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Implementation of Direct Access Physical Therapy Within the Military Medical System
Eliza Szymanek1, Megan Jones1, Casey Shutt-Hoblet1
1Madigan Army Medical Center, JBLM, Tacoma, WA 98431, USA.
Military Medicine
|July 10, 2021
Summary
Direct access physical therapy (PT) for musculoskeletal (MSK) injuries in the military significantly reduces healthcare costs and lost duty days. This initiative optimizes military healthcare by leveraging PT expertise for improved readiness and reduced long-term disability.
Area of Science:
- Military health
- Musculoskeletal (MSK) medicine
- Healthcare optimization
Background:
- Physical therapists (PTs) are musculoskeletal (MSK) experts serving in direct access roles within the military since the Vietnam War.
- Direct access PT has historically reduced imaging, medication, and overall healthcare utilization.
- Military readiness is the highest priority, necessitating efficient healthcare resource allocation.
Purpose of the Study:
- To implement and evaluate a readiness-focused direct access physical therapy (PT) initiative at Joint Base Lewis-McChord.
- To assess the impact of direct access PT on healthcare utilization, costs, and duty days lost to MSK injuries.
- To optimize the military healthcare system for acute MSK injury management.
Main Methods:
- Initiated a direct access PT sick call program in May 2018.
- Developed an algorithm for screening and identifying appropriate service members for direct access PT.
- Established dedicated PT sick call hours across seven clinics.
Main Results:
- Completed 3,653 initial PT evaluations in the first 18 months.
- Common injury locations included knee (26%), ankle (26%), low back (16%), and shoulder (15%).
- Estimated potential savings of $3.6 million in healthcare utilization costs.
Conclusions:
- Direct access PT optimizes military healthcare, reducing costs and lost duty days.
- This model decreases imaging, days on profile, and referrals to specialty care.
- Integrating PTs into the acute MSK injury management team is crucial for military readiness.
