Direct access refers to the ability of patients to be evaluated and treated by a physical therapist without being referred by a doctor or other healthcare practitioner. If you feel you have a problem that may benefit from the skilled services of a physical therapist, you may be able to refer yourself to physical therapy for treatment. Sometimes direct access is called self-referral.
In the United States, provisions for physical therapy services are governed by each individual state through a "state-practice" act. The practice act is legislation that outlines how physical therapy services will be delivered. Historically, each state's practice act provided that physical therapy services would be provided only if ordered by a licensed physician or other licensed healthcare practitioner. Each state lists different professionals who may refer patients to physical therapy, including podiatrists, dentists, and nurse practitioners.
Healthcare is expensive. It seems that with every passing year, more money is being spent on healthcare, with no objective data that patients are achieving better outcomes. A system that allows the patient to directly seek the services of a physical therapist can help save healthcare dollars by eliminating unnecessary tests or other specialist referrals. Many conditions can be successfully evaluated and treated with no expensive diagnostic testing. Visiting your physical therapist directly allows you to start on treatment right away with very little risk of further injury. Physical therapy is a low-cost value-packed healthcare service.?
Some opponents of direct access to physical therapy services argue that patients may be put at risk if they visit a physical therapist directly. Physical therapists lack the ability to order certain diagnostic tests or prescribe medication to help manage pain.
To date, there is no objective data indicating that self-referral to physical therapy puts patients at increased risk. Also, there is nothing indicating that self-referred patients consume more healthcare dollars during or after their physical therapy care episode.
Physical therapists are also trained to recognize "red flags" that may signal the need for more invasive medical intervention. In those cases, referral to your physician or healthcare provider is made immediately.