Physical Therapists Ordering Imaging and Making Direct Referrals in a Military Healthcare Setting; Two Case Studies

Physical therapists in the military are allowed some of the widest scope-of-practice privileges in the USA. These privileges include ordering imaging, making direct referrals, and serving as direct-access providers. This independent functioning model may help contribute to more efficient and effective patient care. In this study, two cases are presented to highlight the decision-making process of physical therapists who were able to order imaging and make direct referrals that contributed to successful patient outcomes. The purpose of this study is 2-fold: (1) to highlight physical therapists ordering diagnostic imaging and (2) to correlate physical therapists making direct referrals. The first case involves an active duty military female who sustained an ankle injury. She was referred to physical therapy and underwent conservative treatment with minimal progress. The physical therapist used her privileges to order imaging, interpreted the findings, and referred the patient to an experienced podiatric surgeon. The second case involves an active duty military male who sustained a knee injury. He was referred directly to physical therapy by the hospital urgent care. The military physical therapist evaluated him and determined that an orthopedic referral was necessary. Both of the prior mentioned cases resulted in successful outcomes, with patients returning to their prior level of function. In the military healthcare setting, physical therapists have a unique set of practice privileges that can contribute to timely patient management, improved patient satisfaction, and more efficient and effective care. This healthcare model may be considered in civilian settings in the future as well.