When physical or other therapies are prescribed (e.g. for low back pain), the authorized treating provider (ATP) should communicate on a regular basis with the physical or other therapist to whom the patient has been referred. With this communication, the ATP will determine whether functional gains are being realized and whether the patient can return to work at full or modified duty.
If functional gains are not occurring by the end of a specified "time-to-produce-effect" interval, the ATP should confirm that continued therapy is reasonable and necessary. If it is not, the therapy should be discontinued. An alternative form of treatment could be prescribed, the diagnosis reconsidered or, if warranted, maximum medical improvement could be declared.
This article reviews the elements observed in therapy documents for physical therapists and authorized treating physicians.