Twin bills have been filed in both the Texas House and Senate that, if approved, would allow physical therapists to perform patient evaluations and treatments without the requirement for a physician’s prescription.

Here is a cleaned-up (retyped) version of Senate Bill 433:

 Retype of SB 433: Download

The TPTA website has links to both the House and Senate bills, as well as a one-page summary of speaking points.

What can you do?

Whether you agree with the bill or not - make an informed opinion and then make your opinion count!

First, read the text of the bills.  Next, read the one page summary from the TPTA website.  It has many good points.  Finally, form an opinion and then make it known!  Contact your local representatives in both the Texas House and Senate — send an email, give them a call. Find out who your representative is by following this link:  http://www.fyi.legis.state.tx.us/

PTs in Texas have practiced knowing the exceptions to the referral requirement — but, did you know the exceptions were expanded in February 2008?

Chapter 322.1(a)(2):  Provision of Services now includes the following exception –

• (B) A PT may provide instructions to any person who is asymptomatic relating to the instructions being given without a referral, including instruction to promote health, wellness, and fitness.

The remaining exceptions are: [emphasis added to original text]

• (A) A PT may evaluate without referral.

• (C) Emergency Circumstances. A PT may provide emergency medical care to a person after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity without referral if the absence of immediate medical attention could reasonably be expected to result in a serious threat to the patient’s health, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

• (D) Prior referrals. A physical therapist may treat a patient for an injury or condition that is the subject of a prior referral if all of the following conditions are met.
  • (i) The physical therapist must notify the original referring healthcare personnel of the commencement of therapy by telephone within five days, or by letter postmarked within five business days;
  • (ii) The physical therapy provided must not be for more than 20 treatment sessions or 30 consecutive calendar days, whichever occurs first. At the conclusion of this time or treatment, the physical therapist must confer with the referring healthcare personnel before continuing treatment.
  • (iii) The treatment can only be provided to a client/patient who received the referral not more than one year previously.
  • (iv) The physical therapist providing treatment must have been licensed for one year. The physical therapist responsible for the treatment of the patient may delegate appropriate duties to another physical therapist having less than one year of experience or to a physical therapist assistant. A physical therapist licensed for more than one year must retain responsibility for and supervision of the treatment.

Get more information at the Executive Council of Physical Therapy & Occupational Therapy Examiners website.

I had the pleasure of meeting Mark Turek, chief investigator for the Texas Physical Therapy Association.  Mark presented some recent incidents at the ECPTOTE Board meeting and one issue on abandonment caught my attention. 

A physical therapist accepted a position with a company and set an agreed-upon start date, but the therapist requested several delays in the start date due to “family matters.”  Eventually the therapist did not begin the new job.  The clinic submitted the therapist for abandonment.

I asked Mark about this particular case, and it led to an interesting conversation.  Here’s a summary. . .

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