Physical Therapy No Longer Has To Be a Waiting Game

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“Time is on my side, yes it is.”

When Mick Jagger sang these words back in 1965, it’s a safe bet he wasn’t sitting home in excruciating pain because he hurt his lower back bringing in groceries from the local supermarket.
For years the norm has been for anyone inflicted with an injury to get mired in the seemingly never-ending rolls of bureaucratic red tape before they even had the opportunity to see a physical therapist. There was time not well spent waiting for a doctor’s appointment. Then you had to deal with the insurance behemoths that didn’t see you as John or Jane Doe, but only as Case #76144533908167. Then it was what seemed like hours spent trying to reach them on the phone (“Please hold. Your call is very important to us. Although not important enough that we would actually have someone pick up the phone.”). And while this waiting game is taking place, your back is now registering an 11 on the pain meter.
But truth be told, the physical therapy community deserves some of the blame here. For years we did nothing to try to knock the status quo off-kilter, simply by using the same old tired excuses:
• “We can’t see patients without a referral.”
• “Our physicians send us plenty of patients.”
• “If we get physicians mad at us, they won’t send us referrals.”
• “Why should I waste time trying to get patients when the physicians are going to make all the decisions anyway?”

But things have now changed. Several years ago the physical therapy community began to wise-up to the situation and made the decision to take on the insurance and medical fields by lobbying to allow patients to have direct access to the PT of their choice. At first it appeared to take on the shape of bringing a knife to a gunfight. But perhaps spurred on by this David & Goliath mentality, the physical therapy community prevailed and laws were enacted allowing patients to now have the option to side-step their local doctor’s office and have direct access to the physical therapist of their choice.

In a nutshell the law states:
• Massachusetts is one of 18 states that allow patients total, unrestricted access to a physical therapist. No type of physician referral is required for a physical therapist to treat a patient.
• If the PT feels that the patient’s care goes beyond the physical therapy scope of practice, or if PT is contraindicated, the therapist must refer the patient to an appropriate licensed practitioner.
• If the patient was referred to the PT, the PT must communicate with the licensed referring practitioner throughout duration of treatment.
• The PT must also disclose to the patient any financial interest if the referring physician derives income from the PT services.

Perhaps this shift in the way of doing things was inevitable. After all, patients now have a greater awareness of their healthcare situation, not only through places like Google and WebMD, but because they now have more skin in the game as they see their healthcare costs trending upwards. Patients are more inclined to spend more hours on their computer and phone researching various treatment methods for their pain and discomfort, and are now in a position to make their own decisions. And they are making these decisions before they ever set foot in their physician’s office.

Here is what patients are learning from their research:
• Studies have shown that seeing a physical therapist from the start for such things as lower back pain presents a cost savings.
• Physical therapy leads to a better outcome, which means less time away from work.
• Having access to a physical therapist is quicker than getting a doctor’s appointment.
• Physical therapy is a proven alternative to the use of opioids and the baggage that comes with it.
• Physical therapists can treat specific areas of pain, whereas physicians tend to treat the body as a whole.

Just to be clear, I am not advocating choosing physical therapy over visiting your doctor, should an injury warrant it. But if the pain is due to neuromusculoskeletal issues, then visiting a physical therapist as soon as possible would seem the prudent course to take.
Sadly, and this again falls on us as physical therapists, many people don’t realize that this direct access exists and many people are still waiting painful hours, days and even weeks to get the relief their body so badly craves. And that’s because we have not taken the time to educate the public that the waiting game is over and the road to pain relief no longer has to detour through their physician’s office.

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