These are statements of the Board of Physical Therapy Examiners as to what ethical practice is and should not be construed to control billing issues, insurance issues or employment contracts.
Q. Can the periodic reevaluation requirement be satisfied by the physical therapist assistant having a conference or discussion with the physical therapist about the patient's condition?
The practice act requires reevaluation of the patient on every eighth treatment day or every sixty calendar days, whichever comes first, when care is provided by the physical therapist assistant. The physical therapist has the authority and obligation to reassess and modify the plan of care and associated physical therapy interventions as appropriate on each visit (whereas a physical therapist assistant does not). The Board considers the reevaluation standard to be satisfied when the physical therapist sees the patient and performs some type of evaluation (as limited or detailed as the physical therapist feels is necessary dependent on the patient's condition). A conference or discussion about the patient will not satisfy the reevaluation standard.
Q. May exercise physiologists and/or athletic trainers document in the physical therapy record?
Section 40-45-280 of the physical therapy practice act establishes the physical therapy record. As the physical therapy record is established to document physical therapy care, only physical therapists, physical therapist assistants and appropriate students are authorized to provide documentation in the physical therapy record. There is nothing in the physical therapy practice act that prohibits the physical therapy record from being a component of a multi disciplinary chart. Exercise physiologists and athletic trainers should function in a physical therapy treatment program as aides (guidelines for utilization of nonlicensed personnel are established). Thus, they should not provide documentation in the physical therapy record.
Q. May physical therapists or physical therapist assistants work as massage therapists?
Massage therapy is a regulated profession in South Carolina, and massage therapy services are to be provided by appropriately licensed individuals. Treatment interventions provided by physical therapists and physical therapist assistants should comply with the physical therapy practice act. These physical therapy interventions may include therapies which can also be provided by licensed massage therapists under their own license. No physical therapist or physical therapist assistant should hold himself or herself out as massage therapists unless they are appropriately licensed.
Q. May physical therapist assistants perform any type of screen (restorative, contracture, etc.)?
As a screen involves the collection and interpretation of data to reach a conclusion as to the need of skilled physical therapy care, the Board has determined that a screen is an evaluation and that only a physical therapist should perform it.
Q. May physical therapists or physical therapist assistants work as personal trainers?
There is currently no requirement that personal trainers in South Carolina be licensed or hold any professional credential. The Physical Therapy Practice act defines physical therapy as the care and services provided by or under the direction and supervision of a licensed physical therapist. Any such services under the direction and supervision of a licensed physical therapist would need to comply with the statute and regulations governing the practice of physical therapy. This would mean that a physical therapist assistant would not provide care unless there had been an evaluation performed by a physical therapist. A referral from a medical doctor is required if care was to continue beyond 30 days. However, if a licensed physical therapist or physical therapist assistant DOES NOT hold him/herself out to be a physical therapist or physical therapist assistant or to be engaged in the practice of physical therapy, then this Board has no jurisdiction over their personal training practice. In practice, this means that the licensee does not refer in any way to his or her physical therapy credentials when working as a personal trainer.
Q. May physical therapists perform wound care services?
The care and treatment of wounds has been performed by physical therapists in South Carolina and the United States for many years. The physical therapy treatment has included, but has not been limited to, whirlpool or other forms of hydration, debridement of a sharp or blunt nature or by use of other mechanical or chemical agents (specifically prescribed by a physician when appropriate), and dressing changes. Educational support for these procedures in many cases are provided in the physical therapy schools and in multiple forms via continuing education. There are no statutory limits in place regarding physical therapy intervention with wound care services (including debridement) or on the setting in which any such treatment may occur. To date, there have been no complaints received and no disciplinary actions taken against any physical therapy licensees regarding the performance of any wound care activity. The Board has taken no steps to limit the practice of physical therapy in this area.
Q. What type of medical practitioner is required to provide a physical therapy referral?
With amendments to the Physical Therapy Practice Act in 1998, no referral is necessary prior to initiation of physical therapy intervention. Be advised that a physical therapist would be subject to discipline if the therapist has treated or undertaken to treat human ailments, otherwise than by physical therapy, or has practiced physical therapy and failed to refer to a licensed medical doctor or dentist any patient whose medical condition should have been determined at the time of evaluation or treatment to be beyond the scope of practice of a physical therapist. If physical therapy treatment is to continue beyond 30 days from the initial evaluation and the patient was not referred by a medical doctor or dentist, then the patient must be referred to a medical doctor or dentist.