If you see a ortho/walk-in doctor or primary care physician for a certain body part that is hurting and they refer you to physical therapy for that body part, your physical therapist (PT) can only treat you for that specific body part!

Scenario 1 (Modern Healthcare): You are updating your home and have painted all weekend, as a result, your shoulder has been hurting and after a week of resting it, it's not going away. So you decide to go to your doctor to get the shoulder checked. You pay your insurances' co-pay to see the doctor, you pay for $80 worth of x-rays to find nothing is wrong with the bone and then are referred to physical therapy. A few days later you begin to have mid back pain which you bring up to your PT. Your therapist reluctantly tells you they cannot treat you for your mid back because the referral was only meant for the shoulder. In fact, you would have to see a physician again to get another referral specific to your back. But why? Your insurance largely dictates who you can see and what you can be seen for.

Scenario 2 (Cash-based private PT): You are updating your home and have painted all weekend, as a result, your shoulder has been hurting and after a week of resting it, it's not going away. You schedule directly with your concierge PT, and pay a flat fee with no co-pays. A few days later you begin to have mid back pain which you bring up to your PT. Seeing a cash provider, we can tackle both at once! No need for another referral or co-pay.

This is an all too common scenario. See the difference?

In today's health care world your insurance tells you that you must have a referral to see physical therapy. Did you know you can go straight to your physical therapist?

Meet Elsa

(True story though name has been changed to protect identity)

Elsa is a 59-year-old grandmother who was recently playing at the beach with her grandchildren when she tripped on a beach towel and fell both knees into the sand. Elsa has dealt with knee pain before and has been told by an orthotist that she is "bone on bone". She waits some time for her pain to subside on her own, but it does not and now she is having trouble walking at work. So she visits walk-in orthopedics and pays her insurance co-pay to see the orthotist. She receives x-rays (as is customary for ortho walk-in) and is told she has bone-on bone. It is recommended she receive an MRI and was given an anti-inflammatory for her pain. She received an MRI the next day (a several thousand dollar cost) with no significant conclusions and no changes since her last MRI. Another week goes by with no improvement even though Elsa has taken time off of work, she returns back to walk-in (pays another co-pay) and sees a different provider. This provider looks over her history and decides to try a cortizone injection (another cost) and then gives a different script for pain medication. He also recommends that she see her primary care physician. Elsa follows up with her primary provider two weeks later (as she had no availability to get in sooner), pays another co-pay and as a last resort is recommended to see physical therapy. Elsa has been seen in physical therapy before for her knee pain. She describes her situation and recent injury to the therapist and was seen in two visits with "amazing improvement" from her home exercise program and hands-on techniques provided by the therapist.

Does this assembly line of providers sound familiar? By the time you actually receive direct and specific conservative treatment for your injury, you've spent thousands of dollars out of pocket (co-pays, imaging, medication, injections, office visits) this is especially true if you have a high deductible. And because of the busyness of today's hospitals and clinics, long waits to gain access to providers can often take weeks, maybe months - long enough for your acute injury to turn into a chronic condition which can lead to compensations that can cause havoc on your body. Did you know that you can bypass that assembly line of providers? Most states have direct access which means you can go directly to a physical therapist for treatment, without a doctor referral which means less cost in the end , less hassle and faster resolution of your pain so you can get back to doing what you love.