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What is direct access?

What is direct access?

Written by:  Paul Kochoa, PT, DPT, OCS, CKTP, CGFI


Did you know that you can see a physiotherapist without going to a physician first?  It’s called “direct access” and it’s a law in 46 states (.pdf link) that allows a healthcare consumer, that’s you, to see a physiotherapist without a physician referral or prescription.

The specifics of the law vary from state to state. (In New York, you can see a physiotherapist, who’s been practicing for at least 3 years, for 30 days or 10 visits, whichever comes first.  In New Jersey, you can continue to see a physio past that 30 day mark, but you have to be making reasonable progress, and have a follow-up appointment with your primary physician.)  If some of the above requirements are not met or your health issues are out of the physiotherapist’s scope of practice, you may be referred out to another medical professional by the physiotherapist.

Direct access marks a significant change in primary care medicine.  It marks the erosion of a “gatekeeper” that separates the consumer and the service.  According to a survey conducted by ProMedica, a non-profit healthcare organization, published in PT in Motion magazine, the reasons why consumers go to a particular physiotherapist are changing.

In 2002, the majority of patients picked their physiotherapist based on who they were referred to see by their physician.  In 2009, patients started choosing their physiotherapist based on location and ease of access.  This also marks another trend that patients are less and less likely to follow their physicians’ advice in whom to see.  Healthcare consumers are now more savvy in spotting trends, doing their own research on the internet, and have access to reviews and opinions of healthcare providers at their fingertips.

The trend is positioning the physiotherapist as a primary care medical professional.  Most physiotherapists have doctorate degrees.  They are the specialists in regards to movement dysfunction and treat many problems and some even specialize in their selected field: cardiovascular/pulmonary, clinical electrophysiology. geriatrics, neurology, orthopedics, sports, pediatrics, or women’s health.

Physiotherapists can treat problems without medication, without expensive tests like x-rays or MRIs that may even be unnecessary, and can even help you avoid surgery.  Direct access to physiotherapists also uses less healthcare dollars.  More bang for your buck.  Bottom line is that if you have pain, you can go see a physiotherapist.  They should be your first resource when it comes to functional issues or pain with movement.  For more information, you can check out, the consumer gateway for the American Physical Therapy Association, or ask your local physiotherapist.

If you would like more information, please call Professional Physical Therapy and Training at 973-270-7417.  Our offices are located within the YMCA locations in Madison and Summit, NJ.  You do not need to be a member of the YMCA to visit with us.


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