In this day of expensive health care, putting the PT at the start of the medical model in the treatment of low back pain saves money for individuals as well as the system as a whole. Direct access PT allows the trained PT to not only examine an acute low back pain patient but start effective treatment as well in the same session. Advanced imaging is usually a case of VOMIT: Victims of Modern Imaging Technology. The studies are rarely needed for low back pain without radicular signs.
Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges.
Health Serv Res. 2015 Mar 16;
Authors: Fritz JM, Brennan GP, Hunter SJ
OBJECTIVE: Compare health care utilization and charges for low-back-pain (LBP) patients receiving advanced imaging or physical therapy as a first management strategy following a new primary care consultation.
DATA SOURCE: Electronic medical record (EMR) and insurance claims data.
STUDY DESIGN: Retrospective analysis of propensity-matched groups.
DATA COLLECTION/EXTRACTION: Claims and EMR data were used. Utilization and LBP-related charges over a 1-year period were extracted from claims data.
PRINCIPAL FINDINGS: In the propensity-matched sample (n = 406), advanced imaging recipients had higher odds of all utilization outcomes. Charges were higher with advanced imaging by an average $4,793 (95 percent CI: $3,676, $5,910).
CONCLUSIONS: For patients with LBP whom newly consulted primary care referred for additional management, advanced imaging as a first management was associated with higher health care utilization and charges than physical therapy.