Physical therapist awareness of diagnostic imaging referral jurisdictional scope of practice: an observational study

J Man Manip Ther. 2024 Aug;32(4):435-445. doi: 10.1080/10669817.2023.2296260. Epub 2023 Dec 21.

Abstract

Objectives: To examine physical therapist awareness and utilization of imaging referral privileges in the United States (US) and how it relates to direct access frequency.

Methods: This study utilized survey data collected in 2020-2021 from US physical therapists. Subjects were asked about imaging referral jurisdictional authority in their state. Responses were analyzed for accuracy and compared to the level of jurisdictional authority and its impact on imaging referral. Analysis of imaging skills performance and imaging referral practices were compared to direct access frequency.

Results: Only 42.0% of physical therapists practicing in states that allow imaging referral were aware of this privilege. Those practicing where imaging referral was allowed via state legislation were significantly more likely (p < 0.01) to be aware of this privilege (71.4%) compared to those granted by the state board (25.2%). Those aware of their imaging referral scope were more likely (p < 0.01) to practice imaging referral (44.5%) compared to those who were unaware (3.2%). Direct access frequency was positively associated with imaging skill performance and imaging referral practice (p < 0.01). Doctors of Physical Therapy, residency/fellowship-trained physical therapists, and board-certified physical therapists all reported practicing greater frequency of direct access (p < 0.01).

Discussion/conclusion: There is a striking lack of awareness of imaging privileges among physical therapists as influenced by the level of jurisdictional scope. These results suggest that the lack of awareness may have a dampening effect on diagnostic imaging referrals. The American Physical Therapy Association should consider engaging with state boards to raise imaging privilege awareness.

Keywords: Diagnostic imaging; access to care; health legislation; health policy; procedures and techniques utilization; referral and consultation; scope of practice.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Clinical Competence
  • Diagnostic Imaging
  • Female
  • Humans
  • Male
  • Physical Therapists*
  • Referral and Consultation*
  • Scope of Practice*
  • Surveys and Questionnaires
  • United States

Grants and funding

No grant support was attained or utilized in regards to this manuscript. This manuscript was approved by the High Point University Institutional Review Board, Reference Number 202007-952. I affirm that I have no financial affiliation (including research funding) or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript, except as disclosed in an attachment and cited in the manuscript. Any other conflict of interest (i.e., personal associations or involvement as a director, officer, or expert witness) is also disclosed in an attachment. No funding was obtained to support this study.