Ohio physical therapists getting direct patient access

A new state law allows patients to bypass physician referral.

By Myrle Croasdale — Posted Aug. 2, 2004

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A few new private physical therapy practices are popping up in Ohio, according to anecdotal reports, two months after the state's governor signed into law a bill permitting patients to head straight to their physical therapist when they start to ache.

Ohio is the 48th state to give patients direct access to physical therapists, but its law has a few caveats. After the initial evaluation, the physical therapist must inform the patient's physician of his or her findings within five days. And if there is no substantial progress in the patient's condition after 30 days, the physical therapist must consult with or refer the patient to a doctor.

Molly A. Katz, MD, president-elect of the Ohio State Medical Assn., said the new law is a disservice to the public.

"We believe patients need a medical diagnosis before any physical therapy is begun," Dr. Katz said. "Physical therapy is very important, and it should be done in collaboration with a physician. That's the bottom line."

Many conditions can masquerade as musculoskeletal problems, she said, such as hairline fractures from osteoporosis.

While some physical therapists might be familiar with the condition and would refer such patients to their physicians, PTs aren't trained to diagnose such diseases.

Nancy Garland, executive director of the Ohio Physical Therapy Assn., said the association's goal was to cut out an extra step for patients with chronic conditions.

Garland used her own situation as an example. She said she has a condition that causes contractions of the muscles in her neck and shoulder.

When she has a flare-up, she said, she doesn't need to see her doctor, she needs to see her physical therapist.

Garland noted that there is no evidence from other states that would indicate that patient safety is put at risk by direct access to physical therapists.

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