Physical Therapy Management: An Integrated Science.

Walter J. St Louis, MO 63416-3318, Mosby-Year Book Inc, 1993, hardback, 282 pp, illus, $37.95.

The purpose of this book is to analyze and synthesize traditional management principles and concepts, so it can assist a physical therapy manager to function more effectively and manage scarce resources optimally in a changing environment. The book is recommended as an excellent resource for the manager of a physical therapy service, regardless of the practice setting. It would also be useful as a reference or required textbook for students enrolled in a baccalaureate or postbaccalaureate curriculum. I believe, however, that students would benefit from the use of additional readings or reference material to gain greater insight and understanding of many basic management principles and concepts.

The author uses four chapters to present basic management principles and concepts related to organizational systems and structures, management systems, behavior of employees in an organization, and the control of employee behavior. The two chapters about organizational behavior and behavior control contain excellent information to assist the physical therapy manager to better understand why employees behave as they do and to better evaluate an employee's behavior and, if necessary, change that behavior or performance. The supervisory and working relationships between the physical therapist and the physical therapist assistant, and information about the changing role of the physical therapist assistant are important aspects of these chapters. The remaining chapters are more directly related to physical therapy practice and management.

Chapters 2 and 3 provide excellent overviews of how physical therapy services fit in community-based systems (hospital, home health, etc) and in complex systems (multihospitals, outpatient facilities, managed health care settings). This information assists the physical therapy manager to better understand his or her role in these settings. An alternative organizational structure, known as service or product line management, is presented in chapter 4. The role of the manager in this structure is compared and contrasted with his or her role in a more traditional structure. Excellent rationale and support for this alternative structure is provided. Other strong chapters include chapter 5, "Law and Regulations Affecting Physical Therapy Practice"; chapter 10, "Ethical Aspects of Physical Therapy"; chapter 14, "Quality and Productivity in Physical Therapy"; and chapter 15, "Fiscal Management of Physical Therapy Services."

The material presented in this book is current and "on the cutting edge" as much as can be expected given the unknown factors associated with health care delivery in the United States. The text is enhanced with numerous tables, figures, charts, boxes, and examples of documents such as job descriptions, performance appraisal forms, the Code of Ethics and Guide for Professional Conduct for the Physical Therapist and the Physical Therapist Assistant, and the Standards of Practice for Physical Therapy. In addition, many chapters contain one or more case studies to give the reader the opportunity to participate in various types of managerial problem solving and decision making. These cases were prepared by wellknown, experienced, and respected physical therapy clinicians, and many of the cases were based on real-life experiences or situations. In order to permit and encourage the reader to become more interactive with the text and to aid his or her understanding of the material presented, it would be beneficial if each chapter contained at least one case study. References are listed at the conclusion of each chapter, and most of them were published within the past 5 to 6 years.

Selected or suggested readings are provided for most chapters. Very few references or suggested readings are listed for several books related to health care management that are frequently cited in other publications. Identifying these books could benefit the inexperienced manager by providing a broader and more comprehensive perspective of management theories, principles, and concepts. Definitions of terms are contained in five chapters, but it would have been helpful if several other chapters included this feature.

In summary, the author has produced an excellent resource to assist the manager of a physical therapy service in areas relating to traditional management principles and concepts and in applying this information to specific physical therapy management areas. The author concludes the book by speculating about some of the issues she believes will confront the physical therapy manager in the future. The material is presented with a positive outlook, and each reader should reflect upon it as he or she plans for the future.