Research Podcast - Cost of PT First
In this episode, wed dive into the real-world impact and value of seeing a physical therapist first, discussing findings from the Health Services Research article by Frogner et al. (2018) and the APTA economic value report. The conversation highlights how early access to physical therapy drastically reduces downstream healthcare costs, imaging, injections, surgeries, and opioid prescriptions. Its also emphasize the gap between evidence and implementation—despite strong research support, physical therapy is often underutilized as a first-line treatment due to systemic barriers, awareness gaps, and misperceptions about cost and value. They advocate for stronger messaging, both to the public and within healthcare systems, about the long-term cost savings and outcomes tied to PT-first care models.
5 Big Takeaways
- PT First Saves Money and Lives Early -- access to physical therapy significantly reduces downstream healthcare costs—cutting the use of imaging, injections, surgeries, and especially opioid prescriptions
- Only 2% of LBP Patients See a PT First -- Despite overwhelming evidence, only a small fraction of patients with low back pain go to PT first. Most enter the system through urgent care, primary care, or specialists, which often leads to less effective and more costly care paths.
- Cost Perception Is a Major Barrier -- Many patients wrongly assume physical therapy is expensive. In reality, it's often cheaper in the long run than multiple physician visits, imaging, or procedures.
- Clinicians Must Be Advocates -- PTs need to champion their role not only through patient care but also through community education, marketing, and collaboration with other healthcare providers to shift the referral funnel.
- Data Alone Doesn’t Shift Behavior—Messaging Does -- Research supports PT-first care, but behavior change lags behind. We discuss the need for better storytelling and communication strategies to convey the real value of physical therapy to patients, insurers, and policymakers.
1. Frogner BK, Harwood K, Andrilla CHA, Schwartz M, Pines JM. The Association Between Early Physical Therapy and Subsequent Opioid Use: A Retrospective Cohort Study. Health Serv Res. 2018;53(6):3927–3946. doi:10.1111/1475-6773.12817 2. APTA.
2. The Economic Value of Physical Therapy in the United States: A Summary Report. https://www.apta.org/apta-and-you/news-publications/research-reports/economic-value-of-physical-therapy
