Perceived Concerns Surrounding the Utilization of Physical Therapy Aides in Michigan

Utilization of support personnel to perform physical therapy treatments has been a controversial topic in the physical therapy profession for many years. As Managed Care and other health care changes emerged, physical therapists have been pressured to cut costs while maintaining productivity. The use of non-licensed personnel became common place to meet these demands. The purpose of this study was to investigate five research questions. First, to what extent do physical therapists delegate patient treatment and utilize physical therapy aides in Michigan? Secondly, does aide utilization differ based on: the ways in which aides are identified to patients, various settings of practice and the percent of traditionally insured patients versus managed care patients? Thirdly, to what extent are physical therapists faced with perceived concerns with aide utilization? Three hundred and thirty physical therapists that are members of the M.P.T.A. were systematically mailed surveys according to zip codes. One hundred and sixty-four therapists responded to the survey. The data were analyzed using SPSS 8.0 program, version. Results were analyzed using both Chi-square and Fisher Exact tests for cross-tabulations, as well as descriptive research techniques. Physical therapists delegated all eight of the surveyed treatment tasks. Exercise with equipment was delegated the most with 79 respondents delegating this task, and wound debridement was delegated the least by six responding physical therapists. There were no significant findings pertaining to aide utilization and methods of aide identification. However, descriptive analysis of data was conclusive in that physical therapists who responded to our survey were identifying physical therapy aides according to A.P.T.A. guidelines. Delegation to aides was more likely to occur when therapists treated greater than fifty percent Managed Care patients as compared to therapists that treated less than fifty percent Managed Care patients. Statistically significant results occurred in the Managed Care category with the delegation of exercise with equipment and electrical stimulation treatments. With regard to perceived concerns, ultrasound was the only patient treatment that showed statistical significance. Physical therapists that had perceived concerns with delegation of ultrasound were less likely to delegate than therapists without concerns. Other important relationships emerged through descriptive research