The P1 Project - The Physio One Project

Physical therapists (otherwise know as physiotherapists or "physios" in most other countries worldwide) are, without question, the practitioners of choice for the first line of assessment and treatment of musculoskeletal disorders, and in the prevention of injury and optimization of human performance.

The mission of the Physio One Project is to be a strong advocate for professional autonomy within the world of physical therapy, and to promote consumer awareness and advocacy regarding the role, evidence, standards, and outcomes of physical therapy in both health and health care, injury recovery and injury prevention. This will focus on 3 key areas:

• 1. Promoting the autonomous practice of and consumer direct access to physical therapy within the health care system (and the limiters that affect this); and
• 2. Promoting evidence-based practice within the scope of practice of physical therapy.
• 3. Create a community of both consumers and providers to discuss these issues openly and freely.

Some Frequently Asked Questions -

What is the international standard for physical therapy?

In the vast majority of countries, patients have direct access to a physiotherapist, much as they would a doctor, osteopath, chiropractor, or massage therapist. They practice as autonomous providers in that they do not require a referral or the permission of a gatekeeper to evaluate and treat patients. This is considered the accepted standard of care in most countries.

Can a consumer access a physical therapist directly and freely within the United States?

Currently, 17 states have direct access to evaluation and treatment by a physical therapist. Although 48 states have some degree of access, only 17 states have legislation that provides a patient with the right to access a physical therapist for evaluation and treatment without a gatekeeper.

Why do I need a gatekeeper's referral?

It depends on who you ask. The gatekeepers will tell you it is an issue of protecting your safety - though these claims continue to be refuted by research time and time again. They have not sought to impose these regulations on other health care providers. Sadly, the issue is not one of public safety or other issue. The gatekeeper model is a legalized monopoly, and the limits to the patient's access to care are related more to protection of turf than they are to the betterment of the health care system or providing patients with greater options for care.

How does this affect consumers?

Consumer awareness of physical therapy - and the limiters to practice that are imposed on the profession from outside special interest groups - is low. If the consumers don't know the issues - then, well, the issues really don't exist in anyone's minds but our own.Thus begins a virtual cycle of "accepted standards of care" in the community, and the consumer simply doesn't have the information to understand the issues at hand and how they affect their quality of care, access to care, and cost of care.

Consumers are also not aware of "evidence-based practice" and how these issues affect their health care. All providers are not created equal - and some utilize evidence-based strategies far more than others. Again, it is in the best interests of the consumer to understand what these strategies are, and how they impact their care and provide better outcomes. Let's make "evidence-based standards of care" the new community standard.

Don't other professional associations do this?

Professional associations are, quite frankly, too busy putting money towards lobbyists. And lobbyists are too busy accepting these dollars. And while these factions continue to wage legislative battles that are driven by campaign dollars and broken promises, the consumer continues to suffer. The growth of the profession in the United States is also limited internally by those that desire to remain subservient ancillary providers even though their training and clinical expertise says otherwise. A strong consumer voice is necessary.

What needs to change in order for consumers to access the provider of their choice?

Simple - your voice! The P1 Project's primary goal is effective consumer awareness and advocacy. Consumers have votes - and votes decide legislators' fate.

Won't it take a lot of money to sway political action groups?

The P1 Project will not devote any finances to political campaigns. Funding will be directed towards a grass roots effort for change. If the voice is loud enough, and disruptive enough, change will occur. We have seen this throughout world history, and this will be no different.

Where can I find more information on the P1 Project and its goals?

Further information on the history of the P1 Project and its origins can be found in Episode 13 of the podcast "Consumer's Guide To Health" which can be found here. You can also read "Vision Now: A Physical Therapist Manifesto", a "call to arms" for the profession as a whole.

I hope you will join us in the discussion and in supporting the P1 Project.

Position Statements

• Vision Now: A Physical Therapist Manifesto
• Abolish The Gatekeeper Model Now

Suggested Reading - Consumer Direct Access

2012

• Bo Knows Football, But Seth Knows Health Care
• How The Gatekeepers Conveniently Ignore The Solution For The Primary Care Shortage
• 62,900 More Reasons For Consumer Direct Access To Physical Therapy
• Is Transparency A Game Changer In Consumer Direct Access To Physical Therapy?
• Fed Up? Governor Perry And Health Care In Texas
• Models Of Practice, Physical Therapist Autonomy, And The Meaning Of Life
• The APTA's Vision 2020: My 12 Year Report Card
• Is Physical Therapy In The United States Heading In The Right Direction?
• Senator Nelson's Editorial And Its Impact On Direct Access To Physical Therapy In Texas
• Consumer Direct Access To Physical Therapy Needs A Game Change
• The APTA, Seventeen States, And The Harsh Reality Of Direct Access To Physical Therapy
• Physical Therapists And Their Self Image: An International Perspective

2011

• PT Talker Interview: The Role Of A Physical Therapist
• News Flash: Another Study Confirms Direct Access Saves Money

2010

• Three Important Consumer Issues In Physical Therapy And Health Care

2009

• Big Pharma, Big Tobacco, And ... Big Medicine?
• Direct Access: Adding To The Evidence
• Letter To Texas Legislators: Direct Access To Physical Therapy
• Direct Access To Physical Therapy

2008

• Turf Wars

2007

• Direct Talk About Direct Access
• Roadblocks To Care

Suggested Reading - Evidence-Based Practice