You Do!!! That’s right. Many people don’t know it but you have a right to choose your provider. You have freedom to choose where you go for physical therapy with the exception of a small number of self insured companies and HMO Plans.

All patients have a common law right, based upon court decisions, to control the care provided to them, including who renders it. Thus, when patients voluntarily express preferences for certain providers, their choices must be honored regardless of the payor source or type of care.

Federal statutes of the Medicare and Medicaid Programs guarantee Medicare beneficiaries and Medicaid recipients the right to freedom of choice of providers (Medicaid recipients may waive this right if they participate in waiver programs). Consequently, when Medicare patients and non-waiver Medicaid patients voluntarily express preferences for providers, these choices must be honored.

Here are a couple web sites to check out regarding your rights. The first is FirstGov for Consumers at www.consumer.gov and the second is the United States Department of Health and Human Services at www.hhs.gov .

In Arizona, a direct access state, you can make an appointment with a physical therapist directly without a physician referral. Over the past several years, the American Physical Therapy Association (APTA), in cooperation with each state’s Physical Therapy Association, has lobbied congress for Direct Access in each state. Direct Access, as stated by the APTA, “is the ability of a physical therapist to provide evaluation and treatment to patients without the need for a physician referral. At this time, more than 35 states have some form of direct access as part of their state practice act. Physical therapists in states that currently have restrictions to direct access are actively working with those state legislatures to make the changes needed to permit patients/clients to have access to care.”

As the nation accepts Direct Access for Physical Therapy services, clients will now be able to go directly to a therapist for assessment and treatment. In most states, it is still required for patients to follow up with their primary care physician or specialist as a prescription for therapy services is still required to continue ongoing PT treatment. This immediate access to therapeutic care in cooperation and conjunction with the diagnostic assessment of the physicians and supporting medical community leads to a much higher rate of success in a timely manner for the individual seeking services.

Your physical therapist should coordinate care with your primary care doctor and/or specialist to assure open and direct communication with your physician. In all states and facilities, physical therapy services should be provided by a licensed physical therapist or physical therapist assistant under the direction and supervision of a physical therapist.

That said, how do you choose the best physical therapy? With over 20,000 physical therapy offices nationwide, choosing the best one can be overwhelming. The key is to research your choices so you find the office that fits your needs and provides quality care.

Here is a list of factors to consider:

• Specialty “Niche” clinics. Many private practices have specialists in a variety of physical therapy realms such as sports medicine, orthopedics, aquatic therapy, pediatrics, neurology, balance, Alzheimers, Parkinsons, Feldenkrais, and Womens Health. Look for a setting that specializes in your area of need. Next, look into the education of the staff and their experience.
• Reputation of the clinic. Referrals from friends or references are excellent ways to choose the best clinic for you. Likely if your friends and family would recommend a certain location, you will also have a good experience.
• Location and availability. Easy access in and out of the location is important as is the physical location of the practice. Find a place that can accommodate any special needs you might have. Distance to the physical therapy office, however, should not be a primary concern.
• Customer/Patient outcomes. Ask the practice if they are engaged in a national outcome study. Outcome studies will tell you the percentage of patient satisfaction, level of patient improvement after therapy, and average number of treatments required for specific diagnosis. These numbers are compared to other practices around the country and can assist in maximizing quality and efficiency of care.
• Facilities available for continuum of care. See if the facility or practice you are interested in will offer pre and post operative programs as well as post rehabilitation fitness programs. Post rehabilitation programs will help keep you healthy and out of formal physical therapy.
• Atmosphere of the clinic. Trust your first impression (ie. Phone call, front office, etc.). Evaluate the quality of the phone conversation you have with the facility and the friendliness of staff to accommodate your needs.Interview and tour the clinic. Stop by the clinic/practice a tour of the physical property. It should be clean, safe, easily accessible for your personal needs and friendly.

Locations of clinical settings include private practices where the facility is owned and operated by licensed physical therapist(s), hospital departments (in and out-patient), rehabilitation facilities(in and out-patient) for more involved and neurological/brain injury cases, and in some cases, a physician owned clinic.

The most important part of a physical therapy office is the clients and community that are served. As a profession, it is a privilege to impact lives in our community in such a positive way. Always realize, you are the consumer and you have choices when it comes to your physical therapy provider.

Laura Markey, PT, DPT, FAAOMPT
Center for Physical Excellence