Physical therapists in primary care are not a “nice to have”—they are one of the most practical answers to physician shortages, multimorbidity, and the global rehabilitation gap. This report explains how integrating PTs into primary care teams improves access, reduces costs, and makes care safer and more coordinated for people with physical and functional needs.​

Why this matters

Primary care in the U.S. is under strain from rising chronic disease and a projected shortage of up to 48,000 primary care physicians by 2034. At the same time, about one in three people worldwide live with conditions that would benefit from rehabilitation, including musculoskeletal, cardiovascular, pulmonary, cancer-related, and metabolic conditions. The authors argue that putting PTs inside primary care teams—rather than only in downstream rehab clinics—helps close this gap by improving access, care navigation, and overall cost of care.​

Key takeaways from the report

• PTs embedded within primary care teams improve outcomes, lower total healthcare costs, reduce provider burnout, and increase patient satisfaction.
• Two main access pathways exist: warm handoff within the same PCP visit or direct triage scheduling using a simple checklist.
• This model differs from private-clinic direct access because patients first contact a primary care clinic that includes a PT on the team.
• Consistent global evidence shows integrated PTs reduce imaging and opioid use, shorten wait times, improve patient and provider satisfaction, decrease unnecessary referrals, and reduce PCP workload.

Where this is already working

The authors outline several operating models that U.S. clinics and systems can learn from:

• The Military Health System has used PTs as first-contact providers for decades, with recent pilots reducing imaging, restriction days, and specialty referrals while improving cost and disability outcomes.
• The VA has shown that co-located PTs reduce cancellations, lower treatment drop-off, and decrease wait times, with a national plan to integrate PTs into all PACT teams by 2025.
• The U.S. Public Health Service reports >80% reduction in PT access delays, lower opioid prescribing, and improved satisfaction due to same-day PT availability.
• PACE programs and safety-net clinics use interdisciplinary teams including PTs to support older adults and underserved groups, though Medicare billing limits remain a barrier for some FQHCs.
• Regional systems like Bellin Health rotate PTs into primary care clinics for real-time consultation and continuation of care in outpatient settings when needed.
• Some private PT practices embed therapists inside independent primary care clinics to create coordinated, co-managed patient pathways.
• Employer-sponsored and direct primary care clinics use PTs to manage high-volume MSK cases, showing lower total care costs when employees receive most care through the integrated model.
• International first-contact PT programs (UK, Sweden) show high patient confidence, fewer prescriptions and referrals, improved work environments, and reduced physician workload.

How to make this work in practice

The paper frames implementation around three planning domains: structure, practice, and culture.​

• Clinics should choose their access model (warm handoff, direct triage, or both) and establish clear triage criteria aligned with PT competencies.
• Practices should estimate PT visit volume from diagnosis patterns and design shorter, focused primary-care-style visit lengths.
• Organizations must select an appropriate financial structure, including incident-to billing, standard PT billing, consultant roles offset by savings, or self-pay consults.
• Primary care PTs need strong multisystem screening, comfort with multimorbidity, and advanced interdisciplinary communication skills across multiple specialties.
• PTs ideally should have privileges to direct care within scope—including ordering imaging/labs and coordinating referrals—though regulations vary by setting.
• Teams must educate PCPs, nurses, MAs, and administrative staff early to build clarity, trust, and role alignment.
• Clinics should prepare patients with clear messaging that PTs are standard members of the primary care team for physical and functional conc

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What this means for clinics, systems, and employers

For leaders trying to redesign primary care, the message is straightforward: integrating PTs into primary care teams is a proven way to improve access, reduce unnecessary tests and prescriptions, lower total costs, and support both patients and providers. The report offers concrete examples and implementation checklists that can be adapted across federal, regional, private, and employer‑based settings.​

Call to Action

If you are planning or refining a team‑based primary care model, this paper is a high‑value blueprint. It shows how different U.S. systems have already integrated PTs, what outcomes they’ve achieved, and which operational decisions matter most for sustainability.

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