Musing on Diagnosis

Physical therapy clinicians seem increasingly interested in diagnostic process and content as the profession moves toward more independent modes of practice. This interest is probably sustained by the following: 1) The recent success of chapters in obtaining direct access (currently, in 20 states an individual legally has direct access to a physical therapist); 2) The referral relationship between physical therapists and other health care practitioners now is primarily an “evaluate-and-treat” rather than a prescriptive mode (ie, physical therapists are now writing the prescriptions rather than just filling the prescriptions); 3) An increased awareness that the diagnostic process allows a more rational approach to planning, prescribing, and assessing treatment or management strategies; and 4) An intellectual stimulation and satisfaction derived from using the diagnosis as the keystone of practice. Working against these positive vectors are our conditioned notions that only physicians make diagnoses, or that making a diagnosis is equivalent to practicing medicine.