In order to determine how direct access (DA) has been utilized and how it has impacted the practice of physical therapy in Idaho, surveys were mailed to each member of the Idaho Physical Therapy Association (n = 138). There was a 59% return rate (n = 81) and 63 of the surveys met the requirements for this study. Seventy percent of the respondents had treated patients without physician referral, and of those respondents, a mean of 8.2% of their patients were seen without referral. The primary reasons for not treating without referral were that employers did not allow it (56.3%) and that insurance companies did not reimburse for treatment without referral (18.8%). The results of this survey indicated that PTs who treat DA patients worked most often in the outpatient setting (x2= 10.1, p= .007) and that orthopedic patients were the patient type most often treated without referral (m = 65.8%). Male physical therapists (PTs) worked more hours in the outpatient setting (t= 2.8, p= .007) than female PTs and treated without referral more often (x2= 6.0, p= .029). The primary means of reimbursement for DA patients was insurance (55.9%), followed by direct "out-of-pocket" payment by the patients (34.7%). The results of this survey indicated that many PTs in Idaho treated patients without referral. Employer permission and third party reimbursement might increase PT evaluation and treatment without referral.
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