role of the physical therapist as a consultant.

3.  Consultation
“Consultation is the rendering of professional or expert opinion
or advice by a physical therapist.
or
“Consultation is the practice of providing advice for a fee.”
The consulting physical therapist applies highly specialized
knowledge and skills to identify problems, recommend solutions,
or produce a specified outcome or product in a given amount of
time on behalf of a patient/client.”

4. This is a two way interaction
Client pay fee and physical therapist in return give
expert opinion
 A process in which a person or an organization
seeks help, which the consultant provides
 The ultimate outcome of the process is a change in
the way the person functions or an organizations
operates.

5.  The person or an organization seeking help is the
client, who may also be known as the
Customer, Patient, or Advisee”.
 key function of Physical therapy profession are
Advising ,Coaching ,counselling & consulting
 Frame work of Responsibilities in term of client:
1. Assessment
2. Investigative studies
3. Problem solving
4. Advice
5. Specialized services
6. Administrative skills

6.  Level 1:Service Based Consultation:
 A PT consultant contract to provide direct patient
care services for a rural hospital on a temporary
basis.
 A PT consultant Contract to develop a new
speciality service for individual with lung disease
that develop secondary to a occupational exposure.

7.  A physical therapy practice has a problem with a
very high percentage of reimbursement denials
from a particular third party payers. The group hire
a PT Consultant to develop and implement a
training program for the rehabilitation team that
will provide guideline for the reimbursement and
for effective documentation that charges for
support.
 Hire a PT consultant to develop procedures that will
ensure that the practice is in compliance. (Health
insurance portability and accountability act )

8.  A PT Consultant is hired by a newly formed
physical therapy group to help develop its services
from the ground up: Mission statement, Budgeting
,policies and procedures, hiring criteria and
marketing strategies.
 A PT consultant is hired by the same group a year
later to help determine whether the practice should
expand in to new market.

9.  A Physical therapist engages a consultant. They
meet at least four times a year to brainstorm the
ideas for the physical therapist’s practice and
professional development.
 Others:
 General Physical therapist consultants
 Physical therapy education consultants
 Physical therapy private practice development consultants
 Sports medicine consultants

10. Method:
 Determine the potential Clients are willing to pay
(find out the fee paid other consultant in the area).
 Determine your living and business expenses.
 Calculate the no of consulting days per year you
need to break even. for example lets say the daily
consultation fee for PT consultants in your area is
1000.Rs and your annual income goal is
200,000.Rs
 200,000/1000 = 200
 You will need to work about 200 billable days to
meet your income goal.

11. The proposal should include the following sections,
which are based on an outline by Hoyt
 Purpose of the proposal [or an objective]: A
brief statement, couched in general terms, of
what the client wants.
 Solution or action steps: this section
specifies the sequential actions to be taken,
including dates for submission of periodic
progress reports. The steps may include
information and data gathering, design,
content to be included, materials needed, and
the implementation strategy

12.  Anticipated benefits: The improvements the
client can expect as a result of the
consultation.
 Evaluation: A plan for measuring the
effectiveness of the consultation.

13. Elements of patients /clients
Management
Examination
Evaluation
Diagnosis
Prognosis
Intervention
Out come
Phases in Consulting
Date collection
Identifying problems
through diagnostic analysis
Setting goals and
planning for Actions
Taking actions, cycling
Feedback, and completing the
project
Evaluation

14. 1. Entrepreneurial talent
2. Ability to communicate
3. Ability to work under pressure
4. Ability to diagnose problem and find
solution
5. Ability to build a trustworthy relationship
with clients.
6. Technical capabilities
7. Good Advice
8. Must be adventuresome (willing to accept
risks and determine to answers the
problems)

15.  Consultant must place clients interests above their
own
 Trusting and being trusted.
 It will improve Quality of Relationship with clients
 It will reduce Legal and ethical issues

16. 1. The duration of the agreement
2. In what ways ,when ,and by whom the agreement can
be terminated.
3. The nature and scope of services to be performed
4. The details of payments of compensations and costs
5. Special requirements to protect the client such as
handling of confidential information
6. The manners in which any dispute will be resolved.
7. The manners in which formal notice to be given and
change of assignment.

17.  Lippitt have devised a code of ethics for
consultants based on 11 principles:
 Mnemonic (I.A.A.M.R.C.C.C.R.R.P)
1. Intraprofessional and interprofessional
relations
2. Avoidance of misrepresentation
3. Announcement of services
4. Moral and legal standards
5. Responsibility
6. Competence

18. 7.Confidentiality
8.Client welfare
9.Remuneration
10.Responsibility toward client organization
11.Promotional activity

19.  Ethical principles provide general guidance for
helping us make ethical decisions:
a) Respect for autonomy
b) No maleficence
c) Beneficence
d) Justice

20.  The principle of nonmaleficence is an
obligation not to inflict harm intentionally.
 Most persons who choose a health care
career only want to help people, not harm
them.
 One way to remember the meaning of this
principle is to think of the phrase in the
Hippocratic oath, "To first do no harm."
Usually issues of nonmaleficence are
discussed when patients are at the end of
life.
 We often must decide if continuing
treatments cause the patient more harm
than benefit.

21.  The principle of beneficence is a moral obligation to act to
benefit others.
 There are, however, risks associated with beneficence.
Sometimes we want to help our patients so much, that we begin
to believe that we know what is best for them.
 We sometimes believe that they should do whatever we
recommend since we have the most knowledge about their
condition.
 When we believe that we know what is best for a patient even
when they do not agree, we risk stepping over the boundary
from beneficence to paternalism. When this happens, the
patient's autonomy is not respected.
 If you find that you are trying to convince patients to do things
your way by saying, "It is for your own good," you might be
using a form of paternalism.

22.  The principle of justice means that all similarly situated
persons receive their "fair share" of benefits and assume
their fair share of burdens.
 For example, health care is a benefit that should be fairly
distributed and taxes are a burden that we also try to
share fairly.
 There are at least three types of justice that include
:
1 .compensatory (Compensatory justice concerns
compensation for wrongs that have been done)
2. Procedural (Procedural justice involves how the laws
are procedurally carried out)
3. Distributive. (Distributive justice involves the fair
allotment of benefits or burdens, especially when there is
competition for resources. )

23. THANKS