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Content of Physician Referrals to Physical Therapists at Clinical Education Sites in Indiana

AL Clawson, PT, was Assistant Professor, Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN 46227, at the time this study was conducted.
E Domholdt, EdD, PT, is Associate Professor and Dean, Krannert School of Physical Therapy.

Background and Purpose. The content of physician referrals to physical therapists was studied as an indicator of the level of decision making required of physical therapists. Subjects and Methods. Seventeen managers of clinical education sites in Indiana provided diagnosis and treatment information on a total of 2,267 patient referrals. Results. Differential diagnoses were specified in 39.6% of the referrals, and specific treatment orders were present in 32.6% of the referrals. Outpatient referrals contained significantly fewer diagnoses (29.1%) and specific orders (28.2%) than did inpatient referrals (56.0% and 39.5%, respectively). Conclusion and Discussion. These results indicate that physical therapists working in clinical education sites in Indiana must frequently exercise independent decision-making skills in determining the nature of the patient complaint and the appropriate treatment for the complaint. Academic programs that choose to expose students to a full range of decision-making situations should ensure a balance between inpatient and outpatient experiences.

Key Words: Autonomy • Differential medical diagnosis • Physician referrals • Professional issues • Treatment orders

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