Forum - Spring 2014
Table of Contents
Here’s a quick look at the FSBPT calendar for 2014 & 2015.
Is the world getting smaller?
Many of us receive real-time updates about our friends, family and even world events every time our smart phones beep, blink and buzz. To me, smart phones are the latest example that technology is making the world – and information - much more accessible. The world sure SEEMS to be getting smaller.
These new technologies might be able to broaden e-health capabilities in all sorts of ways.
As your physical therapy licensing board’s administrator/executive director, you are invited and your participation is funded by the Federation to its annual meeting.
This column reviews the legislative and regulatory activity and topics of interest currently being addressed in various jurisdictions. Specific topics discussed in this article are practice act updates, ordering X-rays, manipulation, dry needling, referral requirements (direct access) and Medicare payments.
The purpose of this article is to address the issue of "abandonment" in a professional setting and the rights and obligations of practitioners, specifically as it relates to adverse actions against a license.
Telehealth may be used to overcome barriers of access to services caused by distance, unavailability of specialists and/or sub-specialists and impaired mobility. Telehealth offers the potential to extend physical therapy services to remote, rural, underserved and culturally and linguistically diverse populations.
Among the states using telehealth for physical therapy are Alaska, Arizona, California, Georgia, Oklahoma and Washington. It’s also used in Australia, Canada and the European Union,. A Canadian study concluded that telehealth is at least as effective as usual care with the potential to increase access to PT.
Based on recent rulings by the Supreme Court and Fourth Circuit, state regulatory boards may run the risk of violating federal antitrust statutes. There are two cases critical to physical therapist boards - the Phoebe Putney Medical Center and the North Carolina State Dental Board.
In 2014 FSBPT will submit information to the Buros Center for Testing to be evaluated for accreditation of the National Physical Therapy Examinations (NPTE).
This process requires a substantial documentation effort that reflects NPTE development processes and analysis of test data. The feedback FSBPT receives through the accreditation process helps to ensure that the NPTE program adheres to best practices in measuring the knowledge and skills necessary to perform effective physical therapy.
The headline: “Physical therapist sentenced, agrees to pay $328,828 to resolve false claims act liability”
The date: February 25, 2013
Federal consequences: The licensee entered into a civil settlement but did not admit liability. He agreed to pay $328,828 for conduct that occurred between 2007 and 2010. He entered into a six-year integrity agreement with the U.S. Department of Health and Human Resources to ensure future compliance with Medicare requirements. He waived his right to indictment and pleaded guilty to obstruction of a federal monitor (he had reconstructed his charts after saying they were stored off site.)
Physical therapy is in a very difficult ethical climate. There is a crisis of confidence. People are facing challenging moral dilemmas and have to address the competing needs of multiple stakeholders.
For instance, a case was reported to a physical therapy board by an insurance company of two therapists who were seeing about 60 patients a day. All the billing was for individual sessions.
One description of impairment of a healthcare professional is the inability or impending inability to practice according to accepted standards as a result of substance use, abuse or dependency. The term substance use disorder can be divided into substance abuse and dependence. Substance abuse results in adverse social and professional consequences. Addiction manifests as physiologic and behavioral systems related to a maladaptive pattern of substance use.
The practice of physical therapy is defined by state statute and administrative regulations of the board. Ethical violations are covered in different ways in various jurisdiction statutes.
The American Physical Therapy Association (APTA) developed a Code of Ethics for the physical therapist. APTA says, “The code of ethics for the physical therapist delineates the ethical obligations of all physical therapists as determined by the House of Delegates of the American Physical Therapy Association.”
The APTA Code of Ethics may be incorporated into state law by regulation or statute. In Kentucky, the APTA Code of Ethics is not adopted into law, although other states may have done so. In those states, the code of ethics is binding and enforceable under law.
There is currently no role for advanced practice physiotherapists in Alberta, Canada but that advanced practice does exist in Ontario, Canada, where 7,600 of the nation’s 18,000 physical therapists work.
In terms of the health policy context, Canada focuses on primary care (the right provider at right time with right service) and providing patients with a “medical home.” Much effort is going into creating new delivery models to accomplish that end.
The words ‘never, ‘just’ and ‘honestly’ may not mean what you think…and beware of anyone using the number three.
Every word has a meaning, and people mean exactly what they say. Identifying exactly what they said may well be determined by how well one listens.
People tell the truth in the same way and people are deceptive in a similar fashion. Most of the techniques need no verification, as “We are talking about the English language.”
In preparation for this session, 52 physical therapy jurisdiction websites were reviewed and rated. On a scale of one to five, just one site received a five. Eight sites earned no points at all. The majority of sites received one or no points.
The rating viewed the site through the eyes of someone who is not an informed consumer. They were based on content rather than aesthetics and included accessibility of that content.
While many physical therapy boards’ mission statements agree that public safety is a prime concern, their websites don’t encourage or assist the public in playing a role in its own protection.
Sixty percent of the foreign-educated physical therapists (FEPT) evaluated by the FCCPT* are not found to be substantially equivalent to a US (first professional) physical therapy degree without supplemental coursework.
* Foreign Credentialing Commission on Physical Therapy