Direct Access, Referral Requirements, and Interaction with Other Health Professions
Direct access in Oregon
Oregon allows patients to seek physical therapy without a physician referral, but direct access is not unlimited. The PT must screen for red flags, stay within scope, and refer when the condition needs medical diagnosis or treatment. Board rules and the Practice Act set when a referral or consultation is required, including prolonged care without expected progress.
Referral and collaboration
When a referral is required, it should be specific enough to guide care. PTs communicate with physicians, nurse practitioners, physician assistants, chiropractors, and other providers. The PT remains responsible for recognizing when the patient's needs exceed PT scope. A referral does not transfer the PT's duty to monitor.
Worked example
A patient self-refers with low back pain. The PT screens for cauda equina, fracture, infection, and cancer; findings are negative. The PT treats and re-assesses. If after a reasonable trial the patient worsens or fails to improve, the PT refers for medical evaluation rather than simply continuing passive care.
Traps
Do not read direct access as no referral ever. Do not treat a red-flag presentation because the patient asked. Do not assume a referral protects you from a bad plan. Do not ignore another provider's restrictions; coordinate, but keep your own clinical judgment.