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ADVANCE Perspective: Physical Therapy & Rehab Medicine

A Case for Direct PT Access

Published October 17, 2011 9:43 AM by Brian Ferrie

An Oct. 14 press release from the APTA detailed the results of an intriguing new study in the journal Health Services Research. The study suggests "the role of the physician gatekeeper in regard to physical therapy may be unnecessary in many cases" and could have significant implications for the U.S. health care system. Funded by a grant from APTA, its Private Practice Section and the Section on Health Policy and Administration, this study examined non-Medicare claims data and compared self-referred episodes of physical therapy to physician-referred episodes of physical therapy.

Published ahead of print by HSR on September 23, the study found that patients who visited physical therapists directly for outpatient care had fewer visits and lower overall costs on average than those who were referred by a physician, after adjusting for age, gender, diagnosis, illness severity and calendar year. In addition, overall related health care use -- or care related to the problem for which physical therapy was received, but not physical therapy treatment -- was lower in the self-referred group after adjustment.

Jane Pendergast, PhD, professor of biostatistics and director of the Center for Public Health Studies at the University of Iowa, was lead author of the study. Coauthors included Stephanie A. Kliethermes, MS, a doctoral candidate in biostatistics at the Center for Public Health Studies, University of Iowa; Janet K. Freburger, PT, PhD, research associate and fellow at the Sheps Center for Health Services Research and a scientist at the Institute on Aging at the University of North Carolina, Chapel Hill; and Pamela A. Duffy, PT, PhD, OCS, CPC, assistant professor, Public Health Program, at Des Moines University in Iowa.

What is your reaction to these findings and their potential impact?

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