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Bill to expand PTs' roles faces opposition

TIFFANY L. PARKS
Special to the Legal News

Published: August 19, 2014

The Ohio State Medical Association, Ohio Orthopaedic Society and Ohio Academy of Family Physicians have voiced opposition to a bill that would allow a licensed physical therapist to make a physical therapy diagnosis of a patient’s condition in order to determine if the patient’s condition is within or outside a physical therapist’s scope of practice.

“House Bill 220 would permit a physical therapist to evaluate, diagnose and determine a plan of therapeutic treatment for a patient. Under current law, a physical therapist can evaluate and assess, but not diagnosis, a patient’s disability. This bill changes that,” said Dr. John Kean, an orthopaedic surgeon.

Kean, who offered opposing testimony for the bill on behalf of the OSMA and OOS, noted that the proposed legislation also would allow a physical therapist to order tests, including diagnostic imaging and studies that are performed and interpreted by other licensed health care professionals.

“The first question you must ask yourselves when considering this bill is, quite simply, why? Why do we need this bill? What problem is it going to address,” he said. “I submit that it could potentially create more problems for a patient than it would ever theoretically solve.”

The bill’s sponsor, Rep. Ron Hood, R-Ashville, has said the measure is rooted in common sense.

According to the proposal, if the patient’s diagnosis is not within the physical therapist’s scope of practice, the physical therapist would be required to refer the patient to another health care provider.

Carol Sauer Albright, a licensed physical therapist, joined Hood in calling for the bill’s passage.

“Physical therapists have direct access to patients in Ohio. Given our extensive education and clinical practice, we are often the most appropriate medical professionals to evaluate and treat those with musculoskeletal issues, as well as determine whether the individual requires further assessment by a different medical practitioner,” she said.

As an example, Albright said “shoulder pain” is not specific enough for a physical therapist to effectively treat a patient, yet that memo is often written on patient referrals.

“As a result of our own thorough evaluation, we develop a working PT diagnosis that is more specific,” she said, adding that ordering diagnostic tests seems like a “natural responsibility” for physical therapists.

“When we are the entry point to the medical system, the ability to order appropriate tests including diagnostic imaging allows faster progress toward resolution for the patient. It is also necessary in making an appropriate differential diagnosis. Asking my patient to make a second medical appointment with a different practitioner to order an X-ray, Doppler, MRI or EMG often takes one to three weeks. It requires further expense and delayed care for the patient.”

HB 220 is before the House Health and Aging Committee.

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