For years the U.S. Military has been utilizing a direct access model to physical therapy as the first option for musculoskeletal injuries. The initial installation of physical therapists was due in part to treating the needs of American soldiers in WWI, and in 1942, physical therapists started receiving relative military ranks. The increased need for physical therapy through WWII led to the development of training programs that continued to spread through military engagements around the world. Military physical therapists have served through many deployments, reducing unnecessary medical evacuations of service members with musculoskeletal injury by almost 20%.
A number of factors led the Army to begin utilizing therapy as a primary care option in 1971. The leading concern was the immense number of patients with neuromuscular problems in conjunction with a shortage of orthopaedic surgeons. To alleviate the lengthy delays and get the soldiers treated quicker, Army physical therapists began serving as independent practitioners to provide primary care to these neuromuscular patients.
While at first there appeared to be reservations over the potential of missed or incorrect diagnoses, the therapist’s education and clinical experience proved to be quite valuable. The Army developed protocols for continuing education, quality assurance and a doctorate program to expand said efforts. Therapists in the Army now have the ability to order x-rays, bone and CT scans and MRIs. They can now restrict work duties, prescribe medications like analgesics, muscle relaxants, and NSAIDs, and have become responsible for admitting and referring patients to a variety of specialty clinics for medical evaluation.
Many states are seeing the benefits of unrestricted access and adopting more of the Army’s care model in lessening those restrictions. Direct access in the US Army has been advantageous, leading to its continued use today. Patients with neuromuscular complaints are receiving prompt evaluations and are able to start treatment more quickly. Additionally, the number of sick-call visits has decreased and physicians are being utilized far more efficiently than before. With over 40 years of positive results and no record of legal action brought against an Army physical therapist, they now operate in all areas of the Armed Forces, including Army medical facilities across the country.
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