What is direct access and self-referral?

What is direct access and self-referral?

Direct access and self-referral means that patients are able to refer themselves to a physical therapist without having to see anyone else first, or without being told to refer themselves by another health professional. This can relate to telephone and face-to-face services, as well as those delivered via new media such as over the internet.

Reference: Department of Health (2008) Self-referral pilots to musculoskeletal physiotherapy and the implications for improving access to other AHP services. Department of Health; London, UK.


Why self-referral is considered a valuable term:

  • It is thought to be clearly understood by the patient/client.
  • It clearly defines the source of referral.
  • It defines a group of patients/clients which in turn allows for analysis and comparisons across sources of referrals eg patients/clients who referred themselves versus general practitioner/family physician referral to physical therapy. With clear comparisons evidence can be produced to support self-referral as being clinically and cost effective.

Direct access is the term that is more familiar across the profession globally and among other health professionals and government officials. Direct access does not refer to access between health professionals eg a physician has direct access to physical therapists. However, it may mean that physical therapists have direct access to assess and treat patients without a medical referral, for example on an Intensive Care Unit determining which patients need physical therapy.

Both terms are still appropriate to use.

This section includes WCPT's own resources, and sources of information from others; all of these can support advocacy efforts to develop direct access to physical therapy services.