Physical Therapy and Direct Access

Physical Therapists have historically been required to work under the direction of a referring physician. While this has been a relationship that has worked in the past, the profession of Physical Therapy is growing with advanced degrees now required of all new graduates to have their Masters in Physical Therapy and more programs offering a Doctorate in Physical Therapy. As Physical Therapists and the profession of Physical Therapy advances, the relationship between the therapist and the physician must be redefined.

In order for a client to seek the services of a Physical Therapist, they have been previously required to see their primary care physician first for an initial assessment. The primary care physician then had the option of writing a referral to therapy services or referring the patient to a specialist such as an orthopedist, cardiologist, neurologist, or one of many other specialists. While this diagnostic assessment is critical to the success of the patient and the therapist, the time it took the patient to be processed through these systems has been extensive. With more time lapsing, the patient often suffered from increasing pain and decreasing function. Without the immediate intervention and education provided by a Physical Therapist to compliment the ongoing diagnostic assessments, patients have had to unnecessarily wait to solicit and initiate the services of a Physical Therapist.

Over the past several years, the National American Physical Therapy Association (APTA) in cooperation with each state’s Physical Therapy Association has lobbied congress for Direct Access in each state. Direct access, as stated by the APTA, “is the ability of a physical therapist to provide evaluation and treatment to patients without the need for a physician referral. At this time, more than 35 states have some form of direct access as part of their state practice act. Physical therapists in states that currently have restrictions to direct access are actively working with those state legislatures to make the changes needed to permit patients/clients to having access to care.”

As the nation accepts Direct Access for Physical Therapy services, clients will now be able to go directly to a therapist for assessment and treatment. In most states, it is still required for patients to follow up with their primary care physician or specialist as a script for therapy services is still required to continue ongoing PT treatment. This immediate access to therapeutic care in cooperation and conjunction with the diagnostic assessment of the physicians and supporting medical community leads to a much higher rate of success in a timely manner for the individual seeking services.

The National APTA has issued a Vision Statement for Physical Therapy services over the next 12 years. The APTA Vision Statement for Physical Therapy 2020 is “Physical therapy, by 2020, will be provided by physical therapists who are doctors of physical therapy and who may be board-certified specialists. Consumers will have direct access to physical therapists in all environments for patient/client management, prevention, and wellness services. Physical therapists will be practitioners of choice in patients’/clients’ health networks and will hold all privileges of autonomous practice.”

More Physical Therapists are graduating from college with their Doctorate of Physical Therapy. There is also a growing trend of practicing Physical Therapists with their Bachelors and Masters Degrees to go back to school to earn advanced degrees in order to achieve the Vision of the APTA. As advanced clinicians, we are now able to achieve and support the APTA’s vision to provide direct access to Physical Therapy services in our communities.