Taylor T K, Domholdt E
Indiana Center for Rehabilitation Medicine Inc, Indianapolis 46254.
Phys Ther. 1991 May;71(5):382-9. doi: 10.1093/ptj/71.5.382.
The purpose of this study was to examine process and content issues related to legislative change to permit direct access to physical therapy services. Data sources were survey questionnaires sent to the presidents of the 52 chapters of the American Physical Therapy Association (APTA), APTA publications, state statutes, and personal contacts. Results were based on the experiences of 35 chapters, 17 in direct-access states and 18 in non-direct-access states. The majority of direct-access states obtained their status in a single legislative campaign; the majority of non-direct-access jurisdictions attempting legislative change have been unsuccessful for 2 or more years. Over 80% of the chapters reported using legislative lobbyists. Opposing forces varied from state to state and included hospital and medical associations, physicians, chiropractors, and physical therapists. The following limitations on practice in a direct-access mode are found in the various practice acts: diagnosis requirements, eventual referral requirements, physical therapist qualifications, patient consent requirements, and practice setting restrictions.
本研究的目的是探讨与立法变革相关的过程和内容问题，该变革允许直接获得物理治疗服务。数据来源包括发送给美国物理治疗协会（APTA）52个分会会长的调查问卷、APTA出版物、州法规以及个人联系。结果基于35个分会的经验，其中17个分会位于直接准入州，18个分会位于非直接准入州。大多数直接准入州是在一次立法活动中获得其地位的；大多数试图进行立法变革的非直接准入司法管辖区在两年或更长时间内都未成功。超过80%的分会报告使用了立法游说者。反对力量因州而异，包括医院和医学协会、医生、脊椎按摩师和物理治疗师。在各种执业法案中发现了以下直接准入模式下的执业限制：诊断要求、最终转诊要求、物理治疗师资格、患者同意要求和执业环境限制。
