How Direct Access Can Save You Time and Money

If you have been injured, then you probably know the struggles that come with getting quality help. It typically starts with, what appears to be, a rushed 5 minute evaluation from your physician. You know you haven’t broken a bone, yet you are sent for an X-Ray regardless just so you can get a prescription for an MRI. After two-weeks and multiple doctor appointments, they finally recommend that you see a physical therapist..

Wouldn’t it be nice if there was a way to seek immediate care after an injury instead of being bounced back and forth between consultations and imaging labs. Imagine being able to go to a one-stop-shop for any injury where your doctor sits and listens to you, understands your concerns and works directly with you every appointment to ensure you achieve your goals.

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If this interests you, let us explain why direct access is an option for physical therapy that you will want to start taking advantage of.

First let’s start by explaining what a Doctor of Physical Therapy is and what our role within the healthcare system is. A doctor of physical therapy (DPT) is a healthcare professional who aims to assess the quality and capacity of movement in individuals dealing with or without chronic pain, injury, or disease.

Our role in the healthcare system primarily lies within the rehabilitative setting focused on mitigating pain by restoring, maintaining and enhancing overall health and fitness. In recent years our role is expanding; allowing patients to directly access our educational resources in regards to rehabilitation and functional performance. We can now act as the first line of defense for the inevitable setbacks that life will throw our way.

While direct access has been around for many years since granting rights to all 50 states in 2015 and converting the physical therapy degree to a doctorate level, this approach to care has recently gained a lot more popularity. While each state has its own specific regulations we will explain how this process is regulated in the state of New York.

Physical therapy services can be rendered by a licensed clinician without a physician’s referral for 10 visits or 30 days, whichever comes first. A physical therapist can treat via direct access if they are over the age of 21 and have been actively treating for a minimum of 3 years, which holds true for all of our clinicians here at Perfect Stride Physical Therapy (PSPT).

Unfortunately, not all insurance plans will cover this style of treatment, however, the clinic should inform you about your specific health care benefits prior to your scheduled visit. At PSPT, we verify all potential client’s insurance information in order to give them transparent pricing and information about everything you need to know prior to your first visit.  

So many of us see our primary care doctor for annual physicals, and while these are important, there is nothing physically done during the exam. So why is this the standard measurement of health that we hold ourselves to?

You might be thinking, why would I go directly to a physical therapist before seeing my MD or getting an MRI. Don’t they need a specific diagnosis before seeing me? Well, not quite. While an MRI is a valuable resource that can detect damaged tissues, the image presented is your body at one moment in time. This image may not be of the position you experienced the injury and thus we must not allow the results to completely dictate our outcomes.

Other common questions we hear; Are physical therapists qualified to diagnose my injury? Are their diagnoses accurate? Will seeing them first alter the course of my treatment? Won’t I be paying more?

With respect to qualification, physical therapists have a doctorate level education. This is a three-year program that mixes didactic learning with clinical experience. Along with a higher level of education that includes multiple systems (musculoskeletal, cardiovascular, neurological, integumentary, along with many others) we are required to have 3 years of experience before we can evaluate you before any other healthcare practitioner.

This allows us to properly examine you to determine you are a good fit for physical therapy and that your symptoms aren’t being caused by another system, in which case we must refer you back to your doctor for further evaluation.

The Journal of Orthopaedic and Sports Physical Therapy (JOSPT, October 2005) described over 50,000 patients being seen by PTs via direct access and no incidence of injury or adverse events were reported. In fact, since 1990, about 30 case reports have been written in the JOSPT describing instances where PTs recognized unusual examination findings and referred the patient to a physician or other health care practitioner. This led to a more timely diagnosis for a multitude of conditions, including cancer, fractures, and infection.

In regards to accuracy Moore et al (JOSPT, 2005) compared clinical diagnostic accuracy between PTs, orthopedic surgeons and non-orthopaedic providers for interpretations of MRI radiographs in patients with musculoskeletal injuries. The PTs and orthopods demonstrate interobserver agreement as indicated by a high per kappa coefficient suggesting equal competency in their clinical decision skills.

A study in 2015 analyzed the implication of early adherent physical therapy interventions and financial burden in patients with low back pain. 122,723 patients were analyzed, 59.2% (n = 72,641) were categorized as receiving early intervention physical therapy.  “Patients who received early physical therapy had a decreased likelihood of receiving advanced imaging, spinal injections, lumbar spine surgery, or opioid use. Total LBP-related costs during the 2-year follow-up for patients receiving early physical therapy were an average $1202.29 lower compared to patients receiving delayed physical therapy, with a mean cost of $1,828.24 and $3,030.53, respectively. Similarly, non-LBP healthcare costs with early physical therapy were an average $1011.22 lower than those with delayed physical therapy, with a mean cost of $8,687.25 and $9,698.47, respectively.”

Who is to say that you need to be injured to seek professional medical advice from a physical therapist. Why should we wait until we are in pain or recovering from surgery to finally ask for help? At Perfect Stride Physical Therapy, our physical therapists hold advanced athletic certifications (such as running and strength and conditioning) which can help bridge the gap between your performance and recovery. Direct access physical therapy allows us to promote proactive caring for your body instead of doing so reactively after the “damage” has already been done.

Overall, physical therapists aim to create functional diagnoses. These are different from medical diagnoses, which determine specifically injured tissues. A functional diagnosis is focused on understanding what an individual’s limitations are and why they may be having them in the first place. While it is important to know which tissues are explicitly damaged it is just as important to understand the why behind an injury, this way we can “attack” the source.

In our opinion, in conjunction with the research posted above, direct access physical therapy can save you time and money. Physical Therapists receive extensive knowledge in regards to movement analysis and examination helps us identify ways to improve your functional performance. Each doctor of physical therapy has its own unique approach, all centered around a common goal: to transform society by optimizing movement to improve the human experience.

If this is something you are looking for, fill out the form below to contact us to see how we can help you with your movement-related goals.

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