physical therapists: who we are in 45 minutes or less
TRANSCRIPT
PHYSICAL THERAPISTS:
Who We Are in 45 Minutes or LessLaura M. Romeo, SPTMay 20, 2015
TODAY’S TOPICS Physical therapist education and how it has evolved;
Licensing and continuing education; Guide to PT Practice and Colorado Practice Act; Brief Overview of PT Documentation
WHO ARE PHYSICAL THERAPISTS?
American Physical Therapy Association: “Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility.”
Movement experts with musculoskeletal knowledge second only to orthopedists (Childs, et al, 2005)
SCOPE OF PRACTICE Examination Evaluation Diagnosis Prognosis Intervention Outcome assessment I have no idea what’s happening in this picture
EVOLUTION OF PT EDUCATION
Certificate Programs (1900 – 1930) Response to poliomyelitis epidemics, those wounded in World War I
“Reconstruction aide” Baccalaureate Programs (1930-1950) Educational standard from 1950-1980
EVOLUTION OF PT EDUCATION Post-Baccalaureate Requirement (1980 – now) Master’s Degree required as of 1999
Current: Clinical Doctorate Transitional DPT (tDPT)
EDUCATION AND WHERE WE ARE NOW Doctorate of Physical Therapy Baccalaureate degree required in any major; required basic science and math pre-requisites
Typically 3-year full-time programs, didactic and clinical education
FOR YOUR REFERENCE… A few specialties and their abbreviations: CSCS: Certified Sports and Conditioning Specialist OCS: Orthopedic Certified Specialist CCS: Certified Clinical Specialist PCS: Pediatric Certified Specialist CHT: Certified Hand Therapist FAAOMPT: Fellow of the American Academy of Orthopedic Manual Physical Therapists
ATC: Athletic trainer (NOT the same as personal trainer, and may or may not be a PT)
More information through the American Board of Physical Therapy Specialties http://www.abpts.org/home.aspx
LICENSING REQUIREMENTS Physical therapists are licensed by states and District of Columbia
CAPTE and then NPTE Signature designation – “PT” or “PT, DPT” Continuing education requirements in Colorado
DIRECT ACCESS Referrals vs. no referrals No medical diagnoses, but well-equipped to identify when a patient’s signs and symptoms fall outside scope of practice
Colorado is a direct-access state
COLORADO PRACTICE ACT Colorado Revised Statutes Title 12 – Professions and Occupations Article 41 – Physical Therapists
Pertinent points: State physical therapy board is the agency that regulates PTs; PTs need to complete a physical therapy program and be licensed in order to practice;
Lists “special practice authorities and requirements,” including supervision, medication administration, wound debridement, even physical therapy of animals;
Requires PTs in Colorado to maintain continuing professional competency;
Grounds for disciplinary action and all the cool ways PTs can get in trouble
AMERICAN PHYSICAL THERAPY ASSOCIATION Vision Statement: Transforming society by optimizing movement to improve the human experience. Yeah…
Some history and function Early on, had a role in how to further the “status of physical therapy within the medical establishment”
Plays a role in regulatory and legislative arenas. Effective or not? Lots of debate Keeps members up to date on research
GUIDE TO PHYSICAL THERAPIST PRACTICE Developed as a resource for physical therapist and physical therapist assistants “Description of practice”
Preferred Physical Therapist Practice Patterns
AND NOW, WHAT YOU’VE ALL BEEN WAITING FOR…
THE SOAP NOTE
S - SUBJECTIVE Anything the patient reports, related to their therapy Patient states her pain is 5/10 today. Patient reports her exercises seemed to help but had trouble remembering to do them.
O - OBJECTIVE What the therapist actually did in the session Sometimes (often) it’s really vague… Manual therapy x15 m followed by therex x15 min. E-stim and heat pack x10 min. Educated patient on HEP.
And sometimes it’s really specific. Coordination activities including bear crawls, crab walks, and jumping jacks to warm-up x5 min. Therapeutic exercise to include single-leg balancing with ball toss x5 min, obstacle course while walking in tall kneeling x10 min, education on safety and body awareness.
Which would you prefer?
A - ASSESSMENT How the therapist evaluates the patient’s performance/progress during the session Is the treatment doing what it should? Is the condition/injury behaving as expected?
How did the patient perform the exercises you gave them? Did they do them correctly or did they cheat?
How did your manual therapy elicit change? This section requires the most thinking.
P - PLAN What’s on the agenda for the next session
Discharge planning, plan of care Never EVER EVER EVER want to see the word “maintain” in this section
SOAP – SOUNDS CLEAN, RIGHT?
Copy and paste lingo that makes me crazy (but that you will see often): “Patient will benefit from continued physical therapy services, including but not limited to modalities, e-stim, therapeutic exercise, manual therapy, and neuromuscular re-education.”
“Patient tolerated treatment well” or “Patient did well with all activities” or “Continue with plan”
Notes like these, in my humble student opinion, are lazy.
QUESTIONS? Was this helpful for you? What else do you want to know? My contact info and life story: [email protected] [email protected] www.lauraromeo.com