Founder Letter: It’s Time for PTs to Unlock the Power of Direct Access

We as physical therapists have fought for direct access for, well, as long as I can remember. But did you know that all 50 states now have some form of direct access? Yep; thanks to all of our hard work, direct access to therapy has shifted from being the exception to being the rule. Yes, in some states, that access is limited, but still—we now have the ability to, at the very least, perform an initial exam for any patient with any insurance, including Medicare, in every single state. And yet, I know very few clinicians are actually taking advantage of this right, and I want to know why. What’s keeping us from exercising the autonomy we’ve fought so long and hard to achieve? Is it that we’re afraid of insurance companies? Are we nervous about liability? Are we not educated about the direct access laws in our states? Is it simply that we don’t know how to market ourselves to prospective patients? Or, did we neglect to plan out our strategy for capitalizing on direct access once we achieved it?

Direct access eliminates the middleman—and having no middleman changes the game, big time. Historically, we’ve relied heavily on physician referrals, thus becoming codependent in our existence and identity. We haven’t felt the need to—or challenged our own abilities to—generate business. Today, even with a marked shift in healthcare—and POPTS increasing in prevalence—we still put too much stock into physicians and insurance companies selling our strengths on our behalf, which means the general public has a very narrow perspective on what we actually do. Yes, referrals are important—and will continue to be for the foreseeable future—but we are moving into a new age of healthcare, one that gives the consumer far more decision-making power. Our codependency on insurance companies has brainwashed us into thinking that they are our partners. We’ve been made to believe that they truly value us; and yet, they continue to cut our payments. The worst part is that there are some of you out there still signing contracts for less than what it takes to run your business. Enough is enough. Direct access empowers us to serve a different audience, and that’s the consumer.

But to do that, we must take a step back and look at what we do from a consumer perspective. Essentially, it’s time for a new version of our marketing strategy. We all have to re-examine our brand—both at the individual clinic level and as an overall profession. Do general consumers really understand the meaning of descriptors like “doctorate-level musculoskeletal expert” or “neuromuscular expert”? Do they know what we mean when we say we “enhance function” or “transform society”? Terms like these have left physical therapy somewhat shrouded in mystery. And if potential patients don’t even understand what we do, they can’t possibly understand why they’d benefit from our services. As I said above, the game has changed. A business-to-consumer (B2C) approach requires a different strategy and, frankly, a different budget—one that is most likely foreign to PTs who’ve long relied on the business-to-business (B2B) approach for gaining referrals.

Of course, capitalizing on direct access requires more than a simple pivot in marketing tactics. It also demands that you reassess your customer service model, intake and medical history process, and liability insurance—not to mention your business model. (FYI: Incorporating direct access into your strategy doesn’t mean you have to go totally cash-based.)

For all of these reasons—and countless others—we’re dedicating this month’s blog and webinar to direct access. It’s one of the biggest—and most beneficial—changes that has occurred within our industry. But to reap the rewards of direct access, we have to know the laws—and how to use them to our advantage. I encourage all of you to follow this month’s materials closely, ask questions, and drive discussions. It’s taken a lot of time—and a lot of blood, sweat, and tears—to win this battle; now the challenge is doing something meaningful with what we’ve achieved.

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