{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:45:40Z","timestamp":1791895540785,"version":"4.3.4"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate physiotherapists\u2019 perceptions of direct access to physiotherapy in Tyrol, Austria, and identify profession-specific barriers and facilitators to its implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative exploratory study. Data were collected through semi-structured interviews and analysed using structured qualitative content analysis. Reporting adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tyrol, Austria; physiotherapists working in outpatient practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Ten state-recognised physiotherapists (seven women, three men; mean age = 30.9 years,\n                      <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                      \u2009=\u20096.9) working in musculoskeletal care, recruited via purposive and snowball sampling. Professional experience ranged from 0.4 to 15 years across private practices, clinical and rehabilitation settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s) or exposure(s)<\/jats:title>\n                    <jats:p>Exposure to current physiotherapy models, including informal elements of direct access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome(s) and measure(s)<\/jats:title>\n                    <jats:p>Perceived readiness for direct access, including competencies, barriers, facilitators and training needs, derived from structured qualitative content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four main themes emerged: (1) Status quo \u2013 informal direct access already exists, with physiotherapists undertaking triage roles without a legal framework; (2) Professional competence \u2013 moderate-to-high confidence in differential diagnosis but lower confidence in red-flag screening; (3) Organisational barriers \u2013 legal uncertainty, liability concerns and hierarchical physician relationships; (4) Training needs \u2013 demand for structured education in red-flag screening, imaging interpretation and mentoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and relevance<\/jats:title>\n                    <jats:p>Participants reported perceived readiness for direct access but also identified gaps between theoretical knowledge and clinical confidence. The findings highlight targeted training, interprofessional collaboration and remuneration as important considerations for safe and equitable implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155261493268","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:13:32Z","timestamp":1791634412000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Physiotherapists\u2019 perspectives on direct access in a referral-based system in Austria \u2013 A qualitative study"],"prefix":"10.1177","author":[{"given":"Leon","family":"Ernhofer","sequence":"first","affiliation":[{"name":"Health University of Applied Sciences Tyrol, FH Gesundheit Tirol"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4390-7422","authenticated-orcid":false,"given":"Jean-Pascal","family":"Grenier","sequence":"additional","affiliation":[{"name":"Health University of Applied Sciences Tyrol, FH Gesundheit Tirol"},{"name":"Department of Internal Medicine II, University Clinic of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32340-0"},{"key":"e_1_3_3_3_2","unstructured":"Dachverband der Sozialversicherungstr\u00e4ger. 2025 Jahresbericht chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/https:\/\/www.sozialversicherung.at\/cdscontent\/load?contentid=10008.802869&version=1770616932 (2025 accessed 12 March 2026)."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2024-112974"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(25)00064-5"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2021.07.007"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235364"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2019.1674388"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20120060"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2012.12.011"},{"key":"e_1_3_3_11_2","unstructured":"Physio Austria. 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