Direct Access Compared with Referred Physical Therapy Episodes of Care

Direct Access vs Referred Physical Therapy

With the rise of direct access in recent years, patients are now able to see their physical therapist without a physician referral.   This game changer for physical therapists puts increased pressure on their differential diagnosis ability, but also allows the opportunity to get the patient care in the more acute phase of injury.

With the several factors affecting direct access, what does the research tell us about how the patient is affected? Do patients seem to get better more quickly? Do they require more or less physical therapy visits? How many patients end up getting referred to another discipline?

This weeks article is a systematic review to help us better understand the how direct access changes the patient experience and pathway to recovery,  Join us as we review and discuss this weeks topic!



Share your expertise with us by leaving a comment below!



  1. Cody W says:

    This is a good article with some really good statistics. I did not know that the number of states that allow direct access are up to 47 in the U.S. I am curious to know how many other countries allow direct access for PT services and how the process differs.
    On another note, I really like the idea of direct access but struggle with reimbursement as insurance doesn’t typically pay for direct access services at this time (something that I think needs to change). I know that most patients in my area would not be interested in paying for their services out of pocket.

  2. Steph says:

    Does anyone run a cash based practice that can help boost my understanding of the business model? I have a colleague that runs her practice on a cash based model and primarily gets her patients by way of direct access. She does well with her practice, but it seems to me that it would be difficult to maintain a full caseload as patients are most likely seen less often than through traditional PT. I would love more information.

  3. Lisa G says:

    I have been watching a change of culture in my area of the US in the last 3 years. As Cody pointed out there are more and more states that have direct access. There are so many more people that have high deductible health care plans as well, these health care consumers are so much more aware of where and how they are spending their dollars. If a cash based clinic can demonstrate that they are able to get outcomes with less cost (visits) that is a sure win.

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