APTA Responds to Forbes on Physician Referral

April 7, 2008

Dear Editor:

In Rich Karlgaard's April 7 column ("Two MRIs Cost $14,961") the author states that before his son was allowed to be referred to a physical therapist for muscle atrophy treatment, he was required to have two MRIs to check for other ailments. The tests found no additional conditions and cost nearly $15,000.

The American Physical Therapy Association (APTA) agrees that is a high price for a physician referral. Currently 44 states and the District of Columbia allow physical therapists to evaluate and treat patients without a physician's referral under varying circumstances, which we call "direct access" to physical therapist services.

The education and clinical experience required to become a licensed physical therapist provides the judgment needed to establish a diagnosis, determine if consultation with another health care provider is necessary and design an individualized plan of care for the patient.

Studies show that unnecessary visits to physicians not only result in excess costs, but they also cause delays in treatment that can reduce functional outcomes for patients. Removing these burdens and providing direct access coverage under Medicare will make for a more efficient health care system for patients and providers.



R Scott Ward, PT, PhD
American Physical Therapy Association