ReboundLogo_4C copyA number of years ago obtaining access to physical therapy services required a formal prescription (“referral”) from a physician. This meant that a patient had to be seen first by a doctor and then referred on to PT.


The APTA (American Physical Therapy Association) opposed this regulation stating, “This requirement does not recognize the professional training and expertise of the licensed physical therapist nor does it serve the needs of those patients who require physical therapy but must first be seen by a physician.”


Additionally, the APTA went on to state: “Today’s environment of health consciousness, pursuit of physical fitness, and the promotion of a concept of wellness is tempered by the need to control the escalating costs of health care. One goal of the state legislatures in the 1990’s was the reform of the burgeoning health care system. Two areas of intense legislative focus have been increasing access while still achieving cost containment. One of the most effective tools for cost control and increased access is easily attainable yet often overlooked and underutilized by the legislatures – that of direct access to the services provided by health care professionals.”


“Physical therapy is the case in point. Entry into the profession and practice of the profession are stringently regulated by all states, and as highly trained health care professionals, physical therapists have a proven track record of effectively treating millions of patients. Physical therapists are well-qualified, both through formal education and clinical training, to evaluate a patient’s condition, to assess his or her physical therapy needs and, if patients demonstrate conditions, signs and symptoms that should be evaluated by other health care professionals before therapy is instituted. Physical therapists recognize when it is appropriate to refer patients to these other health care professionals for consultation.”


Through diligent work, the APTA has secured “direct access” to physical therapy services in 48 states. Removing this provision, according to a study done at Georgetown University and Johns Hopkins University, will realize a cost savings of approximately $1,200 per patient episode of care.


How has this impacted our incredibly active northern Colorado community? Coloradoans are among the nation’s leaders in overall fitness and outdoor activities. Many work hard, but play even harder when it comes to sports and fitness. As such, the incidence of overuse injuries, strains, sprains and other musculoskeletal injuries is also high. These types of injuries most often do not require multiple expensive diagnostic tests, emergency room visits, or immediate surgical consultation. They need physical therapy.


Direct access in Colorado results in patients getting an immediate start on their rehabilitation. This “Try PT First” mentality not only saves significant money, but it also gets patients to the one profession that can help them most quickly with these types of injuries. It is not uncommon for a patient, who was previously stuck spinning their wheels inside the medical system, to ask us, “Why didn’t they send me to PT sooner?”


Of course it is imperative that physical therapists be able to recognize injuries or conditions that are not immediately appropriate for PT, and to get them to a different health care practitioner or medical specialist. That is how the system should work.


As many active patients know (runners, swimmers, cyclists, triathletes, and others) it’s not uncommon to go to a doctor, explain your pain/injury and your training regimen, and be told you need to take extensive time off or pick a new sport. That can be a huge blow mentally, and perhaps even unnecessary if the patient has not at least tried some physical therapy to keep them “in the game.” Having direct access allows patients to take advantage of the very service that very well could save a sports season or even a career.


On a side note, although the state recognizes direct access to physical therapy services, there are a few health insurance companies that still require a prescription from a doctor for them to cover your visit. With a quick call to the PT clinic they should be able to tell you if that is necessary or not.


If an injury gets you down, and is limiting your work or play, “Try PT First” and utilize your options with direct access.

This post written by Brad Ott, Owner, MSPT

Direct Access to Physical Therapy Services – The Past and Present

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