Oklahoma House Passes Physical Therapy Referral Bill

The Oklahoma House passed legislation Wednesday that allows physical therapists to treat ailments without a prior referral from a doctor or other medical professional.

The House voted 68-21 for the legislation and sent it to the state Senate, where similar legislation is being considered.

The bill removes restrictions in current state law that require a doctor or other medical professional, such as a dentist or podiatrist, to refer a patient before a physical therapist can diagnosis and treat an ailment.

Rep. Arthur Hulbert, R-Fort Gibson, the bill’s author and himself a physical therapist, said allowing physical therapists to treat human ailments without referrals would lead to fewer unnecessary physician visits and help lower health care costs. Hulbert said 48 other states already have some form of direct access to physical therapists without physician referrals.

Opponents said physical therapists need physician oversight because they do not have the same level of education and training to reliably diagnose a patient’s disorder.

“You might have a pain in your arm and have a heart attack and think it’s just a pulled muscle,” said Rep. Pam Peterson, R-Tulsa, whose husband is a physician.

Physical therapists are an important part of the medical team that includes a variety of allied health professionals, she said.

“But they are not the captain of the ship,” Peterson said. “They’re not trained to discover cancer.”

Rep. Mike Ritze, R-Broken Arrow, also a doctor, described the bill as “an expansion of scope” for physical therapy professionals that should require them to receive the same level of education and training as doctors.

But another physician, Rep. Doug Cox, R-Grove, said he supported the bill and believed physical therapists “have a wonderful knowledge and get wonderful results.”

Cox disagreed that the measure would expand the scope of physical therapy practice because the legislation does not allow them to do anything more than they already do. Physical therapists are primarily concerned with impairments and improving mobility and movement through diagnosis and physical intervention.

Hulbert acknowledged that the training physical therapists receive is different than that of medical doctors.

“Physical therapists are not trying to be MDs,” he said. But Oklahoma ranks second in the nation in the level of restrictions on physical therapy practice and ranks among the worst in the nation in health outcomes for its citizens.

He said opponents of the bill had implied that removing the physician referral restriction would threaten patient safety.

“It is safe? Yes,” Hulbert said.