Direct Access: 3 Reasons why you should go see your physical therapist first for your pain

Direct access means the removal of the physician referral mandated by state law to access the services of a physical therapist for evaluation and treatment. In short, you can take your hard earned money, valuable time, and resources to the health professional you want without a referral note, and in this case, it is your physical therapist. The state of Utah by law has been a direct access state for three decades allowing patients to be seen directly by their physical therapist, bypassing a physician referral.º Some of the common questions are: Is their great risk involved? What are they allowed to do on a first visit? Will it save me time or will I just end up going back to my doctor? Below are those questions answered and 3 reasons why you should go see your physical therapist first for you pain and injury.

1. Doctors of physical therapy are trained to screen for serious medical problems
You may say, “A physical therapist cannot order imaging studies so how will they really know if I am OK with certainty?” That is a great question and we should ask ourselves when is it appropriate to order imaging? A physician will ask specific questions and look for warning signs before ever ordering imaging to look further into the problem. A physical therapist will do the same by asking specific questions to screen for “red flags” that would warrant a referral to a physician. Deyo et al states that a radiograph should be limited to the following presenting with these signs and symptoms: Trauma, age > 50 years, history of cancer, unexplained weight loss, fever, or failure to improve after 4-6 weeks of conservative care.¹ These are the questions that will be asked by a physical therapist to deem whether or not a patient should be passed on or if they are appropriate to be treated immediately. Roughly 1% of the population falls under this criteria of a serious pathology requiring imaging while a fair amount being in the scope of physical therapy care. In summary, a physical therapist will ask the same questions your physician will to screen properly and assure you are within the scope of physical therapy practice.

2. Saves your time
Time is a valuable commodity that most of us cannot afford to waste. Many of us have been to our primary care physician and we know that in specific cases such as low back pain or many orthopedic injuries they will refer such cases to the physical therapist. In a recent study by Childs et al, an exam was administered to assess knowledge of managing musculoskeletal conditions among physicians, orthopedic surgeons, medical students, physical therapy students, physical therapists and several other health professionals. They found that with the exception of orthopedic surgeons/orthopedists, physical therapists and even physical therapy students currently enrolled in graduate programs scored higher than any other profession.² Going to the health professional who is specifically trained in musculoskeletal, movement based, joint disorders will accelerate your recovery significantly.

3. Saves money
This goes hand in hand with saving time. We are able to save on costs by not attending multiple doctor visits when they are unnecessary. This can not only waste money in the short term, but ultimately it delays the appropriate care needed, which can then turn a small simple issue into a much bigger one costing the patient significantly more. A study by Mitchell et al compared direct access episodes versus physician referral episodes and found that direct access episodes encompassed a fewer number of visits (7.6 vs. 12.2 physical therapy office visits) and substantially less cost ($1,004 vs. $2,236).³ Those who sought out a physical therapist not only saved money over their episode of care but also time in the form of less doctor visits.

Overall, our staff at Back at Work Physical Therapy wants everyone to be return to the activities, hobbies, and lifestyle that are valued most. The most important thing is that the correct healthcare professional is found, as soon as possible, and the pain that is limiting your enjoyment is eliminated. Understanding that you can go directly to your physical therapist by law in the state of Utah for pain and disability is the take home message and allows another avenue for those seeking relief. Call our staff in Layton at 801-217-3755 or in Logan at 435-213-3850 or visit us on our website to learn more and schedule an appointment at www.backatworkpt.com.

Dr. Jonathon Eichner PT, DPT

0.http://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Direct_Access/DirectAccessbyState.pdf.

1. Atlas S, Deyo R. Evaluating and Managing Acute Low Back Pain in the Primary Care Setting. Journal of Geriatric Internal Medicine. 2001; 16:120-131.

2. Childs JD, Whitman JM, Sizer PS, et al. A description of physical therapists’ knowledge in managing musculoskeletal conditions. BMC Musculoskelet Disord. 2005;6:32.

3. Mitchell JM, de Lissovoy G. A comparison of resource use and cost in direct access versus physician referral episodes of physical therapy. Phys Ther. 1997 Jan;77(1):10-8. PubMed PMID: 8996459.