Patient Access to Physical Therapy - A Personal Experience

Patient Access to Physical Therapy

My parents recently underwent orthopedic surgical procedures.  One had hand surgery to straighten and fuse an arthritic DIP joint of the index finger.  The other had surgery to address painful deterioration of the MTP joints of the first three toes.  

My mother was in a hand cast for 8 weeks and had it removed a little over a week ago.  She now has swelling and stiffness of the entire hand and as expected, diminished strength and muscle atrophy.  Today she asked me multiple questions:  "Should I be stretching it more?  Why are my other fingers so stiff? What can I do for the swelling?  When is my strength going to come back?  When is the feeling going to come back in my index finger?"  My response was, "These are all great questions for a physical therapist who specializes in hand therapy."  Much to my chagrin, my mother received only one session at the surgeon's office for HEP instruction consisting of a few simple range of motion exercises.    

My father had orders to remain non-weight bearing for 6 weeks and is now in a cam boot with instructions to increase weight bearing 40 lbs. per week.  Last week he called to ask when I would be able to to come over and show him how to walk with the walker and maintain the 40 lb. weight bearing limitation.  The only  problem:  they live two hours away.  Again my response was, "This is a great question for your physical therapist!"  But again, you guessed it - no physical therapy ordered.  Today as my parents left our house I had to explain to my dad the proper technique to safely descend the three steps from the porch to the sidewalk.

As of this post, the Texas Physical Therapy Association has made significant progress in achieving "Patient Access to Physical Therapy".  When this legislation passes, patients will have the right to access a physical therapist without the burdensome and unnecessary requirement of obtaining an order from a physician (or from one of the other laundry list of health care providers who are legally allowed to prescribe physical therapy).  House Bill 1039 has passed favorably out of committee and now sits in the House Calendars Committee.

If you are a PT or PTA practicing in Texas, NOW is the time to act.  Please use the House Calendars link above to find out if your representative serves on this committee.  I urge you to call and ask that HB 1039 be placed on the House Calendar.  If you are former or past physical therapy patient, your support of HB 1039 in the form of a telephone call or email would be greatly appreciated.

HB 1039 will serve the best interests of our patients.  Physical Therapists are the most qualified and skilled health care professionals in human movement and function, and patients should have the consult a physical therapist whenever the need arises - just as they have the ability to consult a physician, dentist, or an orthopedic surgeon.  The fact that my parents were not able to consult a physical therapist in a timely manner illustrates the importance of passing this bill, and is also a great example of flaws in the current "gatekeeper" system.  It's time that the Texas legislature recognize the fact that PT's don't need an order from an MD to "Evaluate and Treat" in order to do their job.