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Direct Access to Physical Therapy: Should Italy Move Forward?

Filippo Maselli, Leonardo Piano, Simone Cecchetto, Lorenzo Storari, Giacomo Rossettini and Firas Mourad
Additional contact information
Filippo Maselli: Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), Campus of Savona, University of Genova, 17100 Savona, Italy
Leonardo Piano: Fondazione dei Santi Lorenzo e Teobaldo, 12050 Rodello, Italy
Simone Cecchetto: Direction of Health Professions, APSS, 38014 Trento, Italy
Lorenzo Storari: Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), Campus of Savona, University of Genova, 17100 Savona, Italy
Giacomo Rossettini: School of Physiotherapy, University of Verona, 37129 Verona, Italy
Firas Mourad: Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Luxembourg, Luxembourg

IJERPH, 2022, vol. 19, issue 1, 1-7

Abstract: Direct access to physical therapy (DAPT) is the patient’s ability to self-refer to a physical therapist, without previous consultation from any other professional. This model of care has been implemented in many healthcare systems since it has demonstrated better outcomes than traditional models of care. The model of DAPT mainly focuses on the management of musculoskeletal disorders, with a huge epidemiological burden and worldwide healthcare systems workload. Among the healthcare professionals, physical therapists are one of the most accessed for managing pain and disability related to musculoskeletal disorders. Additionally, the most updated guidelines recommend DAPT as a first-line treatment because of its cost-effectiveness, safety, and patients’ satisfaction compared to other interventions. DAPT was also adopted to efficiently face the diffuse crisis of the declining number of general practitioners, reducing their caseload by directly managing patients’ musculoskeletal disorders traditionally seen by general practitioners. World Physiotherapy organization also advocates DAPT as a new approach, with physical therapy in a primary care pathway to better control healthcare expenses. Thus, it is unclear why the Italian institutions have decided to recognize new professions instead of focusing on the growth of physical therapy, a long-established and autonomous health profession. Furthermore, it is unclear why DAPT is still not fully recognized, considering the historical context and its evidence. The future is now: although still preliminary, the evidence supporting DAPT is promising. Hard skills, academic paths, scientific evidence, and the legislature argue that this paradigm shift should occur in Italy.

Keywords: direct access; physical therapy; cost-effectiveness; scope of practice; orthopedic manipulative physical therapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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