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Transition to Rehab Management

Direct Access

Published October 12, 2012 5:32 PM by Karen Schiff

This third and final class of the semester, "Direct Access," has taken more time than I expected, as I realize there are more than 20 articles I need to read and take quizzes on, as well as listen to the lectures that coincide. This is proving to be one of the more challenging classes for me, not only for the volume of content, but also because I'm not familiar with this idea of a primary consultant for musculoskeletal dysfunction.

Since I've started the DPT program, I realize I've become a perfectionist with grad school. I want to learn everything, and test perfectly, before I'm honored with the DPT. Perhaps I'm a bit excited that next semester is my case report, followed by another flight to my school for an on-campus class, which will be followed by another trip for graduation (fingers crossed). I think I'm getting a little ahead of myself by daydreaming of that moment, as this pile of articles sits in front of me. The articles, lectures and quizzes are only 25 percent of my grade, so the other projects patiently wait for me to complete the task at hand.

I notice a common thread among the articles I've read so far. At the top of the list is the medical profession being a bit leery about letting PTs be the primary consultant for patients. What I didn't realize is for how long direct access has been a goal for many people, and in different regions of the world. Twenty-two years ago I worked with therapists from Ireland, Germany and England in my hometown of Chicago. Little did I realize the vast background of education and knowledge these wonderful therapists possessed. A couple of us stay in touch (Orlagh in Ireland, for example). From reading her Facebook page, I realize she has her own private practice there.

The skills these therapists were equipped with were vague to me at the time, as a new graduate of a BS program in PT. However, over time and throughout the past year and a semester, I've come to appreciate what they had under their belt when I met them. They were able to confidently assess a patient, in a direct-access setting, with musculoskeletal dysfunction, among other diagnoses. It's only now that I realize, from reading these articles, the implications of having such knowledge under my own belt. This is a motivator beyond what I expected.

With another week behind me, consisting of a surprise need for a plumber to visit twice this week and new tires for a car, I must keep my chin up to complete my assignments. Onward and upward to the remainder of lectures, articles and projects for this class. I anticipate a rewarding experience, as well as a great case report for the spring semester!


Thank you, Dean.  I can only hope that direct access will someday affect me in a hospital setting.  The more I read these articles, I realize how behind we are in terms of being able to be the primary contact for neuromusculoskeletal dysfunction.  I can only hope it happens in my lifetime, or the lifetime of the  new graduates where I practice.  

Karen Schiff October 17, 2012 7:21 PM

Karen, having just returned from practicing for three years in England where I worked completely autonomously, it is very strange to once again be dependent upon an MD for orders.

Once you've worked in direct access, it is very difficult to go back. Good luck with your project!

Dean Metz October 14, 2012 4:52 PM

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