Part 1

As the petitioner who has submitted the proposed regulation, I feel the need for clarification and context on my initial proposal, and some much-needed responses to comments published in opposition.  There is quite a bit of unsupported statements out there made by parties in opposition to the petition claiming this petition will somehow “endanger patients,” or “endanger staff,” by allowing individual patients, not practitioners, to make the medical decision (and it is a medical decision) as to whether they will wear a mask or not.  I will attempt to call these comments out to point out the fallacy of their arguments. There also is the issue of the Board of Physical Therapy’s receipt of my petition and the actual language posted by the Board. The Virginia Board of Physical Therapy didn’t post exactly word for word what my petition originally proposed. The Board paraphrased a good portion of my proposal, and changed my language in certain phrases, which I feel was dishonest. It did not reflect the actual proposed language, which I will repeat below. In addition, the Transmittal Sheet as published also didn’t include the rationale behind why I feel this regulation is necessary, which provides much needed context and supporting background. I do appreciate the comments on both sides, but as the petitioner, I feel that by not posting the rationale behind my proposal, the Virginia Board is deliberately withholding necessary supporting information critical to supporting my position. 

First, my original proposed language.  This is word for word, Proposed Clause 5:

Original version: A practitioner shall not: “5. Require a patient, prospective patient, or family member to wear a mask as a condition of providing physical therapy services.  A practitioner shall not refuse to provide physical therapy services to a patient or prospective patient should a patient, prospective patient, family member or authorized patient representative (including Parental Guardian) choose to not wear a mask.  A mask shall be considered any covering across the face that is intended solely as a means of potential infection control.”

The Board’s paraphrased version, made to appear that a patient is refusing to wear a mask: “The petitioner requests that the Board amend its regulations to: (1) prohibit physical therapists and physical therapy assistants from refusing to provide physical therapy to patients or prospective patients if those individuals or their accompanying representatives refuse to wear masks.”

The distinction here is critical.  Refusal and choice are two drastically different concepts. Refuse means to refuse a lawful order issued by a government agency and there is no choice for the patient – it is required by law. Choice means there is an option if one wants to wear a mask, but it is not required.  Under current Virginia state public health regulation and Executive Orders, there is no longer any public health crisis requiring an employer to mandate its employees, nor ordinary citizens, to wear masks as a condition of citizenship, let alone the ability to receive necessary physical therapy care, worship at a religious institution, attend school, or to participate in commerce, for that matter. The decision to wear a mask is that of the patient’s, prospective patient’s, or the family member’s alone.  A practitioner has no legal or ethical right to force or make decisions for the patient, especially if the patient does not have informed consent on the efficacy of masks.  If a patient or therapist wants to wear a mask, they are free to do so. But a practitioner has no legal authority under existing Virginia state law or Board of Physical Therapy regulation to refuse to provide physical therapy if a patient, prospective patient, or family member accompanying them chooses not to wear a mask, especially since this type of tyrannical behavior was never practiced or allowed prior to 2020, and definitely since all Executive Orders mandating mandatory masking in Virginia have now been lifted by Governor Youngkin. 

Responding to comments such as these: “Health care providers must be allowed to set protocols to protect patients, clients and staff members from infectious diseases. Physical therapists are often in very close contact with clients and clients are often in shared gym space with other vulnerable patients/clients. The proposed rule makes such protections impossible.” This assertion that the proposed rule makes such protections impossible is laughable, since anyone who has visited a physical therapists’ office ever (or in the past two years, for that matter) know that more than adequate safety protocols have been implemented, including disinfection of surfaces with sanitizing sprays that are proven to kill the COVID-19 virus, use of enhanced filtering of indoor air with new HVAC systems, individual patient temperature screens, and patient health surveys prior to entry into a therapy area that naturally preclude you from being seen if you demonstrate symptoms of the virus that causes COVID-19 disease (I know firsthand because I have required three physical therapy regimens over the past 24 months, two for post-surgery rehabilitation).  The commenter provides no evidence how allowing a patient to make a decision on mask wearing makes such protections impossible.   

The rationale of mandating masking as a condition to receive necessary care also hypocritically fails to consider that under existing Virginia Department of Health orders, individuals are allowed to work out in gyms without a mask and are also not required to be “vaccinated” in order to work out.  So, somehow individuals (who can be sick, by the way) are allowed to freely enter and work out in a gym, without a mask (and not “vaccinated,”), and there is no regulation requiring the masking or vaccination status of gym customers. Yet somehow, a Physical Therapist can refuse a patient, who is simply attempting to rehabilitate themselves from an injury or physical ailment, simply because they have made the choice to not wear an ineffectual mask, which has been overwhelmingly shown to not stop the spread of this virus or stop its transmission?  How does that make any sense? Given the fact that there is documented evidence that mask wearing actually can make one sick (https://www.sciencedaily.com/releases/2015/04/150422121724.htm; https://www.aier.org/article/the-dangers-of-masks/; https://www.aier.org/article/masking-a-careful-review-of-the-evidence/; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490318/), then how can a practitioner explain that forcing one to wear a mask is actually “protecting a patient’s” health, or is not putting the staff or Practitioner at risk? If you demand that a patient wears a mask upon entry to your practice and will not treat a patient if they do not wear a mask, but in the process of that patient being required to wear a mask, they actually do get sick from wearing a face mask, how does that protect anyone? 

The practice of forced masking as a condition of receipt of medical care continues to this day because all patients in all physical therapists offices are considered “guilty until proven innocent,” or unethically assumed to have COVID-19 and require them to wear a mask, without even asking if a patient has symptoms, or has previously had COVID-19, recovered, and now possesses natural immunity (a documented medical fact the FDA and Pfizer, manufacturer of one of the COVID-19 “vaccines,” have been forced to admit: Youtube.com/watch?v=5eJ5TIT6zvk).  Do practitioners demand every patient prior to entry into a physical therapy office take precautions against the flu before they enter?  Norovirus? Rotavirus? Tuberculosis? HIV? Pertussis?  Meningitis? Pneumonia? Strep throat? Each of these infectious diseases are highly contagious and kill hundreds of thousands of individuals each year worldwide and in the United States, including in Virginia, but no physical therapist requires masking or mandatory vaccination to stop the spread of each of these diseases prior to one receiving care. Despite unsubstantiated claims to the contrary from opposers of my petition claiming masks have been effective in stopping the virus, the evidence does not exist.

Proposed Clause 6

Here is the original text as I proposed, stating a Practitioner shall not:

“6. Enact, implement, enforce, or execute any practitioner-authored, insurer-required, corporate, or organizational policy, instruction, or guidance (including, but not limited to, guidance issued by the Centers for Disease Control, local County or municipality Board of Health, or Virginia Department of Health) that prohibits patients or prospective patients from receiving physical therapy services based upon an individual’s choice to not wear a mask.

The Board’s paraphrased version: ““The petitioner requests that the Board amend its regulations to: (2) prohibit physical therapists and physical therapy assistants from enforcing any requirements for patients, prospective patients, or patient representatives to wear masks to receive physical therapy, including when following policies of insurers or organizations or when following guidance issued by the Centers for Disease Control, local health departments, or the Virginia Department of Health;”

One can obviously see the difference in my proposal.  My proposal simply limits a practitioner from enacting, implementing, enforcing, or executing any practitioner-authored, insurer-required, or organizational policy, instruction, or guidance prohibiting patients, prospective patients, family members, or authorized patient representatives to receive medical care based solely upon an individual’s choice to not wear a mask.  The proposal does not claim outright that a practitioner cannot place some necessary restrictions on the receipt of care, for example, providing necessary body temperature screening.    

Most Americans have accepted that there is no longer a pandemic gripping the country.   Even the data from the Virginia Dept. of Health proves COVID is no longer a threat: https://covid.cdc.gov/covid-data-tracker/#trends_dailydeaths_totaldeathsper100k.  As further evidence of this, the American Physical Therapists Association’s own web site lists this as an article on their web page, reinforcing the attitude that Americans have moved on from COVID-19: “As BA.2 Variant Cases Rise, Poll Finds Most Americans Unfazed https://www.apta.org/coronavirus-update-april-2022. (Accessed 5/17/22).”  If the association representing the American physical therapy profession even acknowledges Americans are ready to move on with their lives, sans masks and no forced vaccinations, the Board of Physical Therapists can surely not deny the reality of current sentiment (and science) in America.