The sooner the care, the better the health outcomes

January 31, 2019
Direct access helps physical therapy patients save time, money and hassle

It’s a fact: Providing patients with direct access to physical therapy services is proven to improve medical outcomes, lower costs and make wiser use of healthcare resources. Now, area residents and visitors can enjoy these benefits with direct access to physical therapists at Aspen Valley Hospital (AVH).
Direct access is the ability for individuals to see a physical therapist without a physician’s order. In the past, for example, a skier who has a sore back or a hiker who sprained her ankle might have to wait a while before receiving specialized therapeutic treatment. That’s because they first had to call their primary care physician for an appointment, wait for the appointment, Quick read more or view full article and then have the physician assess the injury and write the referral for physical therapy.
“The old system was essentially delaying treatment,” said Louie Carder, Director of Rehabilitation Services at AVH. “With direct access, the patient can contact our physical therapy department directly, schedule an appointment and start receiving care within a few days, if not sooner.”
A vital part of a sensible solution
Direct access was introduced in Nebraska in 1957, and it is now available in many nations around the world. Every U.S. state has some form of direct access, although specific rules and policies vary. In Colorado, direct access provides physical therapists with the important advantage of being able to order imaging services as part of a thorough evaluation of the patient’s injury. If the physical therapist determines that the situation requires more intensive care than physical therapy can provide, he or she will send the patient to a physician who can address the larger issues.
“We’re not trying to replace physicians. There are serious injuries and diagnoses where patients do need to see a primary care provider or orthopedist first,” Carder said. “We’re trying to capture musculoskeletal injuries that are not as serious and can be treated effectively through physical therapy with as little delay as possible.”
Patient-focused approach to care
The benefits of direct access are most apparent to patients, who stand to save time and hassle, receive a diagnosis faster and start treatment sooner.
“We’re doing this for the patients,” AVH Physical Therapist James Spencer said. “Not only can direct access lower costs for patients, it can also save them from unneeded imaging and medications that might be ordered. Most important, we’re trying to decrease the time between when the injury occurs and when the patient starts receiving treatment. Studies show that the sooner we can treat the individual, the better the patient’s outcome.”
A growing body of research backs up the efficacy and efficiency of direct access. A study published in the March 2, 2014 issue of the Journal of the American Physical Therapy Association found that “physical therapists practicing in a direct access capacity have the potential to decrease costs and improve outcomes in patients with musculoskeletal complaints without prescribing medications and ordering adjunctive testing that could introduce harm to the patient.”
In addition, a 2016 article in the Journal of Orthopedic & Sports Physical Therapy, which focused on a review of previous research involving direct access for physical therapy patients with spinal pain, concluded, “Studies consistently showed that early receipt of physical therapy was not associated with unfavorable outcomes (more pain/function/disability, increased medical utilization, more physical therapy visits per episode) or with increased cost.”
Putting physical therapists’ skills to use
Direct access’ benefits are evident across the board. It can free up primary care physicians’ time, since some patients can now bypass the referral process. Because it potentially saves money, direct access can also reduce costs for health insurance providers. (Carder cautioned that patients should check with their health plan for specific benefit information. AVH does not currently accept Medicare or Medicaid coverage for direct access.)
Physical therapists also like direct access because it allows them to perform tasks for which they are already trained, such as screening and diagnosing patients.
“It’s a better use of our expertise, because we’re using a broader range of our capabilities,” Spencer said. “When a patient comes to us directly, we get to use the diagnostic skills we developed during our training — being more of an investigator and figuring out the puzzle on the front end. We’re highly trained in musculoskeletal conditions, and an important piece of direct access is that we’re trained to know when a patient needs a higher level of care.”
To learn more about direct access at AVH or to schedule a physical therapy session with one of our therapists, please call 970-544-1177. Read Less
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