Physical therapists help people who face difficulties with pain management and movement often resulting from severe injuries or illnesses. They help these patients regain their strength, ease pain, restore their range of motion and improve flexibility as they recuperate. They provide therapy classes, stretching maneuvers and exercises to facilitate patients’ well-being. Most physical therapists work as part of a rehabilitation team while others work in clinics, nursing homes, hospitals and private offices. PTs can specialize in the following; neurology, pediatrics, women’s health, cardiovascular and pulmonary, sports physical therapy, orthopedics and Clinical Electrophysiology (APTA 2015). Physical therapists work in close collaboration with physical therapist assistants and aides, physicians and surgeons.
Education and Training Process
To become a professional physical therapist, one will require a Doctorate in Physical Therapy (DPT). The applicants need to apply for the program through the physical therapist centralized application service (PTCAS). DPT programs usually last for 3years. These programs include courses in pharmacotherapy, functional anatomy, applied physical therapy, life span development and complex conditions. Upon degree completion, and clinical internship completion, Physical therapists, is required by the state to become licensed. Licensing is administered by the Federation of State Boards of Physical Therapy (FSBPT). Some states may require a law exam and a criminal background check to issue a license. According to American Physical Therapy Association (2015), residency programs help the graduates train in their specialty. They examine and diagnose patients under the supervision of licensed physical therapists. For a PT to become board-certified, they must complete at least 2000hours of clinical work, pass an exam or complete an APTA-accredited residency program in their area of specialty. PTs are trained on how to use techniques to care for their patients, such as; using assistive devices for example wheelchairs.
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Role of the Physical Therapist and their Typical Sites of Care
PTs improve the movement and manage the pain arising from injuries and illnesses. The duties of the therapists include; reviewing medical history and any referrals of the patient from doctors or surgeons, listening to and observing the patients’ movement. Besides, therapists can diagnose the dysfunctional movements of the patient, set a planned care for the patients and evaluating the health progress of the patient. Also, PT can educate the patients and those affected on how to cope with the recovery process and what to expect during the process. Physical therapists use exercises, hands-on therapy, stretching maneuvers and other equipment to manage the pain of the patient, increase their mobility and prevent further injury or suffering. Most work as part of a rehabilitation team while others work in private clinics, nursing homes, hospitals and private offices.
In 2014 according to BLS, the average annual wage for PT was $82,390. PTs working in schools, nursing care facilities and home health care are the highest paid making $116, 090 while the lowest are paid $56,800.
Level of the Profession
Clinical education prepares physical therapist graduate entry level to practice in physical therapy. However, some graduates advance their education level of practicing physical therapists to Doctor of physical therapy (DPT) degree. This advancement is termed as post-professional. Besides, PTs can specialize in the following areas; neurology, pediatrics, women’s health, cardiovascular and pulmonary, sports physical therapy, orthopedics and Clinical Electrophysiology. Physical therapist assistants and aides assist the patients in recuperating from injuries and illness. They aid the patients in regaining their movement and ease pain. PTAs usually work under the direction and supervision of PTs.
Supply and Demand in the U.S.
According to PT in Motion News (2015), latest data from APTA suggest that the demand for physical therapists is likely to increase. Health insurance coverage is growing, and that means an increase in demand for PTs. Physical therapy is a growing profession, and more graduates are now available, but there is still unmet demand ranging approximately from 606 to 26696. This surplus-shortage of PTs is due to the increased number of citizens with health insurance, increased aging, and population growth in U.S. The Affordable Act, emphasizes on health insurance. There also has been an initiative to better management of chronic illness; therefore, the demand for physical therapy services will remain high. By 2025, demand for the physical therapist is estimated to grow by 23%, while 33% growth in supply. Thus, the increase in supply exceeds the expected growth in demand for services for PTs.
Interrelationships with other Professions
Physical therapists require a close working relationship with other health professionals to provide and manage services to patients. The World Confederation Physical Therapists (WCPT), therefore, expects PTs to have an understanding of the duties of other professions and appreciate both the differences and the similarities (2011). A WCPT policy expects that all PTs with an entry level education to assess and treat patients without referring from a third party, whether a medical practitioner or not. This policy promotes the duty of confidentiality. Physical therapists should maintain the privacy of information regarding their patients. This policy also helps physical therapists to cooperate with other health professionals in the best interests of their patients. Physical therapists work in close collaboration with physical therapist assistants and aides, physicians and surgeons. Therefore, policies and procedures are essential in ensuring communication with their clients’ medical practitioners and other professionals.
Referral Patterns
Before referral, data from a quality clinical database is examined carefully. The physical therapist referral source is then classified as primary care, occupational medicine or specialist. The outcome of the patient’s overall health status determines the phase of the referral. The referral patterns of specialized care in physical therapy occur in two phases. The physical therapist decides whether to refer and to whom the patient should be referred. Physicians before referral should consider one primary reason for the need of referral and other additional reasons. This decision will differentiate patients with same conditions to be referred to different specialists. A short referral should take less than 12 months while more than 12 months is considered a long-term referral. The time duration should be recorded, from detection to referral and evaluation. Alternatively, there is a self-referral, which allows patients to refer themselves directly without PT’s permission.
Liability Issues for the Profession
Physical therapy is a growing profession. The role of the PT involves costs of work related to illnesses. With the growth and risk exposures several liability claims and lawsuits have increased in this profession. They include medical malpractice and negligence liability.
Malpractice in physical therapy involves liability for physical therapy injury, especially in cases relating to a therapeutic relationship. When performing interventions on the patient, the physical therapist should ensure that the method used are accepted, justifiable, safe and comply with the principles of care. PTs should have the working knowledge about the state practice act to make sure that a proper practice act covers their activities. Violating a practice state law can cause adverse action taken by the board of physical therapy. The PT may be suspended, fined or his license terminated. Negligence liability includes; failure of proper supervision of the patient, injuries from manipulation, exercises, heat or stretching. The injuries could result from the inadequate or improper technique.
Reimbursement Issues and Managed Care Issues
There have been issues concerning the increased costs of rehabilitation and growth concern of the care given to the patients. These problems led to the creation of the Health Insurance Marketplace. Thus, more people can receive therapy services.
However, in pursuit of expanding Affordable Care Act, there has been a decline in reimbursements in physical therapy of up to 20-40%. The rate of reimbursement is being controlled by the consolidation of insurance covers (Jannenga, 2011). The decline in reimbursement has led many physical therapists to generate revenue squeezing in more appointments which are an overworked load to generate revenue.
Trends in Medical Technology Impacting this Profession
There have been many exciting improvements and trends in PT. The innovations offer improved opportunities for diagnosis, patient engagement, and treatment. Some of them include iTherapy app and Rehabilitation robots. An iTherapy is an application for smartphones and iPads, which facilitates the interaction between physical therapy professionals and patients. The app contains exercises, protocols, pictures and evaluation forms to aid the patient which are printable. The apps are saving time and money while improving the health of the patient (Milligan 2014).
Another tool used by rehab therapist is the rehabilitation robots. The robots help therapists with exercises and speed up the recovery process for patients. The rehabilitation robots are most helpful to patients with neurological impairments such as strokes, traumatic brain injuries and cerebral palsy.
Conclusion
The knowledge and expertise gained by Physical Therapists in movement science and rehabilitation play a significant role in the health care delivery system. With the quality education and training they acquire throughout their professional career, physical therapists can act as educators, consultants, clinicians, administrators and scientists in different places. They are not only involved in providing the best health care to individuals but also promote public health initiatives.
References
American Physical Therapy Association. (2015). Physical Therapist (PT) Education Overview. Retrieved from http://www.apta.org/PTEducation/Overview/
Jannenga, H. (2011). Ways PT Reimbursement Documentation Falls Short. Retrieved from https://www.webpt.com/blog/post/seven-ways-pt-reimbursement-documentation-falls-short
Milligan, L. (2014). Advancements in PT Tech/Emerging Trends. Retrieved from https://www.webpt.com/blog/post/advancements-pt-techemerging-trends
PT in Motion News. (2015). Demand for PTs likely to increase, even with more graduates available. Retrieved from http://www.apta.org/PTinMotion/News/2015/3/6/WorkforceStats/
