Physical therapy musculoskeletal imaging authority: A survey of the World Confederation for Physical Therapy Nations

Abstract

Objectives Medical evidence largely supports PTs in expanded roles, however, healthcare policy within the United States (USA) typically restricts PTs from ordering musculoskeletal (MSK) imaging. It is unknown how MSK imaging policy in the USA compares to other World Confederation for Physical Therapy (WCPT) member nations. The primary objective of our study was to investigate the authority of PTs to order MSK imaging. A secondary objective was to identify factors associated with the authority for PTs to order MSK imaging. Methods 111 WCPT member nations were surveyed over a 2‐month period on the authority of PTs ordering MSK imaging within their nation. A secondary analysis utilizing a step‐wise binary regression compared member nation demographic statistics to MSK imaging authority. Results 81 member nations responded to the survey. 31 (38.3%) of member nations reported having some level of PT MSK imaging authority while 50 (61.7%) did not. Member nations with lower per capita healthcare costs were significantly more likely to allow PTs to order MSK imaging (p = 0.02). Those with direct access authority were 7.4 times more likely to authorize PTs to order MSK imaging (p < 0.01). Entry‐level clinical degree and years of entry‐level collegiate credit were not associated with imaging authority. Conclusion This is the first study to report MSK imaging policy within the WCPT member nations. While many nations within the WCPT allow PTs to order MSK imaging, the majority of nations still restrict PTs from such practice. Lower per capita healthcare costs and direct access authority were significant predictors of MSK imaging authority, however, causation cannot be established within the confines of this study. Future studies should consider issues such as restrictive policy origin (i.e. governmental vs. institutional), insurance reimbursement (i.e. private vs. public sector policy), and limitations on imaging modality

Musculoskeletal imaging authority, levels of training, attitude, competence, and utilisation among clinical physiotherapists in Nigeria: a cross-sectional survey

“…Approximately 80% of the participants reported that they have musculoskeletal imaging referral rights. Mabry et al [ 6 ] examined physiotherapists’ MI authority in 81 countries (WCPT member nations); only one-third of the countries had affirmative policies. Among the countries were African nations such as Ethiopia and Zambia with full MI authority.…”

“…Among the countries were African nations such as Ethiopia and Zambia with full MI authority. Others were Benin, Ghana, Swaziland, Malawi, South Africa, Rwanda, Tanzania, and Zimbabwe with partial authority covering mostly, the use of plain X-ray and MRI [ 6 ]. Although the majority of the participants reported having MI authority in their practice settings, the MRTB (Physiotherapy Practice) Act 2004 neither affirmed nor restricted Nigerian physiotherapists from MI referral [ 13 ].…”

“…Physiotherapists’ MI authority varies across countries and practice settings [ 4 , 8 ]. A preliminary survey of physiotherapy MI authorities across the WCPT member nations [ 6 ] did not include Nigeria, the authors reported that they were unable to access reliable information from the omitted countries. Knowing the status of physiotherapists’ MI training and authority in Nigeria is an important baseline ahead of the implementation of the newly approved Doctor of Physiotherapy (DPT) curriculum by the National Universities Commission, and the concomitant pursuit of the Practice Act amendment [ 9 ].…”

Elements of Learning and Integration of Diagnostic Musculoskeletal Ultrasound Imaging Into Practice: Physical Therapists' Educational Journeys

“…Research is needed to understand how experienced clinicians use MSK-US, which will bridge gaps related to the scope of practice and MSK-US specialized education needs. 16,32 The development of clinical reasoning skills is essential for physical therapy practice. Yet, limited information exists about the distinct knowledge, skills, and professional behaviors used in applying MSK-US for patient care and how to develop these skills in students and practicing PTs.…”

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“…Traditional pathways can comparably delay care by one year [1]. Many physical therapists within the United States of America are restricted from referring patients directly to a radiologist by their respective state practice acts or state physical therapy board rules [2]. However, when physical therapists are authorized to refer for imaging, they do so appropriately [3,4], accurately [5], and without harm to patients [6].…”