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State Practice Act & Use of Titles
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State Practice Act & Use of Titles - August 5, 2005 11:55:00 AM
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carleenej
Posts: 23
Joined: August 23, 2004
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Greetings all..
I need assistance comprehending the Use of Titles regulation relative to AZ, and how chiropractors can advertise themselves to be "Board Certified in Physiotherapy"?
While the AZ Practice Act http://www.ptboard.state.az.us/Title%2032%20Chapter%2019%20Effective%20August%2025%202004.pdf explicitly states in 32-2042.C (summarized):""physiotherapy", "physiotherapist" is prohibited unless provided by or under the direction of a physical therapist licensed pursuant to this chapter." However, according to AZ Chiropractic Board, a published document lists the steps to obtaining a "Physiotherapy Certification" http://www.azchiroboard.com/geninfo.pdf
Is it just me, or are these two documents in direct conflict with each other?
If you Google "physiotherapy" "chiropractor" and a city name, such as "Tempe" or "Tucson" you will see what I'm referring to here.
I have been asked by patients for clarification on this matter, after they tell me they've had PT.. but by a chiro with these credentials.
Frankly, I am confused as well since this is such a blatant act.
Any thoughts out there on this issue—or other states with this conflict???
~liz
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Re: State Practice Act & Use of Titles - August 5, 2005 1:02:00 PM
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dosrinc
Posts: 335
Joined: December 9, 2004
From: Bonita Springs
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Liz,
120 hours of coursework, 120 FREAKING hours! This stuff really gets me going. After reading the Arizona PT practice act it would seem very appropriate to me for the Board of PT practice in AZ to issue a cease and disist(sp?) order to the chiro association as there are no exceptions to the above stated use of physio, ect.
In Florida the PT practice act does, unfortunately, carry a provision that allows physicians and chiro's to advertise utilizing "physical therapy", "physio", ect.. I wish we could change things, but I understand it would not be an easy process.
Because the AZ practice act seems to be written appropriately I hope that you continue to press the issue.
Good Luck,
Rick
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Re: State Practice Act & Use of Titles - August 5, 2005 2:22:00 PM
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vt2c1ms
Posts: 74
Joined: May 9, 2005
From: Kansas
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I hear the APTA is offering a certification in chiropractic that PT's can advertise for 120 hours also. Crazy.
Mark
PS (just joking about the above statement, just think it is absolutely ridiculous and the APTA has their heads up you know what on some issues)
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Re: State Practice Act & Use of Titles - August 5, 2005 2:31:00 PM
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vt2c1ms
Posts: 74
Joined: May 9, 2005
From: Kansas
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Another thought,
Why would a DC want to merge with the PT profession if they can so easily claim the services of PT? Man, this really blows my mind. I'm sure the are going to be tons of lawsuits in the future years to come. I know it's not in every state but it still blows my mind. Can they claim OT services too?
Mark
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Re: State Practice Act & Use of Titles - August 5, 2005 4:12:00 PM
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TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
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Liz,
AZ has one of the strongest physical therapy associations around, they've had true direct access for 20 years which is something few states have. Get in contact with the AZAPTA and let them know what's going, it will be delt with quickly. BTW, are you a member of the APTA and state chapter association?
_____________________________
Todd
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Re: State Practice Act & Use of Titles - August 5, 2005 4:17:00 PM
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karmzack
Posts: 181
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From: Hawaii
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I think DCs can perform OT if they call it Occupatiotherapy. :)
_____________________________
Zack Solomon MPT, OCS, CSCS
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Re: State Practice Act & Use of Titles - August 5, 2005 5:59:00 PM
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jma
Posts: 2414
Joined: August 24, 2000
From: NY
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Lets hope this gets someone's attention over there.
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Re: State Practice Act & Use of Titles - August 5, 2005 6:55:00 PM
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Synergy
Posts: 592
Joined: March 11, 2004
From: Texas
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Other certain 'individuals' may be viewing this thread thinking "See...there go those whiny little PTs again". For more information on what I'm referring to, see [URL=http://www.chiroweb.com/ubb/open/Forum1/HTML/000676.html]this[/URL] link. As for me, I believe as Todd does...get that infomation to the AZPTA if they haven't already found out.
Rick,
Regardless of how many hours it takes them to obtain a 'physiotherapy certification', it's still ridiculous! This has been mulled over in numerous threads and the main thing that pisses me off is their calling what they're doing physical therapy.
Oops...I may have added fuel to the fire in that 'other' place. Oh we lowly lowly PTs. :)
_____________________________
Chris Adams, PT, MPT
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Re: State Practice Act & Use of Titles - August 5, 2005 7:55:00 PM
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drbuddy
Posts: 429
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From: Pennsylvania
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I see where you guys are coming from, why you are upset with the title, but let me give you an outside look at this...
To most DCs (and maybe even the general population), 'physiotherapy' or even 'physical therapy' is a general term meaning the use of something 'physical' to obtain a 'therpeutic' effect. Take a step back from the issue and look at it yourself. It is a vague term. It would be the same is if your profession was 'Manual Therapy' and you were all 'Manual Therapists'. We'd be having the same argument because the term is so general that I'm sure others would be using it to describe what you do.
Even today, I am still unsure what I should call certain procedures in my office. I use spinal manipulation, manual therapy, physical rehab (as opposed to psychiatric), and physical therapies. Note that I am using the lower case verison of 'physical therapy'. Quite honestly, that is what I would call it if law permitted because I feel it is an accurate description. However, it is illegal and I know that there is a profession 'Physical Therapy' (capitalized), so I try not to use that term to describe what I do.
In my opinion, it is a poor argument to use the point that you all should take a 120 hour course in 'chiropractics' and proclaim that you practice chiropractic. I think it is a more specific term and does not describe a general group of procedures such as the term 'physical therapy'.
Oh, if that is not enough, the part of our exam that tests our use of exercise, estim, ultraound, etc. is called 'Physiotherapy'. We have 4 parts to our national board exams, plus that 5th 'Physiotherapy' part.
Personally, I think it is unfortunate that the name for your profession is also the same as the common name for the use of something physical to obtain a therapeutic effect (or maybe even using therapy to obtain a physical effect). I think that if you would step back for just a moment, you can see why there is confusion and maybe even just a little, see that chiros are not just trying to proclaim that they act in the same capacity as a licensed Physical Therapist.
I guess what I should ask is, what would you rather us call procedures such as estim, ultrasound, cryotherapy, etc? Is 'physical therapies' appropriate? If not, why? I am not saying that I peform 'physical therapy', but I do use 'physical therapies'. You see our dilemma?
By the way, check out Webster's definition of physical therapy :
Main Entry: physical therapy
Function: noun
: the treatment of disease by physical and mechanical means (as massage, regulated exercise, water, light, heat, and electricity)
Like I said, I see your beef, but the person who named your profession needs to take some of the blame too : )
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Re: State Practice Act & Use of Titles - August 5, 2005 8:51:00 PM
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Synergy
Posts: 592
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From: Texas
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Dr. Buddy,
It truly is a dilemma. In reference to procedures such as e-stim, US, ionto, etc., I refer to them as modalities. I've never referred to them as 'physical therapies' and I'm sure most if not all PTs do the same. To me, it sounds redundant. Webster's dictionary would be the last place I'd go to define 'physical therapy' as I'm quite sure the definition is much more detailed. I'm not attempting to be nit-picky and I realize you wanted a simple definition.
In regards to Mark's comment, he was obviously joking about the 120 hours to get a certification in chiropractic (hence his just joking statement). As I already stated above, the problem I have is chiropractors referring to what they do as 'physical therapy' and/or marketing that they perform 'physical therapy'. This, in my opinion, confuses patients as well as degrades my profession.
We are two totally independent professions. I know chiropractors have their patients performing various activities from therapeutic exercise to receiving 'modalities' and I have no problem with that. It may very well be in your scope of practice, however, I do have a problem when it's referred to as 'physical therapy'.
I found the following from Webster's Dictionary:
[QUOTE]Main Entry: chi·ro·prac·tic
Function: noun
: a system of therapy which holds that disease results from a lack of normal nerve function and which employs manipulation and specific adjustment of body structures (as the spinal column)[/QUOTE]Now, I could make the same argument about chiropractic using the above definition as I employ manipulation in my clinic on a daily basis. Yet, however, I do not refer to it as a chiropractic treatment. I'm not in the business of misleading my patients into thinking I am something I'm not.
Thanks! :)
_____________________________
Chris Adams, PT, MPT
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Re: State Practice Act & Use of Titles - August 5, 2005 8:57:00 PM
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carleenej
Posts: 23
Joined: August 23, 2004
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*Oops! Chris is faster on the keyboard than I, but we both come to the same conclusion..*
Dr. Buddy,
Why not use generic terms like 'modalities', 'exercise', etc.? These terms do not have legal ties to any profession.
When I am doing chest PT, I do not advertise that I am doing respiratory therapy, knowing this technically refers to another field of practice although it is treating the respiratory system.
I think what this is a matter of is public protection; not to use semantics to confuse an already baffled public. Title protection exists for this very reason, so we can draw legal distinctions between disciplines.
~Liz
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Re: State Practice Act & Use of Titles - August 5, 2005 9:02:00 PM
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TLB
Posts: 353
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From: Arizona
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buddy,
There is so much in your post that boggles my mind, I don't know where to start. I'll give it a shot, first of all no one that I know of try's to steal the term chiropractic (at least not PT's) that I know of. Your statement that PT or Physiotherapy is a general term is at best ignorant. This is a profession that's been around since the first world war and you are basically using it and profiting from it within the chiro profession. You ask...
"Even today, I am still unsure what I should call certain procedures in my office"
How about chiropractic?
Sorry if that sounds harsh. You seem to be a very nice guy but please don't refer what you do as PT, it's not a general term, it's a profession....
_____________________________
Todd
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Re: State Practice Act & Use of Titles - August 5, 2005 9:37:00 PM
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Randy Dixon
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I agree with Dr. Buddy. Yes, every PT knows that physical therapy is a protected title that PT's own. However, to the general public physical and therapy are two words that describe a process not a profession. To most professionals not connected to PT, it is also confusing. What exactly is physical therapy? No one here can answer that precisely. The name is confusing and it is understandable why others might get confused on the issue. I disagree with Dr. Buddy though that this is often just an honest mistake. I believe many chiropractors intentionally take advantage of this confusion.
Should the name be protected? Yes, but I think that a more specific, less generalizable, name should be given to the profession.
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Re: State Practice Act & Use of Titles - August 6, 2005 1:33:00 AM
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drbuddy
Posts: 429
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From: Pennsylvania
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To all that replied,
Yes, I understand that PT is a profession and that the term "Physical Therapy" encompasses a wide range of talents and procedures performed by your group. I guess I was just trying to shed light on why it is such an issue. Do chiros use it on purpose? I'm not sure...
I wish I was close enough to a chiro college to check out a few books. While I was there, I was reading through a book on chiro education. One school in 1906 started teaching methods using electrotherapy, hot and cold therapy, exercise, etc. to promote healing. I wonder what they called it back then, before PT was a profession. It would be interesting.
How is "physical modalities"?
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Re: State Practice Act & Use of Titles - August 6, 2005 2:38:00 AM
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Diane
Posts: 1507
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From: Vancouver, B.C., Canada
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drbuddy,
"Physical modalities" seems a bit redundant. Just "modalities" would be fine.
The generic sounding quality of the name of our profession aside, I agree with all the posters who point out that it is a protected term, and that chiros have no business claiming to provide it, regardless of how they might try to distinguish it by calling it "physiotherapy." All that does is annoy me, and all PTs in all the other countries of the world besides the US, who call ourselves physiotherapists.
And furthermore, there was no one individual who named physiotherapy/ physical therapy as such. It's origins stem back into the 19th century, into England (1894). The medical/hospital system was burgeoning along with war and war casualties, and the rehabber people all got together and decided they wanted to have rank. In order to gain rank they had to have a name that was descriptive of what they actually did, that was less wordy than "Society of Remedial Gymnasts and Therapeutic Masseuses". So they called themselves physiotherapists, and the profession, Physiotherapy or Physical Therapy, and created sets of national cirricula and exams, so that they could have rank.
A distinctive feature is that our profession sprang up everywhere, all sides of all conflicts, all over the world, simultaneously, in all countries part of or linked to western society. It seemed an idea whose time had come; rather than being created in one country then exported by entrepreneurs the way chiro was, it grew everywhere and linked itself together by not for profit associations, like the World Physiotherapy Association.
I don't think you really get how offensive it is to us when chiros blithly adopt our name and say they do what we do. Yet you and all the other chiros would no doubt audibly steam if any other profession provided "chiropractic". On the contrary, PTs are always careful to distinguish the term "manipulation" (which is a modality) from "chiropractic" (which you deem to be a profession). Only in the minds of chiropractors are the two ideas fused into one, a single identity you lay claim to. This fusion seems to extend over into blithely using modalities and calling them physiotherapy, not getting that actual PTs would be irritated by that. Weird mind set.
I called a chiropractor (in California) to task not very many months ago over this very issue, and he changed his website, took the term "physiotherapy" out of it. He couldn't get why I was enraged about it, but to his credit he voluntarily complied with my demand, upon it being pointed out that there were state acts most places protecting the term.
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Re: State Practice Act & Use of Titles - August 6, 2005 7:42:00 AM
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jma
Posts: 2414
Joined: August 24, 2000
From: NY
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All states should be universal about titles and how they are used. Makes things a lot easier than having different ones.
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Re: State Practice Act & Use of Titles - August 6, 2005 8:18:00 AM
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UTDC
Posts: 222
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I understand what you guys are upset about but, IMHO, I don't see DC's as trying to trick patients into thinking they are PT's.
Chiropractors take classes called "physical therapy," we take board exams (national and state)called "physiotherapy," therefore it is just natural for these terms to pop up once they are in practice. If PT's took classes in chiropractic and set their regulatory boards to certify them in this area.....I think I would be less upset at the PT's in comparison to my own profession which allowed this to happen. If the APTA had addressed this issue long ago, we would not be having this conversation. Many PT's seem to think that some of these terms are protected, when in many cases they are not...
In short, I don't think that there has been an evil plot by the chiropractic profession, this controversy is the result of decades of ambiguity surrounding "physical therapy" in combination with a long precedent of its use outside of the physical therapy profession.
Don't shoot the messenger,
Jeff
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Re: State Practice Act & Use of Titles - August 6, 2005 8:33:00 AM
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carleenej
Posts: 23
Joined: August 23, 2004
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In this case, the language is clearly stated, and it is a class 1-misdemeanor. Professionals cannot claim ignorance to issues like this--a bit of common sense says, to me at least, this doesn't sound right.
If you walk up to 10 people on the street, tell them you are a DC, and you have your "board certification in physiotherapy, or in physical therapy", how would the public interpret this?
~liz
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Re: State Practice Act & Use of Titles - August 6, 2005 8:54:00 AM
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Diane
Posts: 1507
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From: Vancouver, B.C., Canada
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[QUOTE]Chiropractors take classes called "physical therapy," we take board exams (national and state)called "physiotherapy," therefore it is just natural for these terms to pop up once they are in practice. [/QUOTE]Why would these "schools" teach something the name of which is protected by law? That's the most obtuse thing I've ever heard of. But then, I gather from talking with lots of chiros that chiro schools are no paragons of virtue or ethics or particularly respectful of any boundaries the world may set around them, they just go on doing their own thing, oblivious..
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Re: State Practice Act & Use of Titles - August 6, 2005 10:03:00 AM
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UTDC
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Again Diane, you are assuming the the terms are always protected, which they are not...
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