Direct access to physical therapy helps patients jumpstart their recovery

Traditionally, if you wanted to see a physical therapist you would need a referral from a doctor, a process that could take anywhere from a few days to a few weeks. But, if you’ve suffered an injury or are experiencing pain due to musculoskeletal issues, a few days can seem like a lifetime. And a few weeks could mean the difference between a full recovery and chronic pain.

Luckily, there’s another option. Virginia and North Carolina, like many states, offer patients direct access to physical therapy without a referral. In this article, we’ll look at the origins of direct access and how it can help you feel better faster.

The direct access movement

Nebraska was the first state to offer direct access to physical therapy in 1957, but a broader direct access movement didn’t get started until the 1980s when the American Physical Therapy Association (APTA) began to advocate for it.

At that time, industry- standard education for physical therapists was moving from a master’s degree to a doctorate. APTA argued that physical therapists should have more autonomy to work with patients without referral from a physician because their advanced training allowed them to screen out patients with more serious conditions outside the scope of physical therapy.

“We have additional training to screen out those red flags,” says Amber McGill, a physical therapist at Sentara Therapy Center - Treyburn. “For instance, we treat many patients who have trouble with balance. But if we realize they have a blood pressure issue that’s making them dizzy, we’ll refer them to the appropriate doctor for treatment.”

Saving time and money

For patients, the biggest benefit of direct access is that it saves time and money.

Before, patients would have to schedule an appointment and pay for a trip to their primary care physician or a specialist first. Now they can go directly to a physical therapist and start treatment immediately. And, generally speaking, the sooner a patient starts treatment, the better the outcome.

“Patients may try to make an appointment with a specialist, but sometimes those appointments can take weeks to get,” says McGill. “Acute problems can turn into chronic problems while they’re waiting, which can lead to worse outcomes in the long term.”

Every state has different rules around direct access, and some states place limitations on how long you can see a physical therapist without a referral. In Virginia and North Carolina -– the two states where Sentara operates — you can continue to see a physical therapist as long as they deem the treatment medically necessary. The only exception to this rule is for Medicare patients.

“For Medicare patients, we can do an evaluation under direct access,” says McGill. “But to schedule and do follow-up visits, we have to have their plan of care signed by a physician before their next appointment.”

No difference in treatment

Direct access also applies to virtual physical therapy, a service offered by Sentara that allows patients to receive therapy remotely. This combination can help patients get treatment even faster, especially if they don't have reliable transportation or a therapy center nearby.

Ultimately, the only difference in care between those who come via a referral and those who come via direct access is that the direct access patients have to answer some additional screening questions. These questions are meant to catch any potential red flags and document the evolution of the patient’s symptoms up to that point.

“From our standpoint, we have to demonstrate medical necessity, no matter how patients come to us,” says McGill. “And there’s no difference in scheduling for direct access, except we’ll ask if there’s a referring physician. If the answer is no, then there’s a little more paperwork for patients to fill out on the front end.”

Find a physical therapist near you and schedule your appointment today.