Some states include animal rehabilitation in their definition of the practice of veterinary medicine; others offer exemptions. Many states do not address the field at all.
Before adjourning for the year, the California Assembly considered but did not pass a bill that would have removed the state's requirement that physical therapists offer animal rehabilitation only on veterinary premises.
The bill would have required the California Veterinary Medical Board to establish a certificate in animal physical rehabilitation for physical therapists, require facilities that offer animal physical rehabilitation to register with the board, and allow a veterinarian to determine the appropriate level of supervision for a certified physical therapist performing animal rehabilitation.
Valerie Fenstermaker, executive director of the California VMA, said, "The bill allowed for a veterinarian to refer a patient to a physical therapist who owned an independent animal rehabilitation practice with no veterinarian present and without re-establishing the veterinarian-client-patient relationship."
The board and CVMA opposed the bill, and the California Association of Animal Physical Therapists supported the bill.
"I think that PTs have a lot to add to our understanding of rehabilitation," said Dr. Chris Zink of Zink Integrative Sports Medicine in Maryland, president-elect of the American College of Veterinary Sports Medicine and Rehabilitation. "Their training and their thought processes are entirely different from that of veterinarians, and we are better if we work together."
Dr. Zink is on the faculty of the Canine Rehabilitation Institute, based out of Florida and Colorado and founded by another veterinarian, Dr. Janet Van Dyke. The institute offers certification programs for veterinarians, physical therapists, and veterinary technicians.
Adding to the mix, the National Association of Veterinary Technicians in America granted provisional recognition to the Academy of Physical Rehabilitation Veterinary Technicians last year.
Dr. Rosemary J. LoGiudice believes a rehabilitation-trained veterinarian is the appropriate leader of a team working with an animal patient. Dr. LoGiudice is with Integrative Veterinary Rehabilitation & Sports Medicine in Illinois and secretary of the ACVSMR.
Dr. LoGiudice said other team members could include veterinary technicians and physical therapists. She believes all team members need to be supervised by a veterinarian, but her opinion is that the supervision can be indirect, meaning that a veterinarian need not be on the premises.
The AVMA and the American Association of Rehabilitation Veterinarians have supported veterinary supervision of animal rehabilitation but have not specified whether supervision should be direct or indirect. California currently requires direct supervision, with a veterinarian on the premises.
In comments to the California Assembly, the California VMA wrote, "There are many successful veterinary practices with veterinarians, certified registered veterinary technicians and physical therapists providing animal rehabilitation under the current supervision model. The CVMA believes this is best for the animal patient and the client."
The California Veterinary Medical Board wrote that direct supervision allows for collaboration on the total medical picture with the veterinarian who has established the veterinarian-client-patient relationship and has the ultimate responsibility for the patient.
Related JAVMA content:
Jumping into canine sports (July 15, 2018)