My thought for today started with an insightful and thought-provoking blog post by Dr. John Childs regarding the APTA’s proposed new vision statement – and the discussion it inspired. In that discussion, there was a phrase mentioned that nicely summarizes one of the greatest problems facing Consumer Direct Access to Physical Therapy: “It’s all in the language”.

The majority of states have what is termed “Restricted Direct Access”. If this isn’t an oxymoron – much like “jumbo shrimp” – I don’t know what is. No wonder that patients and clinicians, including the gatekeepers themselves, are confused.

The solution lies in the language itself.

The answer lies with the consumer. The consumer can either access a physical therapist to make full use of their skills and training for evaluation and/or treatment – or they can’t. Saying that a consumer has “restricted direct access” is an oxymoron, much like “jumbo shrimp”. Much as I have previously stated in this post and others, you either have it or you don’t. “Restricted direct access” is a misnomer that ultimately places restrictions on a patient’s right to choose.

Direct access to care – in the true sense of the phrase - doesn’t require a third party glorified permission slip. It is a direct relationship established between an autonomous health care professional and the consumer.

The APTA continues to trumpet that there are 48 states that have some form of direct access. Texas is one of them. I can tell you that Texas does not have access that any consumer would ever consider “direct”. The reality is that there are 17 states that have direct access like any other autonomous health care professionals. But what sounds better – 48 or 17? Spin, spin, spin. Playing with words. If you are in one of those states that has sorta-kinda-some-degree-of-consumer-access, try explaining it to a consumer.

So here’s a thought: change the language – for the consumer, and within the profession.

Professional behaviors are consistent with your self image and self talk. The profession, as a whole, must resolve to no longer use the phrase “48 states that have some form of direct access” because it is a falsehood or half-truth to both legislators and the public. It is simply off-target. Language like this just dilutes the harsh reality for consumers and for the profession.

As was noted in the discussion that followed the Childs post, “Once a goal is defined, a strategy then becomes more clear”. This begins with the reality of 17 states allowing consumers to access a physical therapist much like they would any other non-gatekeeper-driven autonomous professional. This would clarify the situation for consumers and provide them with a powerful stimulus for change: the reality of the restrictions placed on their freedom to select a physical therapist as their practitioner of choice.

It is all in the language. Just ask the consumer.

Thanks to @childsjd and @EricaMeloe for providing the inspiration for the post.

Photo credits: Steve Snodgrass