Mansour M. Alotaibi- 1Department of Rehabilitation, Faculty of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
- 2Center for Health Research, Northern Border University, Arar, Saudi Arabia
The growing demand for healthcare services and development of healthcare present an opportunity for expanding physical therapy roles into internal medicine. This perspective discusses the potential benefits and limitations of establishing a formal internal medicine specialization for physical therapists (PTs). While PTs already contribute significantly to chronic disease prevention and treatment, their current scope of practice lacks structured training in internal medicine domains such as metabolic, autoimmune, renal, and systemic inflammatory disorders. Integrating internal medicine into PT education and clinical practice could enhance early identification of red flags, embrace interdisciplinary collaboration, and improve non-pharmacological interventions for various internal medicine-related diseases. Nevertheless, this expansion must be approached with caution, ensuring clear scope definitions, adequate training, and collaborative implementation to mitigate risks such as role ambiguity or misdiagnosis. Drawing on global experiences from advanced practice models and emerging literature, this paper calls for a discussion on the feasibility, safety, and value of internal medicine specialization in physical therapy practice. The goal of this perspective is not to replace medical professionals but to augment chronic disease management through targeted evidence-based rehabilitation strategies and preventative approaches.
Introduction
Clinical physical therapy practice in the United States allows practitioners to pursue various specialty certifications to address a wide range of diagnoses, including orthopedic, neurological, cardiopulmonary, and pediatric conditions (1). Physical therapists (PTs) play a pivotal role in providing exercise interventions across multiple domains, including musculoskeletal, neurological, cardiopulmonary, and oncology, primarily to enhance movement and overall well-being (2). In the United States, all states offer some degree of direct access to PTs without physician referrals (unrestricted access in 21 states and access with provisions in 29 states as of July 2024) (3), necessitating a high level of diagnostic proficiency among PTs. This model has demonstrated significant advantages, including increased convenience, reduced wait times, and decreased healthcare-related costs (4).
As the global population continues to age, the demand for geriatric physical therapy services has increased. Older adults frequently exhibit complex health conditions that extend beyond musculoskeletal impairments, requiring a more integrated and interdisciplinary approach to care. Current physical therapy scopes of practice address various patient needs, including geriatric, orthopedics, neurology, cardiopulmonary care, and wound management; however, none specifically focus on internal medicine. Given the high prevalence of multimorbidity in aging populations, this gap in specialization presents a missed opportunity to enhance patient care.
Although PTs are well-trained to screen for systemic diseases, certain internal medicine conditions present with symptoms that overlap with musculoskeletal disorders, increasing the risk of misdiagnosis. The “Big Three” conditions, vascular diseases, infections, and cancer, can mimic common orthopedic complaints, underscoring the importance of specialized training (5) For instance, acute myocardial infarctions (AMI) may manifest as shoulder pain, and a failure to recognize this subtle presentation could lead to life-threatening delays in care (6). A prospective multicenter study found that approximately 18% of AMI patients experienced diagnostic inconsistencies (6). Given that shoulder pain can mimic symptom of AMI, PTs must possess the clinical expertise needed to accurately distinguish musculoskeletal issues from potentially life-threatening conditions (7). While foundational physical therapy education provides initial training in red flag identification, these complexities warrant the need for a formal credential in internal medicine. Establishing such a pathway would improve diagnostic accuracy and contribute to patient safety, especially in a direct-access environment, where PTs serve as first contact providers.
Physical therapy is uniquely positioned to deliver non-pharmacological interventions, including exercise, manual therapy, and modalities, into holistic patient care. Providing PTs with structured training in internal medicine would enhance their understanding of human pathology and physiology, enhancing their diagnostic capabilities and treatment efficacy. In addition, several chronic diseases may benefit from physical therapy, and patients of such diseases often do not consider PTs part of their healthcare providers. For example, patients with diabetic gastroparesis would rarely seek PTs to improve their symptoms, as management is traditionally led by physicians using dietary and pharmacological interventions. Alongside pharmacological treatment, PTs could help provide exercise intervention and education for such patients to augment medical management and enhance patient outcomes (8). These contributions would occur in coordination with medical management and within clearly defined professional boundaries. The inclusion of specialized PTs in internal medicine in the multidisciplinary care teams would enhance the awareness of PTs’ roles in these conditions and expand accessibility to non-pharmacological support, thereby enhancing patients’ outcomes.
It is important to acknowledge that PTs already play an essential role in the management of many internal medicine-related conditions within the domains of cardiopulmonary, geriatric, and primary care. These contributions are exemplified in management of conditions such as chronic obstructive pulmonary disease (9, 10), heart failure (11, 12), osteoporosis (13), and diabetes (14, 15). However, the proposed internal medicine specialization would expand the scope beyond the above-mentioned domains to encompass systemic metabolic, renal, autoimmune, hematologic, and inflammatory diseases, where PTs currently have limited formal training and recognition. Nevertheless, the overlap between the proposed internal medicine specialty and existing recognized specialties is inevitable. Developing clear scope of practice guidelines, competency standards, and certification pathways would be essential to minimize this overlap and enhance clinical roles and professional development pathways.
Expanding the scope of physical therapy into domains traditionally managed by physicians and nurse practitioners, such as chronic disease management and systemic risk screening may raise concerns about role encroachment or redundancy. Thus, the integration of an internal medicine training into physical therapy practice must be approached with sensitivity to the dynamics of the broader healthcare team. Regardless, the intent of developing this specialization for PTs is to reinforce rather than to replace existing medical roles. Internal medicine-specialized PTs, once integrated in the healthcare system, would operate within clearly defined clinical boundaries, focusing more on non-pharmacological interventions, early risk identification, functional optimization, and interdisciplinary healthcare planning. Evidence suggests that PTs with advanced training working in primary care settings and emergency departments demonstrated high-level of diagnostic accuracy in line with physicians’ diagnosis with musculoskeletal cases (16). PTs with specific training in internal medicine would not assume responsibility for diagnosing complex internal medicine conditions but would serve as collaborators in early identification and secondary prevention. Thus, PTs could successfully function as physician extenders, as suggested by experience from primary care (17) and military setting (18). Traditionally, PTs have successfully served as physician extenders in military settings, handling over 3,500 visits within direct-access models (19). This model has demonstrated benefits such as decreased healthcare expenditure and fewer lost duty days due to musculoskeletal injuries. Expanding this model to include internal medicine training could further elevate the role of PTs in comprehensive patient management and preventative care (17).
This perspective paper advocates for the establishment of an Internal Medicine Clinical Specialist certification within geriatric physical therapy practice. The addition of internal medicine training could elevate PTs’ role in chronic disease prevention and management. By providing PTs with specialized training in internal medicine, they can better contribute to the early detection, management, and prevention of systemic diseases in diverse populations, including older adults. For example, exercise therapy has been shown to significantly improve glycemic control in individuals with type II diabetes mellitus (T2DM) (20, 21). However, most DM patients seek physical therapy services only for musculoskeletal complaints, despite evidence indicating that approximately 80% of physical therapy referrals involve patients with prediabetes or diabetes (22). Internal medicine training would enable PTs to identify T2DM risk factors early, predict complications (23), and contribute to comprehensive care plans that incorporate exercise and lifestyle modifications with pharmacological treatment. This opportunity would allow PTs to further contribute to the provision of healthcare and improve the quality of healthcare services.
Training in internal medicine for PTs would also benefit patients with autoimmune disorders, such as celiac disease, which is associated with reduced bone mineral density (BMD) due to impaired nutrient absorption (24). Individuals with celiac disease face a 50% increased risk of fractures, yet current PT education does not emphasize targeted rehabilitation strategies for this population (25). Limited evidence suggests that physical therapy interventions may improve BMD in this population (26). While adherence to a gluten-free diet with or without pharmacological intervention would recover the diminished BMD at 5 years (27), PTs can further help in speeding up the recovery by providing tailored exercise interventions individuals with celiac disease (28), thereby reducing the risks for skeletal fractures. Additionally, mitochondrial dysfunction plays a critical role in conditions such as exertional rhabdomyolysis (29, 30), a serious consequence of extreme physical exertion commonly seen in military personnel and athletes. PTs are well-trained in providing education and treatment for individuals with this condition (31), and, if they receive specialized training in internal medicine, can further help these individuals improve their well-being.
From an economic perspective, reimbursement challenges often hinder access to PT services for patients with internal medicine-related conditions (32). While evidence on this topic is limited, insurance providers frequently deny coverage due to the lack of clear diagnostic justification for PT intervention. Establishing an internal medicine specialty within PT practice would create a distinct healthcare segment, reinforcing the necessity of PT services in managing internal medicine conditions. Well-trained PTs in internal medicine could contribute to healthcare cost reduction by preventing unnecessary hospitalizations and surgical interventions, thereby alleviating financial burdens on both patients and healthcare systems (33). Preliminary evidence suggests that physical therapy interventions via direct access compared to referred episodes can reduce healthcare costs by lowering hospital admissions, reducing medication use, and improving patient outcomes (4, 33). Nonetheless, robust designs, such as large-scale longitudinal studies and clinical trials specifically address the effects of physical therapy on internal medicine-related conditions. Therefore, future research should examine efficacy, cost-effectiveness, and feasibility of the proposed internal medicine in physical therapy model across different health systems.
Although PTs are increasingly involved in the management of chronic medical conditions, there is no formally recognized credential in internal medicine for PTs. In the United States, the American Board of Physical Therapy Specialties offers 11 specialty certifications, yet none focus on internal medicine (Table 1). In the United Kingdom, specialized physical therapy practice roles require meeting the standards of receiving adequate training and whether the activities PTs practice fall within the general scope of practice of the profession to perform the activity effectively and safely (34). The Charted Society of Physiotherapy participates in the world physiotherapy recognized 13 specialty groups, none of which include internal medicine (35). Similarly, the Australian Physiotherapy Association recognizes nine fields of practice. However, internal medicine is none of the recognized specialty programs available for PTs (36). Establishing a structured specialty in internal medicine in PT would expand the scope of practice under a standardized competency framework and enhance quality of care across healthcare systems.
Table 1. Summary of the currently existing specialty programs for physical therapists and the proposed internal medicine specialty.
Introducing an internal medicine specialty for PT could support improved chronic disease treatment and interprofessional care coordination. By integrating internal medicine principles into PT education and clinical training, PTs can play a more significant role in chronic disease care, improved diagnostic accuracy, and enhanced interdisciplinary collaboration. This initiative has the potential to improve patient care, strengthen interdisciplinary care and improve healthcare system efficiency. Given the mounting evidence supporting the benefits of exercise in managing internal medicine conditions (2, 20, 37), the time has come to formalize this specialization and expand the scope of PT practice to meet the evolving needs of modern healthcare.
While the potential benefits of internal medicine specialization for PTs are compelling, it is critical to consider potential limitations, particularly in terms of resource allocation. If implemented without adequate governance and stakeholder alignment, this model of role expansion could result in scope confusion, inefficiencies, or resistance from other professionals. Although PT in general has been shown to reduce hospitalization rates and prevent costly complications in patients with chronic diseases (38, 39), there is limited direct economic evidence supporting the cost-effectiveness of internal medicine-certified PTs (39). Thus, the specific economic impact of internal medicine specialization in PT warrants further investigation. Implementing such a program would require capital investment in curriculum development, training pathways, certification frameworks, and interdisciplinary integration, and this may be challenging in resource-constrained systems. However, strategic investment in this specialization can be justified through multiple anticipated benefits: improved patient safety through early recognition of red flags, enhanced integration in chronic disease treatment pathways, and decreased healthcare expenditures via reduced complications and unnecessary procedures. Perhaps small pilot programs and cost-effectiveness trials could be conducted to assess the value proposition of this specialization in PT.
As with any proposed expansion of professional roles, the implementation of an internal medicine specialization for PTs may be associated with potential risks. These include role ambiguity, interprofessional resistance, legal liability, and the possibility of fragmented care if integration is not implemented with full coordination. Addressing these risks requires clear scope-of-practice definitions, certification, and interdisciplinary training frameworks for guiding the future steps. Experience from the UK's advanced practice physiotherapy model provides a valuable precedent. Several studies have documented that advanced practice physiotherapy deliver care with diagnostic accuracy comparable to that of physicians in musculoskeletal triage settings (40, 41), decrease wait times (42), enhance patient satisfaction (43, 44), and reduce downstream healthcare costs (45). These outcomes were achieved within structured models that encourage collaboration, training, and risk mitigation. Adapting similar principles could guide the safety and effectiveness for implementing internal medicine specialization in physical therapy.
Data availability statement
The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author.
Author contributions
MA: Resources, Supervision, Investigation, Writing – review & editing, Conceptualization, Validation, Funding acquisition, Project administration, Writing – original draft, Methodology.
Funding
The author(s) declare that financial support was received for the research and/or publication of this article. This work is funded by the Deanship of Scientific Research at Northern Border University, Arar, KSA, through the project number “NBU-FFR-2025-2508-04”.
Conflict of interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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References
1. APTA. Specialist Certification. Alexandria, VA: American Physical Therapy Association (2021). Available online at: https://www.apta.org/your-career/career-advancement/specialist-certification (Accessed April 1, 2021)
2. Luan X, Tian X, Zhang H, Huang R, Li N, Chen P, et al. Exercise as a prescription for patients with various diseases. J Sport Health Sci. (2019) 8(5):422–41. doi: 10.1016/j.jshs.2019.04.002
3. APTA. Levels of Patient Access to Physical Therapist Services in the U.S. Alexandria, VA: American Physical Therapy Association (2024). Available online at: https://www.apta.org/contentassets/4daf765978464a948505c2f115c90f55/apta_direct_access_by_state9.4.2024.pdf (Accessed February 20, 2025)
4. Ojha HA, Snyder RS, Davenport TE. Direct access compared with referred physical therapy episodes of care: a systematic review. Phys Ther. (2014) 94(1):14–30. doi: 10.2522/ptj.20130096
5. Newman-Toker DE, Wang Z, Zhu Y, Nassery N, Saber Tehrani AS, Schaffer AC, et al. Rate of diagnostic errors and serious misdiagnosis-related harms for major vascular events, infections, and cancers: toward a national incidence estimate using the "Big Three". Diagnosis (Berl). (2020) 8(1):67–84. doi: 10.1515/dx-2019-0104
6. Wildi K, Gimenez MR, Twerenbold R, Reichlin T, Jaeger C, Heinzelmann A, et al. Misdiagnosis of myocardial infarction related to limitations of the current regulatory approach to define clinical decision values for cardiac troponin. Circulation. (2015) 131(23):2032–40. doi: 10.1161/CIRCULATIONAHA.114.014129
7. Culić V, Mirić D, Eterović D. Correlation between symptomatology and site of acute myocardial infarction. Int J Cardiol. (2001) 77(2-3):163–8. doi: 10.1016/S0167-5273(00)00414-9
8. Campaniello D, Corbo MR, Sinigaglia M, Speranza B, Racioppo A, Altieri C, et al. How diet and physical activity modulate gut Microbiota: evidence, and perspectives. Nutrients. (2022) 14(12):2456. doi: 10.3390/nu14122456
9. Rochester CL, Alison JA, Carlin B, Jenkins AR, Cox NS, Bauldoff G, et al. Pulmonary rehabilitation for adults with chronic respiratory disease: an official American thoracic society clinical practice guideline. Am J Respir Crit Care Med. (2023) 208(4):e7–e26. doi: 10.1164/rccm.202306-1066ST
10. Meneses-Echavez JF, Chavez Guapo N, Loaiza-Betancur AF, Machado A, Bidonde J. Pulmonary rehabilitation for acute exacerbations of COPD: a systematic review. Respir Med. (2023) 219:107425. doi: 10.1016/j.rmed.2023.107425
11. Murray EM, Whellan DJ, Chen H, Bertoni AG, Duncan P, Pastva AM, et al. Physical rehabilitation in older patients hospitalized with acute heart failure and diabetes: insights from REHAB-HF. Am J Med. (2022) 135(1):82–90. doi: 10.1016/j.amjmed.2021.08.001
12. Dean E, Lomi C. A health and lifestyle framework: an evidence-informed basis for contemporary physical therapist clinical practice guidelines with special reference to individuals with heart failure. Physiother Res Int. (2022) 27(3):e1950. doi: 10.1002/pri.1950
13. Hartley GW, Roach KE, Nithman RW, Betz SR, Lindsey C, Fuchs RK, et al. Physical therapist management of patients with suspected or confirmed osteoporosis: a clinical practice guideline from the academy of geriatric physical therapy. J Geriatr Phys Ther. (2022) 44(2):E106–e119. doi: 10.1519/JPT.0000000000000346
14. Hansen D, Peeters S, Zwaenepoel B, Verleyen D, Wittebrood C, Timmerman N, et al. Exercise assessment and prescription in patients with type 2 diabetes in the private and home care setting: clinical recommendations from AXXON (Belgian Physical Therapy Association). Phys Ther. (2013) 93(5):597–610. doi: 10.2522/ptj.20120400
15. Umpierre D, Ribeiro PA, Kramer CK, Leitão CB, Zucatti AT, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. (2011) 305(17):1790–9. doi: 10.1001/jama.2011.576
16. Moore JH, Goss DL, Baxter RE, DeBerardino TM, Mansfield LT, Fellows DW, et al. Clinical diagnostic accuracy and magnetic resonance imaging of patients referred by physical therapists, orthopaedic surgeons, and nonorthopaedic providers. J Orthop Sports Phys Ther. (2005) 35(2):67–71. doi: 10.2519/jospt.2005.35.2.67
17. Murphy BP, Greathouse D, Matsui I. Primary care physical therapy practice models. J Orthop Sports Phys Ther. (2005) 35(11):699–707. doi: 10.2519/jospt.2005.35.11.699
18. Clark B, Clark L, Showalter C, Stoner T. A call to action: direct access to physical therapy is highly successful in the US military. When will professional bodies, legislatures, and payors provide the same advantages to all US civilian physical therapists? J Man Manip Ther. (2022) 30(4):199–206. doi: 10.1080/10669817.2022.2099893
19. Szymanek E, Jones M, Shutt-Hoblet C, Halle R. Implementation of direct access physical therapy within the military medical system. Mil Med. (2021) 187(5–6):e649–54. doi: 10.1093/milmed/usab245
20. Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. (2017) 32(5):541–56. doi: 10.1097/HCO.0000000000000437
21. Sampath Kumar A, Maiya AG, Shastry BA, Vaishali K, Ravishankar N, Hazari A, et al. Exercise and insulin resistance in type 2 diabetes mellitus: a systematic review and meta-analysis. Ann Phys Rehabil Med. (2019) 62(2):98–103. doi: 10.1016/j.rehab.2018.11.001
22. Kirkness CS, Marcus RL, Lastayo PC, Asche CV, Fritz JM. Diabetes and associated risk factors in patients referred for physical therapy in a national primary care electronic medical record database. Phys Ther. (2008) 88(11):1408–16. doi: 10.2522/ptj.20080129
23. Harris-Hayes M, Schootman M, Schootman JC, Hastings MK. The role of physical therapists in fighting the type 2 diabetes epidemic. J Orthop Sports Phys Ther. (2020) 50(1):5–16. doi: 10.2519/jospt.2020.9154
24. Fedewa MV, Bentley JL, Higgins S, Kindler JM, Esco MR, MacDonald HV. Celiac disease and bone health in children and adolescents: a systematic review and meta-analysis. J Clin Densitom. (2020) 23(2):200–11. doi: 10.1016/j.jocd.2019.02.003
25. Zacay G, Weintraub I, Regev R, Modan-Moses D, Levy-Shraga Y. Fracture risk among children and adolescents with celiac disease: a nationwide cohort study. Pediatr Res. (2024) 95(1):386–92. doi: 10.1038/s41390-023-02826-5
26. Duerksen D, Pinto-Sanchez MI, Anca A, Schnetzler J, Case S, Zelin J, et al. Management of bone health in patients with celiac disease: practical guide for clinicians. Can Fam Physician. (2018) 64(6):433–8.29898932
27. Grace-Farfaglia P. Bones of contention: bone mineral density recovery in celiac disease–a systematic review. Nutrients. (2015) 7(5):3347–69. doi: 10.3390/nu7053347
28. Nestares T, Martín-Masot R, de Teresa C, Bonillo R, Maldonado J, Flor-Alemany M, et al. Influence of Mediterranean diet adherence and physical activity on bone health in celiac children on a gluten-free diet. Nutrients. (2021) 13(5):1636. doi: 10.3390/nu13051636
29. Furman J. When exercise causes exertional rhabdomyolysis. JAAPA. (2015) 28(4):38–43. doi: 10.1097/01.JAA.0000458861.78559.3b
31. Bäcker HC, Richards JT, Kienzle A, Cunningham J, Braun KF. Exertional rhabdomyolysis in athletes: systematic review and current perspectives. Clin J Sport Med. (2023) 33(2):187–94. doi: 10.1097/JSM.0000000000001082
32. Carvalho E, Bettger JP, Goode AP. Insurance coverage, costs, and barriers to care for outpatient musculoskeletal therapy and rehabilitation services. N C Med J. (2017) 78(5):312–4. doi: 10.18043/ncm.78.5.312
33. Bürge E, Monnin D, Berchtold A, Allet L. Cost-effectiveness of physical therapy only and of usual care for various health conditions: systematic review. Phys Ther. (2016) 96(6):774–86. doi: 10.2522/ptj.20140333
34. HCPC. Identifying Your Current Scope of Practice. London: Health and Care Professions Council (2024). Available online at: https://www.hcpc-uk.org/standards/meeting-our-standards/scope-of-practice/what-is-your-scope-of-practice/identifying-your-current-scope-of-practice/ (Accessed July 30, 2025)
35. World Physiotherapy. Chartered Society of Physiotherapy. Southwark: World Physiotherapy (2024). Available online at: https://world.physio/membership/united-kingdom (Accessed July 30, 2025)
36. Australian Physiotherapy Association. Specialist Training Program. Camberwell, VIC: Australian Physiotherapy Association (2025). Available online at: https://australian.physio/specialisation-stp (Accessed July 30, 2025)
37. Correa HL, Rosa TS, Santos RL, Mestrinho VM, Aquino TS, Santos WO, et al. The impact of different exercise modalities on chronic kidney disease: an umbrella review of meta-analyses. Front Physiol. (2025) 15:1444976. doi: 10.3389/fphys.2024.1444976
38. Falvey JR, Burke RE, Malone D, Ridgeway KJ, McManus BM, Stevens-Lapsley JE. Role of physical therapists in reducing hospital readmissions: optimizing outcomes for older adults during care transitions from hospital to community. Phys Ther. (2016) 96(8):1125–34. doi: 10.2522/ptj.20150526
39. Kühr EM, Ribeiro RA, Rohde LEP, Polanczyk CA. Cost-Effectiveness of supervised exercise therapy in heart failure patients. Value Health. (2011) 14(5, Supplement):S100–7. doi: 10.1016/j.jval.2011.05.006
40. Desmeules F, Roy J-S, MacDermid JC, Champagne F, Hinse O, Woodhouse LJ. Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review. BMC Musculoskelet Disord. (2012) 13(1):107. doi: 10.1186/1471-2474-13-107
41. Kersten P, McPherson K, Lattimer V, George S, Breton A, Ellis B. Physiotherapy extended scope of practice – who is doing what and why? Physiotherapy. (2007) 93(4):235–42. doi: 10.1016/j.physio.2007.02.007
42. Thompson J, Yoward S, Dawson P. The role of physiotherapy extended scope practitioners in musculoskeletal care with focus on decision making and clinical outcomes: a systematic review of quantitative and qualitative research. Musculoskeletal Care. (2017) 15(2):91–103. doi: 10.1002/msc.1152
43. Lamb K, Comer C, Walsh N, Smith J, Tang K, McHugh G. The experiences of patients with musculoskeletal conditions accessing first contact physiotherapy practitioner appointments in general practice in the UK: a qualitative study. Musculoskeletal Care. (2024) 22(2):e1908. doi: 10.1002/msc.1908
44. Fennelly O, Blake C, FitzGerald O, Caffrey A, Fletcher L, Smart K, et al. Advanced musculoskeletal physiotherapy practice: the patient journey and experience. Musculoskelet Sci Pract. (2020) 45:102077. doi: 10.1016/j.msksp.2019.102077
45. Richardson B, Shepstone L, Poland F, Mugford M, Finlayson B, Clemence N. Randomised controlled trial and cost consequences study comparing initial physiotherapy assessment and management with routine practice for selected patients in an accident and emergency department of an acute hospital. Emerg Med J. (2005) 22(2):87–92. doi: 10.1136/emj.2003.012294
Keywords: physical therapy, internal medicine, chronic disease management, exercise therapy, rehabilitation
Citation: Alotaibi MM (2025) Do we need internal medicine specialists in physical therapy? Recognizing the need for updating the clinical practice paradigm. Front. Rehabil. Sci. 6:1656054. doi: 10.3389/fresc.2025.1656054
Received: 30 June 2025; Accepted: 25 August 2025;
Published: 9 September 2025.
Edited by:
Maria Nordheim Alme, Western Norway University of Applied Sciences, NorwayReviewed by:
Bård Bogen, Western Norway University of Applied Sciences, NorwayEmer McGowan, Trinity College Dublin, Ireland
Copyright: © 2025 Alotaibi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Mansour M. Alotaibi, bWFuc291ci5hbG90YWliaUBuYnUuZWR1LnNh