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Direct Access/Patient Self-Referral

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
Created by: 1190550002



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