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FOTO Rehab Outcomes Blog

The Timing of When Someone Sees a Physical Therapist: Does it Matter?

Is there value in when a person receives services from a physical therapist?

neck-painWhat I found interesting about this study was that only 15% of the patients who had neck pain actually sought the services of a physical therapist. Okay... I need to take a step back because the data was from 2012 and part of 2013. Maybe more headway has been made in both direct access and referral patterns to increase the referral rate to physical therapists?

My mind immediately wandered to wonder about the 1-year cost after the index visit for everyone who did not see a physical therapist. I know that wasn't the point of the study, yet it would have been interesting to see the demographics of the population that did not receive physical therapy services and the 1-year cost. It seems having that information would help paint a picture of what is different when a physical therapist is not involved in the care.

What could be really interesting is to see data from 2017-through part of 2018. I wonder if physical therapists have been having an increased role in providing care for individuals who have neck pain.  This study shares the trend we may already be aware.  This study confirms what we have learned from other studies regarding the timing of services: sooner is better. 

One question I do have: all three groups treated the individuals in 3-4 visits. I'd be curious as to what interventions were provided and the outcomes achieved. 

You'll find the abstract to the recent study below.

Timing of physical therapy consultation on 1-year healthcare utilization and costs in patients seeking care for neck pain: a retrospective cohort.




Patients seek care from physical therapists for neck pain but it is unclear what the association of the timing of physical therapy (PT) consultation is on 1-year healthcare utilization and costs. The purpose of this study was to compare the 1-year healthcare utilization and costs between three PT timing groups: patients who consulted a physical therapist (PT) for neck pain within 14 days (early PT consultation), between 15 and 90 days (delayed PT consultation) or between 91 and 364 days (late PT consultation).


A retrospective cohort of 308 patients (69.2% female, ages 48.7[±14.5] years) were categorized into PT timing groups. Descriptive statistics were calculated for each group. In adjusted regression models, 1-year healthcare utilization of injections, imaging, opioids and costs were compared between groups.


Compared to early PT consultation, the odds of receiving an opioid prescription (aOR = 2.79, 95%CI: 1.35-5.79), spinal injection (aOR = 4.36, 95%CI:2.26-8.45), undergoing an MRI (aOR = 4.68, 95%CI:2.25-9.74), X-ray (aOR = 2.97, 95%CI:1.61-5.47) or CT scan (aOR = 3.36, 95%CI: 1.14-9.97) were increased in patients in the late PT consultation group. Similar increases in risk were found in the delayed group (except CT and Opioids). Compared to the early PT consultation group, mean costs were $2172 ($557, $3786) higher in the late PT contact group and $1063 (95%CI: $ 138 - $1988) higher in the delayed PT consultation group.


There was an association with the timing of physical therapy consultation on healthcare utilization and costs, where later consultation was associated with increases costs and healthcare utilization. This study examined the association of timing of physical therapy consultation on costs and healthcare utilization, but not the association of increased access to physical therapy consultation. Therefore, the findings warrant further investigation to explore the effects of increased access to physical therapy consultation on healthcare utilization and costs in a prospective study.

 2018 Nov 26;18(1):887. doi: 10.1186/s12913-018-3699-0

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