PT Diagnosis

[Guest guest]

I remember back in the 80's & 90's out patient orthopedic PT's, were concerned

with the question whether we could " diagnose " a patient. I fell into the camp

of making a diagnosis from a good evaluation and treating from that point.

This week at our clinical collaborative roundtable meeting we were reviewing an

article by Jerome Groopman, M.D. regarding heuristic errors in thinking

http://www.jeromegroopman.com/articles/whats-the-trouble.html.. It is a great

article and it created a lot of good discussion.

Via this, I found out that a good portion of my more senior staff felt strongly

about NOT making a diagnosis with their patients. They tended to have been

trained in the 70's or 80's and have practiced most of their career at the same

place. They felt that it was not their place to contradict what a physician

wrote, despite having a different opinion on a patient.

So often we get " back pain, " " knee pain " or a misdiagnosis ( " radiculopathy " vs.

hip bursitis) from a physician's (or, NP or PA's) prescription.

I believe that we need to stick our necks out and state our position with a well

thought out diagnosis on our plan of care. This of course it needs to be within

our scope of practice. Some of my staff opposes this, stating that we are not

MD's and we can only state our feelings in our assessment.

My questions is: What is the role of the PT in defining a diagnosis on a

patient? The APTA's Mission statement states that we are " to further the

profession's role in the prevention, diagnosis, and treatment of movement

dysfunctions. " Yet these staff members are not convinced. I cannot find any

recent clarification on the APTA website, nor anything in an article search.

Is there anything out there that defines our role in diagnosing a patient?

Does anyone have a strong opinion to support or refute their views?

von Lossnitzer, PT

Manager of Sports Medicine and Rehabilitation

Jaques Hospital

Newburyport, Massachusetts