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Foundations of Primary Care Physical Therapy: Combining Symptom and Systems Based Approaches to Differential Diagnosis in a Direct Access Setting
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This course is a slide presentation with instructor narrarating. A quiz is given at the end of the course. 80% score required to obtain certificate. 


Course Description:

With the progression of Direct Access in the Physical Therapy world, it’s imperative that clinicians of all backgrounds have a better understanding of the medical screening process.  While a patient may choose to see a Physical Therapist first for general low back pain, the evaluating clinician should have a solid understanding of the evaluative process to determine if the patient is appropriate for treatment or needs to be referred for further diagnostics and a more in-depth medical evaluation.  In section 1, you will learn about a detailed interview process which will help with developing an algorithm for treatment and determining if this patient lies outside of your scope.  Using a thorough pain scale assessment, comprehensive interview and mindfulness of potential red flags you will feel much more comfortable determining the best course of action for the patient.


When looking at the direct access/medical screening model, multiple different approaches can be used. In section 2, the instructor will focus on a symptom based approach to medical screening and differential diagnosis.  The initial focus of this section is on pain and how it relates to various medical pathologies.  The second part of the course will focus on a wide range of medical diagnoses that are centered around various symptoms a patient might present with for joint, spine, upper and lower extremity regions.  Section 3, the instructor will take you through an in-depth discussion about a Systems based approach to medical screening and specifically how it relates to the cardiopulmonary, gastrointestinal, hematologic, Urogenital, Endocrine, nervous and integumentary systems.  At the end of this course, the participant should have a solid understanding of the medical screening model as it related to the rehab world.


Course Highlights:

  • Learn a Systematic use of medical screening for help with differentials
  • Review when to treat, when to refer and when to treat and refer
  • Review numerous medical diagnoses and their relationship to rehab focusing on joint conditions and spinal related pathologies
  • Analyze multiple unique case studies and put new information to immediate practice
  • Learn the do’s and don’ts of medical screening relating to 7 different body systems
  • Differentiate between red and yellow flags relating to each system reviewed
  • Learn in depth about the Cardiovascular system and why screening is necessary for all patients


Course Objectives:

  • Explain the difference between yellow and red flags to help with the question of treat or refer
  • Explain how to properly administer a wide range of tests and measures to help with the screening process
  • Implement a comprehensive screening plans that can be administered with all patients seen in rehabilitation
  • Describe the various levels of health care and term classification
  • Describe the role of Physical Therapy in Primary Care and differential diagnosis
  • Explain the 8 most common risk factors of cardiovascular disease
  • Differentiate between musculoskeletal related symptoms appropriate for treatment vs red flag symptoms that require a referral to a different medical practitioner

Course Outline: (6.5 hours in length) Course can be paused and resumed. There is a quiz at the end of the course. 80% score required to obtain certificate.

Section 1: Foundations of Primary Care Medical Screening for Physical Therapy

  1. Introduction to Primary Care Physical Therapy
    1. Health Care levels
    2. Classification of Terms
  2. The Role of PT in Primary Care
    1. Rationale for Medical Screening
    2. Successful primary care models in the US
  3. Evidence Based Medical Screening
    1. Levels and grades of Evidence
    2. The use of “flags” in medical screening
  4. History/Interview
    1. APTA Guide
    2. General red flags
  5. General Sources of Pain
    1. 8 Types of Pain
    2. Classification of pain and common locations

Section 2: A Symptom Based Approach to Medical Screening for Physical Therapy

  1. Selected Joint Conditions
    1. Symptoms, Associated findings, anatomical site and risk factors
    2. Inflammatory vs non-inflammatory conditions
  2. Systemic vs Psychogenic Symptoms
    1. Screening tools for Emotional Overlay
    2. Clinical tools for symptom magnifications
  3. Medical Screening: Regional Based Symptoms
    1. Spine
    2. Related medical conditions
  4. Medical Screening: Regional Symptoms of the Lower Quarter
    1. Hip/Knee
    2. Lower Leg
  5. Medical Screening: Regional Symptoms of the Thorax
    1. Thoracic Spine
    2. Cardiac
    3. Pulmonary
  6. Medical Screening: Regional Symptoms of the Upper Quarter
    1. Shoulder Girdle/Shoulder Complex
    2. Cervical Region
    3. BPPV/Neuro Related Pathologies
  7. Case Study Review

Section 3: A System Based Approach to Medical Screening for Physical Therapy

  1. Rationale for Medical Screening
    1. Sensitivity and Specificity
    2. Acceptable metrics
  2. Systems Based Screening
    1. Review of Systems
    2. Use of Red and Yellow flags
  3. Body System Screening
    1. 7 Different body systems
  4. Cardiovascular Screening
    1. Risk Factors
    2. Various common medical diagnoses
    3. Vital Signs and how to administer
  5. Systems Based Screening: Cardiopulmonary System
    1. Review of Common medical diagnoses and red/yellow flags
      1. Cardiopulmonary System
      2. Gastrointestinal System
      3. Hematological and Urogenital Systems
      4. Endocrine System
      5. Nervous System
      6. Integumentary System
Robert McCabe, DPT, OCS

Robert McCabe, DPT, OCS is a distinguished clinician and speaker who brings a wealth of experience to his high-impact seminars. Dr. McCabe has worked alongside Dr. James Andrews at the Andrews Institute of Pensacola where he treated multiple professional athletes. He has served as an adjunct instructor at New York University as well as New York Institute of Technology. Presently he is completing his certification in manual therapy through the Evidence in Motion program while continuing in private practice. He has published research studies pertaining to shoulder/scapula biomechanics in peer reviewed journals. Dr. McCabe is SFMA, FMS, and Graston certified and is an EXOS performance specialist.


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