Your Path Forward

In other countries, it’s common to have your “primary care provider” and your “physio”. If you’re sick, you go to your primary care provider. If you’re hurt, you go to your physio. This concept hasn’t been used in the United States, but why? How might you benefit from having a physical therapist as your go to provider for when you’re hurt? 

Benefits of partnering with a Physical Therapist (PT)

In the United States, it’s commonplace to go to your doctor for any medical concerns, including back pain, shoulder pain, and other musculoskeletal conditions. Maybe it’s a physician, or in some cases, it’s a nurse practitioner or physician assistant. Here’s what is interesting: Physical therapists have significantly more training and education for diagnosing and treating musculoskeletal conditions.

When you compare the training side by side, the differences are glaringly obvious. Why wouldn’t we want someone with significantly more training and education to manage our musculoskeletal health? Well, maybe, it’s because of the societal norms that have been established.

A Brief History on Direct Access

Until the 1960s, physicians were the only provider to manage patients in the United States. Unfortunately, there weren’t enough physicians to care for the growing healthcare needs of society, which led to the introduction of nurse practitioners and physician assistants. The goal was to offload physicians, improve timely care, and expand care opportunities for those who may be interested in working in the healthcare industry. 

So, where does physical therapy fit into the mix? Physical therapy has been widely known as a secondary care option under physician, nurse practitioner, or physician assistant’s guidance, until recently. In 2000, the American Physical Therapy Association (APTA) developed “Vision 2020”, which would change the physical therapy profession in two primary ways: 1) become a doctoral profession and 2) become direct-access providers, which means you can see a PT without a referral. (APTA, 2000) Since then, these goals have been accomplished. All physical therapist programs in the US are now doctoral programs, and physical therapists in all states now have some level of direct-access privileges. Beyond that, many jurisdictions now allow physical therapists to order clinical imaging, such as x-rays and MRIs, and the APTA recently wrote position statements supporting physical therapists ability to prescribe medication and order laboratory tests. (APTA, 2025)

How does this compare to around the Globe? What does the evidence suggest?

As I said above, it is common in other countries to have your “primary care provider” and your “physio”. In many of these countries, they tend to be more consistent with following what best evidence suggests. For example, there are numerous high-quality peer reviewed journals that have made recommendations against particular surgeries (i.e., arthroscopic knee surgery, shoulder impingement surgery, etc.), (BMJ, 2017) and the United States tends to be one of the last countries to follow that guidance. 

We believe that this pattern has continued with how physical therapists are used in many health systems within the United States. To date, the best evidence we have suggests that patients achieve similar to superior improvements in pain and function at a better cost when cared for by a physical therapist compared to usual primary care providers. (Abuhl, 2025) If that’s the case, why aren’t physical therapists practicing in these roles? We believe that should change.

What Forward Physical Therapy is doing about it

We believe the evidence is clear: partnering with a physical therapist will allow you to optimize and manage your musculoskeletal health more effectively. Similar to going to your primary care provider for an annual “check-up” or your dentist for an annual dental hygiene exam, we would love the opportunity to partner with you in managing your musculoskeletal health. Here’s how it works: 

1. Schedule a musculoskeletal health exam
2. Complete the necessary paperwork prior to your exam
3. Meet one on one with your Forward Physical Therapist
4. Establish a plan to optimize your musculoskeletal health

Sometimes, this plan may be “you’re crushing it, but here are some ideas to further optimize your health.” In other cases, the plan may be “you have some pretty clear limitations with your shoulder strength and flexibility right now, and I think you’d benefit from seeing me 1 time per week for the next month.” On the other hand, your physical therapist may identify that you need to be evaluated by another provider, and in that case, the plan might be “I found a couple of concerning features today, and I think you should get an x-ray before we continue with our plan.”

Regardless, you can expect to receive a comprehensive evaluation of your musculoskeletal health and a tailored program to optimize your health through empowering messages.