Rethinking Primary Care: How Physical Therapists Are Changing the Game

When you think of primary care, your mind probably jumps to physicians, nurse practitioners, or physician assistants. But what if the first person you saw for your back pain or joint issue was a physical therapist? Thanks to trailblazing research and recent legislative changes, this is quickly becoming a reality—especially in North Dakota. 

I recently sat down with Dr. Dallas Ehrmantraut, PT, DPT, Assistant Professor and Director of Pro Bono Services at University of Jamestown Physical Therapy Program, and Dr. Bremen Abuhl, PT, DPT, a recent graduate and current clinical research student who will be starting as a UJ faculty member this August. Their passion for physical therapy (PT) is matched only by their commitment to research and advocacy, and their latest study is going to make waves in the healthcare community. 

From the Sidelines to the Front Lines 

Both Dallas and Bremen were drawn to PT through their athletic backgrounds. Like many, they started as athletes and observers, inspired by the way PTs helped people regain strength and confidence. But as their careers progressed, so did their vision for what PT could be. 

“After being a physical therapist for the last five years, I’ve realized the field is way more expansive than I ever imagined,” Dallas shared. “Physical therapists are playing a huge role in healthcare, and that impact is only growing.”

Bremen echoed this, noting that his journey has evolved from direct patient care to a broader focus on advocacy and research. “Helping people trust their bodies again is incredibly rewarding, but I’ve also become passionate about expanding our profession and improving access to care,” he said. 

The Research: PTs as First Contact Providers 

Their recent research, published by Physical Therapy & Rehabilitation Journal, aims to enhance the care provided for patients with musculoskeletal disorders and may have answered a bold question: What happens when physical therapists are the first point of contact for patients with musculoskeletal disorders, instead of traditional primary care providers?  

The results were eye-opening. The study compared outcomes like pain, disability, quality of life, healthcare costs, imaging rates, and prescription medication use between patients who saw PTs first and those who saw primary care providers. 

Here’s what they found:  

• PTs are just as effective as primary care providers in reducing pain and disability. 

• Patients were 45% less likely to receive imaging (like x-rays or MRIs) when seeing a PT first. 

• Prescription medication use dropped significantly for those who started with a PT. 

• Healthcare resource usage was lower without sacrificing patient outcomes. 

In other words, PTs can deliver the same clinical results as primary care providers—while using fewer resources and reducing the burden on the healthcare system. 

Not Competition—Collaboration 

Dallas and Bremen are quick to point out that this isn’t about replacing doctors or nurse practitioners. “We’re not trying to take away from other providers,” Bremen explained. “We want to build up the primary care system, so those providers can focus on more complex cases. It’s about teamwork and making healthcare more efficient for everyone.” 

This collaborative spirit is especially important as the U.S. faces a growing shortage of primary care providers. By stepping into the first-contact role for musculoskeletal issues, PTs can help fill critical gaps and ensure patients get the right care, faster. 

Legislation Meets Research 

The timing of their research couldn’t be better. North Dakota recently passed Senate Bill 2273, legislation allowing physical therapists to order all types of imaging—not just x-rays. This aligns perfectly with their research findings, empowering PTs to take on a more comprehensive role in patient care. 

Dallas is also taking his advocacy to the national stage, heading to Capitol Hill to meet with lawmakers and promote policies that support PTs as essential members of the healthcare team. 

A New Era for Physical Therapy Education 

Both Dallas and Bremen credit the University of Jamestown’s innovative PT and Clinical Research Ph.D. programs for fostering professional growth. The PT program, founded in 2013, achieved accreditation candidacy in its first year and was designed to emphasize innovation and clinical expertise from the ground up. It has consistently delivered exceptional results, with four of the last five graduating classes achieving a 100% pass rate on their national board exams. Meanwhile, the Ph.D. in Clinical Research program was launched just a year ago and is the only fully online, asynchronous program in the world, attracts students globally. This flexible format allows students to pursue advanced research in areas ranging from traditional physical therapy topics to cutting-edge fields like artificial intelligence and genetics, all while maintaining their professional and personal commitments. 

“The flexibility and support here are unmatched,” Bremen said. “If you want to teach, research, or practice at the highest level, UJ is the place to be.” 

The Takeaway 

Physical therapists are no longer just the experts you see after a referral—they’re becoming the first stop for millions of patients with musculoskeletal pain. Thanks to research like this, and forward-thinking legislation, PTs are poised to transform primary care, making it more accessible, efficient, and patient-centered than ever before. 

Find more information on the physical therapy program here: https://www.uj.edu/academics/programs/dpt/  

Find more information on the clinical research program is available here: https://accelerated.uj.edu/academics/programs/clinical-research/