Clinical Reasoning and Advanced Practice Privileges Enable Physical Therapist Point-of-Care Decisions in the Military Health Care System: 3 Clinical Cases

Rhon, Daniel I.; Deyle, Gail D.; Gill, Norman W.

doi:10.2522/ptj.20120148

Cited by 12 publications

(2 citation statements)

References 53 publications

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“…the United Kingdom, USA, Canada) [25, 111–113], but this can vary within countries (e.g. more in the military sector within the USA) [33, 114]. The same inter- and intra-national variability exists within educational requirements for licensure: 3-year clinical doctorates are increasingly required for PTs/OTs in the USA, but PTs/OTs can work with lower credentials [25, 115].…”

Section: Resultsmentioning

confidence: 99%

Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

et al. 2017

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BackgroundPeople with disabilities face challenges accessing basic rehabilitation health care. In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) outlined the global necessity to meet the rehabilitation needs of people with disabilities, but this goal is often challenged by the undersupply and inequitable distribution of rehabilitation workers. While the aggregate study and monitoring of the physical rehabilitation workforce has been mostly ignored by researchers or policy-makers, this paper aims to present the ‘challenges and opportunities’ for guiding further long-term research and policies on developing the relatively neglected, highly heterogeneous physical rehabilitation workforce.MethodsThe challenges were identified through a two-phased investigation. Phase 1: critical review of the rehabilitation workforce literature, organized by the availability, accessibility, acceptability and quality (AAAQ) framework. Phase 2: integrate reviewed data into a SWOT framework to identify the strengths and opportunities to be maximized and the weaknesses and threats to be overcome.ResultsThe critical review and SWOT analysis have identified the following global situation: (i) needs-based shortages and lack of access to rehabilitation workers, particularly in lower income countries and in rural/remote areas; (ii) deficiencies in the data sources and monitoring structures; and (iii) few exemplary innovations, of both national and international scope, that may help reduce supply-side shortages in underserved areas.DiscussionBased on the results, we have prioritized the following ‘Six Rehab-Workforce Challenges’: (1) monitoring supply requirements: accounting for rehabilitation needs and demand; (2) supply data sources: the need for structural improvements; (3) ensuring the study of a whole rehabilitation workforce (i.e. not focused on single professions), including across service levels; (4) staffing underserved locations: the rising of education, attractiveness and tele-service; (5) adapt policy options to different contexts (e.g. rural vs urban), even within a country; and (6) develop international solutions, within an interdependent world.ConclusionsConcrete examples of feasible local, global and research action toward meeting the Six Rehab-Workforce Challenges are provided. Altogether, these may help advance a policy and research agenda for ensuring that an adequate rehabilitation workforce can meet the current and future rehabilitation health needs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-017-0182-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

et al. 2017

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“…The diagnostic success and cost-efficiency of this practice is well documented. [7][8][9] Rhon et al 10 and others [11][12][13][14] have detailed patient examples from deployed and medical centrebased MHS settings of how physical therapists use these clinical privileges for clinical efficiency and diagnostic accuracy. The purpose of this article is to describe the clinical diagnostic reasoning and use of musculoskeletal imaging by a physical therapist as part of the physical therapy management of a patient with a history of neurofibromatosis.…”

Section: Introductionmentioning

confidence: 99%

Imaging in conjunction with physical therapy in management of a patient with history of thoracic tumour

Rendeiro¹,

Deyle²,

Boissonnault

2015

Journal of Manual & Manipulative Therapy

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Background: Physical therapy care for musculoskeletal conditions includes an ongoing process that systematically considers and prioritises diagnostic hypotheses. These diagnostic hypotheses include those that are typical for common musculoskeletal conditions, and must also include more rare conditions that would require care outside the scope of practice of the physical therapist. When additional screening is required, physical therapists collaborate with other providers or directly order the appropriate tests to rule out suspected pathology. Case Description: This article illustrates the use of musculoskeletal imaging ordered by a physical therapist to guide ongoing management of a patient with back pain and a history of cancer. Outcomes: The patient successfully returned to moderate-intensity sport activities after a course of physical therapy. Discussion: This case provides an example of how clinical diagnostic reasoning combined with clinical privileges to order musculoskeletal imaging can facilitate diagnostic accuracy in a timely and cost-efficient manner.

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Severity, Irritability, Nature, Stage, and Stability (SINSS): A clinical perspective

Petersen

Thurmond

Jensen

2021

Journal of Manual & Manipulative Therapy

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Clinical Reasoning and Advanced Practice Privileges Enable Physical Therapist Point-of-Care Decisions in the Military Health Care System: 3 Clinical Cases

Abstract: Physical therapists can provide important contributions to the primary management of patients with musculoskeletal conditions in a variety of settings within the MHS. In the cases described, advanced clinical privileges contributed to the success in this role.

Cited by 12 publications

References 53 publications

Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

Imaging in conjunction with physical therapy in management of a patient with history of thoracic tumour

Severity, Irritability, Nature, Stage, and Stability (SINSS): A clinical perspective

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