Research Reports |
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We appreciate the thoughtful comments from Johnson1 on our article2 that examines variability in surgeon and physical therapist assessments of the need for physical therapy in patients with traumatic lower-extremity injuries. Our database was unique because it allowed for comparison across 8 centers and between surgeons and physical therapists. We were able to contribute to the health services research literature by determining the factors associated with the first step in the referral process—the "assessment of need." As the physical therapy profession continues to advocate for direct access to therapy services, it becomes increasingly important to explore variability in physical therapist clinical decision-making and practice patterns. Consistent evidence supports wide variability in physician referral rates for physical therapy, and it appears important to ask the question: "Would variability exist if physical therapists were making the referral decision?" Our study showed evidence of variability in assessments of need for both surgeons and
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