May 2018

PT Referral Rates Nearly Halved Between 2003 and 2014

A study recently published in the April issue of Journal of General Internal Medicine has found that primary care physician referrals to physical therapists for musculoskeletal conditions declined by nearly half over a 12-year period, while referrals to specialists during that time increased by a similar rate. The researchers analyzed data from the National Ambulatory Medical Care Survey for all musculoskeletal-related visits from 2003 to 2014.

The survey captures data on patients and visit characteristics, diagnoses, services, and ordered tests and includes referrals for physical therapy. The rate of referral to physical therapists decreased from 94.4 per 1000 visits to just 42.9 per 1000 (−45.4%), with similar trends noted in 3 diagnostic subgroups: arthropathy, spine disorders, and soft tissue disorders. Referrals to specialists increased at approximately the same rate over the 12-year period studied.

Although the authors drew no conclusion as to why this trend is occurring, they re marked that it is at odds with the current direction of health care, saying the need for allied health care providers for delivery of high-value care will likely continue to grow.


Freburger JK, Khoja S, Carey TS. Primary care physician referral to physical therapy for musculoskeletal conditions, 2003-2014 [published online April 5, 2018]. J Gen Intern Med. 2018: doi: 10.1007/s11606-018-4426-6.

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