10/02/2025
Don't Let Your Choice Be Chained: The Hidden Costs of In-House Physical Therapy Referrals
Attention Rochester Patients! When your doctor at a large medical facility, like the University of Rochester or Rochester Regional Health, suggests physical therapy, where are you being sent?
While in-house physical therapy practices within these massive healthcare systems may seem convenient, there's a serious, inherent danger to your wallet and your care: physician self-referral.
The Conflict of Interest: Profit vs. Patient Choice
In medicine, an outside referral is often a signal of trust and impartiality. However, when large healthcare systems house multiple physician groups and their own PT centers, the incentives change. A physician-owner or employee of the system may feel pressure (or receive a benefit) to send you to their own facility, even if a superior or more convenient independent option exists.
Here’s the problem with being "steered" to a system's own PT center:
Increased Costs: Studies on physician-owned physical therapy (a model often mirrored by system-owned practices) have shown that they can lead to over-utilization—meaning more total visits per patient—compared to independent PT practices. More visits equals higher costs for you and your insurer.
Less Choice = Less Specialized Care: The best therapist for your specific injury (be it a specialized hand therapist, a pelvic floor expert, or a sports recovery specialist) might be at a local, independent clinic. When your referral is limited to in-house options, you lose the opportunity to choose the best-fit expert for your recovery.
Delayed Care: A patient's right to "Direct Access" to physical therapy is recognized in many states, allowing you to see a PT without a physician referral first (though insurance often requires one). However, system gatekeeping can delay your initial appointment, lengthening your recovery time and potentially increasing your overall healthcare expenses down the road.
Your Health, Your Rights!
The decision of where to receive physical therapy is a crucial one that directly impacts your recovery and your finances. It should be your choice, not a corporate mandate.
What You Can Do:
Ask Directly: When your doctor recommends PT, ask this question: "Are there other physical therapy options outside of this network that you would recommend, or can I choose a therapist that is closer to my home?"
Know Your Plan: Contact your insurance provider to understand your network. You may have the freedom to choose any in-network provider, not just the system's own.
Research Independently: Look up independent, local PT clinics near you. Check their specialties, reviews, and proximity to your home or work. Convenience matters for recovery!
Don't let institutional policy dictate your path to wellness. Demand transparency, exercise your right to choice, and choose the best physical therapy for you!