A Practice Analysis Survey: Defining the Clinical Practice of Primary Care Physical Therapy
Background and Purpose. Due to changes in the health care delivery systems, physical therapy services have moved toward a primary care model of practice. The purpose of this study was to identify the professional responsibilities, procedures, and knowledge areas of physical therapists practicing in primary care settings. Subjects. A sample of 212 physical therapists practicing in primary care settings, and a control group of 250 physical therapists not practicing in primary care settings were surveyed. Methods. The survey instrument was developed with the assistance of a National Advisory Committee (NAC) consisting of 12 subject matter experts. A modified Delphi technique was used to develop the survey instrument and it was pretested by a pilot group of seven physical therapists. The physical therapists were asked whether or not they performed each specified task, and to rate its importance to primary care. The final three-part survey instrument consisted of 171 items. Results. Of the 222 surveys mailed to the primary care group (PCG), 119 (56.1%) responses were received. Of the 250 surveys mailed to the control group (CG), 103 (41.2%) responses were received. The distribution of responses for each item was compared between the primary care and control groups using chi-square analyses for significant differences at the .001 level. Conclusion and Discussion. There were numerous significant differences in professional responsibilities, procedures, and knowledge areas between the primary care and control groups, most notably, in the areas of identifying signs and symptoms of non-musculoskeletal conditions, establishing physical therapy diagnosis, ordering imaging procedures, and prescribing over-the-counter medications. These results provide: 1) evidence that primary care physical therapists have unique knowledge, skills, and abilities when compared to non-primary care physical therapists, 2) useful data for defining the role and function of physical therapists in primary care, and 3) curricular direction to professional, post-professional, and clinical residency or fellowship-based educational settings. Key Words: Practice analysis, Clinical competencies, Primary care, Physical therapists.
Physical Therapy, Primary Health Care, Clinical Competence, Physicians, Family.
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