Referrals

[Kaci Hayworth]

I have been a little confused when taking practice questions regarding who to refer patients to when you are suspecting a neuromuscular cause or a developmental delay. I practice in Texas and I am not able to directly refer my patients to specialty doctors such as geneticists, neurologists, neuromuscular specialists, or developmental specialists. I also cannot refer to an orthotist. I typically call my patient’s pediatrician to inform them of my concerns and then they will make referrals to specialists if warranted.

Are physical therapists able to refer patients straight to a specialist in other states? This really messed me up on a few questions that asked who to refer the patient to based on clinical presentation and symptoms. I was just trying to figure out what the PCS exam would likely expect when answering these questions.

[Helen Carey]

Hi Kaci,
This is a great discussion topic. I would suspect that in most states, PTs would need to go through the child’s PCP or another specialist involved in the child’s care. For the purpose of exam questions, I would interpret a referral question less literally, such as who the child would benefit from seeing for a consult, and not literally that you would make the referral. The exception would be a question asking directly about the PT’s scope of care and legal requirements. In our practice questions, we are probing to see if you understand clinical characteristics that indicate a specific diagnosis/condition/clinical problem needing further examination by another professional. Being able to determine when a patient’s problem is beyond the scope of a PTs knowledge and competence for care is an important clinical practice competency. We teach it in DPT education, it is a part of the new Competency Based Education framework, and is included in Direct Access legislation in many states (and also practice acts). I hope this helps!
Helen

[Helen Carey]

Also, the PCS exam shouldn’t ask questions where their is distinct variability across states, such as specific components of EI eligibility that vary from state to state. It would seem impossible to have a correct answer.

[Helen Carey]

Sorry for the typo: “…where there is distinct variability…”

[Kaci Hayworth]

Great, thank you!

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