As a student
member of the Missouri Physical Therapy Association, I am writing to ask your
support for HB 2090. This legislation, also known as the “Physical Therapy
Scope of Practice”, would allow patients in Missouri to begin physical therapy
services without a referral from their primary medical doctor.


The current
requirement to obtain a referral from a medical practitioner before evaluation
by a physical therapist increases overall health care costs for the patients
and decreases functional outcomes. Direct access to physical therapy would
allow individuals to select physical therapy as their entry point into the
health care system. Research has shown that direct access care has decreased
the overall cost of health care for insurance providers and patients, which is
incredibly important in the United States, where health care costs are soaring.

The systematic review performed by Ojha et. al comparing direct access and
referred physical therapy visits revealed that patients who received therapy
through direct access had paid less, required fewer physical therapy visits
before discharge, and had overall increased satisfaction. Ojha et. al also
reported that medical practitioners generally prescribed medications or medical
imaging before referring patients to physical therapy, which would lead to
increased costs for patients and insurances. Passing HB 2090 would improve
patient access to care and decrease the number of unnecessary visits to physicians
in which patients are only requesting referrals to physical therapy.  


However, the
implementation of HB 2090 does not replace physicians and their role in health
care or change the physical therapy scope of practice. Physical therapists have
doctoral degrees with clinical education in evaluation and treatment of
patients, as well as extensive education of what conditions are treatable
within their scope of practice. Under current Missouri law and ethical
standards, physical therapists are required to refer out if patient care falls
outside the scope of their practice. Approval of the direct access law will
improve inter professional communication between health care providers and
create a mutual respect between the practices. Also, passing HB 2090 will not
increase liability risk or premiums for practicing physical therapists or
insurance companies. According to the twenty two year review of National Practitioner
Data Bank of Physical Therapists performed by Green M. et. al in 2013, there
has been no increase in malpractice claims or liability insurance premiums for
physical therapists practicing in a direct access state.


therapists and physicians have a long history of working together ot provide
the best care for their patients, which would not change with the implementation
of direct access to physical therapy. I believe it is time for Missouri to make
a change that benefits its residents. I would like to thank you in advance for
your support of HB 2090.


I'm Katy!

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