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Table 2 Major themes and sub-themes for interviews with self-referral participants (n = 15)

From: Patient attitudes and beliefs associated with self-referral to physical therapy for musculoskeletal complaints: a qualitative study

Theme1: Knowledge of the Direct Access Program

“So, I ran into [a physical therapist]. She was in the break room the morning I was hurting so severely, and she told me to try physical therapy first to see if that would help it, and if not, they would recommend maybe a physician for me to see. At that point I figured anything would help. I felt like especially the hands on would break it because it felt like a trigger point area. I figured that was the best route to go before pursuing the surgeons or sports medicine physicians here.” (3)

Theme 2: Patients’ Attitudes and Beliefs Towards Treatment

Sub-Theme 1: Openness to Alternative Therapies

“I’ve been a nurse for almost 40 years, so I’m into kind of treating myself and I think that other modalities may work first. Like heat therapy, maybe doing yoga, doing self-care treatments first.” (23)

Sub-Theme 2: Beliefs About Medications and Surgery

“The medication that I take for this [shoulder pain], because they’re not every day, makes me kind of sleepy and dull and that’s difficult to work, so I started exploring other options.” (15)

“I wanted something that would fix it, as opposed to just tolerating it.” (7)

Sub-Theme 3: Expectation of Physician Treatment Recommendation

“So one of the reasons why I didn’t go to a physician first is just because if my pain was the result of an injury, I fell, or I was in an accident, I feel like you need the reassurance of a physician to make sure that there’s nothing broken, or that would need surgery, or something like that, but if you’re just having chronic pain that’s been coming on for a long time, my hip hurts, my knee hurts, I feel like physical therapy and exercise is most often what the treatment that’s going to be recommended, so I just went there first.” (27)

Sub-Theme 4: Preference for Lower Cost Options

“Well, I’m not going to go to the orthopedic doctor if I can go to therapy. Bypass that $50 co-pay at orthopedics and go on to therapy and see if they can help” (32)

Theme 3: Resonant Prior Experience with Physical Therapy

“Just due to my past experience with the results that I had with physical therapy once [a physical therapist] saw me for my lower back I went on my way. Then, I guess it was something earlier this year. I called [him] up and said, ‘I can curl, but I can’t push’. He said, ‘It sounds like a cervical issue.’ He treated me and did a great job on that.” (6)