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Raising the Bar in Rehab

Direct Access Discussion

Published December 20, 2012 10:37 AM by Lisa Mueller

As I've become more comfortable in my outpatient orthopedic setting, I've occasionally seen a few patients under direct access, maybe five to seven overall. I wasn't totally comfortable with it as first, since I was still unsure about the orthopedic practice setting and being able to screen for red flags in addition to treating the patient's primary injury. Having practiced orthopedics for almost a year now, I'm more confident in seeing patients and utilizing my direct-access rights. I'm also happy when I'm able to minimize the delay of patients getting treatment.

We talked a lot about direct access in school. It, along with the DPT degree, was a common discussion in class. I think there were times when my classmates and I didn't think we could possibly squeeze another ounce out of the "Direct access and DPT degree" conversation. But, there was one side of the discussion we never approached, and I'm beginning to struggle with it a little bit.

I work with a few rehab clinicians who don't have the rights to direct access, and when I see patients under direct access I feel like I'm undermining the unity in our department. My coworkers are very talented and extremely knowledgeable, but they aren't physical therapists and therefore cannot practice under direct access. It's nothing against their skill set; it's simply the current way our practice acts are established for practicing in a clinical orthopedic setting.

I also think direct access creates some confusion with our patients. "So, I can see Lisa without going to my doctor but not Mike? Why not?" I try to explain the differences in our education and credentials, and the direct-access rights for physical therapists, but sometimes patients only hear the smallest part and then it seems like they walk away and think about our team differently.

How do you handle promoting our wonderful profession without minimizing the role of other rehab professionals? Have you explained to patients what direct access is, and why physical therapists are able (in some states) to practice it? What's the best way to keep the peace with coworkers who may not have the rights to direct access?


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