Declaratory Statements - Non PT Tests

1. DME License - Eberhardt Physical Therapy is a licensed physical therapy clinic. We want to get a DME license to sell Alpha Stim J 00 units from our facility. Medicare would require we get a DME number. Before we do this we want to make sure that there is no conflict and that this is okay.

   The Board's opinion is that there is no conflict of interest for a PT Clinic to be licensed as a DME provider. However, please be advised that an evaluation of the patient must be completed by the physical therapist to determine precautions and contraindications as well as the instruction in the use of the prescribed equipment. Additionally, the APIA Guide for Professional Conduct, Principle 7 says:

   "A physical therapist shall seek only such remuneration as IS deserved and reasonable for physical therapy services"

   7.2 Endorsement of Products or Services

   A. A physical therapist shall not exert influence on individuals under his/her care or their families to use products or services based on the direct or indirect financial interest of the physical therapist in such products or services. Realizing that these individuals will normally rely on the physical therapist's advice, their vest interest must always be maintained, as must their right of free choice relating to the use of any product or service. Although it cannot be considered unethical for physical therapists to own or have a financial interest in the production, sale, or distribution of products/services, they must act in accordance with law and make full disclosure of their interest whenever individuals under their care use such products/services.

   B. A physical therapist may receive remunerating for endorsement or advertisement of products or services to the public, physical therapist, or other health professionals provided he/she discloses any financial interest in the production, sale or distribution of said products or services.

   C. When endorsing or advertising products or services, a physical therapist shall use sound professional judgment and shall not give the appearance of Association endorsement unless the Association has formally endorsed the products or services.

2. Finger Prick Test - An outpatient clinic offering physical therapy for babies, children and adults-specializing in children with developmental needs, is interested in broadening services to include group therapy for children 5-18 with both insulin dependency and non-insulin dependency diabetes. Group sessions would consist of three to five patients being lead by a registered physical therapist. The blood sugar level of a diabetic will tend to decrease while performing aerobic exercises. When a patient states that he or she is feeling signs and symptoms of hypoglycemia it is important to test their blood sugar level and administer appropriate sugar supplements. The question is - As a physical therapist is it within our scope of practice to perform a finger prick test on pediatric patients with diabetes who are unable to do so for themselves?

   The Board is mandated by law to insure the safety, health and welfare of the consuming public receiving physical therapy services. The Board is of the opinion that a finger prick test under the circumstances explained is appropriate for you to perform if you have competency in such procedure. This is an appropriate monitoring tool for your diabetic patient.

3. Glucometer Checks - Can a physical therapist perform glucometer checks on patients who are Insulin dependent, as part of the safety precautions for a Diabetic Exercise class?

   The Board is of the opinion that a physical therapist may perform a glucometer check on a diabetic patient if the therapist has demonstrated and documented competency in this procedure. The Board considers this an appropriate monitoring tool for your diabetic patient. The Board recommends that you consult your facilities legal counsel for advice regarding potential legal complications.

4. Glucometer Testing - Can physical therapists performing glucometer checks on patients who are Insulin dependant, as part of the safety precautions for a Diabetic Exercise class?

   The Board is of the opinion that a physical therapist may perform a glucometer check on a diabetic patient if the therapist has demonstrated and documented competency in this procedure and the Board considers this an appropriate monitoring tool for your diabetic patient.

5. Staples/Stitches - In homecare are physical therapists able to pull staples or stitches?

   Pursuant to the Physical Therapy Practice Act, LSA R.S. 37:2401 et seq., and the Board?s Rules, it is within the scope of practice of physical therapy for a physical therapist to pull staples or stitches. A physical therapist may perform an initial evaluation or consultation to determine need for physical therapy and to establish a physical therapy treatment plan, however, the implementation of physical therapy treatment to a patient for his specific condition shall be based on the prescription or referral of the appropriate licensed healthcare provider. Therefore, the removal of staples and/or stitches by a physical therapist can be done pursuant to a prescription or referral from a person licensed to practice medicine, surgery, dentistry or podiatry.

6. Taking of Blood Pressure - Is it part of the scope of services of a PT to take a patient's blood pressure prior to and as needed during therapy?

   The Board has carefully reviewed your letter and is of the opinion that it is within the scope of the practice of PT for the patient's blood pressure to be taken prior to and as needed during the provision of physical therapy services. Furthermore, the taking of a patient's blood pressure and pulse rate are standard and appropriate monitoring tools of the patient's status throughout the treatment session.