Direct Access to Patients

[WildCat5]

My chiropractor told me that chiros have direct access to patients and PT's don't. I am trying to understand this as I thought PT's were more respected by doctors than chiros were and since so many PT's work in hospitals how do they not have direct access?

I am just confused and I am trying to gather facts as I make decisions, thank you to whoever can answer this question, I truly am grateful to you.

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[Grue1some]

It is not the issue in the hosipital b.c the Dr. sends the patient to the Physical therapist. It is when they are working in an outpatient setting. A person cannot go straight to an outpatient clinic and be worked on. They need some form from a Dr. It is different for a chiro. A person can walk into a chiro office and get treatment without getting a form from a medical Dr. Thats why direct access is needed for Physical Therapists so a person can go directly to a PT instead of getting a permission slip from a Dr.


Issues in PT~ It will be a good idea to know them since PT schools will question potential students. Just read DPT by student 30.

Educating 3rd party payers (insurance providers).
While educators and state law is now recognizing PT's as primary care
providers, many insurance carries will not reimburse PT's for services
if there is no written referral from a physician.

Limitations of insurance coverage for physical therapy services.
Content of PT treatments or the number of total sessions must often be
tailored to take the patient's financial concerns into account, usually
this is due to limitations placed by the insurance company.

Inability to implement direct access.
Although many states allow physical therapists to work with direct
access to patients by law, many insurance companies and institutions
don't recognize this, so it is not used in day to day practice.

 

[crockdub]

In my best guess, the reason DC's have lobbied so hard to gain direct access is because most MDs will not refer a patient to a DC. I would imagine that MDs will not have any problem refering a patient to a PT.

From what I have heard from the PT I used to work for, many states will allow direct access soon. It's all about who will pay for the better lobbyists.

 

[truthseeker]

Most states do allow direct access. The problem is that most insurance companies do not pay without a referral from someone else. I think the difference is that historically, PTs started out as part of the team and actually a "physician extender" type of trade.

DCs started out independently and have never been part of the team.

PTs have moved quantum leaps forward in their training, knowledge, and respect but the historical association of PTs of being essentially techs is hard to change. I remember less than 10 years ago when someone asked me if I had to go to college to do what I did. People are still surprised when I have completed my PT evaluation and explanation to them. They say you know more than the doctor. I tell them that I am a specialist in NMSK disorders and we work as a team with the physicians. Many times, they call me when they have other problems. Some of those problems are NMSK related and some are not. If you have good self confidence it is not difficult to tell them "I don't know" and send them to their primary care physician.

Another problem with the perceived level of training between DC and DPT is that the DCs usually refer to themselves as "Dr. XYZ" whereas PTs refer to themselves as "Tom". The trust of the lay public will always gravitate to those with the title "Dr.". Many people go to DCs with diagnoses that are NOT NMSK related and the best DCs recognize that and refer on. The others in the profession sometimes cannot recognize when things are outside their scope and continue to treat the patient without good results, and potentially with devastating results.

The bottom line is that people need to be able to trust that their careprovider, whether it is a PT or a DC or an MD has their best interest in mind first, and financial gain second. They also need to be able to trust that the treatments provided or recommended have some basis in science and have been tested and vetted for effectiveness and safety.

 

[R1krazy]

I am a practicing PT who holds his DPT degree. Currently the majority of states LEGALLY allow direct access as part of the physical therapy practice acts. The problem exists with insurance companies (ie. medicare) who will not reimburse for any exam or treatments without a referral. Therefore the only way to be reimbursed is via self pay (which has its own problems)--but then you have direct access which is legal in the majority of states.

Currently Medicare is running a pilot program in 2 states giving PTs direct access with reimbursement. If you want to read more, go to each states practice act. Massachusetts is pretty clear about allowing direct access to PT's. Good luck in your search.

 

[PT2MD]

You seem to begin many of your posts with "My chiropractor told me...". That's just an observation.

I agree with what truthseeker said. It doesn't matter if you can do it. The more important issue is: What insurance plans currently reimburse PT's implementing direct access?

 

[WildCat5]

You seem to begin many of your posts with "My chiropractor told me...". That's just an observation.

I agree with what truthseeker said. It doesn't matter if you can do it. The more important issue is: What insurance plans currently reimburse PT's implementing direct access?

I don't even know what your talking about now, I am still an undergrad finishing prereqs I know nothing about insurance, I am here to learn!

 

[PT2MD]

I don't even know what your talking about now, I am still an undergrad finishing prereqs I know nothing about insurance, I am here to learn!

It seemed initially that your impetus for asking questions was your chiropractor (direct access and the dual degree thing). My question at the end was actually a rhetorical question and not aimed directly at you. Just reread truthseekers post and disregard mine.

 

[Husker DPT]

Wildcat, I will give you my advice. If you notice the replies to your questions seem critical, it's because of your choice of language when asking them. Communication is key in the health field. Your response is also often times hostile, and from what I can tell I can trace it back to the manner in which you post your initial inquiries and they are misinterpreted. Precise language is the best way to avoid miscommunication. It's one of the best skills you can master, esp. in the health care field.

 

[WildCat5]

Wildcat, I will give you my advice. If you notice the replies to your questions seem critical, it's because of your choice of language when asking them. Communication is key in the health field. Your response is also often times hostile, and from what I can tell I can trace it back to the manner in which you post your initial inquiries and they are misinterpreted. Precise language is the best way to avoid miscommunication. It's one of the best skills you can master, esp. in the health care field.

thanks.

 

[Britton]

Hey wildcat, don't mind him. I'm sure the guys a real "Fruit". He more than likely could not get into medical school (settled for PT school), and the girls probably don't like him either. I like how he assumes he knows more about getting into medical school than me. I guess we all can't be as smart as him.

 

[Britton]

Look HuskerDPT, I’m sorry for the comment. You just make me mad with your condescending remarks as if “you are the most experienced DPT in the world”, your not trust me. I was not trying to mislead anyone in this forum. I was simply trying to give my humble opinion based on my perspective and experience with my mother as a DPT. No big deal! I apologize for seeming like a troll and I guess I will leave this as one of my last posts on this forum. You win. I don’t need to be here anymore. Good luck.

 

[PT2MD]

I don’t need to be here anymore..

Agreed. Good luck with your personality disorder.

 

[Grue1some]

Look HuskerDPT, I’m sorry for the comment. You just make me mad with your condescending remarks as if “you are the most experienced DPT in the world”, your not trust me. I was not trying to mislead anyone in this forum. I was simply trying to give my humble opinion based on my perspective and experience with my mother as a DPT. No big deal! I apologize for seeming like a troll and I guess I will leave this as one of my last posts on this forum. You win. I don’t need to be here anymore. Good luck.

You are not a troll Britton. I like reading your posts. Just one problem.. Please post in a bigger font! =)

 

[Husker DPT]

Britton, I can't believe you shrunk the font like that! Haha! That's from an earlier thread in which I questioned his use of very large font. Also, I can honestly say stay (or leave), as I am not trying to motivate you one way or the other on that topic.
Wildcat, you're welcome. The two skills that will help you in any career (medical esp) that are essentially nonclinical in nature, is communication and conflict resolution. This is one of those things also "that I wish I had heard before my clinical rotations". So it is intended to be helpful. With communication, for example, if someone asks you the color of the sky - state 'blue'. Not 'well it's not yellow'. The latter is true, but not the intended response. Also, in any job and during clinical rotations, you will receive criticism. An open nonhostile approach to this will benefit you greatly.

 

[WildCat5]

Britton, I can't believe you shrunk the font like that! Haha! That's from an earlier thread in which I questioned his use of very large font. Also, I can honestly say stay (or leave), as I am not trying to motivate you one way or the other on that topic.
Wildcat, you're welcome. The two skills that will help you in any career (medical esp) that are essentially nonclinical in nature, is communication and conflict resolution. This is one of those things also "that I wish I had heard before my clinical rotations". So it is intended to be helpful. With communication, for example, if someone asks you the color of the sky - state 'blue'. Not 'well it's not yellow'. The latter is true, but not the intended response. Also, in any job and during clinical rotations, you will receive criticism. An open nonhostile approach to this will benefit you greatly.

What did I say that was hostile and what's a good website I can go on to be a better communicator? I'm usually not an dingus but there have been some real pricks on this website not that I'm saying you are one.

 

[WildCat5]

I have one more "ignorant" question as some people like to call them. For all of you PT'ers, how many of you had to take biology 1 and 2 or just 1? Thank you.

 

[truthseeker]

I have one more "ignorant" question as some people like to call them. For all of you PT'ers, how many of you had to take biology 1 and 2 or just 1? Thank you.

That is a VERY ignorant question. "PTers" as you call us have taken probably Biology 12. What do you think we study in school?

Do some friggin research at the schools and what the prerequisites are. You are wasting valuable cyber space here.

Jeez

 

[Husker DPT]

I wish I knew of a website for your reference. Communication is most effective when it's concise, and you just have to be attentive to that. As an example, take your above post, and condense it to "Do P.T.'s take biology 1, 2?" That's more precise and concise, and elimates all other excessive verbage but your point is very clear. These ''activities'' are the best I can show you.

 

[Grue1some]

LOL LOL... I just have to laugh at Wildcat's last post....Shake my head and Laugh...I think he is a Troll. If not, how can you help a guy that really just does not get it or is too lazy to find simple stuff. Its more like feeding him an egg. Instead you have to chew the egg for him so he can swallow it.


Here is an "EXAMPLE" of Pre-Reqs you need to take for PT school.
The school is University of St. Augustine.

General Chemistry 6 credit hours
Physics (Kinesiology, Biomechanics) 6 credit hours
Biology 6 credit hours = Biology 1 and 2
Anatomy and Physiology 6 credit hours
Social Sciences (include Psychology, Sociology, Anthropology, etc.)
9 credit hours

Each school has different pre-reqs. Now a set of instructions for you wildcat

1)Find Thread called Physical Therapy schools in USA
2)Clicky it
3)In that Thread, lists all the schools. Find school in your state or whatever school you want to go
4)Clicky it
5)A new page will magically appear and you will see the schools physical therapy page
6)Find Admissions Criteria for each school. It will list the Pre-reqs for the school, GRE score, and GPA.
7)Now go be Magellan and Explore

 

[WildCat5]

LOL LOL... I just have to laugh at Wildcat's last post....Shake my head and Laugh...I think he is a Troll. If not, how can you help a guy that really just does not get it or is too lazy to find simple stuff. Its more like feeding him an egg. Instead you have to chew the egg for him so he can swallow it.

Nah, I'm just smart enough to ask you guys questions and not have to do the work for myself (now where's the glory in doing all this research work and no one to pat me on the back for it?). You guys answered it and saved me time...kudos

 

[WildCat5]

How many of you are actually not ******* when confronted in person?

 

[_FNG_]

How many of you are actually not ******* when confronted in person?

I'm your huckleberry *gets ready for e-fight*

 

[Grue1some]

Nah, I'm just smart enough to ask you guys questions and not have to do the work for myself (now where's the glory in doing all this research work and no one to pat me on the back for it?). You guys answered it and saved me time...kudos

Yup, keep that up in Physical Therapy school or whatever you decide to do. It is called mooching. It gets you places if you are a groupie trying to get on the bus with a rockband. But you are a male so its different. Just flex your brain and you will get attention. Here is a definition of a mooch. "Urban dictionary"

"A scab or freeloader who comes to your house uninvited and overstays his welcome (For more than about 3 days) and proceeds to eat all your food, stink up your bathroom, take all your drugs and just generally leech all the blood from your body during their stay."

"A sponge. A schnorrer. A person who shows up every evening at dinner time. A person who wants other people to pay his way."

"How many of you are actually not ******* when confronted in person?"

--You type a lot of crap. You must feel all powerful sitting behind a computer.

 

[All4MyDaughter]

The tone of this thread is increasingly uncivil and unprofessional. Fighting and insulting other members is not allowed on SDN. Please modify your posting behavior and keep the discussion collegial.

 

[Husker DPT]

Wildcat, at most other website forums, you would be banned. Wish this would happen.
Also, in P.T. school we had students like you. They were ostracized. I don't think you are as much as a mooch as you are non research oriented and ignorant. I would recommend staying away from the health care industry.
I could see the P.T. school interview now: "What is your strengths?"...."My work ethic".

 

[Therapist4Chnge]

Last warning people.....insulting other members will not be tolerated. Any further personal comments/insults will require administrative action.

I'd hope that we all can act like professionals.

-t