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Industry Insights

Direct access to physical therapists helps patients with care, costs

By ,
Joyce Glick, vice president for ambulatory care, Bacharach Institute for Rehabilitation.
Joyce Glick, vice president for ambulatory care, Bacharach Institute for Rehabilitation. - ()

One of the most important elements of the conversation about health care has been how to provide better access to health care at the lowest possible cost.

“Direct access” to physical therapy offers a delivery model that provides patients with the ability to receive timely treatment from a physical therapist while lowering health care expenditures. 

Historically, patients were required to secure a prescription from their physician before seeking physical therapy.

In 2003, the law was changed in New Jersey to allow patients to visit a physical therapist for evaluation and treatment without delay or the need for a prescription.

In fact, this approach is now permitted throughout the United States, with varying guidelines.    

The American Physical Therapy Association notes that, according to a study in the journal Health Services Research, “Patients who visited a physical therapist directly for outpatient care … had fewer visits and lower overall costs on average than those who were referred by a physician, while maintaining continuity of care within the overall medical system and showing no difference in health care use in the 60 days after the physical therapy episode.” 

By allowing patients to schedule a physical therapy appointment without a prescription, direct access eliminates unnecessary barriers and ensures a timely visit to a health care professional. 

All current graduates of an accredited physical therapy program hold a Doctor of Physical Therapy degree. Physical therapists have been taught skills to identify when a patient needs to see a physician, and often work in close collaboration with the patient’s doctor. They are highly educated, with extensive clinical training in evaluating and treating individuals with functional issues related to illness or injury. 

Further, in New Jersey, if a direct access patient is not seeing improvement after 30 days of physical therapy treatment, he or she will be referred to another health care provider.

In the case of Medicare patients, a physical therapist must secure the primary care provider’s approval of the proposed plan of care upon completion of the initial evaluation.

In the case of some managed care insurance plans and HMO plans, the patients need a referral for the initial evaluation before proceeding. It is always important for consumers to be familiar with their insurance plans. Direct access is still available, but a phone call to the insurance provider may be necessary as well.

Direct access to physical therapy affords patients a noninvasive approach to combat pain and improve function, and may even help to reduce the demand for pain medication.

I believe direct access should continue to be encouraged and expanded throughout the health care community. In today’s evolving health care environment, our goal must be to continue to promote the most effective pathways for patients to obtain the treatment they need and deserve. 

The early intervention and positive outcomes realized through direct access has proven to be one such pathway to achieving that goal.

Joyce Glick is vice president for ambulatory care at Bacharach Institute for Rehabilitation, based in Pomona.

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