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INTRODUCTION

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The Guide to Physical Therapist Practice has been an important publication for the physical therapy community both nationally and internationally. It was developed out of a need to better define the role of the physical therapist (PT) in the changing health care arena.1-8 Jules Rothstein, the editor of the journal Physical Therapy, presented his opinions about the role of the Guide in two separate editorials preceding the publication of the 1st and 2nd editions of the Guide.3,4 Box 2-1 provides an overview of several comments made by Dr. Rothstein regarding the Guide including the definition of a guide (directions along a path): the fact that the Guide, to its credit, is nonspecific (drawing large circles; practice patterns that are broadly defined) and that the Guide is a “very gross first approximation of what we do and what we should do … and possibly what we can do.”3,4 Dr. Rothstein concluded his editorial by stating that there is a need (1) for research to help narrow the circle (to develop practice patterns that are less broad and with more specificity) for future versions of the Guide, (2) for dialogue from all clinicians about whether the Guide helps or does not help them in their practice, and (3) to clarify particular items or change them in the future.3

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BOX 2-1 Editorial Comments Regarding the Preferred Practice Patterns First Edition Comments

  1. Definition of a guide as directions along a path.

  2. The Guide is nonspecific and therefore good.

  3. The Guide is not “intended to serve as clinical guidelines … and represents expert consensus.”

  4. The Guide draws large circles (practice patterns that are broadly defined).

  5. The Guide is a “very gross first approximation of what we do and what we should do … . and possibly what we can do.”

  6. The Guide has developed documents that will allow us to gain consensus on practice, which can lead to the examination and refinement of that practice.

  7. The Guide offers fodder for researchers and clinic managers.

  8. The Guide begins to define the world of physical therapist (PT) practice.

  9. There is a need for research to help narrow the circle (to develop practice patterns that are less broad with more specificity) for future versions of the Guide.

  10. There is a need for dialogue from all clinicians about whether the Guide helps or does not help them in their practice.

  11. There is a need to clarify particular items or change them in the future.

Second Edition Comments
  1. The Guide forms a framework for describing and implementing practice.

  2. The Guide has proven that it can be an invaluable adjunct to our literature.

  3. PTs need to understand what this new edition is and what it is not.

  4. The Guide contains the opinions of our colleagues on how to manage patients and clients, which is very different from evidence for practice.

  5. The Guide is a work in progress.

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