Scope of Practice, Standards of Care, and Patient Rights
Scope of practice
A Kansas PT examines, evaluates, diagnoses within the physical therapy scope, establishes a prognosis and plan of care, provides interventions, re-evaluates, and discharges. Interventions include therapeutic exercise, manual therapy, physical agents, electrotherapy, gait and balance training, wound care within scope, and patient education.
Direct access and referral
Kansas uses limited direct access. A PT may examine and treat a patient without a physician referral, but must refer when the condition is outside PT scope, does not improve as expected, or requires medical diagnosis or treatment. The referral rule is a patient-safety rule, not a paperwork preference.
Standard of care
Care must be competent, evidence-based, individualized, and consistent with the plan. The PT must obtain informed consent, respect the patient’s right to refuse or withdraw consent, protect privacy, provide access to records, and avoid discrimination. Reassessment must occur when the patient’s condition changes.
Worked example
During an exercise session, a patient reports new chest pressure and shortness of breath. The PT stops treatment, checks vital signs, recognizes a red flag outside the musculoskeletal scope, activates emergency services, stays with the patient, and documents the event and referral. Continuing the session because the patient “wants to finish” would breach the standard of care.
Traps that cost marks
Confusing a PT diagnosis with a medical diagnosis; continuing treatment after a red flag; ignoring a competent patient’s refusal; and delegating the initial examination or plan development to a PTA.