Direct Access Physical Therapy in St. Louis, Missouri

Direct access physical therapy in St. Louis, MO. On April 28, 2023, Missouri Governor Mike Parsons signed SB 51 into law, making it possible for residents of St. Louis and all of Missouri to access physical therapy without a referral from a physician. The new law allows St. Louis patients who need physical therapy to get the treatment they’re looking for without having to pay or wait for doctor’s appointments.

While Axes has a trusted network of physician partners in St. Louis we consistently work with, we also recognize that direct access physical therapy breaks down many barriers for St. Louis residents. Our occupational and physical therapists in St. Louis have one goal: to get you back to the activities you love safely and effectively. We do that by using our expertise in movement health and the musculoskeletal system to diagnose conditions limiting your function and mobility, and creating evidence-backed treatment plans personalized for your unique situation. If you’d like to learn more about direct access physical therapy in St. Louis, or want to start on the road to a healthier you today, contact us online or call the Axes location nearest you.

What Is Direct Access Physical Therapy in Missouri?

Physical therapy has long been a cornerstone in helping individuals recover from injuries, manage pain, and restore their regular functions. Historically in Missouri, the journey to physical therapy required several steps, starting with a visit to a physician. After a comprehensive assessment of the patient’s condition, the physician would then refer them to a physical therapist, ensuring they receive the appropriate care tailored to their specific needs.

The primary reason for requiring a physician referral previously was to ensure that patients received an initial diagnosis from a medical doctor, confirming that physical therapy was the appropriate treatment. However, in some cases that meant that St. Louis and Missouri residents who clearly needed physical therapy had unnecessary delays in accessing treatment. Previous law also didn’t take into account the expertise that licensed physical therapists in St. Louis offer when it comes to diagnosing musculoskeletal issues.

Enter Direct Access Physical Therapy With Missouri Senate Bill 51

The Missouri chapter of the American Physical Therapy Association had been trying to pass direct access physical therapy in the state for 10 years. Missouri Senate Bill 51 seeks to eliminate certain barriers to physical therapy in St. Louis. The act states:

This act modifies provisions relating to the practice of physical therapy. Under this act, physical therapists with a doctorate of physical therapy or 5 years of clinical experience may evaluate and initiate treatment on a patient without a prescription or referral from an approved health care provider. Physical therapists may provide certain educational information, fitness or wellness programs, screenings, and consultations without a prescription or referral regardless of whether a patient is symptomatic.

Other provisions of SB 51 include:

• It repeals existing provisions that limited the ability of physical therapists to examine and treat specific conditions or injuries without a prescription or referral.
• Physical therapists are required to refer patients to an approved health care provider if
  • The patient’s condition is beyond the scope of physical therapy practice;
  • The patient does not show measurable or functional improvement within ten visits or 30 days (whichever is sooner).
• After ten visits or 30 days (whichever comes first), a physical therapist:
  • Must consult with an approved health care provider before continuing therapy if the patient’s condition has improved and further therapy is deemed necessary;
  • Must provide specific information to the health care provider during this consultation;
  • Shall proceed with continued therapy based on input from the provider;
  • Must notify the provider of ongoing therapy every 10 visits or 30 days unless directed otherwise by the provider.
• The Missouri Board of Registration for the Healing Arts can:
  • File complaints against a physical therapist for evaluating or treating a patient inconsistently with the provisions of the act and existing laws related to the scope of practice for physical therapists.
  • This replaces the previous provision where the Board could complain about a therapist practicing without a prescription and direction from specific healthcare providers.

Professional physical therapists in St. Louis, like those at Axes, are experts in the musculoskeletal system. Direct access physical therapy allows us to use our expertise to best serve our St. Louis communities, while providing safeguards when the expertise of a medical doctor is necessary.

Benefits of Direct Access Physical Therapy in St. Louis

The general aim of direct access physical therapy is to make it more accessible to people affected by certain conditions in St. Louis and throughout Missouri. In doing so, it offers the following benefits:

• Timely intervention — Direct access allows patients to receive care promptly. Early intervention can lead to quicker recovery and can prevent minor issues from becoming major problems.
• Reduced costs — By eliminating the need for a physician referral, patients can potentially save on consultation fees, imaging tests, and other related expenses. Moreover, early physical therapy intervention might reduce the need for more expensive treatments or surgeries down the line.
• Streamlined care — Direct access reduces the number of steps in the care-seeking process. Patients no longer need to schedule and attend a separate doctor’s appointment before starting therapy.
• Empowerment and convenience — Patients have the autonomy to choose their physical therapist and initiate treatment on their terms, leading to a more patient-centered care approach.
• Decreased medication use — Physical therapy can offer pain relief and functional improvement without relying on medications, especially opioids or other painkillers. Direct access can thus help in reducing reliance on medication by providing an alternative pain management solution.
• Improved outcomes — Some studies have shown that patients who access physical therapy directly have similar or even better outcomes compared to those who go through the traditional referral pathway.
• Enhanced patient satisfaction — Direct access physical therapy can improve patient satisfaction through reduced costs and improved patient outcomes.
• Reduced burden on primary care — Direct access can alleviate some of the demands on primary care providers, allowing them to focus on patients who require medical interventions.
• Preventative care — Direct access also allows patients to consult physical therapists for preventive measures, potentially avoiding injuries or conditions from worsening. Before direct access physical therapy was legal in Missouri, you still needed a prescription to see a physical therapist even if you did not have a specific injury or ailment.

What Direct Access Physical Therapy in St. Louis Does NOT Mean

While direct access physical therapy in St. Louis offers a new level of convenience for autonomy for certain patients, there may be some misconceptions about when it’s appropriate and who it’s appropriate for. It’s crucial to clarify what direct access physical therapy does not imply:

• Not a replacement for physicians — Direct access doesn’t mean that physical therapists are replacing the need for physicians or their expertise. Physical therapists and physicians have distinct training and skill sets. While physical therapists can evaluate and treat many musculoskeletal conditions, physicians play a vital role in diagnosing and treating a wide range of medical conditions, prescribing medications, and offering specialized medical interventions.
• Not comprehensive diagnosing — While physical therapists are trained to evaluate and diagnose issues related to movement, posture, and musculoskeletal health, they cannot diagnose all health conditions. For instance, if a patient presents with symptoms that could be indicative of a more systemic issue or a condition outside a physical therapist’s scope, a physician referral is both necessary and in the best interest of the patient.
• Still a collaborative approach — Direct access doesn’t diminish the importance of collaboration between healthcare professionals. Physical therapists often work closely with physicians, sharing insights, discussing patient progress, and determining the best course of action. This collaborative approach ensures comprehensive care, and will still be used when necessary.
• Not a one-size-fits-all — Every patient is unique, and direct access may not be suitable for everyone. Some patients, especially those with complex medical histories or undiagnosed symptoms, can benefit from a physician’s evaluation before starting physical therapy.
• Not ignoring red flags — If a physical therapist identifies “red flags” or symptoms suggesting a more serious underlying condition during an evaluation, they will promptly refer the patient to a physician or specialist for further examination.
• Not bypassing insurance stipulations — While the law may allow for direct access, some insurance policies might still require a physician’s referral for reimbursement.

When to Use Direct Access Physical Therapy in St. Louis (and When Not to)

When to Use Direct Access Physical Therapy

Here are scenarios where direct access physical therapy in St. Louis might be your best choice:

• Minor injuries — If you’ve experienced a recent minor injury like a sprain, muscle strain, sports injury, or a simple fall, and you’re confident about its nature and a physical therapist can reliably diagnose it, direct access can offer immediate assessment and intervention without the burden of seeking a referral.
• Chronic pain treatment — For those dealing with persistent pain, especially related to musculoskeletal issues like low back pain, osteoarthritis, or repetitive stress injuries, starting with a physical therapist can provide relief and management strategies.
• Injury prevention — If you’re aiming to prevent potential injuries, whether you’re an athlete or have a physically demanding job, direct access physical therapy allows you to consult with a physical therapist for guidance and exercise regimens.
• Recurring issues — For conditions or issues you’ve experienced before and have been diagnosed previously, such as recurrent lower back pain, direct access physical therapy can help you address the problem without going through the process of obtaining a referral again.
• Wellness and fitness consultation — If you’re looking to optimize your fitness routine, seeking advice on safe exercises, wanting to ensure you’re using the correct techniques, or even just starting a beginner running program, a physical therapist can provide valuable insights and help you optimize your wellness journey.

When NOT to Use Direct Access Physical Therapy

Despite the improved patient outcomes that direct access physical therapy can offer, there are still many occasions where a collaborative approach between you, your physical therapist, and your St. Louis physician is preferable:

• Severe or acute injuries — In cases of major trauma, suspected fractures, dislocations, or other acute conditions, immediate medical attention is vital. These situations typically require an emergency room visit or consultation with a specialist.
• Complex medical histories — For individuals with intricate medical backgrounds or multiple health conditions, a physician’s evaluation ensures that all aspects of their health are considered before starting physical therapy.
• Red flags — If you exhibit “red flag” symptoms, which might indicate a more severe underlying condition (e.g., unexplained weight loss, night sweats, persistent fever), it’s essential to consult a physician before seeking physical therapy.
• Systemic or non-musculoskeletal symptoms — If your symptoms seem to be related to systemic issues, like digestive problems, respiratory issues, or heart-related symptoms, it’s critical to first consult with a physician to rule out conditions that fall outside the scope of physical therapy.
• Pre/Post-surgical rehabilitation — Physical therapy is often used to help patients prepare their bodies for surgery and to recover strength and mobility after surgery. Pre- and post-surgery rehab requires an active collaboration between a physician and your St. Louis physical therapy team.

While Axes’ St. Louis physical therapists can assist in the treatment of any conditions affecting your mobility and movement health, the above situations are examples of when a corroborative approach with our team and a physician in St. Louis is both necessary and leads to better patient outcomes.

When in doubt, you can always come to any Axes’ Physical Therapy Location near you for a free injury screening, and our licensed physical therapists will be able to tell you if we can begin treatment or if we need to refer you to a physician.

How to Get Started With Direct Access Physical Therapy in St. Louis

If you’re looking for direct access physical therapy in St. Louis, Axes offers a variety of services that can help you regain strength and mobility, and get you back to the things you love doing most. Here’s how you can get started with Axes today:

• Check with your insurance — While Missouri law now allows direct access physical therapy, some insurance carriers in St. Louis still require a physician referral to cover the costs, so check with your insurance about their process. Don’t have insurance? Direct access physical therapy isn’t covered? Axes offers affordable cash-based options that will give you access to the recovery options you need to provide long-term value without breaking the bank.
• Schedule an appointment — You can come to any of our locations for a free injury screening and initial evaluation. This will help us understand your needs and goals, and determine if we can move forward without a physician referral.
• Prepare for your first visit — Write down any issues, concerns, or questions you have so you won’t forget to bring them up when you meet your St. Louis physical therapist. Wear loose clothing as you may do some light stretching or moderate exercise.
• Follow your treatment plan and communicate — All of our treatment plans are completely customized based on your individual needs, and are based on proven, scientifically-backed treatment modalities. Your Axes physical therapist in St. Louis will form a team with you (and, if needed, your doctor) with the common goal of getting you back to the activities you love.

Call Axes For Your Direct Access Physical Therapy in St. Louis Today

Whether you’re itching to get back on the court, want to start a new workout routine, or just want to be able to play with your grandkids without pain, don’t let anything stand in the way of getting back to the things you love doing most. With our blend of expertise, compassion, and state-of-the-art facilities, your journey to a healthier, more capable you is in the trustworthy hands of our licensed St. Louis physical therapists. Don’t let pain or mobility issues hold you back any longer. Call the Axes location nearest you or request an appointment online for your direct access physical therapy today.