Direct Access to Physical Therapy in Michigan is Overdue

2013 ◽  
Vol 3 (1) ◽  
pp. 013-016
Author(s):  
Kevin Patterson ◽  
Rachel Patterson
2006 ◽  
Vol 86 (12) ◽  
pp. 1619-1629 ◽  
Author(s):  
Diane U Jette ◽  
Kerry Ardleigh ◽  
Kellie Chandler ◽  
Lesley McShea

Abstract Background and PurposeOpponents of direct access to physical therapy argue that physical therapists may overlook serious medical conditions. More information is needed to determine the ability of physical therapists to practice safely in direct-access environments. The purpose of this study was to describe the ability of physical therapists to make decisions about the management of patients in a direct-access environment. Subjects. Of a random sample of 1,000 members of the Private Practice Section of the American Physical Therapy Association, 394 participated. Methods. A survey included 12 hypothetical case scenarios. For each case, participants determined whether they would provide intervention without referral, provide intervention and refer, or refer before intervention. The percentage of correct decisions for each group of scenarios was calculated for each participant, and participants were classified as having made correct decisions for 100% of cases or less for each group. Three sets of logistic regressions were completed to determine the characteristics of the participants in relation to the decision category. Results. The average percentages of correct decisions were 87%, 88%, and 79% for musculoskeletal, noncritical medical, and critical medical conditions, respectively. Of all participants, approximately 50% made correct decisions for all cases within each group. The odds of making 100% correct decisions if a physical therapist had an orthopedic specialization were 2.23 (95% confidence interval=1.35–3.71) for musculoskeletal conditions and 1.89 (95% confidence interval=1.14–3.15) for critical medical conditions. Discussion and Conclusion. Physical therapists with an orthopedic specialization were almost twice as likely to make correct decisions for critical medical and musculoskeletal conditions.


2017 ◽  
Vol 29 (8) ◽  
pp. 1463-1471 ◽  
Author(s):  
Leonardo Piano ◽  
Filippo Maselli ◽  
Antonello Viceconti ◽  
Silvia Gianola ◽  
Aldo Ciuro

2014 ◽  
Vol 3 (2) ◽  
pp. 41-43
Author(s):  
Ali Farhad ◽  
Saad Saleem ◽  
Zainab Abdul Razzak

Profession is, not to squeak like a grateful and apologetic mouse, but to roar like a lion out of pride1. Throughout a professional vocation, professionals change the span of their skill, through becoming more specific, through inspiring into recently emergent areas of professional work, or by taking on administration or enlightening positions. They will also be continually developing the quality of their work in a number of areas, beyond the level of proficiency of one’s ability or skill. Professional advancement inculcates a process of incessant development, long-term knowledge, and augmentation, which allow professionals to get better in their practices so as to better serve patients, clients, associations, the profession, and society2. A physical therapist has an enduring professional accountability for maintaining proficiency through ongoing self-assessment, education, and augmentation of information and skills. Physical Therapy, by 2020, will offer such Physiotherapist who are doctors of Physical Therapy and who may be board–licensed experts3. Clients will have direct access to Physical Therapists in all milieus for patient/client management, expectation, and wellness services. Physiotherapist will be practitioners of choice in clients’/patients’ health networks and will hold all rights of autonomous practice4. Physical Therapists may be assisted by Physical Therapy assistants, who are erudite and qualified to provide Physical Therapist–directed and controlled, components of intervention. Physical Therapy profession in Pakistan is rising with a great pace. Every passing minute brings extraordinary revolution in this field and now it is a high time to have some institution takes the responsibility on its shoulder to curtail the nourishing elements of quackery and bring autonomy and sovereignty to the field.


Author(s):  
Filippo Maselli ◽  
Leonardo Piano ◽  
Simone Cecchetto ◽  
Lorenzo Storari ◽  
Giacomo Rossettini ◽  
...  

Direct access to physical therapy (DAPT) is the patient’s ability to self-refer to a physical therapist, without previous consultation from any other professional. This model of care has been implemented in many healthcare systems since it has demonstrated better outcomes than traditional models of care. The model of DAPT mainly focuses on the management of musculoskeletal disorders, with a huge epidemiological burden and worldwide healthcare systems workload. Among the healthcare professionals, physical therapists are one of the most accessed for managing pain and disability related to musculoskeletal disorders. Additionally, the most updated guidelines recommend DAPT as a first-line treatment because of its cost-effectiveness, safety, and patients’ satisfaction compared to other interventions. DAPT was also adopted to efficiently face the diffuse crisis of the declining number of general practitioners, reducing their caseload by directly managing patients’ musculoskeletal disorders traditionally seen by general practitioners. World Physiotherapy organization also advocates DAPT as a new approach, with physical therapy in a primary care pathway to better control healthcare expenses. Thus, it is unclear why the Italian institutions have decided to recognize new professions instead of focusing on the growth of physical therapy, a long-established and autonomous health profession. Furthermore, it is unclear why DAPT is still not fully recognized, considering the historical context and its evidence. The future is now: although still preliminary, the evidence supporting DAPT is promising. Hard skills, academic paths, scientific evidence, and the legislature argue that this paradigm shift should occur in Italy.


Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e125-e126
Author(s):  
N. Lankhorst ◽  
D. Barten ◽  
R. Meerhof ◽  
S. Bierma-Zeinstra ◽  
M. van Middelkoop

2014 ◽  
Vol 94 (1) ◽  
pp. 14-30 ◽  
Author(s):  
Heidi A. Ojha ◽  
Rachel S. Snyder ◽  
Todd E. Davenport

Background Evidence suggests that physical therapy through direct access may help decrease costs and improve patient outcomes compared with physical therapy by physician referral. Purpose The purpose of this study was to conduct a systematic review of the literature on patients with musculoskeletal injuries and compare health care costs and patient outcomes in episodes of physical therapy by direct access compared with referred physical therapy. Data Sources Ovid MEDLINE, CINAHL (EBSCO), Web of Science, and PEDro were searched using terms related to physical therapy and direct access. Included articles were hand searched for additional references. Study Selection Included studies compared data from physical therapy by direct access with physical therapy by physician referral, studying cost, outcomes, or harm. The studies were appraised using the Centre for Evidence-Based Medicine (CEBM) levels of evidence criteria and assigned a methodological score. Data Extraction Of the 1,501 articles that were screened, 8 articles at levels 3 to 4 on the CEBM scale were included. There were statistically significant and clinically meaningful findings across studies that satisfaction and outcomes were superior, and numbers of physical therapy visits, imaging ordered, medications prescribed, and additional non–physical therapy appointments were less in cohorts receiving physical therapy by direct access compared with referred episodes of care. There was no evidence for harm. Data Synthesis There is evidence across level 3 and 4 studies (grade B to C CEBM level of recommendation) that physical therapy by direct access compared with referred episodes of care is associated with improved patient outcomes and decreased costs. Limitations Primary limitations were lack of group randomization, potential for selection bias, and limited generalizability. Conclusions Physical therapy by way of direct access may contain health care costs and promote high-quality health care. Third-party payers should consider paying for physical therapy by direct access to decrease health care costs and incentivize optimal patient outcomes.


2014 ◽  
Vol 94 (3) ◽  
pp. 363-370 ◽  
Author(s):  
Jantine Scheele ◽  
Frank Vijfvinkel ◽  
Marijn Rigter ◽  
Ilse C.S. Swinkels ◽  
Sita M.A. Bierman-Zeinstra ◽  
...  

Background In the Netherlands, direct access to physical therapy was introduced in 2006. Although many patients with back pain visit physical therapists through direct access, the frequency and characteristics of episodes of care are unknown. Objective The purposes of this study were: (1) to investigate the prevalence of direct access to physical therapy for patients with low back pain in the Netherlands from 2006 to 2009, (2) to examine associations between mode of access (direct versus referral) and patient characteristics, and (3) to describe the severity of the back complaints at the beginning and end of treatment for direct access and referral-based physical therapy. Design A cross-sectional study was conducted using registration data of physical therapists obtained from a longitudinal study. Method Data were used from the National Information Service for Allied Health Care, a registration network of Dutch physical therapists. Mode of access (direct or referral) was registered for each episode of physical therapy care due to back pain from 2006 to 2009. Logistic regression analysis was used to explore associations between mode of access and patient/clinical characteristics. Results The percentage of episodes of care for which patients with back pain directly accessed a physical therapist increased from 28.9% in 2006 to 52.1% in 2009. Characteristics associated with direct access were: middle or higher education level (odds ratio [OR]=1.3 and 2.0, respectively), previous physical therapy care (OR=1.7), recurrent back pain (OR=1.7), duration of back pain <7 days (OR=4.2), and age >55 years (OR=0.6). Limitations The study could not compare outcomes of physical therapy care by mode of access because this information was not registered from the beginning of data collection and, therefore, was missing for too many cases. Conclusions Direct access was used for an increasing percentage of episodes of physical therapy care in the years 2006 to 2009. Patient/clinical characteristics associated with the mode of access were education level, recurrent back pain, previous physical therapy sessions, and age.


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