Unlocking the Advantages of Direct Access Physical Therapy

Recent study has analyzed health care spending in the US from 1996 through 2016. The total spending increased by more than 100% reaching $9,655 per person. Among the 154 conditions, which were included in the analysis, low back and neck pain were the highest expenditures with an estimated $134.5 billion, followed by other musculoskeletal disorders (MSD) with an estimated cost of $129.8 billion¹

In the United States, every other adult reported having been diagnosed with an MSD. Statistics have shown that It drives 18% of all health care visits in the US. Primary care physicians are typically the first line of care for such disorders. However, it has been suggested that visiting other providers such as physical therapists prior physician visits may have equal if not even better outcomes and overall lower costs. A recent review² concluded that direct access to physical therapy is more cost-effective when compared to physician-first plan resulting in fewer visits and better outcomes. Direct access to physical therapy was cost efficient, had less clinic visits and resulted in a much better functional improvement. Interestingly, the study cited another research on acute low back pain indicating that delays in physical therapy access was directly linked to chronic episodes and delivery of inappropriate care models that increased overall costs and longer recovery periods.

Other studies further compared the effects of delayed physical therapy on low back pain³. Patients receiving early PT care had 60% lower total low back pain (LBP) related costs during a 2-year follow-up period. In addition, non-LBP healthcare and in-patient costs were also substantially lower suggesting PT benefits extend beyond the primary reason for treatment. The biggest impact of direct access to PT was seen when those patients were also adherent to their treatment plan. That group of patients had the lowest utilization and costs compared to the others. However, the study emphasizes that many patients may improve regardless of treatment as well. Those who incorporate PT into their treatment, however, are more likely to have shorter pain episodes.

Both studies put an emphasis on the initial management decisions following new episodes of MSD. Those decisions have profound implications for clinical outcomes and costs of treatment. Early physical therapy was associated with low utilization of imaging, spinal injections, lumbar spine surgery and use of opioids.