Diagnosing pathology to decide the appropriateness of physical therapy: what’s our role?

The Guide to Physical Therapist Practice affirms that physical therapists should determine the appropriateness of physical therapy to address a patient\u27s disablement. The decision facing all therapists—during the initial evaluation and every subsequent clinic visit—is whether to treat the patient, refer the patient, or initiate both treatment and referral. This decision is based on whether the patient\u27s clinical presentation is consistent with symptoms and signs of pathology that seem amenable to physical therapy. At minimum, deciding the appropriateness of physical therapy takes confirmation of the pathology suggested in a physician\u27s referral diagnosis, if present. However, anecdotal evidence suggests that more extensive questioning, clinical testing, and referral to other specialists frequently are needed