Direct Access to Physical Therapy Services: Overview

The Problem

In many jurisdictions, the practice of physical therapy is contingent upon the prescription or referral of a physician. This requirement does not recognize the professional training and expertise of the licensed physical therapist nor does it serve the needs of those patients who require physical therapy but must first be seen by a physician.

The Solution

Amend current statutes at the state level to permit direct access to physical therapy services.

Rationale

Today's environment of health consciousness, pursuit of physical fitness, and the promotion of a concept of wellness is tempered by the need to control the escalating costs of health care. One goal of the state legislatures in the 1990s has been the reform of the burgeoning health care system. Two areas of intense legislative focus have been how to increase access while still achieving cost containment. One of the most effective tools for cost control and increased access is easily attainable yet often overlooked and underutilized by the legislatures - that of direct access to the services provided by health care professionals.

Physical therapy is the case in point. Entry into the profession and practice of the profession are stringently regulated by all states, and as highly trained health care professionals, physical therapists have a proven track record of effectively treating millions of patients. Physical therapists are well-qualified, both through formal education and clinical training, to evaluate a patient's condition, assess his or her physical therapy needs and, if appropriate, safely and effectively treat the patient. Physical therapists are also well-qualified to recognize when patients demonstrate conditions, signs and symptoms that should be evaluated by other health care professionals before therapy is instituted. Physical therapists recognize when it is appropriate to refer patients to these other health care professionals for consultation.

The professional training and expertise which characterize physical therapists has been recognized by 48 states and the District of Columbia. These states have removed the out-dated provisions requiring a referral by a physician for a physical therapy evaluation and treatment, from their statutes. Further, these states and the insurance companies that reimburse under direct access will realize cost savings of approximately $1,200 per patient episode of care according to the results of a recent study by Dr. Jean Mitchell and Dr. Greg deLissovoy of Georgetown University and Johns Hopkins University, respectively. Just imagine what this could mean to your state's workers' compensation program or special education department!

If you represent one of the 2 states that still contains barriers to direct patient care by physical therapists, please consider the benefits of reform. By amending the physical therapy practice act in your state, you will be providing your constituents with an additional entry point into the traditional medical system, increased choice in the selection of a health care professional, access to less expensive and more timely care, and a simple, yet, extremely effective way to meet the goals of increased access and cost containment.

For additional information on direct access, please contact APTA's state government affairs department at 800/999-2782, ext 3161.

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