As we face both an election year and a global health pandemic, our current health care system has been widely discuss, debated, and scrutinized. As of January 1, 2015, all 50 states allow Direct Access to physical therapy— patients are allowed to seek some level of treatment from a licensed physical therapist without a prescription or referral from a physician. However, in many jurisdictions this option is limited by state laws or private insurance company regulations. For many patients seeking physical therapy, having to jump through a number of bureaucratic hoops such has primary care visits, referral requirements, and insurance pre-authorization before even stepping into a PT clinic’s door can be frustrated and exhausting.
In November 2019, the American Physical Therapy Association (APTA) released a study examining unrestricted direct access to physical therapy and its effects on health care costs, utilization, and patient safety. After reviewing the insurance claims of nearly 60,000 US adults with low back pain, the APTA found seeking PT first through unrestricted direct access resulted in lower costs of care and less overall usage when compared to patients seeking care with provisional access. While for each patient individually this may seem like a minor difference, it is estimated that as many as 70% of people will experience low back pain in their lives, making it the third most costly medical condition in the US.
Some opponents of direct access argue that patients may be put at risk if they seek PT without first being evaluated by a doctor. However, to date there is no objective data that this is true. PTs are trained to recognize “red flags” that may signal the need for further medical work up, and studies have found that these red flags are accessed by PTs on initial evaluation 61% of the time, compared primary care doctors who assess these risks <5% of the time. Even liability insurers agree that direct access does not correlate to increased safety risks. Research analyzing claims filed to professional liability insurers found PTs already have a low rate of malpractice claims and complaints filed against them with data showing no increase in reports against PTs treating patients without a referral.
If you are suffering from a musculoskeletal condition that results in pain or limitations in function and daily activities, a visit to your local physical therapist is a safe place to start your road to recovery. Why let pain win? Request an appointment with one of our clinicians today.