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Is a diagnosis nevertheless required by a diagnostician in order for a physical therapist to provide treatment under current law?

Physical therapists are not required to have a referral from a physician in order to provide treatment. The scope of practice of a licensed physical therapist in 1965 was set forth in then Section 2660 of the Business and Professions Code (All section references are to that Code). That section provided:

"2660. The term "physical therapy" shall mean the treatment of any bodily mental condition of any person by the use of the physical, chemical and other properties of heat, light, water, electricity, massage and active, passive, and resistive exercise. The use of roentgen rays and radioactive materials for diagnostic and therapeutic purposes, and the use of electricity for surgical purposes, including cauterization, are not authorized under the term "physical therapy" as used herein and a license issued hereunder shall not authorize the diagnosis of disease."

Section 2621 further provides:

"2621. Nothing in this chapter shall be construed as authorizing a physical therapist to practice medicine, surgery, or any other form of healing except as authorized by Section 2620."

The scope of practice of physical therapists (now section 2620 of the Code) was notably broadened by the authorization to perform physical therapy evaluations and treatment planning. May a physical therapy evaluation supplant a diagnosis when a diagnostician has not seen a patient initially? The Legislature reiterated in section 2621 that physical therapist may not practice medicine or diagnose (q.v. Section 2051).

It is clear from a reading of these statutes and authorities that recognizing disease or other physical condition is a result of the making of a diagnosis, and that logically a disease or other physical condition cannot be treated without a diagnosis. Therefore, if a physical therapist encounters a patient whose condition has not been diagnosed by a diagnostician, he or she should not treat the same without advice as to the diagnosis of the patient's condition by a physician.

To conclude, the Physical Therapy Board of California concurs with the opinions of the Attorney General and staff counsel, which support that a physical therapist may practice without a physician's referral, provided that a diagnosis is obtained from a diagnostician.

Note: This document is not a declaratory opinion of the Physical Therapy Board of California.