Separate physiotherapy council in NCHRH

1. As per research done in 1999 by Gavin Daker-White, et al. Orthopaedic physiotherapy specialists are as effective as post-Fellowship junior orthopaedic surgeons in the initial assessment and management of new referrals to outpatient orthopaedic departments. It is a research article published in "Journal of Epidemological Community Health". Also, physiotherapists/physical therapists are playing a major role in helping a patient in his direct hospital cost. This research article clearly telling that, Physiotherapists/Physical Therapists are efficient in examination a patient and having a capability to assess and treat a new referrals as a first contact personal. http://jech.bmj.com/content/53/10/643.full.pdf+html

2. A research done in 2005 stating that Physiotherapist/Physical Therapist having a major role in Accident and Emergency care for patients with soft tissue injury without fracture. As we know, Accident and Emergency care means we are not considering only fractures. Other than that, like inflammation, cellulitis, effusion, bursitis, tendonitis, tenosynovitis. In this article, they clearly mentioned that "there is a difference in diagnostic style of physiotherapists and doctors rather than disparity in injury type". Even, patients expressed greater satisfaction with their Accident and Emergency care by a physiotherapist/Physical Therapist in this research article which was done in UK. http://emj.bmj.com/content/22/2/87.full.pdf+html

3. Another research was done in 2003, concluding that "A physiotherapy practitioner working with an extended role is a valuable addition to an Accident and Emergency department. Also, a Physiotherapist is playing a role in developing the protocols with other medical professionals". This one is clearly showing the important role of a Physiotherapist/Physical Therapist in examination of a patient and in the planning of treatment. http://emj.bmj.com/content/20/1/37.full.pdf+html

4. In USA a research done to know the Physiotherapist/Physical Therapist knowledge in managing musculoskeletal conditions. And its done in 2005, clearly stating that "Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists. The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions. http://www.biomedcentral.com/1471-2474/6/32

5. In Melbourne, Australia year 2007, another research was done to know the efficacy of a physiotherapist/Physical Therapist in assessing and planning out the treatment for musculoskeletal conditions in a orthopaedic outpatient department as a first contact person rather than a orthopaedic surgeon. In this study, Physiotherapists/Physical Therapists identified the same patient management plans as the surgeon for 74% of the group. Patients and doctors reported high levels of satisfaction with the physiotherapist. This study is also giving a clear view that, Physiotherapists/Physical Therapists can be as a Independent practitioners as a first contact persons. https://www.mja.com.au/public/issues/186_12_180607/old10986_fm.pdf All above research articles are clearly stating that, Physiotherapists/Physical Therapists can be a direct access health care providers in the society. these all are with evidence based and also by a peer reviewed decisions, which i submitted above.

6. Also another research done in 2006, concluding that the risk from either diagnosis or intervention from a physical therapist is extraordinarily low, with the possibility of substantial benefit. This optimal combination of substantial benefit, with little or no risk, is relatively rare in the healthcare field and therefore represents an attractive healthcare investment. Physical therapists/Physical Therapists are diagnostically competent and fully capable of determining the appropriate patient to treat or refer. The diagnostic accuracy of physical therapists has been directly compared to orthopaedic surgeons in prospective clinical trials, physical therapists have been found to be as diagnostically accurate as the orthopaedic surgeons and patients were more satisfied when they were seen by the physical therapists. So, this research giving clear view that, there is no any harm to the patient when a Physiotherapist/Physical Therapist handled case on direct access. http://www.sonafe.org.br/images_up/Direct_Access_Physical_Therapy_and_DiagnosticResponsability.pdf

7. The recent research done in 2011 and in that they stated "Multiple data sources, including a systematic review of the literature, revealed that direct access does not pose a risk to public safety and may result in better outcomes with regard to cost and quality of care". And it clearly given a path that "Direct consumer access to physical therapy services appears to be sound health policy". http://www.physther.net/content/92/2/236.abstract

8. And another research study clearly stated that "In 2006, direct access to physical therapy was introduced in the Netherlands". Also, by changing from refferal based to direct access also, patient ratio was didn't decline and patients used this self referral base. This study clearly stated that "already Physiotherapy/Physical Therapy is having its own independent status and also, Direct access capability in so many other countries. http://www.physther.net/content/88/8/936.full.pdf+html All above research evidence are giving a bright way to the Physiotherapy/Physical Therapy profession, to have a major role in health care profession. But, in India by lacking of proper regulatory body our Physiotherapists/Physical Therapists are not getting proper scope and support to prove themselves. My kind request to the government is "please go through all these scientific research evidence and please help Physiotherapy/Physical therapy profession in India by giving an independent status".

9. An experienced Physiotherapist/Physical Therapist, an Orthopaedic Surgeon, and two Orthopaedic Residents having similarly high diagnostic skills. This also proved in 2009, and showing the Clinical Diagnostic Accuracy of 85.3% (29/34 correct) for the Physiotherapist/Physical Therapist, 84.4% (27/32 correct) for the Orthopaedic Surgeon, and 80.0% (24/30 correct) for Orthopaedic Residents in diagnosing a Acetabular Labral Tears. Results showing that a Physiotherapist/Physical Therapist is having more percentage of Diagnostic accuracy than Orthopaedic Surgeons. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953315/pdf/najspt-04-038.pdf 10. An important case has been reported in 2009, A 77-year-old man was referred for physical therapy by his primary care physician with diagnoses of lumbar spine and left hip osteoarthritis and possible trochanteric bursitis. After the examination, the physical therapist determined that the patient should return to his primary care physician for further testing.

Findings leading to this conclusion were pain severity out of proportion to the reported injury, the presence of night pain, a positive “sign of the buttock,” and empty end feels of all hip joint motions, which represented a noncapsular pattern of joint restriction. The patient was diagnosed later with primary lung adenocarcinoma with widespread metastases. A computerized tomography scan of the left hip revealed a metastatic lesion at the left proximal femur. By playing a timely role by a Physiotherapist/Physical Therapist here gave very good and accurate information about the exact cause of a problem facing by a patient, which is failed by a primary care physician to diagnose it primarily. This is an outstanding example to tell about the stamina and clinical sound full knowledge of a Physiotherapist/Physical Therapist for direct access and for independent status. http://ptjournal.apta.org/content/89/3/248.full.pdf+html These all are a few examples for Physiotherapy/Physical Therapy capabilities in health care profession. Also, it evolved in various branches in health care and serving the people with sound full knowledge and timely concern. Madam, please consider and please check thoroughly about my given research evidence and my points and please help Physiotherapy/Physical Therapy profession in India for an independent status.
Yours Faithfully, n.ananth