Current evidence based research has supported the use of physical therapy direct access services in both reducing health care costs and providing quality care. Avoiding unnecessary physician and emergency room visits reduces costs for the patient and health care system. Also, physical therapy direct access services has been shown to be effective and less costly than first access physician care for musculoskeletal injuries.
As direct access in physical therapy continues there is more data to support its implementation on reducing health care costs. A study published in 2014, “Direct access compared with referred physical therapy episodes of care: a systematic review,” found fewer visits needed and less medication used in direct access cases (Ojha et al., 2014). Direct access is another way to reduce medication dependency among patients which continues to be a growing problem in this country with associated rising costs. In addition, Ojha et al. found increase patient compliance and satisfaction with treatment during direct access physical therapy versus physician referral (Ojha et al., 2014). If patients are satisfied with treatment, increase compliance will occur and better outcomes follow.
Another benefit to direct access physical therapy care is patient outcomes and quality of care. Some opposing the transition of these services argue that physical therapists do not have the background to safely treat without a physician’s referral; however, the data supports there is safe and effective treatment. A study published in 2015, “Physical therapists as primary practitioners in the emergency department: six-month prospective practice analysis,” found physical therapists utilized in the emergency department as first point medical providers were efficient in identifying red flags and low number of adverse incidents (de Gruchy et al., 2015). These results could easily translate to an outpatient physical therapy direct access patient evaluation setting.
Lastly, another recent study published in 2015, “DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS,” supports physical therapist skills as direct access providers (Crowell et al.., 2015). Physical therapists ordering musculoskeletal diagnostic imaging in a 2 year period appropriately ordered test over 80% of the time (Crowell et al., 2015). Over 55% of the cases in the study were acute cases (Crowell et al., 2015). Diagnosis by physical therapists were confirmed 64% of the time by diagnostic findings as well as 90% of the time with surgical findings (Crowell et al., 2015). This recent study makes a strong case for direct access physical therapy care allowing diagnostic imaging ordering.
Crowell, M. S., Dedekam, E. A., Johnson, M. R., Dembowski, S. C., Westrick, R. B., & Goss, D. L. (2016). DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS. International journal of sports physical therapy, 11(5), 708.
de Gruchy, A., Granger, C., & Gorelik, A. (2015). Physical therapists as primary practitioners in the emergency department: six-month prospective practice analysis. Physical therapy, 95(9), 1207-1216.
Ojha, H. A., Snyder, R. S., & Davenport, T. E. (2014). Direct access compared with referred physical therapy episodes of care: a systematic review. Physical therapy, 94(1), 14-30.
Ojha, Heidi A.; Brandi, Jason A.; Finn, Kathryn M.; Wright, W. Geoffrey (2015). Cost Efficiency of Direct Access Physical Therapy for Temple University Employees with Musculoskeletal Injuries. Orthopaedic Physical Therapy Practice, 2015; 27(4): 228-233. (6p)
Bryan Rodner, PT
He attended Michigan State University and received a bachelor degree in Science with a major in Physiology. During his college experience at MSU, he found passion for physical therapy, which led him to complete his Masters degree in Physical Therapy at University of the Science in Philadelphia. Bryan has practiced outpatient physical therapy in center city, Philadelphia for over 14 years. PTWEBUCATION.com was founded in 2013 to create high quality evidence-based continuing education online for physical therapists in a convenient and affordable platform. In 2014 PTWEBUCATION.com expanded its resources to therapists online by adding a job posting platform. Providing an affordable option for companies to find the perfect hire and convenient continuing education.