This course is designed to teach physical therapists methods for identifying potential medical conditions that may require medical referral. This course will help increase the clinician’s confidence during the evaluation process and assist in diagnostic accuracy. Evidence-based screening tools with be covered along with learning “red flags” for a variety of conditions and body systems. Other subjects to be covered include heart and lung screening exam along with understanding normal and abnormal vital signs and there response to exercise, abdominal screening exam and related special tests, basics of imaging and its role in the differential diagnosis process, review of the upper and lower quarter screening exam along with a cranial nerve and neurologic screen, skin screening exam, psychological considerations, and finally pharmacologic considerations including medicine side effects of commonly prescribed medications seen in the physical therapy settings. The presentation of this course material will provide the physical therapists with the knowledge required to see patients via direct access and allow them to understand potential medical conditions that require referral.
Present an overview of the role of the physical therapist as it pertains to direct access and differential diagnosis.
Relay the importance of a comprehensive history taking in efforts to identify “red flags” that may indicate the presence of potential serious medical conditions.
Review and understand the clinical significance of vital signs and the normal vs. pathophysiologic changes seen with exercise.
Review and learn examination skills for major body systems including skin, cardiopulmonary, abdominal, musculoskeletal, neurological and psychological.
Recognize the indications for commonly prescribed diagnostic tests and their clinical significances.
Discuss pertinent pharmacologic issues including commonly used medications, side effects, and potential interactions of physical therapy treatments with the medications.
Use case studies to highlight clinical decision making processes in the cases involving the initiation of treatment versus medical referral.
Utilize lab time to instruct and practice screening exams for the trunk (heart/lung/abdominal) including inspection, percussion, palpation, auscultation, and special tests, and performance of upper limb and lower limb tension tests.
Daniel W. Higgins, Jr., PT, DPT, OCS, ATC has been practicing in either in the Physical Therapy and/or Athletic Training fields for almost 20 years. He is a licensed PT with a board certification in orthopedics through the APTA’s American Board of Physical Therapy Specialties and also a certified athletic trainer. Dan is a 1995 graduate from Duquesne University with a Bachelors of Science degree in Athletic Training. He then graduated from Chatham University with a Masters in Physical Therapy followed by a Doctorate in Physical Therapy in 2002.
Dan began his career as a certified athletic trainer in which he worked in multiple settings ranging from college and high school athletic teams to the physical therapy clinical setting. Currently, he works as a staff physical therapist with the private outpatient practice of Orthopedic & Sports Physical Therapy Associates, Inc. (OSPTA) in western Pennsylvania, where he holds the position of direct access coordinator and continuing education coordinator for the staff of approximately 45 physical therapists.
With his combined specialization in orthopedic physical therapy and athletic training, evaluating and treating musculoskeletal injuries has always been a focus of Dan’s career. This experience has prepared him to present on the topics of differential diagnosis and medical screening.
Mark Kerestan was born in southwestern Pennsylvania and has lived and worked there for most of his life. He graduated for the Physician Assistant Program at Alderson-Broaddus University in West Virginia in 1984 (Physician Assistant program). Upon successful completion of the National Certification Examination, Mr. Kerestan began his professional career working in correctional medicine and public health. While working as a Physician Assistant with the Supplemental Security Income-Disabled Children’s Program, Mr. Kerestan decided to pursue a degree in Physical Therapy. He, therefore, attended the University of Pittsburgh and graduated in 1988 with a degree in Physical Therapy. After starting his physical therapy career at Jeannette District Memorial Hospital, Mr. Kerestan has since worked for Orthopedic Sports and Physical Therapy Associates (OSPTA), a group of private practices in southwestern, PA for the past 25 years. His practice emphasis has been on Work Injury Management and he has attended multiple courses in this area including those by Blankenship, Isernhagen, Matheson, Porter, and Lechner. He is certified to perform the Ergo science Physical Work Performance Evaluation (FCE system) and is a Certified Ergonomic Assessment Specialist through the Back School of Atlanta.
1995, Mr. Kerestan did a research study on “Work Conditioning Return to Work Outcomes at an Outpatient Physical Therapy Office”, which was published in the Orthopaedic Physical Therapy Practice journal and was presented as a poster presentation at the Pennsylvania Physical Therapy Association Annual Conference. In 2009, Mr. Kerestan, along with Daniel Higgins, PT, DPT, OCS, ATC developed a continuing education course on Differential Diagnosis and Medical Screening for PTs, OTs, and ATCs that has been presented at multiple facilities across the United States. Additionally he has made numerous presentations on a variety of injury prevention and health awareness topics to workers in the health care, steel production, utilities, and chemical processing industries.