Talk:Physical therapy

Difficulty understanding for outsider

I just wanted to chime in and say that as someone who has not had any involvement with physical therapy (and was brought to this page from just clicking through Wikipedia), after reading this article, I still have no idea what exactly physical therapy is. There is a lot of info on who physical therapists are as far as their education and their interaction with other health professionals, but still, what exactly is physical therapy? Gd8775 (talk) 19:46, 25 October 2012 (UTC)

"Massage" has got to go !

I would like to propose that the current definition of "massage" as it is stated, should be changed. If it is, as it remains, we should include in the "massage" section, physiotherapy, osteopathy, chiropractic, even possibly nursing, among others. What I propose is that all the so-called massage techniques become "bodywork" - "massage" is a type of bodywork, as is physiotherapy, as is shiatsu, as is soft tissue therapy etc., etc., as such, it should be listed among the types of bodywork, rather than being a specific category in itself. The term "massage" is pretty much defunct now, it seems to include ANY technique that involves touching a person, and that they not be a physio, osteo, or chiro. I will post this propsal about the various bodywork discussions for some feedback. I think that Wiki is a great starting point to delineate and structure the types of bodywork that exist around the world. (Euripides 03:05, 1 May 2006 (UTC))

Well, 6 years later Massage Envy is practically as big as KFC-- so the term "massage" is pretty much *in vogue* now! Yes, the MTs are trying to divide the health world in half: Surgeons and Massage Therapists. And they wish to replace CBT (psychotherapy) too. They sure don't lack confidence. Of course massage is *heart and hands* and eventually the voracious MTs will be re-classified as some sort of PT and earn their Health Insurance Reimbursements (say by earning a 4 yr degree)-- but right now there are only a few States (USA) who have not caved in to them. TheLordSayeth (talk) 11:23, 8 February 2012 (UTC)

Prescriptive Authority

I'm curious if Physical Therapists (DPT's) have prescriptive authority to write for medicines related and beneficial to their scope of practice (muscle relaxants, anti-inflammatory, pain meds, etc.). I seem to recall hearing that within the U.S.A. PT's have limited prescriptive authority but it depends on the State where they practice and that PT's practicing within the U.S. Military do have prescriptive authority. It would make sense. It might be interesting to include in the article since many people, even if wrongly so, seem to believe that only "real" doctors are able to prescribe medicine (even though, at least in the U.S.A., MD's aren't the only prescribers and even some non-doctor professionals also have prescriptive authority- such as Nurse Practitioners and Physician Assistants). —Preceding unsigned comment added by 69.133.42.16 (talk) 18:43, 5 June 2009 (UTC)

And also Podiatric Physicians — Preceding unsigned comment added by 122.149.239.158 (talk) 10:35, 2 February 2012 (UTC)

It's a very good question, but unfortunately I haven't seen much literature on the prescriptive powers of the DPT, much less in a military setting. I know from the experience of working in a Navy hospital that DPTs in the military are allowed to do spinal OMTs, and they use topically applied dexamethasone (usually by way of iontophoresis), but we had to seek clarification whether DPTs are allowed to prescribe the dex themselves or require a prescription from a GMO. I can't write any of this into the article, of course, because WP would consider it WP:OR, but I'll see if I can find some WP:RS literature on it. Wilhelm Meis (☎ Diskuss | ✍ Beiträge) 00:41, 29 February 2012 (UTC)

Kinesiotherapy

There seems to be a merge to be done with Kinesiotherapy. I believe that the reason for those two sets of articles partly comes from a translation discrepancy, and for cultural reasons. In France & Belgium, Physical therapists are called Kinesiotherapists. In French-speaking Switzerland and Quebec, those professionals are called Physical therapists. To complicate things further, French people believe that Physiotherapy is a subset of Kinesiotherapy (namely, if I am right -- not being an expert myself -- physiotherapy seems to be used to describe part of orthopedic therapy: electrical muscle stimulation, sonography, etc...).

If I'm right, at the time of creation of the first schools, France and Belgium decided to generalize the Physiotherapist term to a more generic "Kinesiotherapist" word. Merge and explain? ;) NicDumZ ~ 06:37, 19 May 2011 (UTC)

Education section cleanup?

It seems to me the Education section could use cleanup. In particular the long lists of lettered items under "Curriculum related to Patient/Client Management..." are hard (for me) to read. Either the content of each bullet could be summarized, or the lists could be reformatted.

Instead of:

• General topic 1: blah blah blah. Blah includes a. blah, b. blah, c. blah...
• General topic 2: blah blah blah. Blah includes a. blah, b. blah, c. blah...

etc.

this might be better:

• General topic 1: blah blah blah. Blah includes
  • Blah blah
  • Blah blah
  • Blah blah
• General topic 2: blah blah blah. Blah includes
  • Blah blah
  • Blah blah
  • Blah blah

etc.

So, summarize, reformat or leave it alone? I am willing to take this on if others think it would be useful. Dedrick (talk) 17:46, 14 June 2011 (UTC)

Almost no mention of pain?

I am not a trained medical practitioner. My only interaction with PT was as a patient. My main symptom was sciatica from a ruptured L5-S1 disc. Yes, I had movement issues but pain was the reason I had to be hospitalized. I was treated successfully (intra-dural? injection) by a Sports Medicine Orthopedist. I was under the impression that in my case my PT instruction was to control / avoid pain and secondarily to enhance movement. I don't understand why this Wikipedia article almost totally omits pain remediation as an objective of PT. TheLordSayeth (talk) 13:29, 24 September 2011 (UTC)

Efficiency?

Are there any study showing the efficiency of physical therapy? Is there a debate on how much of a placebo some techniques linked with physical therapy are?

Is physical therapy 100% scientific? Proven? Efficient? — Preceding unsigned comment added by 109.14.168.181 (talk) 02:25, 8 January 2012 (UTC)

You can read the source here. QuackGuru (talk) 05:40, 1 November 2013 (UTC)

Physical Rehabilitation Technicians

I was wondering if we should add a section on the educational requirements in the province of Quebec, where physiotherapists must complete a bachelor's degree plus a master's degree to have access to the profession. There is also the fact that several CEGEPs in the province, such as Dawson College and Collège Montmorency, offer career/technical programs that lead to the profession of a physical rehabilitation technician (or in French, "thérapeute en réadaptation physique"). These people must not be mixed up with physiotherapist assistants or aides because they are considered professionals all over Canada. --MaxAMSC (talk) 20:03, 28 February 2012 (UTC)

Military Physiotherapists

Do you think another section should be made on the profession of a military physiotherapist? Their education, responsibilities, etc. could be explained. --MaxAMSC (talk) 20:21, 28 February 2012 (UTC)

Opening Paragraph

The sentence in the opening section that states that physical therapists work at times with occupatonal therapists and speech therapists is unneeded. They also work with MDs, DOs, DPMs, DMDs, DDSs, DCs, NPs, RNs, COTAs, CNAs, social workers, and other clinicians. Other pages explaining other professions do not have the other professions listed. What is more is that by degree a 'speech therapist' graduates with a degree in speech language pathology. For this to be an accurate encyclopedia that should be reflected. {Equanimous1 (talk) 02:00, 11 March 2012 (UTC)}— Preceding unsigned comment added by Equanimous1 (talk • contribs) 01:58, 11 March 2012 (UTC)

Occupational therapists and speech therapists are closely related to physiotherapists since they are careers in rehabilitation. By the way, the above careers are linked in the article to make the encyclopedia more accurate... If the reader needs more information, s/he clicks on the link. You should read Wikipedia's guidelines before contributing to any article because your contributions could be interpreted in a wrong way... Take the time to mention the correction on the article's talk page next time. --MaxAMSC (talk) 02:13, 11 March 2012 (UTC)

Also, I hope you are aware that, when a patient receives physiotherapy services, s/he is ALWAYS followed by an MD, an RN, and, in most cases with few exceptions, a psychologist. Physiotherapists that work in the field of dentistry with DMDs and DDSs are very rare.--MaxAMSC (talk) 02:18, 11 March 2012 (UTC)

As a physical therapist who has been working for the last 18 months in a given setting I have not once worked with an occupational therapist or speech language pathologist. The idea that a physical therapist will always work with those professions is a myopic one. In some settings working with OTs and SLPs is routine but to the novice reader they may think that this is always the case, when in fact it is not. When a patient receives physical therapy they are not always followed by an MD, DO, ?RN, or other clinician. The previous setting that I worked in had roughly 60 percent of the patients coming in with patient self referral (direct access) where there was no referring clinician. I also have never received a referral from an RN nor would they be legally allowed to sign a plan of care for a medicare patient. I mean no harm but the sentence is unneeded and should be removed. (Equanimous1 (talk) 02:27, 11 March 2012 (UTC))

I think I should mention that I am a physiotherapist (BSc, MSc) and kinesiologist (BSc, MSc) in Quebec. I have 11 years of experience, and I teach undergraduate students at university. First of all, RNs (must have a specialized BSc) do not refer patients to PHTs, they follow their progress, like MDs. Trust me, it is legal, and they are trained to do that. Second, in Quebec, patients receiving PHT services must be followed by MDs (very few exceptions). Third, patients that have direct access consult private clinics, they cannot come to hospitals without referal from MDs. --MaxAMSC (talk) 02:38, 11 March 2012 (UTC)

In America RNs do not have to have a BSc. There are 3 entry points to obtain an RN. One of them allows for a RN, BSN. (Equanimous1 (talk) 03:05, 11 March 2012 (UTC))

I think I should mention that I teach in a post doctoral residency and as well I am a physical therapist (DPT, OCS, CSCS). In Canada I have been told that direct access is growing. One of my colleague went to teach a class on patient self referral (direct access) in Canada. This has been due in part to a change in payer source and clinics having to turn to other sources for patients such as patient self referral. Patients can come to a hospital outpatient facility with self referral in America and in acute settings no referral is needed to initiate physical therapy services. I am unsure of the laws of in Canada. Back to the original edit. The last sentence in unneeded and presents an inaccurate view of a profession that works in many different settings. Again this is a myopic view and not the best way to accurately portray the profession of physical therapy. For the neophyte reader they should understand that settings may be very different, a physical therapist may work with multiple clinicians, and a physical therapist may never see an OT or SLP. (Equanimous1 (talk) 02:57, 11 March 2012 (UTC))

In Quebec, laws are different than in the rest of Canada, which has laws that differ from the US.

Since the article is general, I will remove the mentionned sentence in the opening paragraph.

By the way, I also obtained my MD (I know what I'm talking about when it comes to patient referal in the province of Quebec). --MaxAMSC (talk) 03:29, 11 March 2012 (UTC)

Interesting discussion. Actually I (a PT) think the mention of OTs and ST (SLPs) in the lead was appropriate, since every "rehab department" includes all three professions. It's a useful bit of information, whereas the current wording ("other medical services") is too general to be of worth. It's now just a "duh" statement. -- Brangifer (talk) 03:43, 11 March 2012 (UTC)

Yes. I agree. Most rehabilitation departments, if not all, offer OT and SLP services at the same time as PT services. I'll fix the sentence, hoping it will satisfy both arguments... --MaxAMSC (talk) 20:10, 11 March 2012 (UTC)

Looks much better. BTW, I had deliberately removed the "See also" links for OT and SLP because they are already wikilinked. That's standard practice. I see you have (inadvertently?) restored them. -- Brangifer (talk) 20:45, 11 March 2012 (UTC)

They're removed now. Since I added them in the top sentence, they are unneeded in the "See also" internal links. --MaxAMSC (talk) 21:33, 11 March 2012 (UTC)

I understand that PTs work with OTs and SLPs but this is a myopic view of the profession. According to a 2010 demographic profile from the APTA 20.9 % of PTs in the work force work in a Health system or hospital-based outpatient facility or clinic, 33.6% work in a Private outpatient office or group practice, 9.6 % work in an academic institution, .5 % work in a Health and wellness facility, .2 % work in a Research center, and .5% work in industry. The remaining PTs work in acute care, long term care, home care, with the school system, Inpatient rehab, and in 'other settings'. This leaves 65.3% of physical therapists who may never work with an OT or SLP on a daily basis. The remaining 34.7% may or may not work with OT's, SLPs, MDs, DOs, DPMs etc. To the neophyte reader they should understand that the majority of those practicing physical therapy do not work with OTs or SLPs. Perhaps this was the case in times past and if working in certain settings that may be a persons point of view but it is not the currently the case for most PTs. I would cite the reference article above but it is for members only of the APTA. [[Equanimous1 (talk) 03:48, 29 March 2012 (UTC)]]

As the editor who added the sentence diff, perhaps I should state my rationale. The sentence, as I wrote it, started with the key phrase in many settings. This statement makes no pretensions of applying to the whole of the physical therapy profession. Obviously PTs do not work side-by-side with OTs and/or SLPs in all settings, and I myself do not currently work in a setting involving OT or ST, though I have worked in such settings before, including skilled nursing facilities. The key link is that OT and ST are other allied health professions that frequently work together in interdepartmental settings, hospital "rehab dept" settings and often in home health settings, and the link is also recognized by MediCare, who bases RUG levels on the combined efforts of these three disciplines. I suppose if you wanted to add the phrase "but many PT settings do not involve OT or ST," that would be acceptable, though it would be redundant, as the phrase "in many settings" already indicates that the statement is not all-inclusive. Wilhelm Meis (☎ Diskuss | ✍ Beiträge) 16:02, 14 May 2012 (UTC)

Travel Physical Therapy

Added a section on travel physical therapy in the specialty area. I'm new to Wikipedia -- please check it and make sure I followed form properly. :-) OnwardOGH (talk) 22:31, 11 September 2012 (UTC)

This section was removed, but I see no explanation for doing so. Why has this happened?

Because of the rising need for qualified physical therapists, many healthcare and physical therapy facilities have opted to hire travel occupational therapists. These PTs agree to work temporary assignments, often out of state, to fill an existing staffing void. A typical assignment runs between 8 and 26 weeks, with work weeks consisting of 36-40 hours .

Travel physical therapists typically enjoy much higher wages: $113,500/year for travelers, versus $70,700/year for their permanent-position counterparts . Travel therapists working with agencies will also enjoy benefits such as free housing, health/medical insurance, travel reimbursement, loyalty bonuses, and a 401k plan.

While a common choice, working with an agency is not a requirement; they may also choose to work as an IC (Independent Contractor). In this scenario, the traveling physical therapist retains the fees and profit that the agency would have earned, but they also take on the tasks of managing their own housing arrangements, benefits, taxes, and so on . An IC may also have their pay come in a less consistent fashion -- the delay in pay from their hiring facility can be as much as 45 days .

Travel Physical therapists most commonly enter the specialty at the age of 21-30(43%), or over the age of 50 (22%). Location (49%) and salary (28%) are cited as the biggest draws for travel physical therapists when selecting a position .

OnwardOGH (talk) 15:15, 18 September 2012 (UTC)

this really does vary a lot. depending on where you are situ. I know my husband is on the road a lot and there is very little diff in pay packets between him and his perm colleagues.Docsim (talk) 04:15, 20 June 2014 (UTC)

Physical therapy / physiotherapy

User:PhysioPlanet, I have reverted some of your edits because they didn't improve the article and/or violated our manual of style. For example, wikilinking physical therapists in the Physical therapy article was a self-referencing wikilink. Redirects are often bolded, as in the case you changed.

What I can't figure out is how you managed to remove the existing redirect at Physiotherapist without any discussion. That's not allowed. It's an old decision that both Physical therapist and Physiotherapist are supposed to redirect to Physical therapy and any content merged into the main article.

If you disagree, let's discuss it here rather than edit war. Per WP:BRD, I have Reverted your Bold edit, and now we need to Discuss until a consensus is reached. -- Brangifer (talk) 04:47, 1 December 2013 (UTC)

I am a physio in Australia mainly in occupational health and safety. can someone please tell me how we can bring some other countries perspectives into this article. it seems very slanted toward the united states of america only. opening section of this article talks exclusively of united states and legislation. can we introduce other regions like asia pacific.Docsim (talk) 10:24, 30 September 2014 (UTC)