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Written by Dr. Brian A. Magna, PT, DPT, ATC
According to the most updated research in healthcare, musculoskeletal (MSK) conditions are the most prevalent in medicine and only second to the common cold for seeking care. MSK conditions affect 80% of the population in their lifetime. Another study in Spine, noted that 40% of any large gathering have experienced low back pain (LBP) recently.
The costs for these MSK conditions continues to climb with orthopedic and neurosurgeon spine surgery reimbursement greater than most other surgical procedures, with the average cost of a spinal fusion being $34,000. In another study, patients were 25% more likely to receive imaging for LBP if they went to a primary care physician and 33% more likely for imaging in an emergency care setting.
Why are we bringing all this information to you? Not just to increase awareness of MSK costs, but to introduce to you about PT First. Physical Therapy (PT) First studies have shown that early physical therapy vs. usual care in patients with recent-onset LBP has significantly reduced further incidences as well as the cost of other interventions.
Research studies have shown that when PT was performed first, the surgery rate was 3%, but when an MRI was performed first, the surgery rate was 14.3%. Injection rates were 34% when an MRI was performed first but only 12.3% with PT first. Patients were also 28.1% more likely to see a spine surgeon after an MRI but only 8.9% after seeing a PT first.
Similar studies were performed regarding costs for other MSK conditions. Going to a PT first for a knee injury generated an average healthcare cost of $819 dollars compared to $3724 of charges for going to a PT later. Across the board, overall costs for MSK conditions are significantly lower seeing a PT first rather than another healthcare provider.
PT First reduces total cost of care and has shorter durations for the entire care episode with up to 50% savings in some cases.
So where does this leave us? Just reading this information will not change the course of action for patients with MSK conditions, with first instincts for patients is still to see a non-PT provider first when dealing with a MSK condition. Physical therapists believe that PT’s can become the primary care providers of choice for MSK conditions. Another study has shown that PT’s have a 77% accuracy rate when diagnosing a MSK conditions vs, PCP’s, pediatricians, chiropractors, nurse practitioners and family medicine physicians. Only orthopedics have a higher rate of diagnostic accuracy, but remember they have the benefit of x-rays and MRI’s.
Public education regarding the knowledge base and skills of the PT is imperative if we want patients to see PT’s first for MSK diagnosis as well as quicker outcomes combined with lower costs to the patient and the healthcare system in general. Did you know that all PT’s now receive a doctorate in physical therapy and that direct access to PT’s is a law in some form in all U.S. states? In most cases, a patient can see a physical therapist without being sent by their PCP or pediatrician and have insurance cover the cost? Did you know that PT’s also specialize in orthopedics and sports medicine and see more orthopedic patients in a month than a PCP or pediatrician sees in a year? Are you aware that most physicians are not aware that patients do not need a referral to see a physical therapist? The Connecticut law for direct access to PT’s was passed in 2005 and most patients have never heard of it. Education continues to be the key.
We hope you enjoyed this article and you have become better educated in what physical therapists do and are capable of. Please call our offices in Avon or Canton with any questions as well as check us out online at magnapt.com