Did you know that you can go directly to a physical therapist (PT) without needing to go through your physician for a referral? If you are like most folks, this is not common knowledge, but it is information that can save you oodles in time and money and frustration. Going to a PT first is shown to be more effective in resolving the issue than medications and expensive imaging. This article addresses common questions around direct access
- What is direct access?
This is the legal term used to describe a consumer’s right to go directly to a physical therapist without needing a referral from their physician. For example, if your headache gets in the way of you reading, or your back pain prevents you from planting that garden, or you fall off your bike over the weekend and now have a sore shoulder, you can make an appointment with a PT first.
- Is direct access legal?
Absolutely yes! Direct access is mandated by state law, which removes the requirement for physician referral for evaluation and treatment services provided by physical therapists. Washington State obtained this right to directly go to a PT in 1991, under RCW 18.74.012. By removing delays in receiving physical therapy services, this law results in a reduction of cost to the consumer and faster improvement in functional movement. A study by Virginia Mason in 2006 (see illustration) found that going directly to a physical therapist reduced medical costs significantly and improved outcomes. Therefore the elimination of arbitrary barriers to seeing a PT results in more timely and more cost effective care.
- Are physical therapists qualified to deliver services independent of referral?
Unquestionably yes. PTs are educated at the post-baccalaureate level and receive extensive education and clinical training in the examination, evaluation, diagnosis, prognosis, and intervention of patient/clients with functional limitations, impairments and disabilities. All accredited entry-level physical therapist education programs currently culminate in a Doctor of Physical Therapy (DPT) degree, taking at least 7 years to achieve. Physical therapists are qualified to recognize when a patient presents with signs and symptoms inconsistent or outside the scope and skills of the physical therapist and when the patient should be referred to a physician. 
- Can PTs diagnose?
Diagnosis of movement dysfunction is a fundamental part of the physical therapist’s practice. Diagnosis is a cluster of signs and symptoms gathered by examination and evaluation. It is essential to guide the selection of appropriate interventions in physical therapy practice. PTs practice according to the disablement model, which is recognized by the World Health Organization, the National Center for Medical Rehabilitation Research, and the Institute of Medicine. Physical therapists diagnose within the scope of practice as authorized by state law. Differential diagnosis by a physical therapist is essential for the physical therapist to be able to provide the proper interventions. For example, all runners with knee pain are not the same – iliotibial band syndrome, patellar tendonitis and patellafemoral pain syndrome are 3 diagnoses that require very different treatments. But our goal at Stride Physio of returning that runner to their happy place is the same.
- Do insurance companies recognize direct access?
Well… that depends. The caveat to whether you can self refer to PT is that some insurance companies can implement restrictions in reimbursement for physical therapy. When you make your appointment with one of the exceptional physical therapists at Stride Physio, we will check your insurance and help determine whether or not you will need a prescription for our services. We at Stride Physio pride ourselves in making accurate diagnoses and explaining what this means to each patient. With all this said about direct access, we also value working with each patient’s team of health providers, ensuring that each person gets the best possible care via good communication and coordination.
So the next time your back prevents you from playing in the garden, your hip irritates you after sitting or your shoulder limits your ability to play ______ (fill in the blank), give us a call at Stride Physio and we will exceed your expectations in the highest care and service. In the end, direct access means your body wins, your pocket book wins and your freedom to move wins!
Susanne Michaud, DPT, OCS
 American Physical Therapy Association link: http://www.apta.org/stateissues/directaccess/faqs/