The Benefits of Seeking a Physical Therapist FIRST:

by Dr. Ashley O'Rourke PT, DPT, ATC, LAT

"Doctors of Physical Therapy are trained to evaluate and treat a variety of conditions ranging anywhere from chronic low back pain to incontinence to stroke. But why see a physical therapist before another provider?"

Doctors of Physical Therapy are trained to evaluate and treat a variety of conditions ranging anywhere from chronic low back pain to incontinence to stroke. But why see a physical therapist before another provider? According to a study of 150,000 insurance claims, patients with low-back pain are actually better off seeing a physical therapist first in regards to alleviating their pain. The study, published in Health Services Research, found that those who saw a physical therapist at the first point of care had an 89% lower probability of receiving an opioid prescription (therefore avoiding the risk of addiction), a 28% percent lower probability of having advanced imaging services performed (saving the patient money), and a 15% lower probability of an emergency department visit. It did, however, show a 19% higher probability of hospitalization- but why is this a good thing?

This higher rate of hospitalization indicates proper referrals by PTs to specialized care when pain does not resolve by addressing potential musculoskeletal causes first and, instead, may indicate a more serious issue such as an underlying systemic condition: heart conditions, renal failure, cancer etc. Not only can physical therapy make you feel better, but it can reduce the cost of unnecessary imaging, reduce potential dependence on pain medication and "catch" potential underlying conditions early leading to better treatment options and outcomes for such conditions.

Why seek care from a DPT over a PT or PTA?

The ability to recognize and properly refer patients who present with conditions that do not appear to be musculoskeletal in nature is one reason why seeing a DPT, or Doctor of Physical Therapy, would be advisable over seeing a PT, MPT or PTA. This ability to screen patients for various non-musculoskeletal conditions is one reason why the doctorate level degree was developed in the first place. These DPTs have had additional coursework focused on recognizing yellow/red flags for general medical conditions that may not be treatable with physical therapy. They have also had more education on the nature of such comorbidities leading to a more holistic approach to therapy.

Did you know that physical therapists can specialize in certain areas of PT?

Although 42% of consumers know that physical therapy can only be performed by a licensed physical therapist, 37% still believe other health care professionals can also administer physical therapy. What they may also not know is that additionally, many Doctor's of Physical Therapy choose to pursue board certification by the American Board of Physical Therapy Specialties (ABPTS) in specific areas such as neurology, orthopedics, sports, pediatrics, geriatrics, electrophysiology, cardiovascular & pulmonary and/or women’s health. Though definitely not required, seeking treatment from a DPT with these credentials gives you the opportunity to obtain even more specialized care.

Specialty Credential Designations:

• CCS (Cardiovascular & Pulmonary Certified Specialist)

• ECS (Clinical Electrophysiologic Certified Specialist)

• GCS (Geriatric Certified Specialist)

• NCS (Neurologic Certified Specialist)

• OCS (Orthopaedic Certified Specialist)

• PCS (Pediatric Certified Specialist)

• SCS (Sports Certified Specialist)

• WCS (Women’s Health Certified Specialist)

In order to become specialized, PTs must: 1) have current licensure to practice physical therapy in the United States, Puerto Rico, or the Virgin Islands; and 2) have at least 2,000 hours of direct patient care in the specialty area (25% of which must have occurred within the last 3 years). Additional specific requirements are required by each specialty area. PTs must pass the specialist certification examination and be recognized by the American Board of Physical Therapy Specialties to use the above designations.

Doctor of Physical Therapy vs Physical Therapy Assistant vs Physical Therapy Tech/Aide:

Physical Therapist (PT): Physical therapists are licensed professionals who have completed an accredited physical therapist program (degrees have evolved from 4 year bachelor degrees to 7 year clinical doctoral degrees) and have passed a licensure examination.

Physical Therapist Assistants (PTA): are educated at the associate degree level. Depending on state law, they may be licensed, certified, registered, or unregulated depending on the state. PTAs may only provide physical therapy services under the direction and supervision of a physical therapist (PT). They may not perform evaluations, re-evalutions, discharges or alter the plan of care. They may only execute the plan of care established by the PT.

Physical Therapy Aides/Technicians: have no regulatory designator. Physical therapy aides and technicians are on-the-job-trained workers in the physical therapy clinic who assist the PT/PTA with tasks related to physical therapy services. They are not eligible for license, certification, or registration.