Where Would Your Profession Be…?
“Let’s pretend that the New York Physical Therapy Association (that’s you, the members of the Association) is George Bailey and I am the guardian angel...”
Have you ever watched “It’s a Wonderful Life”? George Bailey tries to commit suicide on Christmas Eve and his guardian angel shows him how many people he has touched and the difference he made in his community through the years.
Let’s pretend that the New York Physical Therapy Association (that’s you, the members of the Association) is George Bailey and I am the guardian angel showing you how the association has changed the physical therapists’ practice through legislative activities.
When a bill is passed, the New York State Board for Physical Therapy updates the practice act and enacts regulation so that the law may be implemented. Over the years the practice act has been amended to broaden the physical therapist’s scope of practice. Each passage adds something to the development of the profession.
New York was one of the first states to enact licensure laws for physical therapists.
In 1946, physicians received notification that only those who were licensed with the state were permitted to practice physical therapy. They were cautioned not to refer patients to unlicensed individuals because it could lead to aiding and abetting the illegal practice of physical therapy. By 1972, there was no longer the necessity to be supervised by a physician, and physical therapists were allowed to see patients with a referral as long as the treatment was in accordance with a physician’s diagnosis.
APTA instituted a competency exam with the Professional Examination Service in 1954 which increased the competency level of entry level physical therapists; and by 1959, 45 states had practice acts in place.
By 1993, similar legislation was passed for physical therapist assistants (PTA). The PTA is now allowed to treat in the home, provided that a physical therapist (PT) has done an initial evaluation at the first visit, and the PTA has two years clinical experience. That same year, Governor Cuomo signed two other laws: One stating that physical therapists could accept a referral from nurse practitioners and another that limited the role of the athletic trainer to treatment of athletic orthopedic injuries excluding the spinal cord.
With consumers frustrated with regulations in the 1980s and early 90s, legislation passed mandating managed care reform in 1996. During the negotiation period there was an attempt to eliminate physical therapists from the utilization review process. NYPTA made sure that a nurse or other healthcare provider would not exclusively perform the utilization review. Fortunately, the Governor’s office accepted this compromise: utilization review can now be performed by a physical therapist.
1n 1999, NYPTA worked hard to oppose two bills that would have negatively impacted the practice of physical therapy. Chiropractic organizations pursued legislation that would deny physical therapists the ability to perform manipulation therapy. The bill would have limited manipulation to chiropractors, physicians and doctors of osteopathy. NYPTA continues to oppose this bill. Likewise, NYPTA was also successful in blocking legislation that would allow business corporations from registering as physical therapy providers.
Another milestone in 1999 was marked by passage of whistleblower legislation, prohibiting hospitals and homecare services from interfering with the healthcare provider’s ability to report any practices that may affect the quality of patient care.
During 2000, NYPTA worked diligently at the grassroots level to support enactment of the prohibition on physician self-referral. Its passage was a great victory for NYPTA. The law bans referral of patients to clinical facilities by physicians who have, or whose family members have, a financial interest in those facilities.
For a newly graduated physical therapist, the time a limited permit is valid was shortened from one year to six months in 2002. Additionally, in order to be certified as a physical therapist assistant, another law was passed in 2002 stating that an applicant must pass a national examination. It too establishes a 6-month limited permit for the PTA.
After all these years, NYPTA is still fighting to prevent the un-licensed from practicing physical therapy. In 2003, a licensure law passed that protects the consumer from being treated by an individual who does not have a license to practice. Under this law, the State Education Department has the ability to enforce specific sanctions against those illegally practicing.
And in 2006, after over 25 years of advocacy, direct access legislation was passed that gave physical therapists the ability to practice without a referral for 10 visits or 30 days. Another bill was passed in 2007, which allows physical therapists to accept referrals from licensed midwives.
As is evident, the profession has made tremendous strides over the years. This is due in large part to your willingness to get involved. Each of these milestones represents a multi-year effort with lawmakers and other stakeholders to shape your profession, and it continues to evolve.
With ongoing threats to the practice act via referral for profit, a proposed ban on spinal manipulation, the continued prohibition on business corporations from engaging in the practice of physical therapy, and ongoing efforts to cut funding for early intervention services, it is crucial that you continue your involvement or become active in advocacy for your profession - without you, the PT profession would not be what it is today! Please join us on April 15, 2008 for Lobby Day to celebrate our success and continue our forward momentum!
Posted March 2008 |
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