One of the many new laws that went into effect on Jan. 1 this year is a change in Michigan’s policy that will now allow patients to receive physical therapy without a doctor’s prescription. Michigan is the last state to enact such a measure, which supporters say will empower patients to make decisions about their own health, prevent treatment delays and lower overall medical costs.
“I think it’s a great step in a positive direction for all patients,” Jeffery Regan, head of the physical therapy department at Orthopaedic Associates of Michigan, told the local ABC affiliate.
Michigan’s law is more limited than those in many other states, which is why some providers view it as something of a baby step. Patients are now allowed to go to physical therapy without a prescription for 21 days or 10 treatments, whichever comes first. However, insurance providers will not be required to cover the costs of physical therapy if a prescription hasn’t been issued.
The law also allows people to seek out physical therapists for wellness (fitness) or injury prevention. In a Jan. 7 letter to the Kalamazoo Gazette, therapists Julie Rogers and Ed Orloff suggested “reducing one’s fall risk, optimizing physical performance for sport, posture analysis and ergonomic assessments” as reasons that patients might benefit from physical therapy in contexts other than addressing immediate injuries.
“Direct access is an important progression not only for the profession but will also benefit patients,” says Josh Kernen, DPT/CSCS, Bridgetown Physical Therapy. “It has been proven to be cost effective and safe to go directly to a physical therapist in many cases. Physical therapists can now be a first line of defense for musculoskeletal injuries without the need to see your primary care physician first. This will eliminate many unnecessary visits and speed up access to rehabilitation.”
Patient-Smart Physical Therapy
However, physical therapy isn’t a cure-all, and Consumer Reports recently interviewed experts with the American Physical Therapy Association to help patients know which physical therapy techniques are unlikely to produce positive results.
“Much of what goes on in [physical therapy] visits — especially exercise and hands-on therapy — can help by boosting strength, restoring flexibility and stabilizing joints. But some techniques aren’t backed by sound science and can even do more harm than good,” the resulting article, published in the Washington Post Jan. 5, reads. “And some physical therapists perform proven remedies improperly or spend too much time on things that you can do without their guidance.”
The physical therapists interviewed agreed that heating, icing and whirlpool treatments make patients feel better in the short term, but haven’t been shown to speed real recovery.
The experts also emphasized that increased workout intensity is an important part of building strength. But physical therapists sometimes don’t know how far to push patients without input. “So if you think that you can handle heavier weights or tougher exercises, say so,” the report recommends.
It’s also to a patient’s advantage, the report suggests, to get comfortable with the hands-on aspects of physical therapy, namely mobilization and manipulation. “Your therapist will probably spend considerable time poking, prodding and pushing you, sometimes in ways you wish she wouldn’t,” Consumer Reports summarizes. “Let her; it can help.”