1.26.2012

Why Go Directly to a Physical Therapist?

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Direct Access in physical therapy means that you can go directly to a PT for evaluation and treatment of pain and other movement related issues.

Yes, by law you may visit a licensed physical therapist without supervision, orders, or prescriptions from other health care providers.

[Mud bathing, bull riding, and bone setting are also things that the law permits you to do without approval of other health care providers, but we won't get into that.]

So what's in it for you? Why deviate from the traditional model where you are referred to physical therapy by a physician or other specialist?

1. Three certain things in this world are death, taxes, and rising (insurance) co-pays and deductibles. In most instances of musculoskeletal pain, you'll leave a physicians office with a prescription for pain relieving drugs and a script for physical therapy. Going through a trial of PT first saves you some time and co-pays. Which leads to point number two.

2. Physicians perform a systems review to identify "red flag" situations that warrant immediate attention. Physical therapists are trained and qualified to do this and specifically find root causes of movement related problems. Treating mechanical (movement related) problems requires mechanical solutions, and most physicians don't have the time, training, or desire to get into the nuts and bolts of movement.

3. Time is of the essence. Rest is good, up to a point. If medicine and a few days of rest are not helping your condition, the last thing you need is more medication with more rest. Rest does not identify and address the factors that cause pain or poor movement.

Seeing a PT sooner than later may substantially impact the extent to which you reach full recovery. For example, physical therapists attempt to address that painful plantar fasciitis or lateral shift of your spine before the mind and body begin to compensate and ingrain dysfunctional movement. Which leads to the final point.

4. Independence:  A vast body of evidence from virtually every medical discipline shows that chronic pain is a major dilemma. The more someone adapts a fear avoidance mindset and depends on health care providers, the poorer the outcome. PT is a conservative, patient empowering, proactive means of addressing the root of movement related problems.

No, we don't fix every painful condition for every person. But doing all that we can to set you up for success, and building on that, a little at a time, often goes a long way.

What's the catch? After all, I'm a biased source for talking about the benefits of Direct Access to physical therapy.

The catch is that most physician groups have seen the validity of these claims. They seek to work cooperatively with therapists who they trust to communicate with them if the patient is not improving.

Insurance companies are absolutely on board with this. After all, they are the ones with the most incentive to scrutinize practice patterns and determine what's beneficial and cost effective. For many reasons, very rarely are surgeries, MRI's, and other diagnostic tests deemed medically necessary before you have had a trial of conservative care.

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News story on Direct Access in Pennsylvania: CLICK HERE.

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