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What Direct Access Means For You!

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Added on July 29, 2013

"You're going to need to see a specialist. I'm going to refer you to…"We've all heard a physician utter these words listening with dread; the anger and frustration building up inside. Then, the inner monologue begins:

Didn't I just wait two weeks for this appointment? And now I'll have to wait another two weeks to see another Doctor? And then he'll probably send me to get an X-ray, then a MRI, and then CAT scan! That'll take months! I don't have time for this!

Hopefully it won't become that extreme, but there's no denying that medical practices run on the broken system of referrals. In his New York Times essay, Sandeep Jauhar, M.D. stated:

I was chatting recently with a doctor friend who was depressed because he thought he had lost a referral source.

"This internist was sending me patients," he told me, as I recall. "Then last month he sent me only one patient. And this month only one patient."

I nodded hesitantly, unsure what he was driving at.

"So I understand something must have happened," he said.

"Like what?" I asked.

He threw up his hands, exasperated by my obliviousness.

"He met someone else! He developed a relationship with another cardiologist."

I smiled at the overwrought response, with its connotations of a romantic breakup. But to my friend, this was no joke. Like most specialists, his livelihood depends on referrals.

As a consequence of strict regulations requiring patients to obtain a referral or prescription, Dr. Jauhar's assertion rings true to a substantial degree within the Physical Therapy community. Physicians have long been the gatekeepers – the middlemen – between patients and therapeutic treatment – until recently. Now, forty-eight states, and the District of Columbia have made a ruling enabling patients "direct access" to Physical Therapy services and programs. In other words, the government cut out the middlemen by making it acceptable for individuals to go straight to a clinic of their choice, and receive the resources and treatment they require. No referral, or prescription necessary!

The advantages of allowing direct access are simple: less anger, less frustration, and fewer chances of an aggravated inner monologue. Of course, the newly enacted laws have more practical benefits; patients see a decrease in their costs by skipping a visit to their general practitioner for a referral. One less clinical stop equals more money saved for a rainy day. State Governments and insurance companies are delighted with the results as well. According to a recent study by Dr. Jean Mitchell and Dr. Greg de Lissovoy of Georgetown University and John Hopkins University, States and insurance companies providing reimbursement under the new enactment realize a savings of approximately $1,200 per patient episode of care.

Saving a trip also saves time – a crucial component in any medical field. Larry Briand, MS, PT, ATC, and Kevin Svoboda are quick to point out, "Without direct access, a patient must first visit a physician, who assesses them and makes a referral to a [Physical Therapist]. This process is time-consuming and can be inefficient, sometimes taking three weeks or more for the patient to visit a physician and ultimately end up in a [Physical Therapy] clinic. The patient's condition can deteriorate rapidly in this amount of time, causing their recovery to take exponentially longer."

Direct access empowers an individual to take back control of their health, by allowing them to choose an approach that will best suit their needs. The laws also enable the Physical Therapist by permitting them the right to establish a plan of care and treatment together along with the patient. Following this direct method creates an atmosphere of one-on-one care; permitting the therapist to construct personalized recommendations for the individual. After all, when it comes to rehabilitation, it all about the people.






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