Consumer Direct Access / Patient Access
Did you know that current law in Texas prohibits you from directly accessing your physical therapist for treatment?
Texas consumers seeking alternatives to prescription medication and surgery are choosing physical therapy for the prevention and treatment of conditions affecting movement and function, only to find arbitrary, unnecessary, and costly access barriers.
Currently in Texas, physicians, dentists, chiropractors, podiatrists, physician assistants, and advanced nurse practitioners of all types (midwives, clinical specialists, FNPs) are all allowed to determine if a patient needs physical therapy. Thus, the legislature has already determined that physician training is not needed to determine if physical therapy is appropriate for a patient. Physical therapists are at least as qualified, if not more, than the other professions listed to determine if a patient's condition lies within their scope. The move to post-baccalaureate for physical therapists started more than 10 years ago, and today all 12 Texas PT programs culminate in a doctorate of physical therapy degree (DPT).
It is time to allow Texans direct access to physical therapists so they can benefit from the real cost savings associated with conservative management of movement and function-related conditions..
How to address the problem?
The Texas Physical Therapy Association stands firmly in support of access without ANY arbitrary barriers.
- Consumers are primarily affected—they will have fewer barriers to working with physical therapists. They will not have to pay for “rubber stamp” referrals and they can choose a conservative approach to conditions affecting movement and function.
- Physical Therapists will be able to serve the consumers who seek them out for the prevention and treatment of conditions affecting movement and function.
- Payers can expect lower costs that may cause them to follow the lead of some payers who do not require physician referral under their payment policies.
Reports, Statistics and Analysis:
- An analysis of Blue Cross-Blue Shield claims showed that the total paid claims for physician referral episodes to physical therapy was 123% higher than the paid claims for direct access episodes. In addition, physician referral episodes were 65% longer and resulted in 60% more office visits than direct access episodes. (Mitchell J, de Lissovoy G. A comparison of resource use and cost in direct access versus physician referral episodes of physical therapy. Phys Ther. 1997; 77:10-18.)
- According to the Texas Medical Association, Texas ranks 43rd in shortage of primary care physicians. Any limitation to timely access affects a consumers access to needed physical therapy services.
- Physical therapists are educated, at a minimum, at the masters’ degree level. Many now hold doctorates. By the end of 2009, all eleven accredited PT Programs in Texas will have a Doctorate of Physical Therapy (DPT) program, phasing out the Master's programs.
- CNA Insurance Companies, a leading liability insurer of physical therapists, says "At this time, direct access is not a risk factor that we specifically screen for in our program because it has not negatively impacted our claims experience in any way. In addition, we do not have a premium differential for physical therapist in direct access states, nor do our competitors – a strong testament to the fact that direct access to physical therapy services has not increased the risk exposure presented by physical therapists."
- United States Military – There is no evidence showing that physical therapists pose an excessive risk of misinterpreting patient signs and symptoms. The military has long utilized physical therapists without referral and has done so safely and effectively since the early 1970s.
- 16 states currently have a similar form of patient access with no increase in liability claims or in disciplinary actions.
- Starbucks and Aetna partnered with Virginia Mason to find a new way to deal with back pain, the leading complaint of Starbucks’ baristas. Most who went directly to a physical therapist returned to work within two days, as opposed to those who went thru the physician referral process which took, on average, two weeks. The story was featured in the Dallas Morning News.
- A video produced by an ABC affiliate in Pennsylvania shows how Consumer Direct Access functions: http://www.thepittsburghchannel.com/video/18891587/index.html
Direct Access saves consumers time and money, betwen 23% - 120% on physical therapy services. It is time to give Texas consumers Direct Access to physical therapy. Call, write or visit your legislator TODAY.
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