title: Practice analysis: defining the clinical practice of primary contact physical therapy.
abstract: METHODS
  Nonexperimental descriptive research design.
  
  
  OBJECTIVE
  To describe the frequency of use and perceived level of importance of professional responsibilities, procedures, and knowledge areas by physical therapists practicing in primary contact care settings and to compare these data to similar data from physical therapists practicing in nonprimary contact care settings.
  
  
  BACKGROUND
  Physical therapy services have moved toward a primary contact model of practice in response to changes in the health care delivery system. Several studies have reported the effectiveness of primary contact physical therapy. However, a practice analysis has not been performed to define the clinical practice of primary contact physical therapy.
  
  
  METHODS
  A sample of 212 physical therapists practicing as primary contact providers in the military and civilian sectors, and a comparison group of 250 physical therapists not practicing as primary contact providers were surveyed. A Delphi technique was used to develop the survey instrument, which was pretested by a pilot group. The final survey instrument consisted of 171 items. Chi-square and Kruskal-Wallis tests were conducted to examine significant differences among the 3 groups (P<.001).
  
  
  RESULTS
  Of the 212 surveys mailed to the primary contact group, 119 (56.1%) responses were received (82 military physical therapists and 37 civilian physical therapists). Of the 250 surveys mailed to the comparison group, 103 (41.2%) responses were received. There were numerous significant differences among the 3 groups in professional responsibilities, procedures, and knowledge areas, most notably in the areas of selecting and ordering of imaging procedures, identifying signs and symptoms of nonmusculoskeletal conditions, establishing physical therapy diagnoses, and prescribing over-the-counter medications.
  
  
  CONCLUSIONS
  The study describes the clinical practice of physical therapists functioning in the role of primary contact providers or as members of a diverse team of health care professionals in primary care, which may provide curricular direction to professional, postprofessional, and clinical residency or fellowship-based educational settings.
authors.affiliation: Kaiser Permanente, Department of Physical Medicine, Fontana, CA, USA. edonato@adelphia.net
authors.forename: Edsen B
authors.initials: EB
authors.lastname: Donato
authors.forename: Robert E
authors.initials: RE
authors.lastname: DuVall
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Godges
authors.forename: Grenith J
authors.initials: GJ
authors.lastname: Zimmerman
authors.forename: David G
authors.initials: DG
authors.lastname: Greathouse
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001291:Attitude of Health Personnel; D002140:California; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D026761:Physical Therapy Specialty / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011364:Professional Practice / Q000706:statistics & numerical data*; D024382:Professional Role; D017678:Sex Distribution