2019 APTA Federal Advocacy Forum – “Day on the Hill”

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Colorado members at the Forum representing and advocating for the #ChoosePT campaign.

Last week,  the APTA Federal Forum in Washington D.C. took place to advocate for important topics to physical therapists. The Forum brought together APTA members, speakers from the field, and stakeholders on the discussion of regulatory affairs and federal priorities that impact the physical therapy profession and its patients, as well as on learning about new information that comes with a new Congress. Attendees had the opportunity to speak with their representatives in person about issues facing their state and the profession as a whole. Among those in attendance were our very own Regis DPT students and faculty members. Second-year DPT student Hannah Clark reflects on her experience on the Hill and why it is crucial to not only advocate for our profession, but to be involved as a student, in her following essay:

“Issues Discussed at the Capital”

Hannah Clark, SPT – Regis University

To fundamentally agree with the policy positions held by the APTA is an exceptional feeling. As a DPT student who is hoping to delve headfirst into pain management and advocacy for marginalized communities in healthcare upon graduation, my decision to pursue this profession has been deeply validated by attending the Federal Advocacy Forum (FAF). Witnessing leaders within the APTA address topics related to population health, patient choice and access, value-based care and practice, and research and innovation helped me to fully recognize the crucial role the APTA has in influencing the policies that impact our ability to serve society. For these reasons, it felt important for me to join the GAC team advocating at the capital and I was deeply honored to be selected.

Due to the recent success regarding the removal of the Medicare cap, we were able to spend more time becoming educated and advocating for the field of physical therapy in a broader sense. On Monday, we spent the entire day learning about the current political climate in congress from Nation Gonzalez at CNN, the societal impact of healthcare policy from Sarah Kliff at Vox, and attended breakout sessions that detailed information regarding federal policy, payment, the ACA, Medicaid, and IDEA. One of the most emphasized topics throughout the day involved the #ChoosePT campaign. The APTA reminded those attending the FAF of the real impact physical therapists can have on the opioid epidemic through offering vulnerable populations access to non-pharmacological pain management. Clear objectives were presented that tackled this issue in addition to intra-professional issues such as student loan repayment. Several policy priorities were presented for every state to choose from when planning their congressional meetings.

The following topics were addressed by the Colorado GAC team when meeting with legislative assistants:

  • Our geriatric specialists spoke to the vital role in we play in exercise promotion and fall risk reduction in the community. Conversations were also had in the valuable perspective physical therapists can bring to park and recreational center design.
  • Our pediatric specialists asked congresspeople to consider expanding the budget for IDEA as they have witnessed the impact this program has on the lives of children.
  • Our outpatient clinicians provided examples of how they have successfully treated patients experiencing chronic pain and assisted them in weaning off opioids. These individuals also spoke to the measurable reduction in opioid use they have made in their local hospital system by implementing early access to physical therapy services.
  • Our students asked our congresspeople to cosponsor SB970 (and eventually the same bill when it is brought to the house) that would add physical therapists to the National Health Service Corps. This would allow graduates to serve rural populations, often most impacted by opioid addiction, and would offer student loan repayment as an incentive.
  • Our long-time advocates requested that physical therapists be added as community health center providers, as we are a vital element of the primary care team.

In addition to the invaluable time spent at the FAF learning about how physical therapists can impact healthcare quality and access in the U.S., one of the most important aspects of the weekend for my professional growth was getting to know the GAC members I accompanied. The people I spent time with exemplified everything I love and respect about our profession. They spoke with genuine care for their patients, integrity in leadership opportunities, intelligence in considering the complexity of pain, passion for their interventions, and commitment to social responsibility. Our conversations had a large impact on my personal development.

I returned to class following the Federal Advocacy Forum with a fresh perspective. I felt focused and calm as I approached coursework and simulation labs. Attending FAF granted me the opportunity to further shape who I aspire to be as a professional and world citizen. I am beyond grateful for this opportunity and truly believe that if any student were to have the chance to participate in this event, they would foster a deeper appreciation for the APTA and for healthcare advocacy at large.

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Hannah (pictured second from right) was all smiles with fellow members of the Forum at the 2019 APTA Federal Forum in Washington D.C. 

Presenting At CSM 2019, Washington D.C.

It was a cold, rainy national Combined Sections Meeting (CSM) this year in Washington D.C., but that did not stop almost 17,000 people, including several from Regis University, to attend! Regis students and faculty not only learned the latest happenings from others in our field of physical therapy, but also took roles in presenting their research and/or speaking during educational sessions to inform our profession. Below are some highlights of their experiences.

 

 

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DPT students Amber Bolen and Grace-Marie Vega with Dr. Andrew Littmann

“Going to CSM as a student researcher was a wonderful experience! Discussing our narrative review with PTs, students, and other researchers who shared our passion for regenerative medicine will always stand out as a highlight of my time at Regis.” — Grace-Marie Vega

“I loved working as a team with my research partner on our narrative review (the PT’s role in stem cell research for spinal cord injury). Presenting research at CSM was something I never expected to do when I first entered PT school, but Regis faculty encouraged our class to submit for review. We decided to give it a shot and we made it! Being able to speak with people interested in our field of research was an amazing feeling. We even attended a lecture in which one of our cited authors was present. It was also humbling to see how many research posters and lectures came out of Regis and its faculty and students. I look forward to seeing more as a proud future alumni!” — Amber Bolen

 

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DPT students David Cummins and Katherine Heller with Dr. Andrew Smith and Dr. Denise O’Dell

“Attending CSM in Washington, D.C. was an amazing experience. I had the opportunity to share my team’s research, chat with leaders in the profession, and meet dozens of potential employers. The energy and passion at the conference was infectious and I left feeling reinvigorated and excited about the future of our profession.” — David Cummins

 

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DPT students Hannah Clark, Vivian He, Felix Hill, and Erin Lemberger with Dr. Karla Bell, Dr. Melissa Hoffman, and Dr. Nancy Mulligan

“I think that getting to present an educational session at CSM is a fairly rare opportunity, and our team definitely bonded through the intimidating experience of presenting to almost 300 people! In presenting our research on LGBTQ+ related cultural competency, we were also able to identify barriers and build broader awareness of LGBTQ+ issues in our profession. I feel so grateful to our lead researcher, Dr. Melissa Hoffman, for getting me involved in research and making it possible for us all to have this experience!

In addition to the educational session, many members of our research team are involved in PT Proud, an LGBTQIA+ committee in the Health Policy Administration Section of the APTA. As part of that group, we held a membership meeting and happy hour event, which provided a powerful space for LGBTQ+ people and allies in our profession to come together.” — Felix Hill

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Pam Soto, a third year DPT student, presented a platform on “The Impact of Leadership Development Curriculum Through the Eyes of the Physical Therapy Student.”

 

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Class of 2018 graduate Dr. Amanda Rixey presented on preferred method of feedback after simulation experiences for DPT students.

 

And even more!

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Farewell Marcia Smith!

Name: Marcia Smith, PT, Ph.D.

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As we sadly said farewell at the end of the summer to another beloved faculty member, Marcia Smith, who has been with us at Regis for 20 years, second-year student Meg Kates made sure to catch some of her words of wisdom before her retirement! Read the interview below for Marcia’s amazing journey as a PT, educator, and advocator.

How did your journey with physical therapy begin?

When I was 8 or 9 years old, I read a story in a Reader’s Digest publication called Karen, which was the story of a young woman growing up with cerebral palsy in the late 1930s. At the time in history, many of those individuals lived in group facilities for people with disabilities. I remember, in the story, Karen learning how to walk with the help of a physical therapist. My interest was further reinforced in 8th grade, when I saw a television show called Route 66. In the show, main character came down with an illness and had to be hospitalized, and, I remember, a physical therapist helped him get well. Lastly, the gentleman who became the head of the Rehabilitation Center in Grand Junction moved across the street from me. I had lots of opportunities to talk to him and watch him. So, I had lots of opportunities for physical therapy to be reinforced as the career I wanted to pursue.

I graduated with by Bachelor’s in physical therapy from CU, and then I moved to upstate New York, where my husband went to law school. A Bachelor’s degree was all that was really available at the time, unless a person wanted to teach, in which case he or she got a Master’s degree. I had never met a physical therapist with a Ph.D. at the time. I lived in Ithaca for 3 years, and then I moved back Colorado in 1972. There were zero positions open in the state, so I worked vacation relief at nursing homes. Colorado has been saturated a long time. Eventually I got a call from the head therapist at Denver Health, who had heard I was looking for a job and asked me if I would like to interview…I said yes! I was hired and it was the weird, the wild, and the wonderful. At Denver Health, therapists are assigned to teams, so I worked in the Amputee Brace Clinic for 6 months. Then, I did hand therapy. Then, I rotated onto the Neuro-/Neurosurgery team. After that, I told everyone they could rotate around me because I was not going to leave that team.

Starting out, did you always know that you wanted to pursue neuro-focused PT?

No, in fact, I thought I wanted to be a pediatric therapist. In New York, I worked at Tompkins County Hospital and Rehabilitation Center for 2 years. That was a wonderful opportunity. I would see a patient who had an acute stroke and I would get to follow them from acute care to rehab to outpatient. I had the opportunity to fill the spot of a physical therapist on maternity-leave at the Special Children’s Center, which was a freestanding outpatient school in Ithaca. Interestingly, the head of the Special Children’s Center had her Ph.D. in Education and her Master’s in Speech Language Pathology. And she had cerebral palsy. In fact, she was one of the people in the book “Karen.” It was a full circle moment for me. I worked with this woman in the pediatric setting for 8 months before I moved back to Denver where, like I said, there were no pediatric positions. There were hardly any positions, but it was at Denver Health where I decided neuro is what I really wanted to do.

 

Can you tell me more about your experience with Ranchos Los Amigos?

When I was at Denver Health, I felt like I needed to know so much more. I expressed these feeling to my husband and he encouraged me to apply to universities for a Master’s degree. I was admitted to a program for clinical specialization at Rancho Los Amigos, where I learned at a couple of years. The first year was mostly class work, and the second year was all clinical specialization. We rotated between specialties, and I chose traumatic brain injury, stroke, TBI children, GB, and it just goes on like that.

 

What advice would you to someone who want to get into a specific specialty of work?

When I was finishing my Master’s, I can remember a classmate saying to me, “If there are no openings, I will just go do anything.”

And I can remember saying, “I won’t. I refuse. If I can’t be a neuro therapist, I will flip burgers!

So, my advice is to find a place you want to be and stick with it. Secondly, try to pick your final clinical rotation in a setting where you know you would like to practice. Lastly, don’t disregard what you have learned based on the setting you are in. For example, I have used my musculoskeletal and cardiopulmonary skills in practice with my patients with stroke, multiple sclerosis, and Parkinson’s disease. Always be searching for opportunities to use a wide breadth of skills and never putting people into a “box.”

 

What do you think is the next step for the career of physical therapy?

I think that we will always need educators. So, if you’re interested in that route, be considering in what subject you would like to get your Ph.D.

There are other things I worry about. I worry about the cost of education, and the loans that people have to take out. I see how physical therapists are reimbursed in Colorado and nationwide, and it’s hideous. So, I see residency taking us to another level, but, ultimately, we need to be addressed as primary care providers.

Ultimately, we need to be our own advocates. That means writing up clinical studies, asking questions, and answering questions.

 

What is the first step in becoming an advocate? How did you get your start?

When I lived in New York, there were two physical therapists at Ithaca College who would regularly invite me and some others to attend district meetings, and everyone would go. Then, in 1970, New York had its first state conference: that night, everyone volunteered to participate on a committee of the APTA. When I moved back to Colorado, one of my mentors invited me to a picnic, where she asked me if I would become the secretary of the Colorado APTA Chapter.

I asked her, “Do you think I can?”

She said, “Of course you can.”

So, I became the secretary and did that for 4 years before I moved to California to pursue my Master’s, where I continued to follow through with my responsibilities until I came back.

 

What’s the next step for you? What’s in your future?

I am going to continue to do some research. I am going to continue to answer some questions about how we dose exercise for people with Parkinson’s Disease.

I will be doing some traveling. In September, my husband and I will be escorting some friends to Ireland. I am going to see Iceland next. We are going to go for Hawaii for a few weeks, and, then I thought, since we are halfway there, why not go to New Zealand? Why fly back to the mainland? Then we have friends that we will be joining on a river trip on the Rhine. I don’t know after that!

 

Thank youMarcia, for your work and dedication to both Regis and our profession! We are so grateful for all of your contributions and will miss you very dearly at Regis, and we wish you all the best in your new adventure in life! Congratulations!

Regis DPT Students Present: “LGBT+ 101”

 

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Taylor Tso, Hannah Clark, Felix Hill (left to right)

Regis University first-year DPT students Felix Hill, Hannah Clark, and Taylor Tso recently held a session for their classmates entitled “LGBT+ 101 for Student Physical Therapists.” The presentation covered foundational terminology and concepts related to LGBTQIA+ communities, a brief overview of LGBT+ healthcare disparities, as well as tips for making clinical spaces more inclusive. Here are some thoughts from the presenters related to key foundational concepts, what motivated them to present on this topic, and what their plans are to expand on this work in the future:

What does LGBTQIA+ stand for?

LGBTQIA+ stands for Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning, Intersex, and Asexual.

 

What is the difference between gender and sex?

Both sex and gender exist on spectrums. A person’s sex is assigned to them at birth based on their genitalia, typically as either male or female. Intersex people are born with a unique combination of sex traits such as hormones, internal sex organs, and chromosomes. Gender involves a complex relationship between our bodies (think biology and societally determined physical masculine and/or feminine attributes), identities (think inherent internal experience), and expressions (think fashion and mannerisms). While gender is commonly thought of as a binary system (men and women, boys and girls), there are people whose identities do not fall within either of these categories exclusively, or even at all. While many people identify with the gender often attributed to the sex they were assigned at birth (cisgender), there are others who do not share this experience (transgender).

 

Does gender identity have anything to do with sexual orientation?

No! You cannot make assumptions concerning someone’s sexual orientation based on the way they express their gender or based on their gender identity. Sexual orientation simply has to do with whom someone is sexually attracted to or not. It also has nothing to do with how sexually active someone is!

 

Why did you feel it was important to present on this topics?

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 “In spite of our community’s unique healthcare needs and the stark disparities that affect LGBT+ people’s access to healthcare, typical DPT programs offer little to no education that would prepare you to treat LGBT+ patients. We wanted our cohort to be competent and confident in treating this population.” –Felix

“Felix recognized this need at Regis early on and has been working closely with our faculty to develop more inclusive and comprehensive educational materials. As an ally, I have been honored to work with Felix and other members of PT Proud (the first APTA recognized LGBT+ advocacy group) in this process of educating ourselves and others. I believe that the field of physical therapy can do a better job of caring for LGBT+ patients and I want to be a part of the solution.” –Hannah

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What do you believe was the main impact of this presentation?

 “Facilitating educational exposure to LGBT+ topics that people may or may not have had knowledge of before. This presentation sparks curiosity and lays down a baseline understanding for healthcare professionals to better their communication, and thus, quality of care for their LGBT+ patients.” –Taylor

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So you have given this presentation—now what?

 This was just the beginning! Due to negative past experiences and fear of discrimination, many LGBT+ people will go to extremes to delay care. Even if someone has access to health insurance and can afford to come see a PT, which many do not, people are likely to wait until their condition is very serious, which then contributes to poorer outcomes.

We will work to share our knowledge widely throughout the U.S., starting with a presentation at CU in August. But ultimately, workshops are not enough! As board members of PT Proud, the LGBT+ catalyst group in the HPA section of the APTA, we want to ensure that physical therapy professionals across the country receive a basic level of LGBT+ competency training, which will ultimately require changes to DPT and PTA curricula. We will also be working with PT Proud’s Equity task force to influence laws and policies to increase LGBT+ healthcare access.

Felix, Hannah, and Taylor all look forward to the prospect of future presentations.

 

How can I learn more?

Follow PT Proud on Facebook! https://www.facebook.com/PTProud/

Feel free to leave a comment on this post with any questions or thoughts as well!

How Can the APTA Help Me?

Name: Lina Kleinschmidt

Undergrad: Pacific University

Hometown: Stuttgart, Germany

Fun fact: I was born and raised in Stuttgart, Germany

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As a physical therapy student and future physical therapist, the APTA is something you will hear about over and over again. With job opportunities, continuing education classes, research updates and legislation information, the APTA has endless amounts of information at the hands of students and professionals. However, the website and all the resources may seem a little overwhelming. Therefore, here is a little introduction into the APTA and how you can use it to further your education and career.

What is the APTA?

The APTA, or the American Physical Therapy Association, is a professional organization that represents physical therapy students, physical therapists and physical therapy assistants and has over 103,000 members. It is divided into state chapters each with a governing board. We at Regis University are fortunate to have Cameron MacDonald as an assistant professor, and he is the current president of the Colorado chapter which currently has 2,700 members. It is vital for each state to have a chapter since each state has different practice guidelines and thus must have individual legislation.

There are also sections within the APTA, which include: acute care, aquatics, cardiovascular and pulmonary, education, federal, geriatrics, hand and upper extremity, home health, pediatrics, private practice and quite a few others.  These sections allow you as a student or current PT to learn more information about different specialties. For example, I am part of the neurology section and as such, I get quarterly journals that inform me on the latest research and new updates in the realm of neurology and how it affects the physical therapy industry.

Districts are even smaller groups which are broken up by geographical location and each chapter has SIGs or special interest groups. Colorado has five statewide SIGs which include: Colorado Acute/Rehab SIG, Pediatric SIG, Private Practice SIG, PTA SIG and the Student SIG.

Continuing education (CE) classes happen often and allow students or PTs/PTAs to learn more about a specific topic and have hands on practice. I attended a vestibular and concussion CE class last fall and it completely opened my eyes to a world of physical therapy I had never heard of before. The APTA has a national conference called Combined Sections Meeting, or CSM, which is an incredible opportunity to learn about the profession and what new research developments are forthcoming. CSM is also a great way to network and get to know other practitioners in the physical therapy profession. The Colorado Chapter also has an annual convention called the Fall Convention & Expo.

How can I use the APTA?

Now that you have an introduction, it is important to know what you can do NOW. Depending on where you are in your journey, this may be different for each of you. If you are currently applying to PT school, the APTA website can help guide you in preparing for your interview questions, help you understand what is in your scope of practice depending on the state and school you apply to, and impress the faculty by understanding what is happening in the PT profession.

As you start your graduate school career, the first step is to become an APTA member! Some graduate programs require it, others do not. Either way, I highly recommend you become part of the association so you can reap the full benefits of the APTA and have your voice heard. Click here for joining the APTA. Attending state and national conventions will also give you a huge head start on understanding what the real world of physical therapy is like and they are a great chance to meet students from all over the US and also network!  The easiest step is to get involved with SIGs. Each university will have student special interest groups which hold meetings and special guest lecturers which allow students to connect and communicate about a specific PT specialty.

At Regis and CU Denver, we have multiple sSIGs that our students are involved in and I am lucky enough to be involved with the APTA sSIG this year. I will be working closely with the other sSIGs as well as the PTA schools to have a year of amazing events for our students. We hope to open their eyes to all the opportunities in Colorado. These include: panels about specialties and what to do after graduation, a kickball tournament, a national advocacy dinner and so much more!

Yes, this was a lot of information. No, I do not expect anyone to remember it all. But it is important that you get involved and find what you are passionate about. So now, go to www.apta.org and become a member today!

How to Rock a CSM Conference

Name: Grace-Marie Vega

Undergrad: Arizona State University

Hometown: Placentia, CA

Fun Fact: I take pub trivia very seriously!

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CSM, or the Combined Sections Meeting of APTA, is a 4-day national conference held annually,  attracting thousands of students, practitioners, and researchers in the physical therapy field. These are some things I learned from CSM 2018 in New Orleans that I hope will help you navigate through future conferences:

  1. There are so many possibilities! CSM had over 300 educational sessions over the course of three days, not including poster presentations, platform presentations, and networking events. It was a whirlwind of people, places, and free giveaways. To get the experience that you want, and to avoid option paralysis, take some time beforehand to prioritize what you really want to see! In preparation for your own national conference, download the APTA conferences app so you can add programming to your own schedule. The WiFi in the conference halls can be unreliable, so I suggest that you make a plan before you get there, and glance at the map too.

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  1. Do not underestimate your knowledge. On my first day of CSM, I chose programming with subject matter that I felt I knew well enough to discuss. It turns out that I did know it well, because I had already studied it in my coursework, and even read some of the referenced articles. Basically that program was review, and a reassurance that Regis DPT coursework incorporates current best evidence. But I could have learned new things and expanded my awareness of topics that may not get as much coverage in coursework. For the rest of the conference, I tried to pick topics that I was interested in, but not experienced in, and in doing so, I realized that I was not out of my depth. Challenge yourself, and trust that you probably know more than you think.

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  1. Use public transit! Although less convenient, it’s cheaper and arguably more fun than taxis, ubers, and car rentals. I purchased a transit pass that allowed me to utilize all local buses and trolleys. For 3 dollars a day, I rode around New Orleans with locals and CSM attendees alike, and I felt like I was experiencing the city in a much more intimate capacity. Shoutout to the good people of New Orleans who always seem willing to make conversation and give restaurant recommendations while waiting for trolleys.

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  1. Network! As a self-proclaimed hater of all networking-related activity, I urge you to do this! Allow me to make a blanket statement and say that physical therapists are friendly, kind, and wonderful people who love talking to students, sharing their knowledge, and saving lives. Asking questions in educational sessions, talking to vendors in the exhibit hall, and even making small talk with the PT sitting next to you are all ways to get more out of your CSM experience. It’s also a way to dip your toes into the ocean of job hunting. I left with business cards, new aspirations to become a travel therapist, and more free t-shirts than I care to admit.

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  1. Quality over quantity! Strike a balance between conference time and exploration time. You could easily spend your time doing nothing but CSM from dawn to dusk, and that’s awesome! But, you don’t have to do that. You can get there a day early or take a later flight out if it means you have time to wander and be inspired by a new city, new friends, or live music. Your memory of this time will likely not only include the conference, but the people you were with and the place you were in. In my opinion, when you finally get home, your heart should be full, and your feet should be sore.

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Dry Needling…Not a Type of Craft that Your Grandmother Does

Name: Katherine Koch

Undergrad: The Ohio State University

Hometown: Cleveland, OH

Fun Fact: Last summer, I climbed six 14ers

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Dry needlingnot a type of craft that your grandmother does. This type of treatment uses thin filiform needles inserted by a physical therapist into myofascial trigger points, or a tight band of muscle that might be causing pain (1). Dry needling is based on physiological evidence supported by research that is usually part of a broader treatment plan (2). If this needling sounds familiar to you, you’re not alone. Acupuncturists use the same type of needle to adjust the flow of energy, or chi, throughout meridians in the body. Acupuncture is an ancient Chinese medicine and operates based on the belief that these thin needles can relieve tension, stress, and pain when inserted by an acupuncturist (3). While you won’t be getting an itchy sweater from this treatment, it can lead to pain relief for many people. 

However, there is still confusion and debate among physical therapists and acupuncturists concerning the rights and responsibilities of physical therapists in performing dry needling on their patients. This debate of dry needling by physical therapists was recently taken to a Denver district court when the Acupuncture Association of Colorado (AAC) challenged the Colorado State Physical Therapy Board (Board). The AAC claimed that physical therapists had not undergone enough training to perform dry needling and requested the Board reverse the rule that allows physical therapists to practice this method of treatment. The AAC argued that physical therapists only perform 46 hours of training to be certified to practice dry needling, while acupuncturists train for almost 2,000 hours. The association claimed this made dry needling by physical therapists an “unsafe practice of acupuncture” (4). However, this statement is strongly misleading due to the additional 3,400 hours of doctorate level schooling that physical therapists already have behind them before they complete those 46 hours specific to dry needling training. Physical therapists spend three years in graduate school learning how the human body works, what can go wrong with it, and how to fix it within the realm of physical therapy. Additionally, doctors of physical therapy are required to take continuing education courses throughout their careers.

Additionally, the AAC made the claim that dry needling is just a misnomer for acupuncture, while the two are fundamentally different practices. They may look similar to the untrained recipient, but physical therapists and acupuncturists perform their respective treatments with fundamental ideological differences between the two. This is not to say that one is better than the other, and patients may make the informed autonomous decision to receive either or both treatments. However, as the Denver District Court decided, there is no need to prevent members of one profession from performing treatments all together. In December 2017, the court recognized that physical therapists are acting within the Colorado Physical Therapy Practice Act when they perform dry needling.

As the Colorado Chapter of the APTA President Cameron MacDonald put so eloquently,

“this legal debate was brought forth by those who wished to restrict the practice of another profession from their own. This debate could have been about any intervention utilized by physical therapists, and not just dry needling. It is imperative to consider this legal challenge and the lawsuits brought against the Colorado PT Board through the lens of the Colorado consumer of healthcare. Consumers in Colorado are provided access to health care providers which have a defined scope of practice under which to deliver patient care. Health care professionals are expected to provide the best care they can, and to practice under a scope flexible enough to both protect the consumer and not limit the development of practice by health care providers.”

When physical therapists perform dry needling, they are practicing within their professional scope. When acupuncturists perform acupuncture, they are practicing within their professional scope. Both professions can live harmoniously alongside each other while helping patients within their respective realms.

Why does any of this matter? First, any judicial ruling or legislative rule concerning a profession as a whole likely has implications that affect many of its members. In this case, physical therapists that perform dry needling in Colorado were in danger of losing their legal right to treat patients in this way. Further, patients were in danger of losing out on a treatment that can benefit them. To be effective health care providers, it is imperative that physical therapists are informed practitioners in order to best advocate for their profession and best treat their patients. Denying to inform themselves and take positive action does a disservice to future physical therapists and patients who will benefit from the work done to advance the profession today. In order to practice as autonomous providers, physical therapists must continue to advocate for their profession and understand the issues surrounding it. It also stands to reason that since the American Physical Therapy Association participated in this case as an amicus party and presented information that no doubt helped sway the case, physical therapists should support and be members of the organization that advocates for them on this broad level.

This debate is not in Colorado alone; lawsuits in three states have gone the opposite way and the state boards have been forced to remove dry needling provisions from their practice acts.4 Since each state has their own physical therapy act, it is important that the Colorado practice act, which will be revised next year, continues to maintain its inclusive language that provides “for new developments in physical therapy practice, which includes dry needling” (Caplan and Earnest, LLC, personal communication, January 9, 2018). For the good of physical therapists, patients, and the future of physical therapy as a profession, this particular case is closed.


If you are a student physical therapist, like myself, who hopes to perform dry needling as a professional one day or if you simply would like to learn more about its practice, please refer to the references below.

  1. Dry Needling by a Physical Therapist: What You Should Know. American Physical Therapy Association. http://www.moveforwardpt.com/Resources/Detail/dry-needling-by-physical-therapist-what-you-should. Published December 25, 2017. Accessed January 28, 2018.
  2. Gattie E, Cleland JA, Snodgrass S. The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;:1-41.
  3. Miller J. Physio Works – Physiotherapy Brisbane. Acupuncture and Dry Needling. https://physioworks.com.au/treatments-1/acupuncture-and-dry-needling. Accessed January 28, 2018.
  4. Migoya D. Acupuncturists sue Colorado’s physical therapy board over the very definition of their craft. The Denver Post. https://www.denverpost.com/2017/04/05/acupuncturists-sue-board/. Published April 7, 2017. Accessed January 28, 2018.