Practice Issues in Physical Therapy: Current Patterns and Future Directions.

Practice Issues in Physical Therapy: Current Patterns and Future Directions

Edited by Mathews J. Thorofare, NJ 08086, Slack Inc, 1989, paperback, 182 pp, illus, $33

This book addresses major issues physical therapists must face to "proceed with the achievement of goals necessary to develop a profession of substance." Each of the 12 chapters addresses a separate issue, and each chapter was written by a leader in the physical therapy field. The current president of the American Physical Therapy Association wrote the introduction, chapters 6 and 12, and the appendix.

Johnson sets the stage by providing a brief history of our professional development in education, the relationship of practice and education, and the need for strong research-based education programs at the professional doctorate level.

Practice issues are the focus of the next three chapters, in which Burch discusses direct access, Tygiel outlines the referral-for-profit dilemma, and Kigin explains specialization. in the next chapter, Carpenter outlines the history of the physical therapist assistant (this is the only time physical therapist assistants are mentioned) and discusses the following issues: membership rights, licensure problems, specialization, and future trends. In Chapter 6, Mathews discusses clinical education and how practice issues affect clinical preparation. Reimbursement, legislation, and health care delivery systems are the focus of the next three chapters. Weinper clarifies the confusing acronyms HMO, PPO, EPO, and PTPN and encourages potential private practitioners to consider carefully the type of practice to enter. Walter reviews the growing use of computers in research, education, information processing, practice management, and patient care. Gillespie, Fitz, and Gordon discuss interdisciplinary care and challenge us to encourage collaboration between education and practice. Finally, Mathews looks into the future, providing a health care scenario of expanding technological capabilities and decreasing availability. She envisions health care rationing, self-health monitoring, and broad political power for elderly persons. She further envisions a physical therapy profession that will be out of the hospital setting and out of geriatric care. Clinical specialists, educated in professional doctorate programs, will render highly technological care that focuses on wellness and health promotion.

Overall, this is a thought-provoking book that highlights the major issues facing the profession today. As might be expected in a collection of articles, some are better written than others. The editor is to be commended for including less popular topics-such as the physical therapist assistant and interdisciplinary collaboration-along with the better-known and more debated issues. Some discussions, such as Burch's description of direct access legislation and Kigin's outline of specialization, serve to place issues in a historical frame of reference. Other discussions, such as Tygiel's description of referral for profit, may stimulate disagreement and debate. I highly recommend the book for all physical therapy education programs, as a stimulus for seminar discussions on the issues facing our profession. This text also would be valuable reading for physical therapists who wish to participate actively in the evolution of the physical therapy profession as it moves from "adolescence to adulthood."

Bella J May, EdD