Can you see a physical therapist without a referral?

Can you see a physical therapist without a referral?

Can you see a physical therapist without a referral? The answer is yes! One of the things I touch on in my interview with Caitlin Casella is wanting to normalize the idea of physical therapists and other pain centered movement coaches as the first line of care with musculoskeletal related pain. The standard protocol for a long time has been a visit to your primary care physician first who will make an assessment, rule out anything serious, and then refer you out to a physical therapist. As Caitlin explains on the podcast, physical therapists are now undergoing more advanced training to be able to rule out serious conditions during an initial visit. That’s what differentiates a Doctor of Physical Therapy (DPT) from a Masters in Physical Therapy. So you may not have to go through your PC the next time you have a chronic pain issue and want help.

Why might you want to see a DPT?

In our standard-of-operation for medical care, there can be a pattern of over-medicalization of a simple pain issue that results in a downward cycle (I write about that downward cycle here and share how it can play out in an example with my client here.) The story often goes like this:

1. you experience a pain that starts to nag.
2. You might ignore it for a while but it persists.
3. You go to your primary care physician who then refers you to an orthopedist or orthopedic surgeon.
4. Meanwhile, a few weeks have gone by where you might be worrying and/or avoiding physical activity.
5. The specialist then needs imaging. Add a few more weeks.
6. The imaging comes back, something shows up on the scan, and then you're recommended to go to physical therapy -- or in some cases to a surgeon.

At least 6 weeks have passed now since you initially scheduled your appointment with your PC, 6 weeks of lost opportunity to work with someone who can immediately help you get moving, educate you about your pain, and rehab your painful part. Not only is there lost time, but depending on the imaging, the radiologist, and the specialist, you might be primed with fearful messages such as, "You should stop most physical activity for a few weeks," or "Your knee is almost bone on bone, which explains your pain," or "Your hips are in pretty rough shape." These messages are often misleading and not paired with a more complete picture about how pain works. Furthermore, once uttered, they cannot be 'unheard' and can contribute negatively to the way you think about your body and therefore move it -- which contributes negatively to your current and future pain state.

Fun fact: Even the military has decided to use physical therapy as the first line of care for musculoskeletal injuries because it's more effective in terms of treatment and in terms of the financial burden for the patient and the healthcare system as a whole.

Get straight to healing!

There are a lot of caveats here -- clearly acute injuries and other chronic injuries within a more complex context require different kinds of attention. The main point I'm trying to share is that going the primary care route is about diagnostics while going the physical therapy route is about healing. While it's not strictly one or the other, you can drastically speed up your recovery time if you head toward the healing route first. You may not actually need the diagnosis -- the diagnosis, which is sometimes just an educated guess, is often irrelevant to the healing process (and can sometimes even impede the healing process!). This is a bold statement that includes several concepts within it. Just keep following along :) and we'll cover these concepts in greater detail over time.

How this model fits into The MOB

One of our goals at The MOB is to keep our members moving while initiating the rehab process immediately. Two of our coaches are DPT’s, one is a pain coach, and two others are strength coaches with a comprehensive understanding of musculoskeletal pain. This awesome team that teaches a combination of 12 strength and mobility classes a week helps our members address any aches and pains as soon as they start.

• No doctor’s visits — make an appointment right with your coach OR talk to them before or after class.
• No waiting rooms — our coaches are fully present with you when you schedule time with them.
• No excessive paperwork — you’re already part of The MOB!
• No endless exercise print-outs — our coaches work with you during class and will give you tailored-to-you exercises if you schedule a 1:1 session with them. Nothing is cookie-cutter!

Interested in joining The MOB? Learn more here.

keep moving, alia