Can Chiropractors Advertise PT? This State Association Didn’t Think So!

07-12-15 Justin Dunaway 0 comment

People often question the value of an APTA membership. Is it worth the $400+ a year? Where does my money go? What do I get? While on the surface it feels like an expensive journal subscription, access to a difficult to navigate website, and discounts on online con ed and conferences, the value of the APTA goes much deeper.

On the national level, the APTA advocates for both patient and profession, drives legislation, funds research, and tells the world who we are and what we do. But your national dues also fund your state chapters; and while these chapters provide a wide variety of services, I believe that their work surrounding legislation and advocacy is of utmost importance. Every day your state chapter is working to protect and advance your scope. The following is just one of the many examples of a state association chapter working diligently to protect physical therapy, for all physical therapists, not just members.

In January, the Arizona Physical Therapy Association (AzPTA) received an email from one of our members. He was very frustrated with both the PT and Chiropractic state licensing boards’ response to a complaint he filed over a chiropractor’s use of the term ‘Physical Therapy’ on the window of their clinic.

The long version, complete with statute details, is below. In the short, what happened was this: the Chiropractic Licensing Board believed that the regulations protecting use of the term “Physical Therapy/Physiotherapy” were unenforceable or, in some cases, not applicable. The Physical Therapy Licensing Board did not believe they had the authority to pursue this avenue any further, and the member was left with the knowledge that his assertions were correct, but without the power to change things.

After receiving this email and assessing the situation, the AzPTA stepped in as an important resource in this fight. The AzPTA met with the PT Licensing Board, established the appropriate next steps, and officially requested an opinion of the attorney general regarding this issue.

After several months of waiting, the Attorney General, who has the authority to interpret laws and issue opinions on their meaning, released his opinion in favor of the AzPTA, assuring that the right to use the term “Physical Therapy” is one that only PTs hold.

Term and title protection is a very important issue in physical therapy and the AzPTA worked diligently to do everything in their power to make a difference, not just for this one member or the many PTs that filed complaints, but to protect PT and, more importantly, the general public. It’s stories like this that show the true value of membership in the APTA. For these reasons, I am and always will be a member of the APTA.

I encourage all PTs and PTAs (members and non-member) to reach out to your chapter to find out what’s happening in your state. Be aware of the things the association is doing and has done. Understand some of the core values of the APTA. Most importantly, I encourage all PTs and PTAs to join the APTA. Your membership and your voice are the fuel that feeds this value, protects our scope, drives change in our profession, and ultimately enhances our ability to care for the public.

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Long version commence! Below begins the specific statute that protects the use of terminology that implies PT services. We pick up as the AzPTA has just received a letter from a constituent and member who is unsettled by a chiropractor’s use of the term “Physical Therapy” on their clinic window.

According to state statute (ARS 32-2042 C),

“A person or business entity or its employees, agents or representatives shall not use in connection with that person’s name or the name or activity of the business the words “physical therapy”, “physical therapist”, “physiotherapy”, “physiotherapist” or “registered physical therapist”, the letters “PT”, “LPT”, “RPT”, “MPT”, “DScPT” or “DPT” or any other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy, unless these services are provided by or under the direction of a physical therapist who is licensed pursuant to this chapter. A person or entity that violates this subsection is guilty of a class 1 misdemeanor.”

This member filed a complaint with the PT Licensing Board, the licensing board forwarded it to the Chiropractic Board, and several months later the Chiropractic Board made the offending chiropractor change the window wording from “Physical Therapy” to “Physiotherapy”. Obviously, this was not a satisfactory solution. The member wrote an email to the Chiropractic Board restating his concern regarding the continued violation of the state statute. This was the Chiropractic Board’s response:

“As you are likely aware, chiropractors are not subject to the statutes regulating physical therapy. In addition, this Chiropractic Board has made a determination that use of the term “physiotherapy” is appropriate for any licensed chiropractor who possesses a certification in Physical Medicine Modalities and Therapeutic Procedures.”

The member then forwarded this response to the Physical Therapy Licensing Board … and shockingly, they agreed!!!

As one can imagine, the member was upset and frustrated and asked the AzPTA if there was anything else that could be done. Protection of the term physical therapy is very important and should be only used by physical therapists. It was the AzPTA’s feeling that use of this term, by any profession other than physical therapy, is unlawful, damaging to our profession, and most importantly, misleading to the public.

With this in mind, the AzPTA executive board discussed the matter and decided that we needed to get involved. The issue seemed to be a difference of opinion regarding interpretation of the law. The Chiropractic Board felt that the law didn’t apply to them.

“As a Chiropractor is licensed by the State of Arizona, they must adhere to the laws and rules as they apply to Chiropractic.  If you review A.R.S. § 32-900 (7) and (8) you will see the definition of Physical Medicine Modalities and Therapeutic Procedures.  A.R.S. § 32-922.02 provides authority for the Board to issues Specialty Certification in this field. The fact that physiotherapy does not appear in statute does not preclude this Board from determining its use is appropriate. Clearly you previously attempted to have the Physical Therapy Board address your complaints and that Board forwarded the matters to the Chiropractic Board where the jurisdiction lies. The Chiropractic Board cannot discipline based on the Physical Therapy Board statutes which you quoted.”

The AzPTA felt that the state statute applied, as it reads above, to any “person or business entity or its employees, agents or representatives.” Clearly, there is no exception for chiropractic in this statute.

Since there seemed to be so much confusion, we drafted a letter defining the issues and our concerns and sent it to the PT Licensing Board. After reviewing our letter and hearing our arguments at a board meeting, the PT Licensing Board stated that they did not have the authority to interpret the law or the jurisdiction to do anything, aside from forward complaints to the chiropractic board.

It became clear that we needed clarification of the law from an office that sits above both licensing boards; we needed an Opinion from the Attorney General.

After several months of waiting, the outcome was this:

“Everyone in Arizona, including chiropractors, is subject to the prohibition in Section 32- 2042 on the use of the word “physiotherapy” and other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy, unless those services are provided by or under the direction of a licensed physical therapist. “

A.R.S. § 32-2042(C) and (D) clearly prohibit any person or business entity from using terms that are restricted thereunder unless physical therapy services are provided by or under the direction of a licensed physical therapist. “ – Arizona Attorney General Mark Brnovich

These are the battles being waged behind closed doors by your state associations. Many of them you will never hear about, but support through membership and advocacy is needed to win these and I believe that being a member of the APTA is the right choice.

To see the Opinion of the Attorney General or for more information on the APTA and AzPTA click the following links.

Opinion of Arizona Attorney General Mark Brnovich

American Physical Therapy Association

Arizona Physical Therapy Association

For More information on the AzPTA communications with the Arizona PT Board of Examiners or the Arizona Office of the Ombudsman please email me.

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Dr. Justin Dunaway PT DPT OCS Cert SMT Cert DN

Former AzPTA Executive Board Member

Current member of Oregon PTA Government Affairs Committee

Co-founder/Instructor Manual Physical Therapy Alliance