Texans no longer need referrals to see a physical therapist


AUSTIN (Nexstar) — Texas is now the 49th state to offer patients direct access to physical therapists.

Previously, state law only allowed patients to get treated by physical therapists after they received a physician’s referral.  

“What it means is we can get the patients foot in the door sooner, which we all know that things will improve and get better sooner, the sooner that we focus on them,” said Austin Sports Medicine Director of Physical Therapy Samantha Pittsford. 

During the 86th Legislature, lawmakers passed House Bill 29, which allows a patient to see a physical therapist with a doctoral degree for up to 10 days without a physician’s referral.  

“Earlier treatment of musculoskeletal injuries leads to less pain, earlier healing and a better quality of life for Texans,” said Keri Jackson, a physical therapist with Remedy Therapy Staffing. 

Physical therapy education continues to evolve and there is a growing focus on residency and fellowship programs. If the physical therapist has a doctoral degree and additional training, like a residency, that limit under the new law goes up to 15 days. 

“It’s better than what we had before, but at least it’s a step in the right direction,” Pittsford said. 

Dr. David Teuscher, past president of the American Academy of Orthopedic Surgeons, says this law emphasizes a team effort that takes place between physical therapists and physicians. He says in his 35 years of working as an orthopedic surgeon, physical therapists have played an integral role in helping his patients with the rehabilitation process. 

“It’s really a team practice,” he said. “I think House Bill 29 is important because it will give you the ability to have independent and direct access if you have a non-operative condition. If you don’t get better, you need to see a physician.” 

Certain injuries may only need treatment from a physical therapist, but there are some other cases where a patient will need help from both professionals, he says. 

“If you have a hip fracture and you want to get back up, you want to be independent, we’ll fix your hip fracture as orthopedic surgeons,” Teuscher added. “Physical therapists will rehabilitate you, get you back up and walking for an independent life.” 

Patients will have to sign a disclosure form, acknowledging that they understand that physical therapy isn’t a substitute for a medical diagnosis by a physician and that their treatment is not based on radiological imaging. The form also requires patients to note that a physical therapist cannot diagnose an illness or disease and that a person’s health insurance plan may not cover the services. 

Though she says some areas of their professions overlap, Dr. Leonora Landers, chiropractor at Barton Creek Chiropractic, doesn’t feel like the bill will impact her industry. She also points to a need for a combined effort among chiropractors, physical therapists and physicians.  

“We can work together,” she said. “As long as we’re open to understanding the scope of practice — we very much understand what a physical therapist does. My hope is that a physical therapist is not afraid of a chiropractor and understands what a chiropractor does.” 

According to the legislation’s bill analysis, the U.S. military has allowed direct access to physical therapy since the 1970s. 

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