By the year 2015, the United States will have 62,900 fewer doctors than needed. By 2025, the number will double. Even if you don’t factor in changes in health care law, there will still be a need for over 100,000 doctors by 2025. These statistics are from the latest estimates from the Association of American Medical Colleges. But these numbers really haven’t changed much since 2010. The greatest demand will be for primary-care physicians, traditionally the gatekeepers within the current health care system..
Patients need access to care. But as it stands right now, in the current gatekeeper-driven model, they won’t get any care (or it will be expensive, emergency room-based care) because there simply aren’t enough gatekeepers (physicians).
But there is an easy solution – and physical therapists can provide it. Now.
At this moment, there are 200,000 licensed physical therapists in the United States. The precedent has been set globally. In many countries, consumers can access a physical therapist directly without a referral requirement or treatment limitation. Physical therapists have the clinical skills and training necessary to solve the problem nationwide. Physical therapists have a unique and broad-based skill set that could provide effective and appropriate care and stem the tide of consumer access issues.
It doesn’t require a physical therapist (or any other health care professional, for that matter) to “play doctor”. It simply means that physical therapists could be a direct access point for many patients. Physical therapists having the skills to provide effective and appropriate care within the scope of their training, or to refer cases on to an appropriate provider as needed.
Physical therapists can solve this problem immediately. But the devil is in the details, as they say. The current antiquated gatekeeper model would need to be eliminated to do so in the vast majority of states.
The American Medical Association, the primary group supporting a physician gatekeeper model (for all of the obvious reasons), provides us with a rather intriguing contradiction in terms. On one hand, the AMA tells us that the country is in dire straits and there is a need for more physicians to provide patients with access to care. That’s the public version. But on the other hand, behind the closed legislative doors, they are unwilling to support any means of accomplishing this that would potentially change their role in the antiquated gatekeeper model. Why? It is an issue of turf protection more so than patient access.
The patient, as we all know, pays the price for legalized monopolies. Fewer choices, less competition, delays in receiving care, higher cost, and no better outcomes given the current system.
We are in this for the patient. It is time for everyone to do what is right for the patient, and not pay lip service to the stated ideal. The numbers don’t lie – if we don’t find a new and better way, patients will go without access to care. That is simply unacceptable in today’s health care world.
Since I know that physicians truly want what is best for patients – and that access to care is a better option than none at all – I urge the AMA and state and federal legislators to support consumer direct access to physical therapy nationwide. Physical therapists can provide the solution, and they can do so now.
The patient deserves it. Stop talking about it and get it done.
Photo credits: trekkyandy
"Running Injuries: Etiology And Recovery- Based Treatment" (co-author Bridget Clark, PT) appears in the recently released third edition of "
" by S. Brent Brotzman, MD and Robert C. Manske, PT.
