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DirAcc/Self-Referral
Direct Access/Patient Self-Referral
Question | Answer |
---|---|
What are the components of Vision 20/20? | 1. Autonomous Practice 2. Direct Access 3. DPT 4. EBP 5. Practitioner of Choice 6. Professionalism |
Autonomous PT Practice | PTs will practice autonomously & collaboratively to provide best practice to the pt. Autonomous PT practice characterized by: independent, self-determined, professional judgment, & action |
Direct Access | Consumers have legal rights to directly access PTs for the dx of, interventions for, & prevention of, impairments, fxnal limitations, & disabilities related to mvmt, fxn, & health |
DPT | DPT reflects growth in body of knowledge & expected responsibilities that PTs master to provide best practice to the consumer All PTs are obligated to engage in continual ed, skills, & advancing PT |
EBP | Access to, application & integration of evidence to guide clinical devisions to provide best practice. Includes best available research, clinical expertise, pt values & circumstances. Aims to enhance pt mgmt & reduce unwarranted variation in provision |
Practitioner of Choice | PTs to be recognized as preferred providers among consumers & other HC pro's for dx, interventions, prevention of impairments, fxnal limitations, & disabilities related to mvmt, fxn, & health |
Professionalism | Demonstrate core values by aspiring to & wisely applying principles of altruism, excellence, caring, ethics, respect, communication & accountability. Working with other pros to achieve best health & wellness in individuals/communities |
Why do PTs want direct access? | Major goal of state legislatures since 1990's has been to reform our US HC system by focusing on increasing access & containing costs. Direct access an effective tool for cost control |
What 3 states don't have any form of direct access? | Michigan Indiana Oklahoma |
Results of delays in HC | Higher cost Decreased fxnal outcomes Frustrated pt's seeking PT tx Eliminating referral mandate results in timely & thus more effective PT services |
Points of Opposition | PT's will miss an underlying medical dx PT's have a very low rate of malpractice & a low rate of claims filed against them Rate of malpractice no higher in states with direct access vs. states without it |
MD's say PT's cannot diagnose. What should we say? | Dx is a label for a cluster of s/sx gathered by exam & eval that is essential to guide selection of interventions. Dx is fundamental to PT practice. PT's dx don't conflict with the medical dx. They're 2 separate things. |
Inadequate Education? | PT curriculum is now "beefed up". Our textbooks are written by PT's as well as many doctors. PT's go through education on when to refer a patient to a physician or HC provider |
PT Safety | No evidence of PTs being convicted, or having had licenses revoked/suspended related to direct access, nor reports of adverse pt events |
Why should policymakers be concerned with direct access? | Allowing individuals to make decisions regarding their HC is good policy. Eliminating referral requirement is one step to making HC more accessible. |
Responsibilities of PT's with Direct Access Privilege | State's Laws Company's policies/procedures Standard of care isn't different for pt's seen by referral & those seen by direct access Necessary knowledge & skills to provide highest standard of PT without or with referral |
Is direct access required? | No, it is optional for PT clinicians |
Do liability claims increase with direct access? | There is no history of increased liability claims related to PT practice related to direct access |
Referrals | Will still be an important component of HC delivery for all professions |
When not to treat | Knowledge of when not to treat is as important as knowledge about when to treat |
Communication | Communication with relevant HC providers continues to be as important as ever, even without a referral |
Reimbursement for PT services provided under direct access | Medicare- pays w/o referral since 2005, but pt must be under care of a physician (certifies the POC) Medicaid- pt must have referral 3rd party insurance- many don't require referral but be sure to refer to contracts signed with each |