More on Manipulation in Washington State


By: Brett Windsor PT, PhDc, MPA, OCS, FAAOMPT

Good evening…thought I’d take the time to add a bit more on the state of the manipulation bill in Washington State. It seems pretty quiet out there, which makes you wonder how the bill will actually impact practice. The bill passed the house on a 92-6 vote and then the senate by a 49-0 margin…so it could be considered a consensus bill by any stretch.

The key is in the implementation. The bill provides for the secretary of health to issue an endorsement to a physical therapists license that will allow them to manipulate the spine. In order to receive such an endorsement, a physical therapist must meet certain criteria. First, one has to have at least one year of post-graduate practice experience averaging at least 36 hours per week.

Additional requirements include:

a) Training in differential diagnosis of no less than 100 hours

b) Procedural training in manipulation of no less than 250 hours

c) Specific training in diagnostic imaging of no less than 150 hours

Much of this training will be received in DPT School, but the biggest hurdle would appear to be the clinical practice supervision requirement:

d) At least 300 hours of supervised clinical practical experience in spinal manipulation

So far it looks like the practical supervision must be provided by a physical therapist who has the endorsement, or by a chiropractor or osteopath. There doesn’t appear to be any grandfathering in of therapists with advanced training in manipulation through a fellowship or similar, so it begs the question of how any initial physical therapists will be able to receive the endorsement? Perhaps some will look to be supervised by a DO…or a DC? We’ll see.

If someone out there has better information, please feel free to comment and let s know, but at this point we must beg the question… does this bill really make any practical difference to the ability of PT’s to manipulate the spine in Washington State? Or is the technique to remain the domain of the lay manipulators? We’ll soon see…should be some interesting times on the licensing board.

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