In popular culture, the word “access” implies exclusivity—like a backstage pass to a rock concert or high-level clearance to government files. When it comes to direct access to physical therapy, however, the opposite is true. Instead of physician referral this and MD’s approval that, it’s “You need physical therapy? Come on in!” That’s right; direct access essentially cuts out the middleman—no backstage passes, security authorizations, or physician prescriptions necessary. But with autonomy like this, comes new responsibilities.

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What is Direct Access?

Direct access is exactly what it sounds like: patients having direct access to physical therapy services. This means that they do not need a physician referral or prescription in order to receive the services of physical therapists. Not long ago, this type of open market was simply a dream for both private practice and hospital-based PTs. But today, some form of direct access exists in every state plus the District of Columbia (the most recent additions being Oklahoma and Michigan), and at the very least, a patient can receive an “evaluation and some form of treatment without physician referral,” explains the APTA. However, they note that “some states have time or visit limits or provisions tied to treatment without a referral.” (Stay tuned to our blog; later this month, we’ll break down the direct access PT laws for each state.)

Why Should PTs Care?

As WebPT COO and founder Heidi Jannenga explained in a recent EIM blog post, “We’ve relied too heavily on physician referrals and too little on our own abilities to generate business. We still put too much stock into physicians and insurance companies selling our strengths on our behalf...” This is why PTs must care about direct access. In an era of increased regulations and declining reimbursements, PTs must depend on themselves much more than they have previously, and direct access is their ticket to do just that, because it empowers them to generate their own business.

The APTA explains that beyond being in the driver’s seat when it comes to obtaining patients, direct access also empowers PTs to:

  • Improve collaboration and develop more meaningful relationships with other healthcare providers.
  • Better compete with POPTS and other referral-for-profit entities.
  • “Be responsible for all clinical decisions related to physical therapy patient care.”
  • Diversify revenue and demographics appeal by adding “cash-based services in the areas of prevention, fitness, and health promotion.”
  • Eliminate the need for unnecessary referrals, which saves patients time and money.

One more way direct access helps PTs: it eliminates barriers to entry. If people want PT, there shouldn’t be anything in their way of getting it. That’s what direct access does: opens the market and enables people to seek the services they want without restriction. Sounds about American as apple pie, right? And who doesn’t want apple pie? (Seriously, does anyone have apple pie? I’d love a slice.)


And with that, let’s kick off our direct access month! What do you want to know about direct access? Share your questions in the comment section below, and we’ll tackle them throughout our October blog posts and during this month’s webinar.

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