Top 5 Questions Physical Therapists Can’t Answer
Estimated Reading Time: 3 minutes
One aspect of evidence-based practice, from a clinician’s perspective, is knowing what questions to ask about a condition, a population, or an intervention—and how to find research-based answers. From a bird’s-eye view of the physical therapy profession, evidence-based practice also means understanding how physical therapists (PTs) practice, determining whether they are following clinical practice guidelines, and explaining variations in care.
This was 1 of the reasons APTA created the Physical Therapy Outcomes Registry. In addition to providing practices and facilities with actionable data about their own organizations for benchmarking against other practices (see this PT in Motion article "Strength in Numbers" for more), an increasing volume of clinical data will help transform how we treat patients.
Ready for your quiz? Here we go…
What are the top 10 diagnoses in physical therapist practice today?
This seems like a pretty simple one, right? Wrong. The government collects data on top medical diagnoses in ambulatory care facilities, for example. But there hasn’t been a single comprehensive repository to collect this data.
The Registry can help by… characterizing the most common physical therapy diagnoses. This would help us to better understand physical therapy in a broader sense and determine what types of patients are most commonly seeking physical therapist services.
Do we know if physical therapists are following published clinical practice guidelines (CPGs)? Are those CPGs effective at improving patient care?
There has been no way to measure whether PTs are even aware of CPGs, let alone following them. While there are valuable studies on the effectiveness of interventions for low back pain, for example, to compare apples to apples researchers often exclude patients with certain comorbidities. This means the results don’t necessarily reflect the clinical population you see.
The Registry can help by… tracking physical therapist interventions in combination with patient data on a broad scale. This would help to not only see what PTs are doing, but influence future CPGs based on recorded patient outcomes.
Can we explain variations in care by different physical therapists?
To use the low back pain example, we have had no way to know, aside from anecdotal evidence, why this PT uses X intervention and that PT uses Y intervention for treating similar patients who present with the same symptoms.
The Registry can help by… identifying patterns in the data. Are there comorbidities present? Do PTs with more advanced training tend to use different treatment strategies? Understanding these and many other questions could really guide the profession, individual practices, and individuals PTs.
What proportion of patients are covered by private payers, Medicare, and/or Medicaid?
We don’t know this yet. Your future employer might not even know it, depending on their IT set-up. This information has legislative and policy implications related to payment. In addition, patient outcomes may vary depending on payer.
The Registry can help by… recording all of this data and putting it in 1 place. The profession as a whole would benefit, because APTA and the various sections and chapters would be able to align advocacy efforts appropriately.
Is there an easy way to identify the number of physical therapists practicing in medically underserved areas of the country?
Aside from surveying each facility that employs PTs in these areas, no. But it would be helpful information to know, in order to identify shortages and how better access to physical therapy could improve community health.
The Registry can help by… recording not just patient data, but physical therapist data by National Provider Identifier (NPI). So you won’t just know that Anytown PT Associates treated 80 patients last month; you’ll know that 3 individual NPIs were associated with that facility.
Answering these important questions is not something individual practices can do alone. There is strength in numbers, and together we can take the physical therapy profession to a whole new level.
To learn more about the Physical Therapy Outcomes Registry, visit www.ptoutcomes.com.