Rick Wickstrom, PT, DPT, CPE, CDMS
House Health and Aging Committee
Mr. Chairman, members of the Health and Aging Committee, my name is Dr. Rick Wickstrom and I am here on behalf of theOhio Physical Therapy Association (OPTA) to testify as a proponent for HB 220, which is intended to update and clarify some of the language for the scope of practice by licensed physical therapists in Ohio.
I am a doctor of physical therapy, a certified professional ergonomist, and a certified disability management specialist. I own a private physical therapy practice and contribute regularly as a volunteer and occupational health expert for my professional association at a state and national level. Much of my professional career has been dedicated to preparing occupational health professionals such as physical therapists with the skills and tools needed to assess functional job demands, evaluate worker fitness, and help overcome barriers to safe work and lifestyle performance. I have a particular interest in systems improvements that improve consumer access to healthcare professionals who care about cost-efficiency, reducing adverse treatment complications and preventing needless work disability.
HB 220 represents an update to language in our physical therapy practice act that helps to clarify a licensed physical therapist’s skills that related to triage, evaluation and managementof pain, impairment, functional limitations, and work disability. Ohio’s Physical Therapy Practice Act already holds licensed physical therapists accountable to forge collaborative, interdisciplinary relationships with medical doctors or other professionals in order to address specific medical management needs that are outside of our scope of practice or expertise.The update of language in HB 220 is consistent with our doctoral education model of physical therapy and research that measures the cost-efficiency of physical therapy in the US Military and other settings.
Many of you are acutely aware that we now have a very serious problem in Ohio with addiction complications and disability as a result of over prescription of pain medications, unnecessary surgery, or inappropriate work activity prescriptions. Despite a well-intentioned effort to regulate over prescription of opioids for pain, a domino effect has occurred that seems to be driving more Ohioans to obtain heroin or other drugs illegally and incur criminal offenses to support their addiction.
Licensed physical therapists are highly educated healthcare professionals with specialty training in examination, evaluation and diagnosis of movement disorders that result from neuromusculoskeletal conditions. Movement of physical therapist education programs to a clinical doctorate degree has included expanded coursework and clinical training to prepare physical therapists for a more expanded role in primary care, prevention and wellness.Our physical therapy plan of care includes prescription of appropriate exercise, physical activity and therapeutic procedures that provides safe treatment alternatives to manage pain, reduce impairment and expedite recovery of function.
To ensure that our clients receive safe and appropriate treatment, physical therapists have the responsibility to perform a detailed examination and evaluation in order to arrive at a differential diagnosis, and monitor how our treatment impacts our findings of impairment and functional limitations. The reason why we need to have latitude to request appropriate diagnostic tests is to ensure that our plan of care is safe, timely and appropriate for the patients that we serve.
The language in HB 220 helps to better clarify the consultative skills of a physical therapist that relate to evaluation of activity limitations and services that help bridge the gap between health problems and work demands. Impairment ratings and functional capacity evaluation are examples of services that I already perform in my private practice; however, this is not adequately described in the outdated language of our scope of practice what was written before our education evolved to a clinical doctorate. Direct ordering of diagnostic tests such as x-rays has been proven cost-efficient in the US Military system for decades. This has resulted in avoidance of treatment delays, earlier return to activity, and cost savings benefitsthrough avoidance of unnecessary referring physicians fees, diagnostic tests, and medical treatment that may incur under a medical gatekeeper model.A Functional Capacity Evaluation goes far beyond the scope of the traditional physical examination performed by other doctors because it emphasizes objective measures of impairment and functional performance. Physical therapists have been the lead profession in establishing guidelines for functional capacity evaluation to support recovery of function and return to safe and appropriate work.
In summary, the updates requested to our practice act in HB 220 are entirely consistent the current doctoral educational model for physical therapists and are justified by research on models for physical therapy triage and practice for the US Military and other settings. As early as 1975, studieshave demonstrated the value of military physical therapists in an expanded role of primary screener for individuals presenting with complaints of lower back pain. Participating orthopedists found no significant errors of omission or commission by physical therapists and recommended continuation of the program on a permanent basis.
Thank you for the opportunity to testify as a proponent to HB220.I would be happy to respond to any of your questions.
1