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Health-focused practice: Implications

Health-focused practice in physical therapy practice has several implications for professional education and research as well as clinical practice. First, health-focused practice legitimizes health as a focus of physical therapy rather than a primary focus on illness and disability. Epidemiology and the elements of health, health risk, and chronic conditions that need to be included in entry-level curricula are outlined. Even when illness or disability is the reason for a patient seeing a physical therapist, health-focused practice will ensure that the patient’s health priorities are being addressed in the context of the presenting concern and priority. This will provide an optimal level of care for the patient overall and may augment the management of the primary problem (e.g., a weight reduction program for a patient with low back pain, or smoking cessation in a patient with cardiovascular disease being seen for a groin strain). Lifestyle factors impact the health and well-being of individuals multisystemically. Address-ing lifestyle factors may eliminate the cause of an individual’s impairments as opposed to a primary focus on the impairment and enhance quality of life. Even if the cause is not eliminated, the symptoms may be reduced such they are more responsive to impairment-focused interventions.

Health-focused physical therapy practice would enable those involved with developing practice standards and clinical competencies and professional education curricula to integrate content related to health and epidemiological trends and priorities. In turn, such health proficiencies articulated by the profession would help have this essential area of health care recognized by third-party payers of health care, which is an important initiative given the powerful force that this has been directing physical therapy practice in some countries (e.g., the United States) (APTA, 2001). With the profession adopting health-focused practice in the 21st century, researchers can cite health as a primary value of care within the profession, hence, a legitimate area of research investigation by physical therapists. Physical therapy research is needed to help develop and refine health and wellness assessment and out-come measures, and the sensitivity of risk factor indices as outcomes. A healthy control group would be an advance in the biomedical research model (e.g., randomized control clinical trials as well as other research designs) so that the power of health can be fully understood. The inclusion of a health focus into physical therapy practice this century is both timely and evidence informed. This focus legitimizes health and well-being as physical therapy priorities, irrespective of a practitioner’s specialty or practice setting. In turn, health-focused practice alerts other health care professionals and the public to the profession’s commitment to this fundamental value and formally establishes common ground with other professionals committed to the health and well-being of the people in our communities. Such assessment and inter-vention need to be viewed as clinical competencies as well as the skills to effect health behavior change through outcome evaluation. Early detection and intervention, the leading health priorities in the 21st century, may avert the potentially life-threatening lifestyle conditions.

Acknowledgment

References

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