A growing problem throughout the country is the misuse or inappropriate advertisement of physical therapy services. People who are not licensed physical therapists have held themselves out to the public as providing "physical therapy" or "physiotherapy," or use the initials "PT" to describe their services. This characterization is misleading to the public, illegal in some states, and a disservice to individuals who are in need of physical therapy and who think they are receiving it, but in reality are not.

When the public receives treatment such as physical therapy, people deserve to know what treatment they are receiving and that the person performing the treatment is a licensed physical therapist (PT) who has the requisite education and training to provide the treatment.

Massage therapists, chiropractors, personal trainers, or health care practitioners may share some of the same treatment modalities or techniques that also are used by physical therapists; however, an intervention should only be described or advertised as physical therapy or physiotherapy when provided or supervised by a licensed physical therapist.

In addition, some fitness personnel, specifically personal trainers, have mistakenly used the initials "PT" which is the recognized and protected state licensure designation for licensed physical therapists. The use of the licensure designation "PT" by licensed physical therapists is to ensure public protection; these specific initials denote to the consumer that the person is licensed by the state to practice physical therapy.

Terms

• Physical therapy
• Physiotherapy

Titles

• Physical therapist or physiotherapist
• PT (state licensure designation for physical therapists)
• Educational degrees obtained by physical therapists that are used in conjunction with the state licensure designation of PT, such as the DPT or MPT

Physical Therapy – NOT a Generic Term

Physical therapy is not a generic term. It describes the care and services provided by or under the direction of a licensed physical therapist. Other health care providers have attempted to classify physical agents, mechanical modalities, and/or electrotherapy as "physical therapy" or "physiotherapy." The use of these modalities can be described as the practice of physical therapy only when a licensed physical therapist provides the modalities. Some professions may use some of the same physical agents and modalities as physical therapists, but only physical therapists and physical therapist assistants under the direction and supervision of physical therapists practice "physical therapy."

What makes the terms physical therapy and physiotherapy exclusive to the physical therapy profession is the distinct education of physical therapists, the special body of knowledge of the physical therapy profession, the regulatory standards and requirements for licensure as a physical therapist, and the unique perspective, specific skills, practice standards, and specialized care that are provided by licensed physical therapists.

As clinicians, physical therapists engage in an examination process that includes taking the patient/client history, conducting a systems review, and performing tests and measures to identify potential and existing problems. To establish diagnoses, prognoses, and plans of care, physical therapists perform evaluations, synthesizing the examination data and determining whether the problems to be addressed are within the scope of physical therapist practice. Based on their judgments about diagnoses and prognoses and based on patient/client goals, physical therapists provide interventions (the interactions and procedures used in managing and instructing patients/clients), conduct reexaminations, modify interventions as necessary to achieve anticipated goals and expected outcomes, and develop and implement discharge plans.

The patient/client management elements of examination, evaluation, diagnosis, and prognosis should be represented and reimbursed as physical therapy only when they are performed by a physical therapist. Physical therapists are the only professionals who provide physical therapy examinations, evaluations, diagnoses, prognoses, and interventions based on the physical therapist's examination and evaluative process. Intervention should be represented and reimbursed as physical therapy only when performed by a physical therapist or under the direction and supervision of a physical therapist.

Protecting the Public

The rationale behind term protection generally relates to the protection afforded to consumers and patients. Specifically, state regulatory bodies are often concerned that an individual or entity that is not properly qualified to provide physical therapy services may, for example, advertise or represent that physical therapy services are being provided, when in fact there is no physical therapist involved in the provision of services. A consumer also may mistakenly believe that someone using the initials "PT" is a licensed physical therapist, when in fact they are not.

In addition to consumer protection issues, term protection also seeks to address concerns relative to third party payers. For example, third party payers who bundle physical therapy benefits with those of other health care professionals may, depending on the time a service is provided, offer a "physical therapy" benefit that is in fact exhausted before the patient ever sees a licensed physical therapist. Additionally, allowing nonphysical therapists to use terms such as "physical therapy" may result in a payer reimbursing for a service that it believes to be physical therapy when in fact there is no physical therapist involved in the provision of services.

The protection of the terms physical therapy and physiotherapy is not referring to protection against the use of various physical agents, modalities, or procedures by others, but rather is against the inappropriate labeling of those modalities and procedures as physical therapy.

Term Protection and State Laws

In analyzing the level of term protection available in a particular jurisdiction, a number of issues must be considered. Some jurisdictions expressly limit the use of terms such as physical therapy, physiotherapy, physical therapist, and physiotherapist to those individuals who are licensed pursuant to the jurisdiction's physical therapy practice act. Conversely, other jurisdictions do not expressly protect the use of all of these terms, but rather they imply that the use of such terms is limited to use by a licensed physical therapist. For example, statutory language in a jurisdiction may provide that an individual cannot hold himself or herself out as practicing physical therapy unless licensed. This language arguably implies that the term "physical therapy" cannot be used by an individual who is not licensed as this would be holding themselves out to the public as practicing physical therapy. The jurisdictions also vary in their protection of physical therapy related abbreviations. Some jurisdictions protect the use of a broad list of designating abbreviations (eg, PT, DPT, RPT, LPT, and any other letters, words, or insignia indicating or implying that an individual is a physical therapist).

In addition to strictly protecting the use of the terms themselves, some jurisdictions also limit other related activities. For example, certain jurisdictions contain an expressed limitation on the ability of an individual or entity to bill for a service as "physical therapy" when it is not provided by or under the direction of a licensed physical therapist. As another example, a number of jurisdictions expressly prohibit advertising for the provision of physical therapy services where a physical therapist does not provide or supervise the care provided. When determining the strength of term protection afforded to physical therapy in a particular jurisdiction, consideration of the above issues should serve as a good starting point for such an analysis.

Term Protection Violations and Complaints

A primary complaint among the physical therapy profession is the advertisement of physical therapy and physiotherapy services to the public by individuals who are not licensed as physical therapists. Such advertisements are found in the yellow pages, print advertisements, clinic web pages, business cards, etc. The most common is an advertisement for a health care clinic owned and operated by someone who is not a licensed physical therapist who advertises physical therapy or physiotherapy, or uses the initials 'PT.'

If a violation of your state's term or title protection law is suspected, contact your state's physical therapy regulatory board to find out the specific laws and regulation in your states and how to file a complaint. View a directory of state licensure boards.