As state lawmakers weigh ideas to aid New York's struggling health care workforce, physical therapists across the state want the Legislature to consider their solution to ease the burden — though it will be a tall order to convince policymakers before session ends in five weeks.
Members of the state chapter of the American Physical Therapy Association met with state lawmakers about legislation last week that pertain to physical therapy care. At the top of their list is a bill to end restrictions on how long they can treat a patient without a referral.
“We believe it’s time for our professionals to work at the top of their license,” American Physical Therapy Association N.Y. President Michael Tisbe said.
New York physical therapists with fewer than three years' experience can only treat patients for 10 visits, or 30 days, without a referral.
Members of the state chapter of the American Physical Therapy Association lobbied met with several lawmakers last week pushing for them to advance the bill before session ends June 6.
Tisbe said it will allow New Yorkers access to PT care they need without waiting for a referral, which will reduce invasive surgeries, the use of addictive painkillers and overall health costs.
"Given the fact that there's less and less primary care physicians that are coming out of school that are working in New York state, we're looking to really help be the triage, be an entry-level profession and really to help refer to those specialists the appropriate number of patients they should be seeing," Tisbe said.
Tisbe argues PT degree programs are at the doctoral level, and new therapists are more than equipped to treat injuries and reduce patient loads in doctor's offices and emergency rooms.
Physical therapists have pushed to scale back the state education law requirement for over a decade.
"There's no good reasons why there should be limitations on direct access," said Marcia Spoto, a physical therapist and chair of APTA's Public Policy Committee. "We've had direct access since 2006."
Spoto said insurance companies currently curtail PT visits, which in turn prolongs a patient's care.
"It's in no interest to extend care beyond what's needed," Spoto said. "The sooner they get in to see us, the better. Movement impacts all aspects of health. There's a lot of good reasons to get people moving."
But several health organizations continue to lobby against the bill, including the Medical Society of the State of New York and the state Society of Orthopaedic Surgeons.
They argue the 10 visits or 30 days for evaluation mandated under state law does not inhibit patient access to physical therapy care and provides an adequate time for treatment response.
“If enacted, this legislation will fragment the coordinated team approach, increase the time for treatment and definitive diagnosis which may result in increased costs and negatively impact patient safety," according to a memo from the society against the legislation. "Physical therapy is very important, and it should be done in collaboration with a physician.”
MSSNY on Monday referred to the society's memo and will continue to fight back against the legislation.
Several lawmakers also share the health experts' concerns, which has kept the bill stalled in the Higher Education committees in both chambers. Many pieces of legislation to alter the scoper of practice for various health specialists have stalled in the committee over concerns of weakening health standards and impact on the quality of care.
"We review all legislation related to professional scope of practice that comes before the Higher Education Committee," committee chair Assemblywoman Pat Fahy said in a statement. "At a time when New York is experiencing shortages in a number of health care-related fields and professions, it is vital we continue working to find shared solutions that maintain critical standards while ensuring New Yorkers' access to health care."
But other lawmakers support the measure. Assemblyman John McDonald III has been a pharmacist for decades and said he'll vote for the bill if it's brought to the floor for a vote.
Fifteen years ago, McDonald got a torn meniscus while campaigning before an election. Eight weeks of physical therapy allowed him to completely evade surgery — and any use of addictive painkillers.
"It worked like a charm," the assemblyman recalled Monday. "And quite frankly, it reminded me of how the body works, how the body moves."
McDonald agreed the change could help cut down on the number of New Yorkers who struggle with chronic long-term opiate use, but said he does not see the policy preventing overdose-related deaths. He added while he supports the legislation, it is not a substitute for critical support for resources that assist people with substance abuse disorders.
Lawmakers who sponsor the bill have work to do to change the minds of their Higher Education Committee colleagues before June, but McDonald argued it's important for the Legislature remove barriers for people to access the health care they need.
"We've done a very good job of building silos — we need to stop," he said. "If we want our health care system to work, we need to get rid of the silos. We need to build on collaboration."