Doctors at the University of Utah have introduced a simple yet groundbreaking policy that’s making a big difference for patients with low back pain. Dr. Michael Campian and his team recognized that while treatment guidelines recommend physical therapy as a first-line approach, patients were waiting an average of four weeks or more before receiving a referral. Research clearly indicates that starting physical therapy soon after a back pain flare-up significantly improves both short- and long-term outcomes. So, the doctors asked, “Why wait for a doctor’s appointment to recommend physical therapy?”
The team instructed front desk staff to offer patients an immediate physical therapy appointment when they called for low back pain, without requiring them to see a doctor first. This new system has produced remarkable results.
With some patients requiring a doctor’s order for physical therapy and others being allowed direct access, the team naturally created two groups: one with immediate access and another with usual care. Those in the immediate-access group saw a physical therapist within 72 hours, while the usual-care group waited the typical four weeks or more. The immediate-access group achieved more than double the improvement in physical function and also saw reductions in the use of costly imaging and treatments: x-rays (24% vs. 63%), MRIs (0% vs. 16.9%), and injections (1.9% vs. 20.8%).
This approach highlights the powerful impact of starting physical therapy during the acute phase of back pain. While the concept isn’t new, the simplicity of allowing patients direct access to physical therapy from the outset has proven to be a game-changer in improving outcomes and reducing unnecessary treatments.
Source:
Campian M, Hedin T, Hansen P, et al. Rapid access to physical therapy for low back pain: a continuous quality improvement project. Presented at: Annual Meeting of the Association of Academic Physiatrists. 2017; Sacramento, CA, USA.