical therapy (DPT)degree.

Why is there a greater Urgency for all PTs to have the

DPT Degree?
DPT Program Prepare Students
 More directly involved in the processes of evaluation, diagnosis & patient
management

 Supervising treatment

 Writing clinical case reports

 Documention

 Evidence Based Practice

Help to eliminate individuals who are not willing to
“go the extra mile” for the profession.

DPT will distinguish PTs from other Allied health

Practioners such as massage therapist,Athletic trainers
and Kinesiotherapist.
t.DPT is the key to fulfill
Vision of having all PTs hold Clinical Doctoral Degree.
Post Professional Degree.
Board Certification of Specialities
Concept of Specialization in PT practice.

Peadiatric Orthopedic Cardiopulmonary

Specialization Neurology

Integ Sports Geriatrics

 BOARD CERTIFICATION OF SPECIALISTS
The APTA House of Delegates approved the concept of specialization
in PT practice in 1976, and the requirements for certification in
advanced clinical competence were approved in 1978. Appointment
of the first nine-member American Board of Physical Therapy
Specialties (ABPTS) followed shortly thereafter, and subsequently
the first specialty council in cardiopulmonary physical therapy was
established,
which developed criteria and a qualifying examination for this
specialty. Over the years, specialty councils have been created for
clinical electrophysiology, geriatrics, neurology, orthopedics,
pediatrics, and sports physical therapy. The responsibilities of the
ABPTS and of each of the specialty councils are listed:
 ABPTS
 ● Develops, implements, and revises policies and procedures related to specialist certification
and recertification processes
 ● Develops the minimum requirements for certification and recertification to be used across
all specialty areas and approves the specialty-specific requirements developed by the specialty
councils.
 ● Approves and recommends the formation of proposed specialty areas to the APTA House of
Delegates and creates those approved
 ● Oversees the activities of the specialty councils and approves the certification and
recertification of qualified specialist candidates
 Specialty Council
 ● Delineates the advanced knowledge, skills, and abilities for their specialty areas and produce
the Description of Advanced Clinical Practice/Description of Specialty Practice document
 ● Determines the academic and clinical requirements for initial certification and
recertification
 ● Screen applicants for eligibility to sit for examinations
 ● Develops assessment tools (including the certification examination) for initial certification
and recertification, in cooperation with the ABPTS testing agency and ABPTS-approved
consultants
Direct Access Issue
“Direct access is the ability of a physical therapist to
provide Examination, evaluation and treatment to
patients without the need for a physician referral.”
 Objections to direct access included
(1) the belief that education of PTs was not sufficient to allow
them to serve as initial contacts for entry into the health care
system;
(2) the risk that serious medical problems might be missed in
systems other than the musculoskeletal system; and
(3) the fear that increasing the autonomy of PTs would shift
them to private practice and create staffing shortages in
hospitals.
Primary Goals
The public is best served when access is unrestricted.

 Direct access eliminates the burden of unnecessary

visits to physicians to obtain physical therapy services,
which can result in delays and denial of services
provided by PTs.
The delays in care result
Increased costs,
Decreased functional outcomes
Increased Patient frustration.
Role OF Physical Therapist Assistant
Physical therapist assistant is defined as the care and
service provided by or under the direction and
supervision of a physical therapist.

Physical therapists are the only professionals who

provide physical therapy.
 Physical therapist assistants under the direction and
supervision of the physical therapist are the only
paraprofessionals who assist in the provision of
physical therapy interventions.
box 3-2 selected curriculum requirements from evaluative criteria for physical
therapist assistant programs
Communication
 Communicates verbally and nonverbally with the patient, the physical therapist,
health care delivery personnel, and others in an effective, appropriate, and capable
manner
Individual and Cultural Differences
 Recognizes individual and cultural differences and responds appropriately in all
aspects of physical therapy services
Behavior and Conduct
 Exhibits conduct that reflects a commitment to meeting the expectations of
members of society receiving health care services
 Exhibits conduct that reflects a commitment to meeting the expectations of
members of the profession of physical therapy
 Exhibits conduct that reflects practice standards that are legal, ethical, and safe.
 Plan of Care
 Communicates an understanding of the plan of care developed by the physical
therapist to achieve short- and long-term goals and intended outcomes
 Demonstrates competence in the implementation of selected components of
interventions identified in the plan of care established by the physical therapist
 Demonstrates competency in the performance of components of data collection skills
essential for carrying out the plan of care
 Adjusts interventions within the plan of care established by the physical therapist in
response to the patient’s clinical indications and reports such adjustments to the
supervising physical therapist
 Recognizes when intervention should not be provided because of changes in the
patient’s status and reports this to the supervising physical therapist
 Reports any changes in the patient’s status to the supervising physical therapist
 Recognizes when performance of an intervention is beyond the skill level appropriate
for a physical therapist assistant and initiates clarification with the physical therapist
.
 . Participates in the education of patients and caregivers as directed by the supervising
physical therapist
 Takes appropriate action in an emergency
 Completes thorough, accurate, logical, concise, timely, and legible documentation that
follows guidelines and specific documentation formats required by state practice acts,
regulatory agencies, and the practice setting
 Participates in discharge planning and follow-up as directed by the supervising physical
therapist
 Reads and understands the health care literature

Education
 Under the direction and supervision of the physical therapist, instructs other members of
the health care team using established techniques, programs, and instructional materials
commensurate with the learning characteristics of the audience
 Educates others about the role of the physical therapist assistant
Administration
 . Interacts with other members of the health care team in patient care and nonpatient care
activities
Standards of Ethical Conduct for the
Physical Therapist Assistant
Preamble/Introduction

Physical Therapist Assistants are responsible for

maintaining and promoting high standards of
conduct.
Standard 1
Physical Therapist Assistants provide services under
the supervision of a Physical Therapist.
Standard 2
Physical Therapist Assistants respect the rights and
dignity of all individuals.
Standard 3
Physical Therapist Assistants maintain and promote
high standards in the provision of services giving the
welfare of the patients their highest regard.
Standard 4
Physical Therapist Assistants provide services within
the limits of the law.
Standard 5
Physical Therapist Assistants make those judgments
that are commensurate with their qualifications as
Physical Therapist Assistants.
Standard 6
Physical Therapist Assistants accept the responsibility
to protect the public and the profession from
unethical, incompetent, or illegal acts.
Code of Ethics in Physical Therapy Practice
(APTA)
 PRINCIPLE 1  PRINCIPLE 6

 PRINCIPLE 2  PRINCIPLE 7
 PRINCIPLE 8
 PRINCIPLE 3
 PRINCIPLE 9
 PRINCIPLE 4
 PRINCIPLE 10
 PRINCIPLE 5
 PRINCIPLE 11
 PRINCIPLE :01
 A physical therapist shall respect the rights and dignity of all
individuals and shall provide compassionate care.
 Attitudes of a Physical Therapist
a) A physical therapist shall recognize, respect, and respond to
individual and cultural differences with compassion and sensitivity.
b) A physical therapist shall be guided at all times by concern for the
physical, psychological, and socioeconomic welfare of patients/clients.
c) A physical therapist shall not harass, abuse, or discriminate against
others.
PRINCIPLE :02
A physical therapist shall act in a trustworthy
manner towards patients/clients, and in all other
aspects of physical therapy practice.

2.1 Patient/Physical Therapist Relationship

2.2 Truthfulness
2.3 Confidential Information
2.4 Patient Autonomy and Consent.
 PRINCIPLE :03
 A physical therapist shall comply with laws and regulations governing
physical therapy and shall struggle to effect changes that benefit
patients/clients.

3.1 Professional Practice

A physical therapist shall comply with laws governing the qualifications,
functions, and duties of a physical therapist.
3.2 Just Laws and Regulations
A physical therapist shall advocate the adoption of laws, regulations, and
policies by providers, employers, third party payers, legislatures, and
regulatory agencies to provide and improve access to necessary health care
services for all individuals.
3.3 Unjust Laws and Regulations
A physical therapist shall try to change unjust laws, regulations, and policies
that rule the practice of physical therapy.
PRINCIPLE :04
 A physical therapist shall exercise sound
professional judgment.

a) 4.1 Professional Responsibility

b) 4.2 Direction and Supervision
c) 4.3 Practice Arrangements
d) 4.4 Gifts and Other Considerations
PRINCIPLE :05
A physical therapist shall achieve and maintain
professional competence.

a)5.1 Scope of Competence

b)5.2 Self-assessment
c) 5.3 Professional Development
PRINCIPLE:06
 A physical therapist shall maintain and promote high
standards for physical therapy practice, education and
research.

6.1 Professional Standards

 6.2 Practice
 6.3 Professional Education
 6.4 Continuing Education
 6.5 Research
PRINCIPLE :07
A physical therapist shall seek only such
remuneration (fee) as is deserved and reasonable
for physical therapy services.

7.1 Business and Employment Practices

7.2 Endorsement of Products or Services
7.3 Disclosure
PRINCIPLE :08
A physical therapist shall provide and make
available accurate and relevant information to
patients/clients about their care and to the public
about physical therapy services.

a)8.1 Accurate and Relevant Information to the Patient

b)8.2 Accurate and Relevant Information to the Public
PRINCIPLE:09
 A physical therapist shall protect the public and the
profession from unethical, incompetent, and illegal acts .
9.1 Consumer Protection

a) A physical therapist shall provide care that is within the scope of practice as defined by the
state practice act.

b) A physical therapist shall not engage in any conduct that is unethical, incompetent or
illegal.

c) A physical therapist shall report any conduct that appears to be unethical, incompetent, or
illegal.

d) A physical therapist may not participate in any arrangements in which patients are
exploited due to the referring sources' enhancing their personal incomes as a result of
referring for, prescribing, or recommending physical therapy.
PRINCIPLE:

10
A physical therapist shall struggle to address the health needs of
society.
10.1 Pro Bono Service

A physical therapist shall reduce pro bono publico (reduced or no fee) services to patients
lacking the ability to pay for services, as each physical therapist's practice permits.

10.2 Individual and Community Health

a) A physical therapist shall be aware of the patient's health-related needs and act in a
manner that facilitates meeting those needs.

b) A physical therapist shall endeavor to support activities that benefit the health status of
the community.
PRINCIPLE :11
A physical therapist shall respect the rights,
knowledge, and skills of colleagues and other
health care professionals.

11.1 Consultation
11.2 Patient/Provider Relationships
11.3 Disparagement
 QUESTIONS?