PROFESSIONAL PRACTICE IN
PHYSICAL THERAPY
THE PHYSICAL THERAPIST AS A
CONSULTANT
CONSULTATION
“Consultation is the rendering of professional or
expert opinion or advice by a physical therapist.
The consulting physical therapist applies highly
specialized knowledge and skills to identify
problems, recommend solutions, or produce a
specified outcome or product in a given amount of
time on behalf of a patient/client.”
The Interactive Guide to Physical Therapist Practice
with Catalog of Tests and Measures (2002)1
CONSULTATION
Consultation is the practice of providing advice for a fee. This
is a two-way interaction
A process in which a person or an organization seeks help,
which the consultant provides.
The ultimate outcome of the process is a change in the way
the person functions or an organization operates.
The person or organization seeking help is the client, who may
also be known as the customer, patient, or advisee.
Regardless of the label applied to the interaction (advising,
coaching, counseling, consulting), this helping process is a key
function of all professionals, including physical Therapists.
PHYSICAL THERAPY
CONSULTATION
The patient/client management role of the PT is a form
of consultation, because patient care is a process of
giving and receiving help
The power of the advice given depends on two factors:
(1)How much the consultant helps clients use their own
knowledge, experience, and expertise to arrive at a
decision or solve a problem
(2) How much the client participates in the proposed
course of action.
PHYSICAL THERAPY
CONSULTATION
Fuller defined the consultant/client relationship as a blend of
service and advice, with some specialized information added.
A framework that consultants could use to clarify their
responsibilities. This model identifies types of consultation in
terms of client demands for the following continuum of
services:
● Specialized services
● Administrative skills
● Problem solving
● Investigative studies
● Assessments
● Advice
EXAMPLES OF CONSULTATION
SERVICES PROVIDED BY PTs
1. Service-Based consultation
2. Needs-Based consultation
3. Relationship-Based consultation
4. Trust-Based consultation
SERVICE BASED
CONSULTATION
A Physical therapist consultant contracts to provide
direct patient care services for a rural hospital on a
temporary basis
A PT consultant contract to develop a new specialty
service for individuals with lung disease that
developed secondary to occupational exposure
NEEDS-BASED CONSULTATION
• A physical therapy practice has a problem with a very
high percentage of reimbursement denials from a
particular third party payer.
The group hires a PT consultant to develop and
implement a training program for the rehabilitation
team that will provide guidelines for reimbursement
and for effective documentation that supports charges
for services.
RELATIONSHIP-BASED
CONSULTATION
• A PT consultant is hired by a newly formed physical
therapy group to help develop its services from the
ground up : mission statement, budgeting, policies and
procedures, hiring criteria and marketing strategies.
• A PT consultant is hired by a same group a year later
to help determine whether the practice should expand
into new markets.
TRUST-BASED CONSULTATION
A physical therapist engages a consultant. They meet
at least four times a year to brainstorm ideas for the
physical therapist’s practice and professional
development.
BUILDING A CONSULTING
BUSINESS
1. Determine the fee potential clients are willing to pay
(e.g., find out the fee paid to other consultants in the
area).
2. Determine your living and business expenses.
3. Calculate the number of consulting days per year you
need to break even. For example, let’s say the current
daily fee for PT consultants in your area is 750, and your
annual income goal is 331000:
331000÷ 1655= 200
You will need to work about 200billable days per year to
meet your income goal.
The Consulting Process
Consultants identify problems, consider alternatives, select
and implement the best solution, and evaluate the solution’s
effectiveness.
The consultant/client relationship begins with acceptance of
a proposal which should include the following sections,
1. Purpose of the proposal [or an objective]: A brief statement,
couched in general terms, of what the client wants.
2. Solution or action steps: Presented perhaps as a bulleted list
or a table, this section specifies the sequential actions to be
taken, including dates for submission of periodic progress
reports. The steps may include information and data
gathering, design, content to be included, materials needed,
and the implementation strategy.
The Consulting Process
3. Anticipated benefits: The improvements the client can
expect as a result of the consultation.
4. Evaluation: A plan for measuring the effectiveness of
the consultation.
The Skills of a Good Consultant
The key to success as a consultant is the ability to build a
trusting relationship with the client.
Good advice
Technical capabilities
Entrepreneurial talent.
The ability to get along well with others,
The ability to diagnose problems and find solutions
The ability to communicate,
The ability to work under pressure.
Adventuresome
Willing to accept risk
Determined to find answers to problems.
ETHICAL AND LEGAL ISSUES IN
CONSULTATION
Codes of Ethics
Lippitt and Lippitt have devised a code of ethics for consultants based
on 11 principles:
Responsibility
Competence
Moral and legal standards
Avoidance of misrepresentation
Confidentiality
Client welfare
Announcement of services
Intraprofessional and interprofessional relations
Remuneration
Responsibility toward client organization
Promotional activities
Respond to each item using a 1−4 scale.
1 = definitely true; 2 = possibly true; 3 = unlikely; 4 = definitely false
1.I am willing to work sixty to eighty hours a week to achieve success. 1234
2.I love risk; I thrive on risk. 1234
3. I have a thick skin. 1234
4. I am good at understanding and interpreting the big picture. 1234
5. I pay attention to details. 1234
6. I am an excellent communicator. 1234
7. I am a good writer. 1234
8. I like to sell myself. 1234
9. I can balance logic with intuition and the big picture with details. 1234
10. I know my limitations. 1234
11. I can say “no” easily. 1234
12. I am compulsively self-disciplined. 1234
13. I am comfortable speaking with people in all disciplines 1234
and at all levels of an organization.
THANKS
Be PROFESSIONAL
