Published ahead of print September 23 in the journal Health Services Research (HSR), the study suggests that "the role of the physician gatekeeper in regard to physical therapy may be unnecessary in many cases." Patients who visited physical therapists directly for outpatient care had fewer visits and lower overall costs on average than those who were referred by a physician, after adjusting for age, gender, diagnosis, illness severity, and calendar year. In addition, overall related health care use—or care related to the problem for which physical therapy was received, but not physical therapy treatment—was lower in the self-referred group after adjustment. Examples of this type of care might include physician services and diagnostic testing. The study also found that individuals were similarly engaged with the medical care system during and after their course of physical therapy care, suggesting that continuity of care did not differ between the two groups.
According to its news release, the American Physical Therapy Association (APTA) believes the results of this study will support efforts to work with legislators and physician groups to establish policies that reduce unnecessary regulations, improve access, and build models of delivery that best serve our patients and the health care system.