I have written a lot over the past few years on my success with Direct Access and patients coming to see me first for musculoskeletal pain vs going through a physician referral.  The literature is coming out with more and more evidence to support my (and I’m sure you other PTs) anecdotal statements.  

Here are a few links from my page here.  Also, check out article in the past that shows we have the knowledge to manage these patients. A recent article in Health Services Research here looked at the comparison of self-referral vs physician-referral episodes to outpatient physical therapy.   If you get the opportunity, you can listen to the authors speak through APTA podcast here.  I also recommend reading the APTA Media Release here as our President and others (who are more renowned in our field!) remarked on the study. I do not have access to the full article so cannot delve but so deep but I find the results very promising for our field. 

Basic findings were those who self-referred had:

–fewer PT visits.

–costs the system less for services.

–overall utilization of other resources for this problem were less. 

We all know this but good to have it in the literature.  Quality of care, with the least cost needed, is what we are striving to provide! Don’t we want this with anything we do on a daily basis?  

I educate my patients all the time in regards to not only having the knowledge to treat you (or refer out if not acting mechanically) but also availability to care in terms of time-frame is more accessible (and quicker usually) coming to me first.  I will include this data now to push more cost-efficient our services are compared to the typical gatekeeper route.  

Physical therapy is growing and consumers are more aware of the benefits now vs anytime in the past.  We are also improving out education and post-graduate work (OCS, Fellowships, etc) to advance our knowledge even more.  It is our job as clinicians to do our part to provide these results to the public, one patient at at time if need be!

This study should also help the state levels make better decisions in terms of getting Direct Access for states who do not have it, but also improve the Direct Access time-frame (i.e. Virginia can only see for 14 business days).  

Good study for the profession, keep it up!


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