Paths ForwardABPTS/ABPTRFE Petition to establish Primary Care PT as an area of specialty and residency practice The APTA Board confirmed primary care as an association priority in the 2019-2021 APTA Strategic Plan. The objective to ‘expand access to physical therapy in primary care settings’ is highlighted under the association goal to ‘Elevate the Quality of Care Provided by PTs and PTAs’. Establishing primary care as an area of specialty and residency practice will facilitate attainment of this goal and objective. Phase 1 of this petition initiative was spearheaded by APTA Board Certified Specialists from a variety of physical therapy practice areas in July 2020. Based upon review by the ABPTS/ABPTRFE Joint Review Board, it was recommended that petitioners create and field a supplemental and full revised survey to address identified areas of concern. APTA Federal Primary Care SIG took over leadership of phase 2 of the petition in 2021, and completed the full revised survey in 2023. Phase 2 of the petition was submitted to the ABPTS/ABPTRFE Joint Review Board in November 2023. Once preliminary approval is received, there will be a 90 day period for open public review followed by an open public hearing before the petition can be presented as a motion to the APTA House of Delegates.
Defining Practice and Competencies The petition and practice analysis survey will assist in defining the scope and competencies of primary care physical therapy. The developing definition of a Primary Care Physical Therapist (PCPT) includes clinical competence and knowledge across the body systems, across multiple areas of practice, and across the lifespan. The PCPT focuses on triage and management of conditions affecting physical function across body systems while efficiently conducting disease and psychosocial screening, coordinating team based care, and incorporating principles of population health, epidemiology, and chronic disease management to promote lifespan care across the continuum. The PCPT practices in a variety of settings including but not limited to: primary care clinics, rural health clinics, academic clinics, health departments, hospital based outpatient clinics, private practice clinics, military settings, urgent/emergency departments, and wilderness/austere environments.
Training and Preparation Gaps in entry level and clinical training need to be addressed to optimally prepare clinicians for practice in a primary care setting. There is opportunity to strengthen competency in medical screening and differential diagnosis, as well as the physical therapists’ role in population health, chronic disease management and lifespan care. When exploring how medical screening and differential diagnosis was instructed in entry level programs, 60% strongly agreed that students were adequately prepared to perform screening and differential diagnosis with patients who were referred, vs only 47% who strongly agreed when patients were direct access. Increasing clinical exposure was the top recommendation for expanding both faculty and student knowledge and skills. (Young 2020). Paths forward must include growing opportunities for post-professional education. A successful petition to establish primary care PT as a recognized area of specialty and residency practice, will necessitate further development of primary care residency programs to provide post-professional education through one-to-one mentoring, structured curricular experiences and guided learning in a team based primary care setting. Young BA, Ross MD, Heick J, Greathouse DG, Green Guerrero H, Boissonnault WG. Exploration of Medical Screening and Differential Diagnosis Instructional Methods and Faculty Perceptions in Physical Therapist Educational Programs. J Allied Health. 2020 Summer;49(2):e89-e97. PMID: 32469380.
Advocacy and Advanced Privileging There are ongoing discussions with executive leadership across health care systems to explore various topics pertaining to advocacy and advanced privileging. Some of these topics are listed below:
Key Contributors: Ashley Cassel and David Macchia
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