History was made on Wednesday, April 20 as HB 637 went to a public hearing in the House Public Health Committee. This is the first time in eight years that a direct access bill has made it to a hearing. But it didn’t come without it’s challenges throughout the day.

The initial meeting was scheduled for 8:00 am with a long agenda full of various bills addressing issues ranging from raw milk to EMS services and all points in between. By 10:00 am, our bill had not been heard, but committee members needed to return to the House for debate on other bills. Many of those wishing to provide testimony on HB 637 stood strong and patient throughout the day, waiting for the meeting to resume.

At 7:00 pm, the meeting finally resumed. Though our numbers had decreased slightly, many clinicians and patients were still in attendance to provide support for the bill.

After hours of testimony on raw milk products and the cottage food industry, physical therapists in Texas finally had their opportunity to speak out on behalf of their patients and their profession.

Our bill was finally presented to the committee by Rep. Eiland at 12:53 am on Thursday morning. Yes, you heard that correctly – the discussion began shortly before 1:00 am in the morning, a full 17 hours after the meeting had started.

Physical therapists and patients alike testified before the committee. Eight people testified in support of the bill, and 2 spoke against it – including a representative of the TMA. It was an intriguing “discussion” to say the least. One of the members of the Public Health committee (a physician) began the (expected) barrage of questions, all of which focused on the standard “issues” that have been the mainstay of physicians since the debate over direct access to physical therapy began.

Fortunately, not only do physical therapists have evidence, but we also have the cumulative experiences of many states and countries to set a precedent in this discussion. The current system creates more barriers to care for the average health care consumer. Physical therapists would simply be working within their current scope of practice.

Those in support of HB 637 displayed tremendous calm under fire and addressed these issues with great fortitude and skill. I would commend the fine efforts of all who stood tall to support this bill. At 2:00 am, as the final testimony in support of HB 637, I attempted to clarify some of the remaining “issues”, but the final point made was that the burden of proof is on those who make the claims about safety. As far as I know, there has been no documented evidence – in any state or country worldwide that has embraced direct access - that direct access to physical therapy will have any adverse effects on cost of care or safety for the patient, or affect the medical malpractice liability claims against physical therapists. The opposition provide much conjecture, supposition, and beliefs, but absolutely no evidence to support these claims.

As a matter of fact, it's the opposite.

In an era of evidence-based medicine and patient-centered care, we need to be driven by what is right for the patient and that which has evidence to support it. Let us all remember the phrase posed by a famous spine researcher - “In God We Trust – All Others Bring Data”.

The public hearing on HB 637 can be viewed in its entirety here. Testimony begins at 5:38 and ends at 6:47. As consumers, watch the video, review the evidence, and act accordingly with your legislators. To provide support for the bill, contact members of the House Public Health Committee: Lois Kolkhorst (Chair), Elliott Naishtat (Vice Chair), Carol Alvarado, Garnet Coleman, Sarah Davis, Veronica Gonzales, Susan King, Jodie Laubenberg, Charles Schwertner, Vicki Truitt, and John Zerwas. Pending bills may reach a vote on Wednesday, April 27 – so please act now!

Addendum: If you thought that this was a problem that was specific to physical therapists in Texas, then think again: nurse practitioners face a similar battle. For a brief overview, read the commentary from Toni Inglis in the Austin American-Statesman entitled "Lawmakers, doctors holding nurses back". Anything sound familiar here?

Photo credits: Wikipedia