This is a really tricky problem for all of us. In NZ we are lucky however things could always change if the rehab drs decided to get organised here.

As for evidence for our treatments I think you have to be prepared to provide evidence as each situation arises, and as there is so much evidence now out there for PT rather than us giving you a list I suggest you get better at accessing and appraising it as the need arises.

If you effectively can do this again and again you can demonstrate your ability to practice autonomously. For evidence of interventions: Do you use PEDro? - The great thing about PEDro is that it is so quick to access and will give you evidence for guidelines, systematic reviews and clinical trials on any subject in physiotherapy that has been researched.

to demonstrate our effectiveness as primary practitioners we also have to provide evidence for our diagnoses as well as interventions and prognosis.

Have you got good evidence-based textbook such as:

Practical Evidence-Based Physiotherapy: Amazon.co.uk: Robert Herbert, Judy Mead, Gro Jamtvedt, Birger Kare Hagen: Books

There are other books but I would highly recommend this for honing your skills at locating, appraising and applying evidence as you need to.

As primary care practitioners we also need to show we can triage for non musculoskeletal disorders that require further investigation. The US has made great strides with this. William Boisonault is a PT who has published exellent textbooks on the topic:

Goodman C, W Boissonnault, K Fuller. Pathology: Implication for the Physical Therapist, 2nd edition., WB Saunders Co., 2nd edition. 2002.

Boissonnault W. Medical Screening for the Physical Therapist. On CD-ROM; 20 hours of material including written examination, December, 2003.

Boissonnault W. Primary Care for the Physical Therapist: Examination and Triage. WB Saunders Co., Publication date September, 2004.

have a look at his website:http://www.orthorehab.wisc.edu/physi...sonnault.shtml


We also need to be politically astute, supporting and encouraging our PT associations to lobby for direct access. Such issues as patient assurance of safety and cost effectiveness direct access make for strong arguments to government bodies