APTA Responds to AMNews Article on Direct Access

June 19, 2009

Dear Editor:

I am writing in response to the June 18 article, "Physiatrists oppose eliminating Medicare PT referral." While the position of the American Physical Therapy Association (APTA) was accurate, readers should also know about the abundant information and evidence that supports removing the burdensome referral process for Medicare beneficiaries.

Delays to access physical therapist care can result in higher costs, lower functional status, and increased hospitalization. A study on the cost-effectiveness of direct access to physical therapists found that there were significant cost savings, appropriate utilization, and a lower number of patient visits when compared with referral initiated physical therapy.

Holding at least a master's degree, many with doctorates, physical therapists have extensive academic and clinical education. Their ability to maintain a patient's health, safety, and welfare, with referral to other health care providers as necessary, has been proven at the state level. Forty-eight states and the District of Columbia have eliminated the physician referral requirement for patients to access physical therapists for an evaluation.

APTA feels strongly that eliminating "red tape," such as these restrictions will go a long way toward making health care more affordable and accessible for all - a major goal of national health care reform. We hope to work with physician groups to establish policies to reduce unnecessary regulations, improve access, and build models of delivery for rehabilitation that best serve the patient, physical therapists, and physicians.

Providing rehabilitation that returns individuals to the highest level of function as possible is an integral part of an effective and efficient health care system, and physical therapists are imperative to that achievement. We appreciate our ongoing collaboration with our physician colleagues to ensure patients have access to cost-effective and high quality rehabilitation services.


R Scott Ward, PT, PhD
American Physical Therapy Association