#5 December 2023
THE NORTH CAROLINA BOARD OF PHYSICAL THERAPY EXAMINERS
PTBoard@NCPTBoard.org
RegulatorySpotlight
Navigating the New Normal: The Impact of COVID-19 on
Physical Therapy Regulation
by C. David Edwards, PT, DPT, Board Chair
As I conclude my second term on the North Carolina Board
of Physical Therapy Examiners, I have found myself
reflecting on how quickly nearly six years have passed and
the unprecedented speed of change necessary to execute
the business of the Board.
I was elected to my first term as a Board Member in 2018.
Our quarterly Board and various committee meetings were
conducted almost exclusively in person. The fellowship and
networking were the highlight of the meetings as Board
members often arrived the evening before, providing an
opportunity to spend some relaxed time prior to conducting
the next day’s formal business. The Federation of State
Boards of Physical Therapy Examiners (FSBPT), a national
body of state PT Boards, held large scale in-person
meetings in cities such as Washington, DC and Arlington,
Virginia to discuss current issues and to provide education
to member boards from all over the United States and its
territories. The stay-at-home mandates changed all this
dramatically, but life went on.
Almost overnight, a Governor’s Executive Order required
North Carolinians to stay at home, necessitating the Board
conduct its business differently. Among other modifications,
open sessions of board meetings must be available to the
public, thus Board IT staff learned to use YouTube
livestreaming for public attendance during Board meetings.
Prior to March 2020, most of us had never routinely used
Zoom or the related virtual meeting platforms, but we
quickly learned how invaluable these tools would become
to continue our work. We became accustomed to the views
of each other’s home offices, dens, kitchens, a patio with a
great view, and yes, occasionally family members still in
their pajamas walking behind the participant on camera.
Eventually, we learned about virtual backgrounds and the
ability to blur the backgrounds. Again, the Governor’s
Executive Orders for public protection required the Board
office staff quickly transition to working from home.
Alternate means of processing applications and issuing
licenses occurred; rules were reviewed, scope of practice
questions were addressed, and public safety was
protected. We became leaner, faster, more creative, and
even more efficient. The team pulled together and re¬
invented the office and the mechanisms of the function
of the Board. Again, life went on.
The COVID-19 pandemic ushered in an era of
unprecedented change, disrupting industries and
reshaping societal norms. Amidst this global upheaval,
the field of physical therapy has not been immune to
transformation. Regulatory bodies, including the NCBPTE,
have played a crucial role in adapting to the evolving
landscape, ensuring patient safety and upholding the
highest standards of care. Physical therapy is known as a
field where human touch is critical. Suddenly, in many
settings, we had to adapt to providing services with
computers and cameras and occasionally smart phones.
Schools adapted to virtual teaching and therapy delivery
platforms. Medicare, Medicaid, and other third-party
payor patients were allowed to have alternative delivery
methods covered such as virtual or perhaps even phone
visits. The Board’s role again, is to review rules, position
statements, emerging practice questions, complaints,
etc. as needed, and to that end, ensure public safety.
Government mandates were issued that relaxed certain
licensure regulatory requirements to allow physical
therapists and physical therapist assistants to provide
services in new ways to meet the needs of patients and
clients. Virtual training sessions on how to conduct virtual
physical therapy evaluations and treatments were held.
There were occasional chuckles in the virtual practice
trainings when the virtual patient and virtual physical
therapy provider suddenly identified new barriers to this
new model of delivery, like who is providing contact
guard assist to the patient doing squats at a chair alone
in his or her home. Providers had to determine things
such as the mechanism for the safe delivery of services,
along with how to coach and direct the patient without
the benefit of human touch. These things were quite
foreign for a hands-on profession, but alas the needs of
the public were safely met, and life went on.
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