Opposition Strategy

Opposition Strategy

Historical Overview of POPTS

Physical therapists have worked for and with physicians since the early 1900s. In fact, Restorative Aides, the precursor of the Physical Therapy profession, were initiated by physicians who sought specialized training in exercise and functional restoration for their patients’ recovery. Initially, physicians (primarily orthopaedic surgeons) individually taught and mentored physical therapists (restorative aides).

For decades, highly trained and committed physical therapists have worked for and with physicians and physician group practices to provide professional, conservative, and ethical physical therapy services for patients. As physical therapists began to expand into private practice and prosper financially from those physician referrals, a self-serving concept of physical therapists working for physicians (POPTS) proliferated under the negative banner of ethics, or lack thereof, and poor quality care.

As the private practice therapists gained leadership in their professional association (APTA), so likewise the concept of physical therapists working in physician-based settings became alarmingly unpopular, was considered unethical, and today is illegal in some states as defined and endorsed in the states Physical Therapy Practice Acts (Delaware, Missouri, South Carolina).

The APTA has begun an aggressive movement through individual state chapters to legislate physical therapists out of physician offices and out of the employment of physicians. A back-door approach of limiting employment setting options for physical therapists through state legislature via physical therapy licensure is the current strategy of choice. The Attorney General’s Office of South Carolina just opined that the South Carolina Physical Therapy Practice Act had the right language to prevent physical therapists from continuing their employment under physicians. The South Carolina Licensure Board sent out a 90-day “Get a new job” notice to its licensed physical therapists and licensed physical therapist’s assistants. Obviously this ruling is being legally challenged.

Other states are aggressively looking into their existing Physical Therapy Practice Acts to see if they can take current language and gain a favorable opinion from their respective Attorney Generals to prohibit physicians from providing physical therapy services and to restrict physicians’ scope of service. Again, the physical therapists can’t alter the physicians’ practice act; however, they are looking to achieve their goal by altering interpretations and existing language of their states’ Physical Therapy Practice Acts. The APTA is providing much support, model language, and encouragement to their state chapters and membership to accomplish this.