A new study suggesting that "the role of the physician gatekeeper in regard to physical therapy may be unnecessary in many cases" could have significant implications for the US health care system, APTA announced in a news release yesterday. Funded by a grant from APTA, the Private Practice Section (PPS), and the Section on Health Policy and Administration (HPA), this study examined non-Medicare claims data and compared self-referred episodes of physical therapy to physician-referred episodes of physical therapy.

Published ahead of print September 23, in the journal Health Services Research (HSR), the study found that patients who visited physical therapists directly for outpatient care had fewer visits and lower overall costs on average than those who were referred by a physician, after adjusting for age, gender, diagnosis, illness severity, and calendar year. In addition, overall related health care use—or care related to the problem for which physical therapy was received, but not physical therapy treatment—was lower in the self-referred group after adjustment. Examples of this type of care might include physician services and diagnostic testing. The study also found that individuals were similarly engaged with the medical care system during and after their course of physical therapy care, suggesting that continuity of care did not differ between the 2 groups.

In the coming weeks, APTA, HPA, and PPS will be providing more information about this landmark study as a communications plan is rolled out to members, the media, and the public. In addition to the news release referenced above, sample presentations, talking points, and other tools will be developed for members to use in community outreach.

Jane Pendergast, PhD, professor of biostatistics and director of the Center for Public Health Studies at the University of Iowa, was lead author of the study. Coauthors of the study were Stephanie A. Kliethermes, MS, a doctoral candidate in biostatistics at the Center for Public Health Studies, University of Iowa; APTA member Janet K. Freburger, PT, PhD, research associate and fellow at the Sheps Center for Health Services Research and a scientist at the Institute on Aging at the University of North Carolina, Chapel Hill; and APTA member Pamela A. Duffy, PT, PhD, OCS, CPC, assistant professor, Public Health Program, at Des Moines University.