Seven Direct Access Myths

It was a normal spring night and my baseball game had just started. It was senior night and I was pitching, we had just finish the first half of the first inning. My teammate struck out, it was my turn to hit, I swung for the ball and my leg popped twice. I went down and didn't get back up, My leg was stuck to my chest and I couldn't move it. The visiting team's coach was an EMT he ran over and said ¨this is going to hurt¨ and pulled my leg straight. What had happened was when I swung the bat my leg didn't move and my kneecap dislocated and instead of my ligaments tearing, they stretched and broke my kneecap. This was a challenge for me because this was the first time I had never broken a bone in my life. I went to the doctor and he said nothing was wrong, so my

Later that night, I would find out that I fractured my femur, clean into two. My doctor told me that I would be out from sports for at least nine to twelve months since it was an extreme injury. Normally, with being an athletic person, I was absolutely devastated. I knew that it was going to be a long recovery, but I did not know that it was going to be a mental setback as much as physical. At first it was nice to have my loved ones come around all the time to visit me and check up on me, but after a while they all moved on. They all headed off to enjoy their summer while I laid on the couch watching television and attempting to do some leg exercises. I had to have help with everything, which led to many arguments. Being independent, I abhorred the fact that I needed help with the simplest things, such as grabbing the remote or even getting up. I became so upset about it that I quit arguing about it. It led me into a lazy mindset that made me not feel as motivated to do things. Once I started physical therapy it felt as though nothing was changing. On our first day we had to so electroshock therapy on my thigh because I could not move the muscles on my

That day when I returned home from school, my mom’s boyfriend called me asking to speak to my grandmother. Typically, Gus would call my grandmother himself if he wanted to speak with her, which was rare. I found out about my mom going to the hospital from my grandmother after that phone call. The doctor told my family that a stroke afflicted her in the middle of the day. My mom confused the date with her birthday, had trouble getting words out and remembering our family member’s names. The nurse had to take her for walks periodically and exercise her legs and arms because they were weak. Seeing my mother in this condition made me appreciate my mother and everything she does for me tremendously. However, I was terrified for my mother’s health.

This frees up the physician’s schedule to see only the medically necessary patients, whereas PTs can share the load of musculoskeletal evaluations. Mitchell and Lissovoy published a study in 1994 on the cost effectiveness of direct access to PTs. They found that the costs for PT visits were 123% higher when patients were first seen by a physician as compared to when they were seen by a physical therapist directly. Establishing close working relationships between medical doctors and PTs, with a 2-way referral of patients, is essential to reduce not only unnecessary referrals, but also improve patient satisfaction and create an efficient process for reducing overall medical costs.

While the hardship that I have been through by no mean even comparable to what Janette has been through, yet in the same way, the adversity and hardship that life brought upon shaped me into the person I am today and made me stronger. This one particular hardship happened in 2010 had eternally changed my perspective. The incident happened in September when the weather was perfect in Hawaii, I was at my first year at college with my heavy 17 credits work load and a 19 hours part time job. Since the work load was intense, I barely had time for myself. Typical days normally involved me go to class, then work, library and bed. One evening, I started to feel throbbing pain in my lower abdomen region, so I wake up and took some pain killers to ease off the pain. The pain got worse rapidly in a matter of hours. My forehead started to sweat, and tears started to trickle down my cheeks. The pain was excruciating. I have never felt this kind of pain in my entire life. I started to scream as the pain started to move from my belly button to my lower abdomen. By midnight, the pain was unbearable and I started to feel as if this agonizing pain could

Under the old Georgia Physical Therapy Act, a physical therapist was allowed to examine and evaluate of patient or client without a referral source. The only treatment a physical therapist could provide without a referral source was in the area of fitness, wellness, or prevention that was not related to an injury. Effective July 1, 2015, the current Georgia Physical Therapy Act grants physical therapists limited direct access, or the terminology used in the act is self-referral. Under the new practice act a patient who self-refers can be seen by a physical therapist for a maximum of 21 days or eight visits before required to have a referral from the patient’s provider. (Georgia Physical Therapy Act, 2015). A stipulation is that a written disclosure must be provided to the patient that the physical therapy diagnosis is not a medical diagnosis. (Georgia Physical Therapy Act, 2015). Additionally, a provider referral is not required for patients who return for treatment within 90 days that have been previously diagnosed with a chronic musculoskeletal condition (Georgia Physical Therapy

As a practicing physical therapist in the state of Georgia, and over 35 years of clinical experience in this healthcare field, I am writing to you today to gain the support of your insurance company, Blue Cross Blue Shield of Georgia (BCBSGA) in the recent achievement of direct access for physical therapists in Georgia. Currently, patients in the state of Georgia now have direct access to physical therapists without the requirement of a physician referral; however under the current health care system physical therapists are still prevented from providing necessary medical treatment to patients, on the account of that services rendered under direct access are not reimbursed by BCBSGA. This extra step places a burden to the consumer by increasing

According to Direct access utilization survey done by APTA in 2010 state with unrestricted direct access for more then 10 years 69% therapist report that their direct access patient contain only 10% of their patient population and this 10% consist of former patient, their relatives and friends. Even though most of the reimbursement companies including medicare doesn’t required initial referral from physician, 64.7% therapist identified reimbursements limitation is one of the primary reason behind lower number of direct access patient (APTA 2010). I work for one of the largest and lidding health care provider company in United state and company policy dictate that we have to have physician referral in order to evaluate and treat patient in all settings.

When I found out that I had a bad knee I was absolutely devastated. It took five doctors to find out what exactly was wrong and it turned out to be way worse than my family had anticipated.

My home has been a place of many medical incedents. My mother has had countless operations before i was old enough to understand. I was three years old for her first one, and I tried to be the a good son. I hoped that if I loved her enough, her surgery would go well and shed be ok. When i had gotten older, i had become much more fearful for her welbeing, but my grandmother was always there to calm ma down and not lose it.

The night of December 9, 2011 was easily one of the worst of my life. It all started before I woke. At around 2:30 in the morning, my grandfather (Pepaw), who resided in Keyser, West Virginia, had fallen very ill. My step grandmother called my father to let him know that his father needed emergency surgery and asked him to travel to Keyser Hospital as soon as possible. After the first surgery was completed the doctors at the the Hospital determined that he needed an additional emergency surgery that they were not equipped to preform. At 5:30 A.M. he was Medevaced to Morgantown, West Virginia for the next surgery. After he arrived, the Morgantown Physicians assessed his vitals, and in consultation with the Keysers doctors, they determined that Pepaw was not strong enough to undergo the second

It was difficult to find the regulations for physical therapy assistants because the information was interspersed in the statutes and rules and in the administrative Code. Much of the law was written more for physical therapist guidance than directed towards the PTA. To apply for an assistant license, the person must be of good moral character, a graduate of an accredited PTA school, pass a board exam, and jurisprudence exam. The license is a certificate and no continuing education is required at this time. The PTA can only practice under the direction of a physical therapist. The assistant cannot evaluate, re-evaluate, discharge, or change a program of a patient and the physical therapist responsible for the patient must be onsite during each treatment. The exception to this rule is in a general supervision capacity. The physical therapist assistant with 2000 hours of supervision in an onsite facility can see a patient independently without onsite supervision (Azsos.gov, n.d.). The physical therapist must be able to communicate with the PTA within 15 minutes, re-evaluate the patient every 4th visit or 30 days whichever comes first and visit the patient the day of communication if needed. There are specific documenting requirements for PTA’s in a general supervision capacity, including documenting the physical therapists name and number, date, intervention and if he PTA consulted with the physical therapist. The

Currently, 17 states in the United States allow for unrestricted direct access to physical therapy and the reminding states still have limitations. Many opponents of direct access to physical therapy are still concern that if direct access is implemented, physical therapists (PTs) could misdiagnose serious medical conditions. However, current literature suggests that unrestricted direct access to physical therapy is safe, cost-effective, and efficient.

I started doing physical therapy immediately, then three days later I could not move my legs. They ran more test and then the doctors saw I have broken my back. I was care flight to Cooks Children Medical Hospital where more test was ran. I was told I had a broken back and could never walk again also the growth plait in my hand was put on backwards and internal bleeding. The hardest thing for me was never being able to walk again, I was an athlete I played volleyball. I prayed really hard before my first back surgery. I came out of surgery ten hours later; I was in bed ridden for five days, the fifth day I was determined to stand on my own. My mother lifted me up out of the hospital bed and I fell and then after 3 attempts I was ready to give up and except my life as a handy cap. My mom pushed me to stand one more time and this time I stood with my mom’s help I took my

Physician owned physical therapy services (POPTS) are organizations in which a physician can financially gain from referring physical therapy services to an institution in which they have ownership or some sort of financial stake in the company of referral. This is commonly known as referral for profit.1 An example of POPTS is an orthopedic surgeon owning his/her practice that employs physical therapists to which he/she only refers their patients. This type of referral not only gives unfair advantage to the physician owner; it more importantly takes away from the patient’s choice of provider. This issue has been a source of controversy for some time. The American Physical Therapy Association (APTA) has been in opposition to POPTS since the late 1970s. This opposition did not gain traction until the Stark legislation in the 1990s; which