States That Lack Direct Access, Discussion of the DPT

[engmedpt]

So I would like this to be an informatory thread with some help from people who may know where the information is. Some states still lack complete direct access and require physician referrals in order for patients to be seen after a set amount of days. Obviously, the biggest argument for the DPT is for direct access and recognition of a pt as a professional that can be seen first and to have the knowledge of when a patient is outside of the therapy scope as well. As with any big changes, red tape is everywhere. So,

1. Does anyone understand how APTA is going about advocacy and what the big issues are? My assumption is that it revolves around discussions with the AMA as well as working with insurance companies, but I don't have a lot of information. Hearsay has told me that Georgia for example has a good need from patients and there are practices that go through the ropes for direct access there.

2. Does anyone know other states that lack access as well and possible timelines until it comes through for those that don't (i.e. the process that a state needs to go through)?

3. Benefits and drawbacks?
Pros: I seem to see, obviously, coming to the pt first as a pro, more collaborative healthcare, significant stress off of doctors to lengthen patient interaction time (less volume for them, although influx of more insured patients may offset that), and recognition of more preventative measures for the general public.

Cons: Insurance companies jacking people around, like always. Perhaps, increased liability? Not sure on that one really considering how the practice is implemented. Pt isn't incredibly delicate and negatively life altering as something like a slip up in surgery.

Any discussion would awesome.

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[PTMattI]

Summary of direct access for each state: http://www.apta.org/uploadedFiles/A.../Issues/Direct_Access/DirectAccessbyState.pdf

 

[jesspt]

I practice in IL and I can't imagine that we'll see any change to our very limited Direct Access legislation. The Illinois Medical Society lobying body is too powerful.

 

[NewTestament]

I practice in IL and I can't imagine that we'll see any change to our very limited Direct Access legislation. The Illinois Medical Society lobying body is too powerful.

All in the name of "consumer protection." Right.

 

[AlanWattsBlues]

Oklahoma recently passed a bill that allows 30 days of treatment without referral:

Oklahoma 49th State to Grant Patients Direct Access to Physical Therapist Treatment​

You'll notice from the title of the article that the APTA defines "Direct Access" a bit differently than you or I might define it. Allan Besselink does a nice write-up of the problem here:

The APTA, Seventeen States, And The Harsh Reality Of Direct Access To Physical Therapy
​

As Jess mentions above, the biggest obstacle is the state medical association--at least that's my understanding of things here in Texas. Arguments against DA seem to be about patient safety. Counterarguments are the increased training of PTs, the decades-long success of the direct access model in the military and the infinitesimal rate of malpractice suits in true direct access states regarding a failure to refer out.

This last one is a biggie. The nightmare, nuclear scenario that scares people and should be taken very seriously. But I don't think the numbers support the argument that PTs miss significant health threats any more than physicians do. I'll try to dig up numbers later...

Arguments for DA include lowering costs, decreasing time spent waiting to be treated and, well, freedom to make your own decisions about your health care.

Practical obstacles include the low participation rate of PTs in their state chapters (not just real participation, but monetary participation). The low rates undermine the ability of the organization to legitimately represent the profession and hamstring funding for lobbying. If state practice acts mandated membership, then I suspect that we would be in a much better situation, but that ship has sailed.

Another practical obstacle is the way that the profession is fractured. Many PTs are working in hospitals--and a small percentage in POPTs--where physician referrals are just ingrained in daily life. There is little financial incentive to care about Direct Access.

And even if you get true direct access, there is still the question of insurance reimbursement. You might be able to see people, but will they come if they can't get their insurance to cover part of the cost?

In the end, politics is ugly business. Here in Texas, a physician who owns a PT clinic chairs the committee that oversees the direct access legislation that makes its way through the capitol building every year. He can (and does) kill the bill with a judicious application of Robert's Rules of Order. It's like Sisyphus and that boulder. Just rolling it up that hill...

 

[Fiveoboy11]

Oklahoma recently passed a bill that allowed 30 days of treatment without referral:

Oklahoma 49th State to Grant Patients Direct Access to Physical Therapist Treatment​

You'll notice from the title of the article that the APTA defines "Direct Access" a bit differently than you or I might define it. Allan Besslink does a nice write-up of the problem here:

The APTA, Seventeen States, And The Harsh Reality Of Direct Access To Physical Therapy
​

As Jess mentions above, the biggest obstacle is the state medical association--at least that's my understanding of things here in Texas. Arguments against DA seem to be about patient safety. Counterarguments are the increased training of PTs, the decades-long success of the direct access model in the military and the infinitesimal rate of malpractice suits in true direct access states regarding a failure to refer out.

This last one is a biggie. The nightmare, nuclear scenario that scares people and should be taken very seriously. But I don't think the numbers support the argument that PTs miss significant health threats any more than physicians do. I'll try to dig up numbers later...

Arguments for DA include lowering costs, decreasing time spent waiting to be treated and, well, freedom to make your own decisions about your health care.

Practical obstacles include the low participation rate of PTs in their state chapters (not just real participation, but monetary participation). The low rates undermine the ability of the organization to legitimately represent the profession and hamstring funding for lobbying. If state practice acts mandated membership, then I suspect that we would be in a much better situation, but that ship has sailed.

Another practical obstacle is the way that the profession is fractured. Many PTs are working in hospitals--and a small percentage in POPTs--where physician referrals are just ingrained in daily life. There is little financial incentive to care about Direct Access.

And even if you get true direct access, there is still the question of insurance reimbursement. You might be able to see people, but will they come if they can't get their insurance to cover part of the cost?

In the end, politics is ugly business. Here in Texas, a physician who owns a PT clinic chairs the committee that oversees the direct access legislation that makes its way through the capitol building every year. He can (and does) kill the bill with a judicious application of Robert's Rules of Order. It's like Sisyphus and that boulder. Just rolling it up that hill...

Direct access is a no brainer. The benefit to be gained far exceeds any risk. Benefits include: less MD/DO/PA/NP/DDS/DC control of a profession that isn't theirs and that they have no training in, more patient control of their healthcare, more physical therapist control of physical therapy, less pain medication prescribing (thus less overdose deaths and addictions in time as direct access would become more widespread and common), less imaging usage (thus less surgery), less delays in appropriate care, less cost, more appropriate usage of healthcare providers, less chronic pain, more productive society. Cons: less PT/referring individual communication?

I guess weighing the pros and cons; risk vs benefit; evidence vs make believe and anectdote ALL go right out the window with "the PT."

Rationalize how people have direct access to booze, cigarretes, all recreation, all leisure, OTC medications, all friends/family opinions, massage therapist, personal trainer, accupuncturist, chiropractor, etc. But not a physical therapist though.

Is there risk on a case by case basis? Will a PT miss?
Yes, but the risk is extremely low. The benefit overwhelms the risk.

So to me this is probably one of the biggest hoaxes in healthcare today. Literally an evolutionary relic is the need for a referral.

 

[DesertPT]

AZ has had unrestricted direct access for many years, but from the therapists that I have talked to about it it seems like it doesn't actually happen in practice that often because a large majority of insurance programs require a physician referral at some point for PT to either begin or continue. Most of the clinics I have been in as a patient required a referral whether you say your insurance requires it or not, just to cover their butts. Some don't, and of course their are cash-based therapists and things like that too. I obviously have pretty limited experience, but my observation so far has been that living in a state with unrestricted direct access is a nice thing to have in your back pocket on occasion, but it does not change the system with the majority of your patients.

It also doesn't seem like the therapists I've been around really have felt that the DPT has done anything to increase the number of patients they see direct access, unfortunately.

The APTA, Seventeen States, And The Harsh Reality Of Direct Access To Physical Therapy

Thanks for this link. When we talk about how many states have direct access, we really should be talking about how many have unrestricted direct access, because that is what the term implies.

 

[Fiveoboy11]

The need for a referral does not protect the patient. Direct access to physical therapists is safe and a lack of direct access is dangerous.

 

[DesertPT]

Rationalize how people have direct access to booze, cigarretes, all recreation, all leisure, OTC medications, all friends/family opinions, massage therapist, personal trainer, accupuncturist, chiropractor, etc. But not a physical therapist though.

Is there risk on a case by case basis? Will a PT miss?
Yes, but the risk is extremely low. The benefit overwhelms the risk.

So to me this is probably one of the biggest hoaxes in healthcare today. Literally an evolutionary relic is the need for a referral.

Excellent point, I hadn't really thought about it this way. Thanks for this.

In the litigious society we live any, any evolutionary relic or loophole will be used by someone for personal gain.

 

[engmedpt]

Very happy I made this post.

Thanks for the links. You guys are much more educated on this than me. I will agree from what someone said above about missing errors and the low chance of that. From what I know, pt has some of the longest interaction compared to others. A 30+ minute eval could be more prone to catching things outside of your profession's scope and recognizing the best plan of action compared to patient visits between 5-12 minutes. The argument for the latter may be that the residency in medicine (which is god awful for their health unfortunately) ingrains all the signs and symptoms of your specialty which is definitely true, but pt literally is already a specialty that doesn't have the liability that comes with prescribing medication or doing something incredibly invasive. You're taught specifically for rehab from day 1 rather than taking your bchems and a vast curriculum before rotating through massively different facets of medicine before committing to something which you then train for at the end of year 3 beginning of year 4 and into your residency.

I've heard some kids going to med school that bash the degree for pt, but I feel like its a contest ingrained in years and years of the MD as the go to which definitely has makes sense for cases involving diagnosing disease, but maybe not for bodily injury unless you have breaks. I feel like that contest translates to the insurance companies and fights with access between advocacy groups. Maybe I've just seen things in my personal experience that make me feel this way, but unless I see some serious cases in which direct access has trends of missing health issues on a very frequent basis or a vast amount of abuse that is the equivalent or more of the amount of abuse in other medical professions (come on, DOs, MDs, DCs, DPMs, DDSs, PAs, NPs all have their bad apples) then I see nothing but politics and red tape keeping things from moving forward well.

 

[engmedpt]

From my own volunteering experience as well, the prescription for pain medication is an all too real problem that destroys people. Even in my very limited experience, I have anecdotes. Less surgery sounds like a large plus as well, but I'm not so sure unnecessary surgery is as widespread and abusive as writing easy scripts for oxy.

 

[engmedpt]

Oklahoma recently passed a bill that allowed 30 days of treatment without referral:

Oklahoma 49th State to Grant Patients Direct Access to Physical Therapist Treatment​

You'll notice from the title of the article that the APTA defines "Direct Access" a bit differently than you or I might define it. Allan Besslink does a nice write-up of the problem here:

The APTA, Seventeen States, And The Harsh Reality Of Direct Access To Physical Therapy
​

As Jess mentions above, the biggest obstacle is the state medical association--at least that's my understanding of things here in Texas. Arguments against DA seem to be about patient safety. Counterarguments are the increased training of PTs, the decades-long success of the direct access model in the military and the infinitesimal rate of malpractice suits in true direct access states regarding a failure to refer out.

This last one is a biggie. The nightmare, nuclear scenario that scares people and should be taken very seriously. But I don't think the numbers support the argument that PTs miss significant health threats any more than physicians do. I'll try to dig up numbers later...

Arguments for DA include lowering costs, decreasing time spent waiting to be treated and, well, freedom to make your own decisions about your health care.

Practical obstacles include the low participation rate of PTs in their state chapters (not just real participation, but monetary participation). The low rates undermine the ability of the organization to legitimately represent the profession and hamstring funding for lobbying. If state practice acts mandated membership, then I suspect that we would be in a much better situation, but that ship has sailed.

Another practical obstacle is the way that the profession is fractured. Many PTs are working in hospitals--and a small percentage in POPTs--where physician referrals are just ingrained in daily life. There is little financial incentive to care about Direct Access.

And even if you get true direct access, there is still the question of insurance reimbursement. You might be able to see people, but will they come if they can't get their insurance to cover part of the cost?

In the end, politics is ugly business. Here in Texas, a physician who owns a PT clinic chairs the committee that oversees the direct access legislation that makes its way through the capitol building every year. He can (and does) kill the bill with a judicious application of Robert's Rules of Order. It's like Sisyphus and that boulder. Just rolling it up that hill...

So as a student about to start what would you recommend moving in the right direction is? I'd say one is awareness, aka showing this to prospective classmates to put everyone on the same level: letting them know what they're getting into and to stop worrying about creating OIA tables when anatomy doesn't even start for four months. As for being a therapist in the field what can you do outside of practicing in those seventeen states and building patient populations by advertisement and promotion of your workplace and profession as direct access (I.e. Have some type of voice for faster progress)?

That article is very eye opening. I felt like a lawyer playing with wording.

 

[jblil]

Alan - thanks for the link to the article about direct access, it was quite interesting.

The author of that blog had a post on APTA:
http://allanbesselink.com/blog/smart/1004-the-aptas-vision-2020-my-12-year-report-card
Pretty scathing, but I can't say I disagree with the gist of the post.

 

[AlanWattsBlues]

http://allanbesselink.com/blog/smart/1004-the-aptas-vision-2020-my-12-year-report-card
Pretty scathing, but I can't say I disagree with the gist of the post.

Yep. In school we get basically no dissenting opinions to vision 2020. It's good to consider a contrary perspective. We've made all these changes by increasing the difficulty of becoming a PT, but has it elevated the profession as it was intended? I guess time will tell....

 

[AlanWattsBlues]

So as a student about to start what would you recommend moving in the right direction is? I'd say one is awareness, aka showing this to prospective classmates to put everyone on the same level: letting them know what they're getting into and to stop worrying about creating OIA tables when anatomy doesn't even start for four months. As for being a therapist in the field what can you do outside of practicing in those seventeen states and building patient populations by advertisement and promotion of your workplace and profession as direct access (I.e. Have some type of voice for faster progress)?

That article is very eye opening. I felt like a lawyer playing with wording.

Recommendations on this are above my pay grade. Probably a good idea to be a member of the APTA, your state chapter and to show up for annual legislative events. I see people post pro-PT stuff on their facebook feeds. I guess that doesn't hurt, but my gut tells me that politics is a personal thing. Change in a state will happen because of key relationships cultivated with sympathetic legislators who are in the right positions of influence. And then brokering some weird deal with the state medical association and the chiros. Petitions, letters, public awareness...it only does so much.

But for now we are in school. I'm happy to focus on not getting failed out. I'll fight in the trenches for the profession once I'm a licensed member of it

 

[engmedpt]

Definitely agree with you on the key relationships. Last question, can participation in your state chapter simply require showing up to events when they come around? Basically, can you be a normal, practicing DPT clinician to have a say or do you need a different position, specifically one

Recommendations on this are above my pay grade. Probably a good idea to be a member of the APTA, your state chapter and to show up for annual legislative events. I see people post pro-PT stuff on their facebook feeds. I guess that doesn't hurt, but my gut tells me that politics is a personal thing. Change in a state will happen because of key relationships cultivated with sympathetic legislators who are in the right positions of influence. And then brokering some weird deal with the state medical association and the chiros. Petitions, letters, public awareness...it only does so much.

But for now we are in school. I'm happy to focus on not getting failed out. I'll fight in the trenches for the profession once I'm a licensed member of it

more involved in advocacy for APTA? Sorry if that is an ignorant question. I really don't know.

Thanks for those articles as well.

 

[AlanWattsBlues]

Definitely agree with you on the key relationships. Last question, can participation in your state chapter simply require showing up to events when they come around more involved in advocacy for APTA? Sorry if that is an ignorant question. I really don't know.

I don't want to misrepresent myself as someone who is particularly in-the-know on this topic. So caveat: I am a second year PT student with an interest in the sport of local politics. Not someone with any special insight.

Shoot a message to your state chapter and see how you can help. Let us know what they say. You'll be less ignorant than me

 

[riseboi]

OP,

Currently, Florida allows for direct access with certain provisions, but there is a bill (HB515 ) that has been introduced to modernize the Florida Physical Therapy Practice Act that will he heard soon. This bill looks to unrestrict direct access in FL. Check out the FPTA website to learn more and to get involved.

 

[NewTestament]

Here it is, riseboi. http://c.ymcdn.com/sites/www.fpta.org/resource/resmgr/Advocacy/FactSheetModPT2015.pdf

I doubt it will pass but it's worth trying. I think a realistic proposal would be to increase the number of days without a physician's approval to 30-60 days. 60 days would be just as good as unrestricted access.

 

[NewTestament]

But I don't think the numbers support the argument that PTs miss significant health threats any more than physicians do. I'll try to dig up numbers later...

Florida failed to find a single case since 2000. Yet 187,000 people will die due to medical errors in hospitals this year. Prescription analgesics kill more people than heroin and cocaine combined. Perhaps physicians should be more worried about their preferred practice patterns than physical therapy.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm#fig2

Practical obstacles include the low participation rate of PTs in their state chapters (not just real participation, but monetary participation). The low rates undermine the ability of the organization to legitimately represent the profession and hamstring funding for lobbying. If state practice acts mandated membership, then I suspect that we would be in a much better situation, but that ship has sailed.

Low participation kills us. PT's don't join because they don't think APTA does anything, but the APTA is weak because no one joins! It's self-reinforcing cycle. Too many PT's are too apathetic and complacent. They just don't care. You can't force anyone to join an organization. And many PT's seem to have no problem with working for a physician. They're hurting our profession. If you want to make good money as a PT, work in home health, skilled nursing, or a rural area. But don't screw the profession.

And even if you get true direct access, there is still the question of insurance reimbursement.

The real problem is a health care model that depends on surrogates (third parties) to manage and pay for health care. That's a different discussion. But you're right. As long as third parties, and especially Medicare, don't reimburse patients for PT without a physician's script, direct access won't change much.

 

[DesertPT]

As long as third parties, and especially Medicare, don't reimburse patients for PT without a physician's script, direct access won't change much.

I feel like this is one the biggest roots of the issue. Even in states that have unrestricted direct access, a very small percentage of the PT patient population comes to therapy as direct access, because most of their insurance policies still require a script. So all the legal and legislative advocacy in the world is only going to go so far if the payers still can't get over the referral thing. Which I think is funny because for lots of patients that could see a PT directly, making them see a doctor first is just an additional and unnecessary thing the insurance company has to pay for. I don't totally get their thinking. If PTs who didn't have a physician referral were likely to cause harm to patients that would result in more expensive care, I could see it. But where is the data that shows this? Insurance companies seem to still believe it...yet the data is nowhere to be found. Why aren't insurance companies all about direct access to PT?

 

[jblil]

Why aren't insurance companies all about direct access to PT?

I think it's because the doctors' & chiros' lobbies prefer the status quo and will work to maintain it.

 

[engmedpt]

OP,

Currently, Florida allows for direct access with certain provisions, but there is a bill (HB515 ) that has been introduced to modernize the Florida Physical Therapy Practice Act that will he heard soon. This bill looks to unrestrict direct access in FL. Check out the FPTA website to learn more and to get involved.

The argument actually looks good to me. Even OT, speech lang, and AuD have access. The argument and some common sense simply make it seem like a no brainer on passing this. Citing the lack of errors since 2000 is excellent support. Of course, I'm young, idealistic and probably overlook things that can go wrong.

 

[DesertPT]

The argument and some common sense simply make it seem like a no brainer on passing this.

I don't think there is anyone in the PT profession who is going to disagree with you here.

 

[tweaze]

I feel like this is one the biggest roots of the issue. Even in states that have unrestricted direct access, a very small percentage of the PT patient population comes to therapy as direct access, because most of their insurance policies still require a script. So all the legal and legislative advocacy in the world is only going to go so far if the payers still can't get over the referral thing. Which I think is funny because for lots of patients that could see a PT directly, making them see a doctor first is just an additional and unnecessary thing the insurance company has to pay for. I don't totally get their thinking. If PTs who didn't have a physician referral were likely to cause harm to patients that would result in more expensive care, I could see it. But where is the data that shows this? Insurance companies seem to still believe it...yet the data is nowhere to be found. Why aren't insurance companies all about direct access to PT?

I can't speak for health insurance, or insurance as a whole, but I did used to work for an auto insurance company and dealt indirectly with Medpay/PIP (Personal Injury Protection). I did see situations where PT was paid for under PIP/Medpay in ostensibly direct access states without a referral, but it was not common. There was not much regard for whether or not a PT was going to cause harm to a patient, but there was concern about being able to support treatment received as being related, necessary, and reasonable to the injuries sustained, and it was generally accepted that the first step to determining that was a doctor's referral to the next step in treatment.

I would think that studies showing that so much money was saved when patients referred directly to PT (course of treatment was shorter, no doctor's bill to pay, etc) would be compelling to an insurance company. However, for the company I worked for, I doubt it was something they were even aware of, let alone were well educated about and looking for studies to support changes to payment processes. From a patient level, I would also argue that the average patient doesn't necessarily think to go straight to a PT. If more patients were arguing for their companies to cover their PT bills acquired through direct access, I think insurance companies would be more motivated to look at their payment policies, but the education level for patients is not necessarily there.

As a point of interest, at my prior job, PT treatment was often considered more favorably as being "active" treatment where the patient was invested in their treatment, as opposed to massage/chiropractic treatment, which was considered a more passive, "feel good" process that did not require patient buy in.

 

[engmedpt]

^This is a really good post. Offers a lot of perspective.

I completely agree in regards to the patient population's perspective on the profession as it isn't an archetype job like MD,JD, MBA etc. that everybody just knows about when theyre growing up. A patient thinks healthcare, they immediately think MD. The change for this would definitely be advertising from direct access states where clinic owners have enough revenue to put their faces out there. Of course, before that happens, COMPLETE direct access would have to happen first. From your post it seems that if insurance companies could get on board and realize the benefit they can get, then that may be the ticket to hacking away the red tape since even in direct states they sometimes refuse to go through policy changes. Seems like the best case for advocacy from an inexperienced but still logical perspective would be:

1. Get insurance co.'s onboard
2. Flush away the contest of titles and maintenance of status quo between healthcare professionals.
3. Marketing. Marketing. Marketing to the general public.

 

[BiffTheFlashRogers]

Not that anyone uses Bing, but my phone accidentally switched search engines from Google to Bing and when I searched "SDN PT" to come to this forum tonight, an ad for the South College program was the top result.

 

[engmedpt]

^Moved post to the starting salary thread where that's mostly being discussed currently.

 

[BiffTheFlashRogers]

^Moved post to the starting salary thread where that's mostly being discussed currently.

Oops! Sorry! Thank you!

 

[engmedpt]

I found out a bit to help and have gotten more educated on this. Heads up, FL needs help. HB 515 was amended in the committee to a 42 day cap before referral (at least better than 21). On APTA's site you can actually send notes to house and senate reps. This is for all states and national issues as well. You just have to take the time. SB710 is going up next and can still have notes sent to reps. Deadlines approaching in less than a week though. I believe anyone can do it as well. Patients, students, PT's, the public. Just need to be sincere, legitimate, and take a few minutes.

 

[engmedpt]

Direct access is a no brainer. The benefit to be gained far exceeds any risk. Benefits include: less MD/DO/PA/NP/DDS/DC control of a profession that isn't theirs and that they have no training in, more patient control of their healthcare, more physical therapist control of physical therapy, less pain medication prescribing (thus less overdose deaths and addictions in time as direct access would become more widespread and common), less imaging usage (thus less surgery), less delays in appropriate care, less cost, more appropriate usage of healthcare providers, less chronic pain, more productive society. Cons: less PT/referring individual communication?

I guess weighing the pros and cons; risk vs benefit; evidence vs make believe and anectdote ALL go right out the window with "the PT."

Rationalize how people have direct access to booze, cigarretes, all recreation, all leisure, OTC medications, all friends/family opinions, massage therapist, personal trainer, accupuncturist, chiropractor, etc. But not a physical therapist though.

Is there risk on a case by case basis? Will a PT miss?
Yes, but the risk is extremely low. The benefit overwhelms the risk.

So to me this is probably one of the biggest hoaxes in healthcare today. Literally an evolutionary relic is the need for a referral.

^A cohesive paragraph of the above would definitely be good.

 

[engmedpt]

All in the name of "consumer protection." Right.

Exactly.

 

[NewTestament]

I found out a bit to help and have gotten more educated on this. Heads up, FL needs help. HB 515 was amended in the committee to a 42 day cap before referral (at least better than 21). On APTA's site you can actually send notes to house and senate reps. This is for all states and national issues as well. You just have to take the time. SB710 is going up next and can still have notes sent to reps. Deadlines approaching in less than a week though. I believe anyone can do it as well. Patients, students, PT's, the public. Just need to be sincere, legitimate, and take a few minutes.

I sent everyone on the committee a letter recommending this legislation. Let's hope it passes. 42 days isn't unrestricted but we should accept it for now. It's an improvement.

 

[engmedpt]

^Absolutely.

 

[keyboardmouse]

Can we get a list of states with and without direct access?

 

[engmedpt]

Check a link above. Someone posted something.

 

[DesertPT]

Can we get a list of states with and without direct access?

http://lmgtfy.com/?q=physical+therapy+direct+access+laws+by+state

 

[dylanh]

I practice in IL and I can't imagine that we'll see any change to our very limited Direct Access legislation. The Illinois Medical Society lobying body is too powerful.

how is IL in general for PTs...specifically chicago..being an expensive city are PTs compensated well for?

 

[engmedpt]

Messages can be sent through the link I put in the thread "SGR and Therapy Cap Repeal"

 

[questionmark32]

Georgia just had a change with their direct access recently. Patients can see PTs for up to 21 days or 8 visits without physician referral


Sent from my iPad using Tapatalk

 

[DesertPT]

Georgia just had a change with their direct access recently. Patients can see PTs for up to 21 days or 8 visits without physician referral


Sent from my iPad using Tapatalk

But they can see a chiropractor for all manner of health problems for as many visits as they'd like without ever seeing a physician. Totally makes sense.

 

[questionmark32]

But they can see a chiropractor for all manner of health problems for as many visits as they'd like without ever seeing a physician. Totally makes sense.

I agree, but this can be seen as a step in the right direction. Chiros fought tooth and nail against this and they had no chance. Hopefully, things will change in Georgia where PTs will have complete autonomy in the coming years


Sent from my iPhone using Tapatalk

 

[engmedpt]

^That state is getting further along then.

House bill went to 42 I believe if everything went through.

21 days=3 weeks ehh.

42= 6 alright its moving

DISCLAIMER: If this didn't go through then someone correct me IMMEDIATELY

 

[engmedpt]

Can you expand on this? I thought it was mostly MD opposition. (odd because I only see collaboration helping the community and both professions without overstepping at all into MD territory).

I agree, but this can be seen as a step in the right direction. Chiros fought tooth and nail against this and they had no chance. Hopefully, things will change in Georgia where PTs will have complete autonomy in the coming years


Sent from my iPhone using Tapatalk

 

[engmedpt]

Update for over in Florida.

HB 515 passed through the House.

 

[ptisfun2]

AZ has had unrestricted direct access for many years...Most of the clinics I have been in as a patient required a referral whether you say your insurance requires it or not, just to cover their butts. Some don't...

Well this is just sad. We really are our own worst enemy at times.
I hope you are seeing the 'not normal' clinics in your state.

 

[engmedpt]

Well this is just sad. We really are our own worst enemy at times.
I hope you are seeing the 'not normal' clinics in your state.

That's not cool.

 

[DesertPT]

Well this is just sad. We really are our own worst enemy at times.
I hope you are seeing the 'not normal' clinics in your state.

Indeed. A couple of places I've been have been clinics that dealt with a lot of workman's comp, so that could have had something to do with it. Another was physician-owned so obviously no direct access their. I wouldn't say that it is the "norm" across the state, especially as more and more HMO's and a lot of PPO's are starting to pay for PT without a script.

 

[engmedpt]

Can you explain workman's comp?

Indeed. A couple of places I've been have been clinics that dealt with a lot of workman's comp, so that could have had something to do with it. Another was physician-owned so obviously no direct access their. I wouldn't say that it is the "norm" across the state, especially as more and more HMO's and a lot of PPO's are starting to pay for PT without a script.

 

[DesertPT]

Can you explain workman's comp?

Uh...I don't really get the question.