There's Power in Numbers...
Great change has occurred in the United States and around the world as the result of people organizing around a single mission.
Dr. Martin Luther King, Jr. said, "There is power in unity and there is power in numbers." In May 1963, King gave a speech called "Keep on Moving" at St. Luke's Baptist Church in Birmingham, Ala.
Consider the social, political and legislative impact that movements/organizations such as: the Labor Movement, the Civil Rights Movement, the Women's Rights Movement and the LGBT Movement has had and is having on society today.
The mission and ideas of these groups have led to the passage of path-breaking laws in our country such as: the Nineteenth Amendment (which granted women suffrage in 1920), the Fair Labor Standards Act of 1938 (which created the minimum wage), the Civil Rights Act of 1964 (which outlawed many forms of racial discrimination), and the Supreme Court decision in June, 2015 that ruled same sex couples have the right to marry in all 50 states.
It's because of the NYPTA's mission, "to empower and support its members in advancing the practice and profession of physical therapy through advocacy, education and research", that the Association has changed, and will continue changing 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.
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.
And in 2012, a bill was passed allowing colleges and universities that offer an accredited Doctor of Physical Therapy program to establish faculty physical therapy group practices.
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!