The American Physical Therapy Association (APTA) is aware that, in the current health care environment, physical therapy professionals are finding new ways to market their services, including opportunities within the veterinary industry. What is important from a risk management perspective is that physical therapists research and understand what they can and cannot do before entering new areas of practice, and what constitutes the provision of a professional service versus the provision of a more general veterinary related service.

While there is no question that physical therapists have knowledge and skills that can be appropriately applied in the veterinary arena, the reality is that this is still a very gray area. The APTA and the AVMA both allow for collaborative relationships between physical therapists and veterinarians; however, at this time, most states do not yet recognize this type of practice as falling within the scope of practice for physical therapists. For this reason, before starting to work with animals in any professional capacity, physical therapists should be certain that they are acting in compliance with both the physical therapy and veterinary practice acts in the state(s) in which they are licensed. They should also consider carefully whether or not their scope of personal competence is compatible with the type of services they will provide.

Most physical therapy professional liability policies, including the one endorsed by APTA and administered by Healthcare Providers Service Organization (HPSO), are designed to cover a physical therapist for medical incidents that arise from the performance of professional services falling within the scope of the physical therapist’s state practice act. State practice acts are designed to protect the public. They define what falls within the scope of practice of physical therapy, and, in some instances, they specifically identify procedures that are considered to be outside the scope of practice. If a practice act does not specifically mention a particular activity, it may be appropriate for a physical therapist to engage in it, if it is ordinarily considered to be a part of physical therapy and if some other state law does not prohibit physical therapists from performing the activity.

With this in mind, the Animal Physical Therapist Special Interest Group has created a liaison program to assist members.  In almost all states, a liaison, who has obtained a copy of their state’s physical therapy practice act and veterinary practice act, is available with the goal of producing a resource directory for therapists who are interested in working with animals.   To find out who your state liaison is, contact the national liaison coordinator, Siri Hamilton, PT, LVT, at 865-974-2993. Individuals are able to contact the appropriate state licensure boards for physical therapy and veterinary medicine themselves, however, contact with the national and/or state liaison should be more efficient.

In the meantime, individuals can contact the appropriate state licensure boards for physical therapy and veterinary medicine themselves. The APTA has these on line at http://www.apta.org/Govt_Affairs/state/state_practice.  Following are suggestions to assist you with your review of the physical therapy practice act. Remember, it is important not to assume. Be sure to request clear answers to any questions you may have.

• If the act does include language that limits practice to humans, by using terminology such as humans, people or persons, then practicing on animals would be a risky professional choice – unless the physical therapist is also a licensed veterinarian or licensed veterinary technician. Use of terminology such as clients or patients would not necessarily exclude practice on animals, but the therapist should check with the licensure board to be sure.

• If the activities are covered, or are not mentioned at all, but are within the scope of physical therapist practice as defined by the Guide to Physical Therapist Practice, you should be able to obtain coverage under a physical therapist professional liability policy for these activities.

• If, after reading the practice act, it is still unclear whether or not the activities are covered, contact either the state licensure board for written clarification, or consult with a local attorney for a legal opinion.

• If the activities are specifically excluded in the practice act, it is unlikely that a physical therapy professional liability policy will offer protection to the physical therapist should an incident arise while performing the activities.

Another issue to be mindful of is that of access. From the PT point-of-view, the issue is whether or not a referral is required prior to evaluation or treatment. In many states that require a referral, the providers that can refer to physical therapy are listed in the practice act. If veterinarians are not listed as acceptable referral sources in the practice act, then a referral from a veterinarian would not satisfy the referral requirement. From the veterinarian point-of-view, the issue is whether or not a therapist can evaluate or treat an animal without the supervision of a veterinarian. The bottom line is that therapists who work with animals need to be mindful that they are intersecting with another professional domain and, at a minimum, should always take the step of consulting with a veterinarian before commencing with treatment.

Finally, it is also important to note that incidents involving practice on animals most likely are not going to be covered by a physical therapy professional liability policy, unless there has been a direct physical therapist/patient relationship. In order for an interaction to be considered part of a physical therapist/patient relationship, there is usually a level of evaluation and documentation that is performed and recorded by the physical therapist. Since there is usually a third party - such as an owner - involved in any interaction with an animal, physical therapists should contact their insurance carrier to determine how/if their coverage would handle third party claims and to find out whether or not they might need additional types of coverage. One potential source for alternative coverage may be your local Veterinary Professional Association. To find out about veterinary resources both nationally and in your area, you can visit the American Veterinary Medical Association Web site at www.avma.org.

How to find out more:

• For general information about animal physical therapy, you can contact the Animal Physical Therapist Special Interest Group by calling the Orthopaedic Section of the APTA at 800/444-3982, or visiting http://www.orthopt.org/sigs/animal_pt_sig/. In addition, there is the Animal Physical Therapy Resource Manual by Lin McGonagle, PT, MS that contains valuable information and a variety of helpful references. This manual is not available through APTA, because it is an independently written and produced resource. To obtain a copy, e-mail Ms. McGonagle at lin@envisage1.com.

• To address specific issues related to animal physical therapy, please contact David Levine, PT, PhD at 423-755-5240, or David-Levine@utc.edu