Try Physical Therapy First! – Seeing a Physical Therapist First for Musculoskeletal Pain Improves Outcomes and Saves Money

By Dr. John R. Mishock, PT, DPT, DC


Why Should I See a Physical Therapist First Through Direct Access?

Musculoskeletal disorders are injuries or disorders affecting the body’s movement or the musculoskeletal system, secondary to pain or limited function. These disorders cost the health care system over 800 billion dollars and are the second most common cause of disability worldwide. (J Gallotti et al. Clin Med, 2023) Studies show that seeing a physical therapist first through direct access can improve musculoskeletal pain faster, reduce or remove the need for some types of musculoskeletal surgery, reduce opioid use, improve patient satisfaction, reduce expensive medical testing, and help patients get needed treatment faster. (Physical Therapy, 2017) 

“Physical therapists are licensed doctors who work with multiple patient populations impacted by disease, injury, and movement dysfunction. They optimize quality of life by maintaining, restoring, and improving patient’s ability to move, function, and live more active lifestyles.” (APTA, 2024)

What is Direct Access?

With direct access, getting the help you need has never been easier. Direct access is a law that allows you to seek care from your physical therapist without a physician referral.

Twenty-eight research studies have validated that direct access physical therapy is more cost-effective than the medical model, with better outcomes and superior patient satisfaction. The medical model is expensive compared to physical therapy because it uses imaging (X-ray, CT, MRI, ultrasound), drugs, and injections. The medical model is often essential to optimize patient care; however, physical therapy is the best option for early, noncomplicated musculoskeletal conditions. Multiple studies have shown that found that direct access physical therapy is a safer model of care than the physician-led model, with 50% fewer adverse events (3% versus 6% for the DAPT and physician-led model, respectively).  (J Gallotti et al. Clin Med, 2023) The physical therapist is well trained to determine which conditions they can manage successfully and will refer them to the appropriate specialist if the condition is beyond their scope of practice.

Consider this: early referrals to physical therapy for low back pain were over 50% less expensive than those who didn’t receive physical therapy. If low back patients sought physical therapy within 3 days of the onset of pain, it could potentially save the US economy over $7.2 billion annually. (Physical therapy, 2018)

Some insurance providers require a physician referral to physical therapy before covering the patient’s cost. That’s no problem. Before continuing your care, we can recommend you to a trusted physician or specialist.

What Can I Expect at Physical Therapy?

As physical therapists, our goals have always been to get people out of pain and back into the activities they enjoy most. Below is a list of what you can expect when you are treated in physical therapy:

  • A complete evaluation of pain and function.
  • Education on body mechanics and prevention
  • Manual therapy
  • Taping/bracing
  • Strength/endurance/motor control
  • Flexibility/ROM activities
  • Gait and balance training
  • Biomechanical and functional retraining
  • Aquatic therapy (Gilbertsville office)

*Direct Access is not applicable to patients in federal or state-funded programs, such as Medicare, Medicaid, or Tricare.

We can help!

We at Mishock Physical Therapy and Associates can be your first stop for any aches, pains, or injuries impairing your quality of life. Visit our website to learn more about our treatment philosophy, our physical therapy staff, and our 5 convenient locations in Gilbertsville, Skippack, Phoenixville, Boyertown, and Limerick at

Dr.Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He has authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, and “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon and




New patient scheduling: 610-327-2600