As a PT, what do you do when you disagree with the doctor's diagnosis?

[jhood654]

As a PT, is there a right way to handle a situation where you disagree with the doctor's diagnosis?

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[ya1]

I do an eval and state that the patient does not present with signs and symptoms of WHATEVER the Dr's DIAGNOSIS IS. For example, I had a patient referred to us for Hip bursitis. No swelling was noted, no pain with palpation over greater trochanter. All tests for trochanteric bursitis were negative. From here, you can either end up with your own different diagnosis or if you did not find anything you as a PT can help the patient with, you send the patient back to the doctor or /and refer to another specialist, and /or suggest specific tests ( x ray, MRI, etc).

 

[jhood654]

Thank you!

I do an eval and state that the patient does not present with signs and symptoms of WHATEVER the Dr's DIAGNOSIS IS. For example, I had a patient referred to us for Hip bursitis. No swelling was noted, no pain with palpation over greater trochanter. All tests for trochanteric bursitis were negative. From here, you can either end up with your own different diagnosis or if you did not find anything you as a PT can help the patient with, you send the patient back to the doctor or /and refer to another specialist, and /or suggest specific tests ( x ray, MRI, etc).

 

[truthseeker]

I think its best to contact the referral source and explain myself. It preserves relationships better than just sending them back. It also keeps the patient happy that they don't need to make ANOTHER appointment.

 

[Re-EntryPT]

I come up with my physical therapy diagnosis and treat accordingly if the patient is appropriate for physical therapy. Documentation is sent to the referring physician. If the patient is not appropriate for physical therapy I refer the patient to the appropriate provider or back to the referring physician with information that the patient was not appropriate for physical therapy because (fill in the blank).

 

[fozzy40]

Just curious, what diagnosis was made by the physician? What diagnosis are you seeing?

 

[Azimuthal]

As a PT, is there a right way to handle a situation where you disagree with the doctor's diagnosis?

Wait, you get a tangible diagnosis? Not, “Body pain?” Or, “Patient says ‘clicking’ in ankle?” Sounds like a keeper.

On a serious note, hip and knee referrals when it’s found to be a lumbar issue is common. I don’t mind those though as I’m doing my part. Communication is key. Don’t know how much time I will spend coordinating care though, with a looming 9% med b cut. Its a zero sum game so CMS is following AMA recommendations to increase the PFS elsewhere for docs.