• Wednesday, July 10, 2013RSS Feed

    What Belongs in an Annual PT Exam - Tell Us

    APTA wants member input on standard elements that should be included in an annual physical therapist examination. Per a House of Delegates charge and goals related to the association's strategic plan, a task force is developing templates for such an exam and seeks comments from the APTA membership at large.

    The deadline for sending comments is July 29, 2013, and member input is valuable, so please review the webpage and consider adding your thoughts to those of your colleagues for this important initiative.


    Comments

    Scar tissue assessment. Particularly on abdominal incisions (new or old scars).
    Posted by Sara on 7/10/2013 8:38 PM
    Is this for competency? It would be determined by instate legislative regulations, correct? It should remain as basic entry level so that we don't need variations for specialties. A pediatric person may not be able to understand in depth cervical spine questions. A legislative, documentation, and legal component would be a good idea in this climate.
    Posted by Daphne Ryan, PT, DPT, MS on 7/11/2013 9:14 PM
    I think and annual exam is a horrible idea, we all ready have increasing CEU responsibilities this would be an undo extra burden.
    Posted by Derek on 7/12/2013 3:28 PM
    REALLY?!?!?!?!
    Posted by John Beauchamp -> ?IY_C on 7/12/2013 9:52 PM
    Are there other clinicians/disciplines that require annual or even bi-annual exams??? What is the goal for such an exam?
    Posted by Sarah Flaim on 7/12/2013 11:00 PM
    We already have the burden of increased documentation requirements including functional reporting and PQRS (combined with reduced reimbursement). We have state mandated CEU requirements. I spend much more time defending charges than I did 15 years ago. ...all this requiring more and more administrative/non-patient care time. We seriously will be required to prepare for and take an annual examination? We will be down to 50% of our time direct patient care and 50% non-patient care. Already I hear of situations where therapists are, under the table, required to do documentation off the clock, 'on their own time' in order to provide 8 hours of direct patient care. This is in the end expected to improve quality physical therapy care?
    Posted by Gary on 7/12/2013 11:31 PM
    The info on the webpage provided above makes it clear that the "annual exam" would be an annual check-up of the patient/client and not of the PT's knowledge base. :-)
    Posted by Victoria Strickland -> BGX[CH on 7/13/2013 8:13 AM
    I think the APTA is referring to an annual screening for patients not therapists
    Posted by Walt Lingerfelt -> @FXbCM on 7/13/2013 9:10 AM
    I think it should have elements to target the various decades of life. For example, women's health might need a screen for 50+ women to target incontinence. There are too many products to treat symptoms but we don't share the news about treating the causes.
    Posted by Anne Vickers on 7/13/2013 12:51 PM
    This would be like going to a physician for your yearly physical. The goal would be to go to your physical therapist for a yearly "check-up" that was functionally or specialty based as I read it.
    Posted by Laurence Greenberg -> @NT` on 7/14/2013 12:39 PM
    Annual examination for therapist. Who is the originator of this idea?After DPT you get foot in a working place. DPT shows you are in learning mode rest therapist has to develop his own skill. keep this skill sharp it is persons responsibility which he /she can enhance by continue education . putting more research and development program rather than exam
    Posted by Deepak sardey on 7/15/2013 9:33 AM
    First,Click on the link before you jump to the conclusion that this is an annual examination of the PT's knowledge! Information is power. Second, because physical activity, or Performance Status, is such a strong predictor of health, and because physical therapists are so highly qualified to assess physical function, the idea does seem to have some merit. But a patient's physcial function is only one aspect of Health. Would the APTA then advocate an annual psychological exam to address other aspects of a patient's health and well-being? And an annual Nutritional assessment? I would like to read the debate that occurred when this was proposed.
    Posted by Sarah Pedersen on 7/15/2013 10:31 AM
    At first glance, this seems like a nice idea. After some consideration, however, I am concerned that the information gained from annual client exams may be used as much for legal purposes, (not necessarily in the client's favor), as it is to benefit the client's approach to their health.
    Posted by Patty Hadley on 7/15/2013 3:16 PM
    I think that all we should develop is something that touches on basic health issues, surgical histories and specific questions for musculoskeletal issues, so it may trigger physical therapists to consider recommending a physician or other specialist referral as needed. I have been amazed at the number of patients that are not informing their physician of symptoms because the patient does not feel it is a problem. A health systems review form for physical therapists will be consistent with what is being asked of other health fields as we move into patient centered/health focused medicine. Many of our patients are already asked to fill out some sort of health questionnaire prior to PT visits. The APTA form would hopefully replace those already used and become a standardized form used by all physical therapy facilities. If the specialty sections within APTA want to develop questionnaires for patients with specific conditions then this should be a different project. This may be a great standardized way to gather health data on specific patient types and to be able to report this data nationally through the EMR process. Could trigger some great research topics!
    Posted by Kimberly Wright -> =FUbAG on 7/15/2013 6:38 PM
    Who do we feel will pay for this yearly exam? I would recommend we work harder to align with referring providers in our region and market our services. Frankly we are infringing into the arena of primary care. We are partners with a clients medical provider. How many people even remember to do or can afford annual physicals for overall health? Will psychologists soon have a lobby for annual mental health screens? The role of the family physician is under valued in our society and within the medical community. A trusted primary care provider should be a patients advocate and know how to access our services when they see a need. And patients ideally should know how to seek us out through effective marketing.
    Posted by Jayne on 7/17/2013 9:06 PM
    I in part agree with Jayne that patients ideally should know how to seek out a physical therapist and for what conditions. Marketing is going to be the key! However, in the current healthcare system we can no longer count on patient's primary care provider as our partner's and hope they will send clients for necessary PT service. Our local insurance company is effectively discouraging "primary care providers" or "gate keepers" use of any ancillary services, including rehabilitation. Use of any ancillary service or service not directly in the providers office, drugs not in formulary, unapproved labs or out of network services are considered inefficient. These inefficiencies are tracked and measured through the insurance EMR during the year and are tied directly to the providers reimbursement that can be moved to lower tiers. If that were not enough of a disinsentive, the providers listing in the "insurance providers handbook" will reflect a decreased "star rating" for those providers considered inefficient or "overusers" of services. Clearly in our community the insurance company (A single non-profit(?)has 87% of Hawaii) is in control of all the healthcare providers. Withholding necessary client service is being disguised as cost reduction. Our patient's here have needed to demand PT from their Dr. and make noise if they do not get a referral, so they have to know who we are and what we can do for them. Marketing like pharmacuetical companies would help us out. Let's get more visible.
    Posted by Betty Fackler on 7/26/2013 12:49 AM
    Nice idea, but probably wouldn't be very logistically and practically feasible. I believe the concept this is intended to protect is already protected under CEU regulation. Adding an annual exam simply produces more cost, more stress on clinicians, and likely would not actually result in improved quality of care in our practical world. Where would this exam stop? We are adding yet more administrative costs and administrative-type to our already administratively over-burdened healthcare system. Let's leave it at CEUs and professional responsibility. Don't forget all the outcome data companies are collecting now to help patients choose a well-trained therapist as well.
    Posted by Jenni on 7/26/2013 2:59 PM
    Including an assessment of body fat percentage would be a vital source of information during an annual examination. A higher percentage of body fat, especially visceral body fat, is linked to a multitude of diseases. Once identified, we can target and quantify the building of muscle and loss of fat that has shown to be so beneficial in almost all populations.
    Posted by Kathleen Hughes -> ALUc?K on 7/29/2013 12:46 PM
    wow, i'm surprised so many didn't bother to actually read what the exam was about. Very bad form people. I hope that the poor effort given to have any understanding of the topic does not reflect upon their patient care. All this is about is collecting input on development of an annual PT examination which will help with the physician shortage and provide the best conservative neuromusculoskeletal and functional care for patients to prevent functional decline or injuries. I have observed a ton of people in the community with obvious difficulty in moving and know that if they would have been coming to me on a yearly basis that they would be moving better. In the case of the younger crowd they would benefit in the same way to prevent injuries, e.g. weekend warriors, or even amateur athletes. Please get on the boat and stay current with the profession or just get off and stop holding us back. I'm sorry for those who are jaded, but the majority of us are not. The new generation, and many of the older of us (PTs/DPTs) are very motivated, highly intelligent and capable individuals entry level trained to provide primary care with evidence based skills to rule out systemic conditions out of our scope and refer to the appropriate providers. Let's move forward together here. -John Leschitz, PT, DPT, OCS
    Posted by John Leschitz -> @OT^DH on 8/20/2013 11:18 AM
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