The headline was simple: "7 Myths About Physical Therapy". The press release from the American Physical Therapy Association was going to debunk some myths about physical therapy. How exciting, I thought.
Maybe this would set the record straight on any number of issues and misconceptions about our profession that exist in the public eye. Surely this would be a great opportunity for us to "Move Forward", yes?
And then, I read myth number one. It was, admittedly, hard for me to overlook.
"Myth: I need a referral to see a physical therapist".
Fact: A recent survey by the American Physical Therapy Association (APTA) revealed 70% of people think a referral or prescription is required for evaluation by a physical therapist. However, all 50 states and the District of Columbia (DC) allow patients to be evaluated by a physical therapist without a physician's prior referral. In addition, 48 states and DC allow for some form of treatment or intervention without a physician referral or prescription (Oklahoma and Michigan being the exception). Beginning November 1, 2014, patients in Oklahoma will be able to seek treatment from a physical therapist without a physician referral. On January 1, 2015, patients in Michigan will be able to do so, as well. Some states have restrictions about the treatment a physical therapist can provide without a physician referral. Check out APTA's direct access summary chart to see the restrictions in your state.
I will be the first to state that proper use of language is important. And I must also say that if I look at the actual words as printed, then no, you don't need a referral to see a physical therapist. As a matter of fact, we exist in the wild, roam freely, walk amongst you, and generally play well with others.
But seriously, seeing a physical therapist isn't the issue. It is the play on words that is critical. Spin is everything.
Let's start with the most critical consumer-related question regarding physical therapy: can you freely and of your own volition access evaluation and treatment from a physical therapist?
The answer is quite simple: no, unless you reside in one of about 18 states - a number that has remained stable for over a decade.
Are the facts presented in the release correct? Well ... yes. But it's all in the spin.
In Texas, yes, patients can be evaluated without a referral. But now the reality check: seriously, how many patients want to be evaluated by a physical therapist, then be told that they can't be treated unless they have a script? Answer: Not many. And, frankly, I don't blame them.
Yes, 48 states and DC allow for "some form of treatment or intervention". But now, again, the reality check: it is typically, if not always, limited to a certain time frame or number of visits before that permission slip (aka script) is required. Oh, just a minor detail buried between the lines.
So in the name of truth-telling and myth debunking, on behalf of the consumers in the crowd, unless you live in one of 18 states, you simply DO NOT have the right to access a physical therapist directly for your care at their professional discretion, much as you would any other health care provider.
No wonder there is so much confusion in the marketplace.
Here's a thought: stop the spin doctoring. Please. Why continue to make the scenario sound far better than it really is? The facts are there, yes, but there is also a spin to them, a fallacy that continues to be perpetuated. It downplays a patient's potential role in changing the health care landscape to increase their access to appropriate care. It certainly diminishes the level of urgency in the eyes of the consumer and the legislator.
I would suggest that consumers and legislators alike would find the issue far more compelling if they were told that only 18 states give you the right to choose. When you live in a country founded on rights and freedoms, I can't imagine that will go over very well with anyone.
Let's debunk this myth once and for all. Please. Consumers deserve the truth, not the spin.
Photo credits: joiseyshowaa