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  • PTs Are Effective Primary Care Providers in Military Settings

    Physical therapists (PTs) who function as musculoskeletal primary care providers (PCP) may provide a better route to recovery than family practice physicians, according to a new study that focused on use of PTs in the military. Decreased use of radiology and medication, and a higher return-to-duty ratio for patients whose PCP was a physical therapist were cited as indicators that PTs are effective "musculoskeletal gatekeepers."

    In the study, which appears in the October issue of Military Medicine, data were collected on treatment approaches and outcomes among PTs and family practice physicians serving as the PCP for members of the military with musculoskeletal complaints. The results showed that PTs used radiology in 11% of cases while family practitioners had an 82% usage rate. Similarly, medication use for PTs was 24%--family practitioners used medication at a 90% rate. The return-to-duty rate was 50% higher for patients whose PCP was a physical therapist.

    Author Lt Col Troy McGill, PT, MPT, USAF, BSC, writes that these results mirror similar efficiencies realized with direct access in the civilian world. In the face of attention to cost containment, and an ever-dwindling supply of internists and family practitioners, he writes that "PT direct access can help fill this void and give patients the safe and effective care they need in a reasonable time."

    APTA provides a wealth of resources in support of direct access and continues to work with policymakers to strengthen the ability of PTs to provide the most efficient and effective care possible. Members of APTA can access the full text of McGill's article through Open Door.


    • I do hope that the AMA is listening - and insurance companies - and most importantly the public-at-large. They need to know that PT's can be (more) effective primary care providers for musculoskeletal issues - now we need to be assigned the responsibility(s) that is/are commensurate with our respective doctorate degree.

      Posted by Ginger Garner on 10/7/2013 3:41 PM

    • Readers should send a copy to their legislators and ins co contacts.

      Posted by Paul Jones on 10/10/2013 7:26 AM

    • Emergency room physicians are very aware of the value of physical therapists practicing in this area. This article shows that we are effective and efficient. Please share this article and the Emergency Department Toolkit with hospital administrators.

      Posted by John Heick on 10/11/2013 7:47 PM

    • Thank you Lt. col McGill for gathering and publishing such great data. This is what our profession needs right now!

      Posted by Jerry McCollow PT on 10/11/2013 11:49 PM

    • I wholeheartedly agree that PTs are effective first-line care providers for musculoskeletal complaints. However, using the title "primary care provider" to refer to physical therapists would be confusing to consumers. The PCP is now viewed in a way traditionally reserved for the family doctor. It does not strengthen our profession to use someone else's title; it makes us look like we want to be something we are not.

      Posted by Connie Posigian, PT, OMPT on 10/12/2013 8:50 AM

    • Can you provide a citation for the article?

      Posted by Kyle Sela -> @HP`>K on 10/15/2013 3:55 PM

    • Is this any surprise? Physiotherapists specialise in acute musculoskeletal conditions, where as GP's and most physicians do not (and in fact many of them do not keep up to date with basic fitness research). I think it's important however to emphasise the difference between acute and chronic care. Unless you're a physio who specialises in chronic musculoskeletal conditions, you shouldn't be treating clients beyond the acute stage and ought to be referring them to an exercise physiologist or rehab specialist after 3 months of treatment. Unfortunately many physiotherapists do not do this and continue to apply acute treatment modalities well beyond the acute treatment period, which of course provides no long-term benefit to the patient. Jason Jarred (My blog: www.skeptifit.com)

      Posted by Jason Jarred on 10/18/2013 8:29 PM

    • Interesting thoughts, Jason Jarred. I guess if you equate physiotherapy/physical therapy to modalities, massage and the moist heat and RICE principles in a "shake and bake" delivery method, you're right. However, Lt. Col McGill, I assure you, isn't proposing that to be the care given that would warrant an improved position of physio's in healthcare to include first response clinicians no matter the acuity. see Spine 2004 and 2008 Long, A. and Journ of PT 2014, Rosedale R. Subclassification for any msk condition is critical to produce good outcomes and I'd be interested to know which personal training and /or fitness specialist organization or diagnosis and treatment methodology has been shown to be reliable and effective. Thanks for your insight.

      Posted by Jason Ward on 6/23/2014 3:42 PM

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