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Sarah Suddarth Byrd, President
TPT - PAC
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Nashville, TN 37215
Dry Needling for Physical Therapists
On June 19, 2014, the Office of the Attorney General, in response to the Tennessee Board of Physical Therapy, opined that “Intramuscular Manual Therapy, also known as Trigger-Point Dry Needling”, is not within the scope of the practice of physical therapy under the Occupational and Physical Therapy Practice Act, Tenn. Code Ann. §§ 63-13-101 to -318. In light of this opinion, I would like to outline how our profession arrived at this current juncture regarding Dry Needling and what we, as TPTA members, can do between now and the reconvening of the Tennessee General Assembly in January of 2015. Why did the Board of Physical Therapy request an Attorney General's Opinion on whether the practice of Trigger-Point Dry Needling was within the scope of the practice of physical therapy? In February of 2013, The Board of Physical Therapy's attorney, who is not the Board's current attorney, requested the Board overturn its statement that Dry Needling was within the scope of practice of physical therapy. Matt Hayes, and other members took the time to educate the Board on the practice of Dry Needling, and ultimately the Board decided to not overturn its position that Dry Needling was within the scope of practice of physical therapy. As a result of the Board's refusal to overturn its statement regarding Dry Needling, the Board's then attorney informed the Board another profession was considering legal action, and asked the Board to request an attorney general's opinion as to whether Dry Needling was within the scope of practice of physical therapy. In order to develop a plan of action, the Board created a Dry Needling taskforce, which included myself, to develop the question and supporting evidence that would be formally submitted to the Office of the Attorney General. The taskforce knew the wording of the question posed to the Office of the Attorney General would be critical, and there was concern from the taskforce that if the language of the question was not properly worded, another profession would pose the question with language more favorable to their profession's position on Trigger-Point Dry Needling. To ensure the question posed to the Office of the Attorney General was properly drafted and supported by the best evidence available, TPTA utilized a grant from the APTA to procure the services of a law firm familiar with requesting opinions from state attorney generals. The law firm reviewed current Tennessee law governing the practice of physical therapy and acupuncture. The law firm also reviewed recent attorney general opinions from surrounding states. After the law firm's research was completed, a 12 page-supporting document was drafted, and the Board agreed to use the law firm's document and submitted the document to the Office of the Attorney General for review. As stated earlier, on June 19, 2014, the Office of the Attorney General opined that Trigger-Point Dry Needling is not within the scope of the practice of physical therapy. In light of the June 19, 2014 opinion issued by the Office of the Attorney General regarding Trigger-Point Dry Needling and the practice of physical therapy, what next steps should TPTA membership take between now and the reconvening of the Tennessee General Assembly in January of 2015? Before I outline what I believe should be TPTA's course of action regarding Dry Needling and the practice of physical therapy, I would like provide a brief history of how far TPTA and its membership have come in the legislative arena. In 2006, physical therapy as a profession, was not well known in the hallways of legislative plaza. At that time, TPTA had few members show up for our day on the hill, and as a whole our membership's interest in legislative affairs was lacking, but this changed when another profession opened our profession’s practice act. In the time period following the events of 2006, TPTA's political action committee or "PAC" has seen tremendous growth. In the days prior to 2006, our PAC has grown from annual contributions of several hundred dollars to annual contributions approaching $20,000 dollars. Our profession's presence on the hill is now well known, and many legislators are now on a first name basis with Joe Black and myself. Our day on the hill is well attended now, and TPTA just completed its third legislative training session this past fall. The legislative training sessions have educated approximately 70 physical therapists and physical therapy assistants. Between now and the reconvening of the General Assembly in January, TPTA will need to draw heavily on our legislative experience to educate the members of the General Assembly about the importance of Trigger-Point Dry Needling to the practice of physical therapy in Tennessee. As in 2006, I see an opportunity to educate more physical therapists and physical therapy assistants on the legislative process. As this issue has demonstrated, our profession needs to not only take action, but correct action, based on our years of legislative experience. We have made many strong connections with legislators at the General Assembly and we must be prepared to utilize these connections effectively. Dry Needling my not involve your practice, but the next legislative fight may. We must stay actively involved in the goings on at the General Assembly, and we must protect our ability to help our patients. The TPTA has decided to address Dry Needling legislatively, and I expect this battle will require considerable resources from our membership. When TPTA addressed Direct Access legislatively, it required a large commitment from our membership. It took many of our members away from their practices and families for extended periods of time over a period of several years before our goal was achieved. During Direct Access battle, TPTA expended a large amount of financial resources and what I like to call "legislative credit" to accomplish our goal. The result of expending legislative credit to achieve a legislative victory comes with the knowledge it takes time, oftentimes years, between legislative battles to build credit with legislators back up. With our legislative credit reserves built back up, we begin this new battle to protect the use of Dry Needling by members of our profession in Tennessee. In the intervening months between now and the reconvening of the General Assembly, TPTA will be laying the groundwork for the legislative battle in January 2015. Our lobbyist will begin the process of reaching out to the lobbyists of other interested professions. TPTA will schedule a meeting to discuss our legislative strategy with the APTA, the law firm hired to draft the question posed to the Office of the Attorney General, and the TPTA Executive Committee. The meeting will also involve the Practice Chair, Legislative Chair and our lobbyist. The TPTA Executive Committee will be meeting on July 31, 2014 in Nashville, TN. The Board of Physical Therapy will meet on August 8, 2014, and the Board meetings are always open to the public. If you plan on attending the Board meeting, I would appreciate it if you would introduce yourself to Cathy Hinton, the Board's liaison, and introduce yourself to me as well. If you have specific questions you would like to ask the Board, I would request you send your questions to Cathy or myself so we can compile and condense the questions so as to move the meeting along. It should be noted, it is ultimately up to the Board to decide whether or not it will entertain questions and comments. The Board's directive is to protect the public, not the profession. Protecting the profession is the directive of the TPTA. As a TPTA member, you may be asking yourself, what can I as a member do now? First and foremost, TPTA members must maintain a unified front on Dry Needling and we as members must be speaking in one voice when we communicate our message. Once the General Assembly reconvenes in January, TPTA will prepare talking points and the names of key legislators sensitive to our cause. In the meantime, I cannot stress how important it is for TPTA members to contribute to our PAC. To find out more information about giving to the TPTA PAC, go to our website where you will find a link on how to give to the TPTA PAC. Remember, PAC contributions do not buy votes, but they do assist in getting TPTA's foot inside a legislator's door. During 2014, TPTA's PAC has seen great activity. Currently, the PAC has seen contributions from 56 members, while this is a high point for our profession, we are still only at a contribution rate of 0.7% from a pool of 4,860 physical therapists and 3,200 physical therapy assistants. As a comparison, chiropractors, whose numbers are significantly less than our own, distributed $56,825 dollars in PAC money during the 2013 cycle. While I firmly believe PAC contributions are the most important tool in our legislative toolbox, I can also not stress enough how important legislator relationship building is as well. Make sure you know your legislator, and if you don't know them, begin the process as soon as possible. As we are in an election year, find out when your legislator's next campaign event is and attend it. Ask your legislator to visit your clinic. Keep in mind, your average legislator has no idea what valuable work our profession performs, so use this as an opportunity to educate them. If you already know your legislator, go ahead and let them know the facts about Dry Needling. Let your legislator know physical therapists have been performing Dry Needling for the benefit of our patients. Make your legislator aware of the recent attorney general's opinion stating Trigger-Point Dry Needling is not within the scope of practice of physical therapy. Also, let your legislator know a bill will be brought during the upcoming legislative session in January and you will keep in touch with them on the details of the bill. If a legislator asks a question you don't know the answer to, then tell them you will find an answer to their question, and you will get back to them. This will provide you with another opportunity to build on the relationship you have developed with your legislator. Finally, TPTA had several practitioners volunteer as Dry Needling content experts and as the time approaches TPTA will create talking points and reach out to you. TPTA has a good start on collecting Dry Needling research articles, and if you have high-level, published research articles you can forward them to Rachel Grubbs who will filter out the duplicates and compile the information.
Tennessee Board of Physical Therapy: August 8, 2014 Meeting The Tennessee Board of Physical Therapy held a regularly scheduled meeting on August 8, 2014 in Nashville, TN. The Board and its attorney Grant Mullins made the following comments on dry needling: I. Can Tennessee Physical Therapists teach, educate or research dry needling? Board attorney Grant Mullins advised the Board to not answer the question. Mullins stated that he has consulted with fellow Office of General Counsel attorneys and he referred to Tennessee Code Annotated 63-13-103 (15) for statutory support. Mullins recommended that each institution that wishes to teach, educate or research dry needling should consult with their own in-house counsel on how the institution should proceed. II. Can Tennessee Physical Therapists perform dry needling in Tennessee? Attorney General Opinion No. 14-62 carries the same weight as the law in Tennessee. Relying on the Attorney General Opinion, Board attorney Grant Mullins clearly stated, "If you are practicing dry needling as Physical Therapist, you are practicing outside of the scope of Physical Therapy in Tennessee." Mullins noted that the penalty for practicing outside of the scope of practice in Tennessee is a class B misdemeanor. III. What is the Tennessee Board of Physical Therapy's position on dry needling? Attorney General Opinion No. 14-62 neutralized the Board’s prior policy on dry needling. The Board moved to withdraw its position on dry needling until legislation is passed at the Tennessee General Assembly. If you have any further questions for the Tennessee Board of Physical Therapy, please contact them at 615-741-3807. TPT-PAC
DISCLAIMER: This State PT-PAC has self-enrolled in this program. All funds raised are disbursed quarterly according to PT4PT, LLC policies and procedures and the contribution records disclaimed in the name of the purchaser along with the contribution to the PAC, in full compliance with this state’s political contributions guidelines.