Trends and Predictors of Primary Care Physician Referral to Physical Therapy in the United States, 2003-2014

August 2017

Janet K. Freburger, PT, PhD; Samannaaz S. Khoja, PT, PhD; Timothy S. Carey, MD, MPH

Carolina HWRC Project: Integration of Rehabilitation Care from the Acute to Community Setting: The Role of Physician Referral


Objectives: 1) To examine temporal trends in PCP referral to physical therapy (PT); 2) To compare these trends to trends in PCP referral to other physicians; and 3) To identify factors associated with PT referral.

Conclusions and Policy Implications

  1. The rate of PCP referral to PT has declined over time while the rate of PCP referral to other physicians has increased.
  2. Clinical factors such as age and visit reason as well as non-clinical factors such as insurance, physician characteristics, and practice characteristics were associated with PCP referral to PT.
  3. The association of non-clinical factors with PCP referral to PT suggests possible under or over-referral to PT.
  4. Further work is needed to understand the role of PT in primary care and its impact on quality of care.
  5. New healthcare models should investigate ways to integrate and improve access to PT when indicated.


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This work is funded through cooperative agreement U81HP26495, Health Workforce Research Centers, with the National Center for Health Workforce Analysis, Bureau of Health Professions, Health Resources and Services Administration, U.S. Department of Health and Human Services. The content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.