Direct Access to Physical Therapy in the State of Michigan
What is Direct Access?
“Direct access” is the phrase used in health care to explain how a person accesses services without a physician referral. In Michigan, this is a newer concept – only a part of health care law since 2014. In 2014 Michigan passed a law (Public Act 260), which allows people in the state of Michigan to be seen directly by a physical therapist for 21 days or 10 visits prior to needing a referral from a physician.
Why is this a good thing?
When you are hurting, time is everything! Direct access allows individuals to expedite the time of evaluation and follow-up care between when they are seen and may save an extra step (and money) on healthcare expenditures, potentially decreasing overall time-to-recovery. If an individual thinks that they may need physical therapy, a prompt evaluation by one of our licensed Doctors of Physical Therapy (DPT) is a great first step. The physical therapist can also screen and refer for immediate attention by your physician as well.
Michigan is the 49th state to adopt a law allowing some form of direct access. Although direct access in the state of Michigan is limited, other states have collected significant data regarding the benefits of having direct access to physical therapy. In a study performed by Joan Mitchell1 in 2012 using data from Blue Cross Blue Shield of Maryland, researchers found that the costs established for physical therapy visits were 123% higher when there was physician involvement than when patients went to a physical therapist directly. The study also showed that physician referral occurrences generated 67% more physical therapy claims and 60% more office visits than when the patient went directly to the physical therapist without a physician referral. This shows that with the ability to go directly to a physical therapist, direct access is not only less expensive, but it also requires fewer visits; taking less time out of the patients’ schedules.
Are physical therapists qualified to deliver services independent of a referral?
According to the APTA (American Physical Therapy Association), “physical therapists are educated at the post-baccalaureate level and receive extensive education and clinical training in the examination, evaluation, diagnosis, prognosis, and intervention of patient/clients with functional limitations, impairments, and disabilities. All accredited entry-level physical therapist education programs currently culminate in a Doctor of Physical Therapy (DPT) degree. Physical therapists are qualified to recognize when a patient presents with signs and symptoms inconsistent or outside the scope and expertise of the physical therapist and when the patient should be referred to a physician.”2
Additionally, “Professional liability insurers and the Federation of State Boards of Physical Therapy affirm that direct access does not jeopardize the health, safety, or welfare of the patient/clients. Health Providers Service Organization (HPSO), the leading carrier of professional liability insurance for physical therapists in the US, states, “Direct access is not a risk factor that we specifically screen for in the underwriting of our program nor do we charge a premium differential for physical therapists in direct access states. We currently have no specific underwriting concerns with respect to direct access for physical therapists.” 2
How do I know if direct access is for me?
If you have an injury, ache or pain, difficulty walking, problems with activities of daily life, difficulty performing work tasks due to weakness or poor endurance or limitations in movement, YOU are a candidate for direct access. If you have questions about your overall wellness or changes you are feeling with aging, EXERCISE your right to direct access today!
1Mitchell, Jean. Cost Effectiveness of Direct Access to Physical Therapy. 2012. Graph. Web. 9 November 2012
2 Gardner, Kelly. FAQ: Direct Access on the State Level. 2018. http://www.apta.org/StateIssues/DirectAccess/FAQs/. June 2018