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    APTA Sets the Record Straight: 'Physical Therapy' Is Not a Generic Term

    APTA responded to FoxNews.com regarding a May 2 article, "How can chiropractors benefit your health?" in which Keith Overland, president of the American Chiropractic Association, said that chiropractic treatment may include "combinations of chiropractic manipulation, physical therapy, and rehabilitative procedures for many musculoskeletal problems." APTA tells Fox News, "'Physical therapy' is not a generic term. It describes only those services provided by a licensed physical therapist. Chiropractors may provide some of the same treatment modalities as physical therapists, but they should portray their services as chiropractic and not as 'physical therapy.'" 


    Comments

    hear, hear. I think chiropratics and physical therapy is a touchy subject. They are two separate entities with some similar approaches. I may use manipulations as a PT, but I would not say that my approach is a mix of exercise, advice, and chiropractics. Isn't Physical Therapy a protected term in the US, or is it only certain state?
    Posted by Brandon Goulding on 5/10/2012 6:47 PM
    The law - in California at least - states that Chiropractors can indeed advertise and bill for provision of "Physical Therapy" services. Physicians can also bill for "Physical Therapy". I've always wondered why that was so.
    Posted by Kevin on 5/10/2012 7:12 PM
    I'm a travel PT who has had licenses in 8 different states. "Physical Therapy" and PT are protected terms in all 8 of those states. If in a state where these terms are protected, I would hope Mr. Overland (who should be highly sensitive and knowledgeable of these issues) would receive a letter from his local PT Board.
    Posted by James Spencer on 5/11/2012 12:31 AM
    Kevin, same thing in Florida! I have been complaining about this to the APTA and the state chapters for as long as I have been a PT! It's time the APTA gets its act together on protecting the term "physical therapy"!
    Posted by Helen Present -> >HS`EO on 5/11/2012 1:50 AM
    Learning techniques on how to use modalities like electrical stimulation and hot packs from a physical therapist does not mean you know how to perform "Physical Therapy." There needs to be serious consequences for chiropractors/chiropratic businesses who advertise "Physical Therapy" without a Physical Therapist on staff.
    Posted by Anne on 5/11/2012 12:14 PM
    And did the response ever get aired or responded to by Fox in a public forum? If not, the record didn't really get set straight
    Posted by Dave on 5/11/2012 3:16 PM
    I would encourage everyone to do their part in protecting our profession and file a complaint with your state PT licensing board if you see someone who is NOT a PT advertising their services as "physical therapy." Many states have laws on the books protecting the term "physical therapy" and the licensing boards are the entities that have the legal authority to enforce the state licensure laws and impose fines.
    Posted by Terri on 5/11/2012 3:26 PM
    I'll add one more to the mix. Health clubs are telling their clients the "PT" will be with them shortly. Their "PT" is a personal trainer. When questioned about this practice, the back pedaling was obvious. Indeed, the use of "PT" in this scenario is not an accidental misrepresentation.
    Posted by Steve on 5/11/2012 3:32 PM
    I believe part of the problem lies in the fact that at many Chiropractic schools they call the classes that teach modalities "Physical Therapy". If these schools are in states with good term protection I wonder if the licensure boards could take action against them. If the schools no longer call modalities Physical Therapy I believe that would help curb the inappropriate use of the term in the long run.
    Posted by John Cormier on 5/11/2012 4:40 PM
    It is indeed up to individual state law to protect titles and acronyms in the United States. The APTA has done a lot to protect our profession, titles, and acronyms. So join the APTA if you're an American PT. You make enough money that you have no excuse not to pay the dues. Physicians' practice acts allow them to practice physical therapy in Texas, for instance. One reason is because they can hire a PTA to treat their patients and then bill full value for PT services. They can skip having a PT's clinical judgement altogether. For those of you aware of the issue surrounding physician-owned PT clinics and the other issue about the future role of PTA's, how do you like them apples?
    Posted by E. on 5/11/2012 5:08 PM
    In some states it prohibit physical therapist from performing manipulation. These states that prohibit PT in manipulation are due to combined lobbying effort of the American Chiropratic Association. Did the APTA fight this states or federal legislations? How come we PT's are losing ground on this issues. The chiro are now getting into PT business as part of their practice. They use the same billing codes as PT (97xxx codes). I encourage you PT's to support your PT political action committee PT-PAC and donate $$$ so we can win some legislation and to protect our profession in the future PTs'.
    Posted by Alex on 5/11/2012 5:34 PM
    My own personal experience is when I had a patient whom used almost 3/4 of her physical therapy benefits (i think around 2 or 3000)in a chiropractors office so I had to discharge her, still recovering from healing. Frustrating and if there is a way to change the rules that would be great. We don't bill manipulation under a chiropractic code. They should not be doing the same. I'm a member of the APTA and I hope they are doing more to support us in what we work so hard at on a daily basis to help our patients recover.....
    Posted by Cortney on 5/11/2012 9:47 PM
    In Tennessee this year we received an Attorney General opinion regarding Chiros ability to use the term physical therapy and directs enforcement. Log onto the state website for a quick read of some exciting news.
    Posted by Scott Newton on 5/12/2012 12:12 PM
    I find this most interesting. If you are not familiar with the HOD recent RC's 1-4 regarding changing the model of out patient PT you should read this. Basically APTA is proposing that PT can be provided by anyone! This is a huge can of worms they are about to open. It seems like APTA is talking out of both sides. Last time I checked PT is to be provided by licensed PTs or PTAs. No one should be making clinical judgments or decision making besides licensed therapists. I hope this does not pass. PTs have worked too hard to identify themselves and their practice capabilities just to give it away because the private practice section is feeling the crunch of the economy. Who isn't feeling the crunch these days?
    Posted by Nicole on 5/12/2012 5:24 PM
    RC3 would have physical therapy performed by whomever the therapist deems appropriate including AT's, EP's and others. How could we claim PT is not generic if this is indeed how we practice
    Posted by Marc Lacroix -> >FP on 5/12/2012 7:12 PM
    Earlier this year in the Detroit Free Press, a chiropractor who is also a state legislator stated that chiropractors do physical therapy. Many people complained but there was no visible response anything like the article (full page article with large color photo)in the Free Press. What about APTA taking out a large one page color add in the USA TODAY newspaper to present these issues and clarify our (APTA's)stance?
    Posted by sam gill on 5/12/2012 9:22 PM
    “While chiropractors often perform SMT on patients, it is also administered by physical therapists and osteopaths. But which treatment is right for any patient depends not only on their specific pain, but their doctor's recommendations and their own comfort level with various options, said Stephen Perle, a spokesman for the American Chiropractic Association.” http://consumer.healthday.com/Article.asp?AID=654498 The Physical Therapist’s public distinction in the application of manual therapy practice utilizing the interventions of manual therapy including soft tissue and joint mobilization/manipulation and manual traction is through the foundation of the PT profession’s unique body of knowledge, competency and perspective on facilitating and managing movement, which results in actions and function to enhance and sustain human performance and quality of life through multiple body systems. In “PT joint mobilization and manipulation”, the implementation of the procedure by its very nature, produces new clinical findings that must be evaluated simultaneously as the intervention is implemented. Examination, evaluation and intervention are inseparable and the manual therapy procedure of mobilization/manipulation is defines as “a manual therapy technique comprising a continuum of skilled passive movements to the joints and/or related soft tissues that are applied at varying speeds and amplitudes, including a small-amplitude/high- velocity therapeutic movement”. (Guide to Physical Therapist Practice).
    Posted by Stephen McDavitt on 5/13/2012 10:19 AM
    PT/PTA's really need to be connecting and active with their local chapters in order to have their voices heard on these issues. There are 14 Chiropractic Institutions in the US. A good handful teach what they term "physical therapy or physiological therapeutics or physiotherapy". The PT Licensure Boards in these states should have the knowledge of who is using what term and which one is protected. If your state's PT practice act has not yet protected these terms you may want to address this with your chapter. These changes can occur at the state level and depend on what has already been enacted in the Chiropractic & Osteopathic practice acts. It is in the best interest for each practitioner to have separate billing codes, ie chiro MT, Osteopatic MT, PT manual therapy. I would just be sure that the 3rd party payors are not considering what the chiro and osteopaths are doing as physical therapy and thus tapping into the client's PT benefits. Again, that is where you and your chapters need to be clear on and knowing who is billing for what.
    Posted by Melissa on 5/13/2012 8:03 PM
    We are finding that our patients' annual insurance benefit for physical therapy is being exhausted (or nearly) by their previous chiropractic care. The chiropractors are using codes and billing "physical therapy". Anyone else run into this? Any suggestions?
    Posted by Karen Brown on 5/14/2012 4:30 PM
    This is to rebut Kevin's incorrect comments regarding chiropractor's use of "physical therapy" and "physiotherapy" in California. According to Tameka Island, Executive Associate, Professional Affairs, California Physical Therapy Association, in California, the terms “physical therapy” and “physiotherapy” are term-protected and only those holding an active license in physical therapy may use these terms. Any unlicensed individuals using these terms may be subject to civil charges per the PTBC. I hope this clarifies the situation in California. Art
    Posted by Art Ando DPT on 5/18/2012 4:10 PM
    http://www.eliteperformancedocs.com/default.html Here is an example of DC's blatantly advertising that they perform "physical therapy". They even state that the "physicians" perform "physical therapy". One guy has "some" training in rehabilitation and the other is an ATC. Neither are licensed PTs! How is this legal?
    Posted by Chris on 5/19/2012 11:23 AM
    @Chris - its not legal. The Oklahoma PT Act says: Okla. Stat. tit. 59, § 887.16(A) “No person shall advertise, in any manner, or otherwise represent himself as a physical therapist or physical therapist assistant or as a provider of physical therapy services unless such person is licensed pursuant to the provisions of the Physical Therapy Practice Act.”
    Posted by Mark M on 5/21/2012 11:28 AM
    I think that the comment posted by Nicole on 5/12 is worth everyone's time to re-read. The HOD of the APTA has several items that are certainly flying under the radar which impacts our profession. Our delegates are responsible for communicating this to us, as members of the APTA, but most people don't know anything about the proposed plans to allow a wide variety of 'other' professionals to treat patients under our license. As of right now there are no plans in place for knowing who is trained appropriately. The PTA's fall under the same branch of the APTA (CAPTE) for their educational oversight. Please encourage all to read the HOD documents on the APTA web site - look under communities, find packet one for some of the info, or contact your state's delegate.
    Posted by Lou Ann on 5/25/2012 12:47 AM
    I am so sick of everyone saying they do "physical therapy". Doctors, chiros, ATC's, even personal trainers!! I've been at PT for 20 years and private practice owner for 10 and contributor to the ptpac but honestly, nothing is being done. Everyone uses our name, opens pt clinics in their offices, and we sit idely by. This profession will at one point lose complete credibility and independence.
    Posted by Dahlia Fahmy on 6/21/2012 10:17 PM
    Yo E....On 5.11.12...PTA's cant work without the supervision of a PT even if they are under a physician...read the rules....we would lose our license..how bout them apples American PT?
    Posted by Dave on 8/8/2012 9:29 PM
    Nice to see other PT's care about this abusive, unprofessional and illegal conduct by many non PT's. It'd be nice to have some direction from the APTA. Perhaps they should have some type of task force developed to screen for this activity and report it immediately. Perhaps the APTA should begin to take legal action against this type of behavior.
    Posted by Burton Ford -> @JR_?L on 12/8/2012 12:01 PM
    Chiropractors are classified as "Physicians" by the Joint Commission (along with MD's, DO's, DPM's, OD's, and DPM's). https://docs.google.com/viewer?a=v&q=cache:5BYzIejDgGQJ:www.jcrinc.com/common/PDFs/fpdfs/pubs/pdfs/JCReqs/JCP-06-09-S6.pdf+joint+commission+definition+physician&hl=en&gl=us&pid=bl&srcid=ADGEESi_OJudOaQrK33VQUAvZrZHQSMV-iqfHWdjIrfpbHbLsV58bJoaJwNigddenRAYAWycIzMA-1srvriL5DgSFBgJ-yIk5WUGk81hu8r15SYFhj_eTD0cNefBMw1_VrpQdhbK3fku&sig=AHIEtbQ1SWQAR9bHjHlL9lxYjLEDoUfSMQ This is also true in the eyes of Medicare and Social Security. More importantly they are classified by state statues in 33 states as "Physicians" excluding the use of drugs and surgery in most of them with a few exceptions . http://www.acatoday.org/pdf/physicianstatus.pdf In most of these states Chiropractic Physicians can take X-rays, draw blood, order other imaging studies such as MRI's, CAT scans, etc. And YES in those states (most of the them) they can advertise that they perform "Physical Therapy". A profession like Medicine, Podiatry, and yes Chiropractic because of their scope of practice can perform "PT" LEGALLY. I am not interested in PT myself but I am getting SLAMMED with it in my program (Doctor of Chiropractic Medicine). I have to take the SAME classes the first two years as MD students and cram in all of the PT stuff...I hate it. I will be hiring a PT to do my physical therapy in the future. Physical therapists are classified by the gov't as technicians/midlevel providers even with the advent of the DPT. If you really want to change things you will have to change the definition of a PT to include being a physician, increase your education to mirror the basic sciences taught in Medical, Osteopathic, and Chiropractic schools and THEN LEGISLATE at the state level. Chiropractic has been very successful doing this and so has Optometry. That said, I hope I clarified this a little
    Posted by ChiropracticPhysician2015 on 1/19/2013 8:18 AM
    Chiropractic does not equal joint manipulation. There are several manipulative techniques with protocols in the chiropractic profession, however the profession itself is not limited to these techniques. Manipulative techniques are but a tool in the improvement and/or rehabilitation of the patient. Chiropractic doctors are physicians because it is within their scope of practice to reach a comprehensive analysis of the patient's overall health status and to make the appropriate decisions to help such patient in his/her recovery. This includes lifestyle habits, fitness and referral to other appropriate professionals when in the best interest of the patient. Therefore, chiropractic physicians have authority to order any diagnostic procedure (imaging, laboratory, orthopedics)in order to plan proper treatments. Chiropractic doctors excel in conservative management and treatment of patients. There are specialties within chiropractic medicine to manage advanced complicated cases weather physical or internal in nature without the use of drugs or surgery. However, DCs know when drugs and surgery are necessary and will refer to specialists in such fields. If a DC makes a referral for PT, he/she will know how to Rx for Tx and what to do if Tx does not work. PTs should market to DCs for referrals as many DCs now would like to concentrate on manipulation or prefer to use a nutrition management practice.
    Posted by Haish on 1/29/2013 4:38 PM
    In response to the comment from ChiropracticPhysician2015 on 1/19/13. I would start by saying that I cannot find anywhere that a Physical Therapist is classified as a mid-level provider (by the government). While this may be the view of some people, the use of mid-level practitioners are broadly used to describe individuals that practice under licensed physicians. As it relates to drug enforcement the term is described as follows: "Pursuant to Title 21, Code of Federal Regulations, Section 1300.01(b28), the term mid-level practitioner means an individual practitioner, other than a physician, dentist, veterinarian, or podiatrist, who is licensed, registered, or otherwise permitted by the United States or the jurisdiction in which he/she practices, to dispense a controlled substance in the course of professional practice. Examples of mid-level practitioners include, but are not limited to, health care providers such as nurse practitioners, nurse midwives, nurse anesthetists, clinical nurse specialists and physician assistants who are authorized to dispense controlled substances by the state in which they practice." Neither of these definitions, nor the term technician, describe a physical therapist. Physical Therapist operate independently of other providers. Direct access is unrestricted in many states, while other states have provisions to direct assess. The title of Physician might be important to you and the chiropractic profession, but it is unimportant to me. I don't have any need to be considered a physician by the joint commission or any other agency. Every states practice act is different, however in Florida the Chiropractic Practice act states "Chiropractic physicians may adjust, manipulate, or treat the human body by manual, mechanical, electrical, or natural methods; by the use of physical means or physiotherapy..." The Physical therapy practice act states: "No person shall practice, or hold herself or himself out as being able to practice, physical therapy in this state unless she or he is licensed in accordance with the provisions of this chapter;..." "(7) “Physical therapy practitioner” means a physical therapist or a physical therapist assistant who is licensed and who practices physical therapy in accordance with the provisions of this chapter. (8) “Physical therapy” or “physiotherapy,” each of which terms is deemed identical and interchangeable with each other, means a health care profession." My guess is that the interpretation of these statutes will vary and the overlap of terms only muddy the waters. In regards to your suggestion about increasing basic sciences, you must not be familiar with the curriculum of DPT programs. They include gross anatomy with cadavaric dissection, neurology, neuroanatomy, pathophysiology, cardiopulmonary, differential diagnosis, and pharmacology to name a few. While I wouldn't compare my medical knowledge at the same level of medical doctors like you do, I would say it covers what I need to know to be a competent independent practitioner. Finally, I would suggest that if you feel "Slammed" with your course work, and "hate" cramming all the "PT stuff", I would suggest you advocate to remove it from your curriculum so you can focus on chiropractic philosophy and technique and leave the Physical Therapy to the Physical Therapist. respectfully, Michael Raiman, DPT
    Posted by Michael Raiman -> AHYa@N on 2/24/2013 1:02 PM
    Listen Physical Therapy was Medicines answer to chiropractic, think what you want but DC'c perfected the use of all therapeutic modalities before the profession of physical therapy was even invented. Stop with all the propaganda there is no argument, PT's do not even know how to perform a neurological or orthopedic examination, I have been a practicing DC for 20 years and we are BAR NONE the experts in musculoskeletal complaints and a person's general health. Period.. end of story, we advocate cleanliness, healthy whole food eating, less invasive treatment, we argued against rampant antiobiotic and vaccination use, people taking responsibility for their health, when it comes to humans general health, not to mention an excellent adjustor can alleviate 90 percent of musculoskeletal aches and pains, migraines, radiculopathy etc... For aches and pains and wellness take me to a DC 9 times out of 10 but if a car backs over me when then mr MD can have at it!! hell just last week a man was in the news for getting his vision back after an adjustment.
    Posted by Dr Peter Martin on 6/6/2013 3:24 PM
    As a private practice owner Google and other search engines are vital to advertising. When I type in "physical therapy" 75% of local results are chiropractors. Now there are 2 on every block. When is the APTA going to go head on at the ACA? As far as manipulation goes I have treated 4 patients in the last 6 months either paralyzed or rushed to ER from chiros!! They will start to lose ground once this danger stops getting swept under the carpet by ACA. I did not re-up my APTA membership not due to money but frustration. Chiros have branded themselves better than any profession I know of. I stopped complaining and started to ACT. I wrote a blog on my website. Www.ptandpainrelief.com and a video blog on YouTube titled Chiropractor vs Physical Therapist. Everyone lets stop talking about it and DO something, we don't need the APTA to talk for us. We all have the ability to write our legislators and ability to inform the public with our blogs/articles!!!! Lets STOP asking others to do our bidding! I am forming a coalition to inform the public myself and anyone who wants to help! Email me at info@PTandPainRelief.com....lets STOP complaining everyone and let's DO SOMETHING!
    Posted by Ryan on 7/13/2013 7:37 PM
    Ryan, That is very interesting that you have treated 4 patients in the last 6 months from chiropractic physicians sending them to the ER. Some reasons I might send a patient with an urgent referral or to the ER who would then most likely require PT later on could include: s/sx VBD, AAA, cauda equina, s/sx heart attack, various fractures such as Jefferson, detection of ↑ intracranial pressure, suspected joint infection, etc. However, the evidence is absolutely not with you on what you seem to be claiming... that the chiropractor injured the patient. VBA is up in the 1/millions, paralysis.... no way buddy. That case was not caused by the chiropractors adjustment (if they even adjusted before sending them to the ER, I bet not!!!). Sorry, this is really upsetting you would make a claim so clearly wrong. Try something more believable like: elderly patient & hvla => broke rib => pneumonia => death. I bet that one exists, maybe even in the 1/50-100 million range. I love PT's. They are underappreciated rockstars, but don't go knockin down chiros unjustified like that. I hole this problem does get fixed with the billing, it is very sad for a patient to not get treatment due to this issue.
    Posted by Chiro Student on 8/8/2013 3:44 AM
    "Dr" martin is the president of palmer college of chiropractic. Go figure. He may want to review when physical therapy vs chiropractic was "invented." And then review entrance stats and the literature.
    Posted by Burton Ford, PT on 9/2/2013 11:09 PM
    I have studied this issue a little bit. I am a chiropractor in Missouri and in Missouri chiropractors can advertise physiotherapy but not physical therapy. However, I noticed in another state that chiropractors are indeed allowed to advertise that they provide physical therapy services. It should be an interesting debate. Is physical therapy a generic term or limited to services provided by a physical therapist? I can see the argument from both sides and have not yet made up my mind on what is the right thing to do.
    Posted by MITCHELL DAVIS on 12/9/2013 11:05 AM
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