In direct access physical therapy practice, what is the role of differential diagnosis?

• A. You must perform differential diagnosis to know when to refer.
• B. It is not allowed to perform any differential diagnosis.
• C. You should diagnose every patient definitively.
• D. You should refer all patients immediately.

Answer: (A)

In direct access physical therapy, you’re the first clinician evaluating the patient, so you must determine whether the signs and symptoms point to a musculoskeletal issue you can treat or to a condition that requires medical referral. This differential decision-making helps you triage safely: treat within your scope when the presentation fits a musculoskeletal problem, or refer promptly if red flags or signals of a non-musculoskeletal condition appear. It protects patient safety and ensures timely, appropriate care. You’re not expected to make a definitive medical diagnosis for every patient, and you shouldn’t refer everyone, but you must screen and decide when referral is warranted.