What should be the scope of knowledge of doctors regarding the practice of physical therapists (PTs) in the Philippines?

Knowledge of Doctors on the Scope of Practice of Physical Therapists in the Philippines

Doctors in the Philippines should have comprehensive knowledge of physical therapists' scope of practice to facilitate effective interprofessional collaboration, which is essential for improving patient outcomes through team-based care approaches.

Core Knowledge Requirements for Physicians

Understanding Physical Therapists' Training and Expertise

• Physicians should recognize that physical therapists are trained to conduct exercise tests, promote physical activity, and prescribe exercise to patients with complex comorbid conditions and a range of physical impairments and disabilities 1
• Doctors should understand that physical therapists need to be proactive in addressing physical activity assessment and promotion with their patients, including educating the public on the role of physical therapists in managing cardiovascular disease and other non-communicable diseases through exercise 1

Recognition of Physical Therapists' Role in Multidisciplinary Care

• Physicians should acknowledge that physical therapists are essential members of healthcare teams addressing the global crisis of non-communicable diseases using team-based and patient-centered approaches for lifestyle management 1
• Doctors should be aware that physical therapists are among the healthcare professionals who should deliver physical activity interventions to patients with inflammatory arthritis and osteoarthritis 1

Awareness of Current Practice Limitations in the Philippines

• Physicians should understand that Filipino physical therapists have traditionally worked under a prescription-based referral system that has limited their clinical reasoning and autonomy in practice 2
• Doctors should recognize that physical therapists in the Philippines face challenges in implementing evidence-based practice due to lack of time, resources, skills, access to research literature, supporting administrative policies, and authority in decision making 3

Communication and Collaboration

Effective Referral Practices

• Physicians should implement standardized information checklists when referring patients to physical therapists to ensure all essential information is accurately provided 4
• Doctors should develop formal processes for communication during key transition points in care, such as initial referral, treatment phase, and guidance phase 4

Shared Decision-Making

• Physicians should adopt patient-centered communication approaches that are "respectful of, and responsive to, individual patient preferences, needs and values" when collaborating with physical therapists 4
• Doctors should establish clear protocols for urgent communication when immediate physician input is needed for physical therapy care 4

Specific Clinical Domains

Physical Activity Promotion

• Physicians should understand that exercise is "one of the most important and effective interventions physical therapists can incorporate into every patient plan of care to promote health and wellness" 1
• Doctors should work collaboratively with physical therapists to select methods for physical activity assessment that best fit their clinical setting to allow meaningful, longitudinal follow-up 1

Rehabilitation Services

• Physicians should recognize that physical therapists focus on the "skills of living" necessary for independent and satisfying living, including customized treatment programs, comprehensive evaluations, performance skills assessment, adaptive equipment recommendations, and family education 1
• Doctors should understand that physical therapists are experts in examining and treating neuromuscular problems that affect individuals' abilities to move and practice in many settings with all age groups 1

Educational and Professional Development Needs

Evidence-Based Practice

• Physicians should be aware that many physical therapy faculties across the Philippines are incorporating evidence-based practice content in teaching, though there remains arbitrary and fragmented coverage of content 5
• Doctors should support effective "educating the educators" strategies for physical therapists, which can have far-reaching positive repercussions on evidence-based practice uptake in physical therapist practice 5

Interprofessional Education

• Physicians should participate in communication skills training programs that focus on interdisciplinary collaboration with physical therapists 4
• Doctors should support the development of EBP training programs for Filipino physical therapists to improve their capacity to engage with referring doctors to determine the most effective treatments for patients 6, 7

Common Pitfalls and Challenges

• Physicians should avoid perpetuating the traditional hierarchical relationship where physical therapists "by tradition and historical practice, take direction from a doctor, on treatment options" 6
• Doctors should recognize that lack of autonomy in decision-making challenges physical therapists' capacity to deliver evidence-based care 6, 2
• Physicians should implement efficient communication protocols that respect the limited time of both physical therapists and physicians 4
• Doctors should establish accountability measures to ensure communication protocols with physical therapists are consistently followed 4