Yes it's skewed, not biased, because you only see the pts that end up being referred to you, so your weak anecdotal evidence means nothing
Pts may understand their symptoms but that's it and webmd and everything else they try to dx and treat themselves is dangerous...although I am all for a pt reading up on their condition once they have been dx
So your solution offers no benefit...you refer when you recognize "other"...docs refer once a mechanical problem that benefits from PT, but at the same time other medical and health issues are taken into account and assessed (something a PT can't do)
Sounds like going to the doc first provides more benefit and going to the PT first doesn't change the amount of referrals or cost.
My first comment is something you state in a later post...
You have a chance to see "Physical Therapy" in your local gym 4 days a week, so therefore you understand what PT is all about. I'm glad you've seen, in your eyes, the entire process of PT.
It is a requirement in most, if not all PT schools, the PT student observe many of the professionals that they are receiving referrals from - PCP, GP, Orthos, DPM, etc. Just to give an example of one Ortho I observed, his average time spent actually in the room w/ the patient was approximately 2 minutes - spanning anywhere from 30 seconds to about 8 minutes. After about the 1st half dozen patients he saw, I was in shocked and started keeping track of this. Now again I know this is not always the case, but I have observed several physicians, like I've stated previously, and the RN spends more time w/ the patient than the physician usually does.
What I see, are patients that are referred to me w/ their almight "diagnosis" from their physician, so automatically they should be healed since this physician has just labeled them, in many cases, with a diagnosis such as lumbago, cervicalgia, knee pain, hip pain, shoulder pain...that's great! One of the most common problems I see that is incorrectly diagnosed is shoulder pain - specifically adhesive capsulitis, rotator cuff tendonopathy, impingement, etc. One of the very 1st things PTs learn in school is differential diagnosis regarding these issues, not because of their complexity, but because of how simple it is to differentiate between each issue. However time, and time, and time again it is commonly diagnosed incorrectly. It's one thing to just diagnose someone w/ something, it's another thing to diagnose someone correctly. Now I'm not saying this happens all the time, I'm just saying that something that should be very simple, is done incorrectly ALL THE TIME, and I'm sure many PTs here would agree with me.
Finally, most patients that would come to a PT first understand why they are going there. They realize that more than likely, their issue/pain is due to some type of injury, and not a pathological process. Therefore, in most cases, this patient we would be seeing will require, or would benefit from PT to treat their complaint. I do realize what you are saying, that a patient can be given an "clean bill of health" in regards to all of their possible medical conditions and how they may or may not be relating to their current complaint. Someone older with multiple medical conditions more than likely will want to go to a physician to make sure it isn't something else; however, if they were to go to a PT (lets say for LBP), and the PT was unable to determine the cause of their back pain, or noticed determined their back pain may be coming from some type of pathology, then yes this person would be sent to a physician for further evaluation.
But this would be based off of the patients preference/choice on who they would like to see in regards to their complaints. Again, as I said before, in the majority of musculoskeletal injuries/issues, the patient has a fairly good understanding that their problem is an injury and not a disease, not vice versa. So while I agree w/ your argument, I also feel that your argument is in the minority of cases when ruling out other possible causes of the issue in question.
