(in)Direct Access

I work in California, a very liberal state. California is one of many states that offers “direct access” to physical therapy services. This means that if you have an injury, ache, or pain, you can walk into my clinic and I can legally treat you. Wonderful, right? Well I wish things were this simple. Unfortunately, I can treat you, but your insurance will not pay for your treatment unless a doctor provides a prescription for physical therapy. Does this seem weird to anyone else? I know the PTs in the room think so.

I am trained to provide physical therapy diagnoses, and determine whether or not someone needs to pursue further medical treatment that I cannot provide (and even read x-rays and basic MRIs) but patients are required to go to doctors offices prior to coming to get treated. The military actually works with true direct access, and it works amazingly! PTs order x-rays and meds, do tons of wound care (even though I would not want any part of this), and can see their patients without having them see a doctor first.

I get asked DAILY by patients why they needed or need to go to their doctor’s office to be told to come to PT, especially when California is supposed to have direct access. My answer is, “I have no idea”.

Think about the cost of going to your doctors office. I know how much they really get from insurance companies (it’s not close to what most people think), but anyways, think of all the money that is paid every year for those visits just so people who know they need PT can get into PT. It’s a lot. If a patient with knee or back pain came to PT first and the therapist saw that the patient wasn’t getting better, the therapist would know to refer the patient to a medical doctor. Chances are that same MD would have sent the patient to PT in the first place. But if that patient goes to PT with TRUE direct access, and gets better, that was one trip to the doctors that was saved, medical dollars that were saved, the doctor’s time was saved and they can provide care to those who truly need it, and all parties end up much happier.

Always Evolve,


2 responses to “(in)Direct Access

  1. I’m a chiropractor in NJ.

    The garbage that insurance companies put us through is the reason why I choose to get better results than everyone else, and just take cash.

    Hopefully, they take off the leash of you guys and free you to compete with each other.

    • Yo Chris,

      I wish people felt the same justification in paying cash to physical therapists as they do chiropractors. When someone’s insurance will no longer offer to pay, they will undoubtably stop coming in for treatment. Even when getting great results, and when a person’s treatment plan is going well this is still usually the case. Hope all is well over there in NJ!

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