The Shift Away from Patient Choice in Orthopedic Physical Therapy
The world of healthcare is constantly changing, and one of the most significant shifts we’re seeing is in how orthopedic physical therapy is delivered. While some changes improve access and efficiency, others quietly make it harder for patients to receive the care that best fits their needs.
One of the biggest sources of confusion we see today revolves around a simple question: Do I need a referral for physical therapy?
At Embody Health and Performance, we believe your choice matters—both in how you approach your care and in the practitioners you trust. And understanding your rights around physical therapy referrals is a critical part of that.
How In-House Physical Therapy Limits Choice
In recent years, many large orthopedic and hospital-based systems have shifted toward in-house physical therapy models. On the surface, these models are often framed as more convenient or more coordinated. But in practice, they can significantly limit patient choice.
We increasingly see patients encouraged—or subtly discouraged—from seeking physical therapy outside of a single healthcare system. Instead, referrals are routed internally to therapists who are financially or structurally tied to the larger corporate entity.
This is where the referral question becomes less about medicine and more about systems.
While these “big box” centers may argue that in-house care allows them to “keep an eye on patients,” the downside is rarely discussed: the decision is no longer truly yours.
A Real Patient Experience
Many patients tell us a similar story: they felt rushed through short appointments, sent for imaging that confirmed what was already suspected but didn’t change how care was approached, and then told exactly where to go for physical therapy—without realizing they had a choice.
One of our patients, let’s call her Helen, came to us after undergoing knee surgery. She had been seeing an orthopedic surgeon at a large, well-known orthopedic center. When it came time for rehabilitation, her surgeon told her she needed to complete her physical therapy in-house so he could “keep an eye on her.”
Helen didn’t feel comfortable with this. She had previously had an excellent rehab experience with Embody Health and Performance and was concerned that the in-house option wouldn’t provide the individualized care she needed to meet her recovery goals.
The good news? Helen wasn’t stuck.
She asked for a copy of her physical therapy referral and brought it to us. We were able to provide the one-on-one care she needed while maintaining clear communication with her orthopedic surgeon throughout the process.
This kind of collaboration—between patient, physical therapist, and physician—is what leads to the best outcomes. The idea that patients must stay “in-house” is not only limiting, it can delay or compromise recovery.
Do You Need a Referral for Physical Therapy?
In most U.S. states, including Minnesota, patients have direct access to physical therapy. This means you can often see a licensed physical therapist without a doctor referral for evaluation and treatment.
So if you’re asking:
- Do I need a referral for physical therapy?
- Can I go to PT without a referral?
The answer is frequently no, from a clinical standpoint.
That said, some insurance plans still require a doctor referral for physical therapy in order to reimburse visits. This is an administrative requirement—not a reflection of what is medically necessary.
Understanding this distinction is key.
Referral vs. Order: Why the Language Matters
Patients often hear the terms PT referral and physical therapy order used interchangeably, but they are not the same.
- A referral for physical therapy is a recommendation from a physician.
- A physical therapy order is typically an insurance-driven document.
Licensed physical therapists are trained and legally allowed to evaluate and treat patients under direct access laws. When referrals are presented as mandatory, it’s often due to system policies—not patient safety.
Why Your Right to Choose Your Physical Therapist Still Matters
When your doctor suggests physical therapy, you have the right to choose where and with whom you receive that care.
At Embody Health and Performance, we believe patients deserve transparency, time, and individualized attention. Whether you choose to work with us or another trusted provider, your care should be guided by fit and outcomes—not corporate alignment.
If you want to receive physical therapy outside of a large system, the process is often simpler than you’ve been led to believe:
- Request a hard copy of your PT referral from your provider
- Send it directly to your physical therapist (a photo or secure email works)
- Ask the orthopedic office to fax the referral to the PT clinic of your choice
These options are legal, common, and well within your rights as a patient.
The Embody Approach to Orthopedic Physical Therapy
At Embody Health and Performance, we don’t see you as just another visit—we see you as a long-term partner in your health.
Whether you come to us with or without a PT referral, our goal is the same: identify the root cause of your symptoms, communicate clearly with your care team, and support your recovery in a way that makes sense for your life.
Your health journey is yours. We’re honored to be part of it.
Frequently Asked Questions About PT Referrals
In many cases, no. Most states allow direct access to physical therapy, meaning you can see a licensed PT without a referral. Insurance plans may still require a referral for reimbursement, but medically it is often not required.
Yes. You can start physical therapy without a doctor referral, especially at cash-based or out-of-network clinics. A PT can determine whether therapy is appropriate or if another provider should be involved.
Many large healthcare systems operate in-house PT models. Referrals are often routed internally by default, which can make it seem like outside care isn’t allowed—even when it is.
A referral is a recommendation from a provider. An order is typically an insurance requirement. Physical therapists do not need either to evaluate and treat patients under direct access laws.
Yes. Physical therapists are trained to screen for red flags and collaborate with physicians when needed. Direct access PT has been shown to be safe and effective for musculoskeletal conditions.
