Direct Access and Medical Screening in Physical Therapy

Many people visit a physical therapist after seeing a physician and being given a prescription to start physical therapy.  However, this is not the only scenario a patient can be seen by a physical therapist. In New Jersey, as well as all the other states in the country, there is “direct access.” This allows a patient to be treated by a physical therapist without a physician referral.

What is direct access and how does it work?

The American Physical Therapy Association defines direct access as, “the legal right to seek and receive the examination, evaluation, and intervention of a physical therapist without the referral from another health care provider.” This means you don’t have to wait a couple of weeks to get an appointment with a physician. This can be a big help when someone is in pain or just unsure of what to do when they are having difficulty doing activities in their everyday life. The next question becomes: how do physical therapists know what to do without a physician referral?

The profession of physical therapy has gone through many changes in the past 20 years, which is as long as I have been practicing. In the past, it was at a bachelors’ level, and then a master’s level, which I got in 2000. Since then the profession has evolved into a doctoring profession.  Older more experienced therapists were given the opportunity to go back to school and get their doctorate in physical therapy, which I did in 2011.  All this advancement in the education levels of our profession has made physical therapists more than capable to see patients without a physician referral.

What’s different about an evaluation using direct access?

Virginia Mason

When a physical therapist sees someone via direct access the first question that we look to answer is if a patient is appropriate to be at physical therapy.  Your physical therapist will direct your care in the right direction.  He or she will also provide you with whatever type of education you need. This is helpful because waiting to see a physician will only create a longer period of time before relief can occur.

How do physical therapists determine if physical therapy is appropriate?

Physical therapists have many movement-based tests and questionnaires we use to aid in the decision-making process.  This allows us to determine your appropriateness for physical therapy.  Some of the screening tests look at how you move on your feet and isolate different body parts. Others use research-based questionnaires to screen for certain problems or rule out various diagnoses. Physical therapists also do a standard examination looking at your range of motion, strength, and joint motion.  This allows us to isolate the areas that are problematic. We take all this information and determine what is best to help you achieve your goals.


In summary, physical therapists are able to see patients without a physician referral. This is something that doctors of physical therapy have been trained in.  At BSR, most of our therapists have gone on to become board-certified specialists in either orthopedic or sports physical therapy.  These advanced certifications make us even more capable and confident in providing the best possible care.  Direct access can be a very useful tool to allow patients to get care quickly and safely.  When physical therapy is not appropriate, you will be referred to the proper health care provider. Give us a call and see if direct access is right for you.


Subscribe to Our Newsletter and Receive Similar Articles

Want to move better without pain? Join thousands of others who subscribe to our newsletter and get exclusive access to more helpful tips and exercises. Here's an example issue of our newsletter, so you can get a preview of what you are signing up for.

* indicates required