HOUSE BILL REPORT

ESSB 6218

As Amended by the House

BYSenate Committee on Health Care & Corrections (originally sponsored by Senators McCaslin, Bauer, Johnson, Conner and Benitz)

Revising certain provisions regulating the practice of physical therapy.

House Committe on Health Care

Majority Report:  Do pass with amendment.  (7)

      Signed by Representatives Braddock, Chair; Bumgarner, Cantwell, Lewis, Lux, Sprenkle and Vekich.

House Staff:John Welsh (786-7133)

AS PASSED HOUSE MARCH 2, 1988

BACKGROUND:

Currently, physical therapists are required to consult with an authorized health care practitioner prior to providing treatment to a patient.  Physical therapists are licensed under Chapter 18.74 RCW to provide treatment of any bodily or mental condition by the use of physical, chemical, and other properties of heat, cold, air, light, water, electricity, sound, massage and therapeutic exercise.  Health care practitioners authorized to serve as consultants include physicians and osteopaths, chiropractors, podiatrists and dentists.

In its 1985 review of the physical therapy practice act, the State Health Coordinating Council (SHCC) recommended the consultation requirement be eliminated.  The SHCC concluded there was no risk to public safety and the consultation requirement served only as a barrier to appropriate and timely care.

SUMMARY:

The requirement of consultation by an authorized health care practitioner is removed for the treatment of neuromuscular and musculoskeletal conditions by physical therapists. Certain orthoses treatment may only be provided after referral or consultation from an authorized health care practitioner.

Physical therapists must refer patients they have cause to believe have conditions beyond their scope and practice.  Failure to make appropriate referrals is a violation of the Uniform Disciplinary Act (Chapter 18.130 RCW).

Physical therapists may not use or advertise the use of spinal manipulation or manipulative mobilization of the spine and its immediate articulations.  Violation of this provision is considered unprofessional conduct and violators are subject to discipline under the Uniform Disciplinary Act, RCW 18.130.

Third party payers and state agencies are not restricted from limiting utilization of physical therapy services through gate-keepers.

The act terminates on June 30, 1991, subject to reauthorization by the legislature after a report by the Legislative Budget Committee by January 1, 1991.

Fiscal Note:      Available.

House Committee ‑ Testified For:    Patricia Muchmore, Washington State Physical Therapy Association; Mark Lane, Washington State Physical Therapy Association; Luci Phillips, Washington State Health Coordinating Council; Jill Floberg.

House Committee - Testified Against:      Mike Ryherd, Washington State Medical Association.

House Committee - Testimony For:    Physical therapists are qualified to diagnose and treat simple pathologies within the limited scope of their practice.  A patient does not need to see a physician first in all cases.  Appropriate referral to other health practitioners is required where the pathologies are beyond their competence.  This will save health care costs.

House Committee - Testimony Against:      Physical therapists should remain under the general direction of physicians because of their inability to properly diagnose medical conditions.  The physician does not necessarily want to practice physical therapy, and makes referrals to physical therapists where appropriate.  But patients should see a physician first.