What to do for an ankle sprain? No Referrals Necessary

Picture this.  An athlete is running around the track at a high school track and field event.  The athlete trips and twists their ankle while rounding a turn.  What happens?

I can tell you it is not the same thing that happens in the real world.  When an athlete gets hurt, the treatment has been completely different than what the public gets.  Until now.

Traditionally, a physical therapist could only treat patients if they were referred by a physician.  In the early 2000's Highmark did a study that revealed quite a few things to the medical community.  First, the military has always allowed physical therapists to see patients without a referral.   Also, the soldiers got much better results and saved money in the process as well.  They have known this since the 70's.  Secondly, the results from the Highmark studies conducted in Pennsylvania and Maryland revealed patients recovered faster and spent less money if they went to their PT first.  

Then Direct Access was born.  Finally the public could have direct access to Physical Therapy without a referral.  Direct access means that a person should be able to directly access a service  professional that has a unique body of knowledge.  

People deserve to have direct access to a Physical Therapist.  That's not me saying it.  That's the Pennsylvania government and health insurance companies saying it.  They want to save costs and help get people back to work as fast as possible.  Just like the military and just like athletic teams.

PTs vow to help people and never hurt them.  Our medical liability insurance is less than 1000 dollars a year.  That's because PT is safe.  We use evidence and prediction rules to determine what we do.  We don't just fly by the seat of our pants.  We have a system to follow that guides our decision making process to deliver our treatments that surprisingly almost never hurt anyone.  In fact this increased independence occurred without an increase in patient malpractice claims nor an increase in our liability insurance expenses.

PTs  see ankle sprains and the same injuries over and over again.  It isn't like what a medical physician does. They are trying to figure out, not only if a person has cancer but which type of cancer a person has.  It is easy for a PT to differentiate between physical therapy cases like ankle sprains and medical cases like a fracture.  We see ankle sprains all of the time.  If it doesn't look like an ankle sprain we will know it right away.  The  red flags are easier for us to see and all of the studies show it.  We then refer patients back to a medical physician.  PTs are typically over conservative and often refer patients to physicians just to have the physicians clear the patient without any risks.  

We are not trying to steal business from physicians.  We always refer back to the physician within 30 days.  The idea is to get treatment early and get back to living your life whether on the field, at home or the office.  

Back to my original question.  What if the athlete sprained their ankle and then was told they couldn't get any treatment until they saw their primary physician first?  The athlete would go untreated for several days and get worse.  They would limp and develop compensations in their movement as well as muscle imbalances.  This in turn makes it harder for the patient to recover when they finally do get treatment which ultimately can lead to the person having lifelong problems if they wait too long.  

This is also the reason it costs more.  If the person waits, it takes more treatments and procedures to get better.  Today, we know that this doesn't make sense but up until a few years ago this is exactly the pathway the public had to go through to get treatment.

Ultrasound

There is one catch, not all PT is created equal.  Some PTs are not certified to treat people off of the street.   The therapists at Revolution Physical Therapy have went through extensive education in differential diagnosis, medical screening, pharmacology and radiology to receive our Direct Access licenses.   My residency training also allowed me to treat athletes stepping right off of the field.  It was a much different experience than most PTs, chiropractors or any health care provider gets to experience unless they work in an arena where they see fresh injuries on a daily basis. It was almost like working in the emergency room sometimes.  I had to make a diagnosis quickly and start the APPROPRIATE treatment ASAP.  It was about getting the athletes back as fast as possible and in the best shape possible.

Cryotherapy

I think people should all have access to this type of service.  Thankfully the laws have changed, and all of the insurance companies out there have changed as well.  Now everyone does have access to this service but most people don't know it yet.

Please send this to anyone who could benefit from learning this information.  Times are changing and we are experiencing a Revolution.  People need to have the best information possible to be able to consume their health care.
 
Any questions?  Please do not hesitate.