Allow Floridians full access to physical therapy services

It seems like today there are more questions than answers with respect to the future of health care in the United States. The U.S. House of Representatives passed an amended version of the American Health Care Act of 2017 in May that still faces an uncertain future.

In 2016, Tampa Bay Times published a column that highlighted the shortfall of primary care physicians in Florida. Since then, elected state officials have implemented key legislative changes that could help address this issue by granting prescriptive authority for controlled substances to nurse practitioners and physician assistants.

Physical therapists are another health care provider that could help alleviate this problem, but a seemingly arbitrary restriction prevents them from doing so.

Current Florida law grants physical therapists permission to see a patient for 30 days, without them first being seen by a physician. This is a slight improvement over the previous maximum of 21 days that was in place prior to the changes made in 2016. However, as the law currently stands, it may discourage patients from originally seeking treatment from a physical therapist. Why should an injured person see a physical therapist first if they’ll need to see a physician in 30 days anyway?

Eighteen states currently allow patients to see physical therapists without any limitation. A study performed by the Health Care Cost Institute suggested that patients who see a physical therapist first for lower back pain treatment have lower treatment costs, lower rates of opioid prescription, and reduced probability of an emergency department visit. Another study published in Health Services Research found that patients that “self-refer” themselves to physical therapists will generally obtain treatment for a shorter period of time. In other words, there is no evidence that patients “over use” physical therapy services if they are free to choose to do so.

A study performed by the Mercatus Center at George Mason University on licensed occupations found little evidence that granting physical therapists direct access to patients had an effect on the labor market for chiropractors, physicians, or physical therapists. The results might be attributed to specific differences in the degree of direct access across states. In addition, many patients could simply not be aware that they are permitted to see physical therapists without physician referral. A general lack of awareness persists with minimal efforts underway to improve awareness.

Critics of physical therapist direct access, such as the American Academy of Orthopedic Surgeons, argue that granting patients the ability to see a physical therapist without physician referral presents a safety risk. Evidence does not seem to support this claim, however. One study, for example, found no evidence that direct access results in higher incidences of malpractice claims. A recent meta-analysis concurred that no additional risks are presented to patients.

Floridians, just like other Americans, deserve the opportunity to receive access to the health care that they need. Patients in Kentucky and Arizona, for example, already have the ability to see a physical therapist directly with no arbitrary restrictions. Floridians deserve to be given the same choice.