"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Tuesday, October 16, 2007

Simple Beginnings

SIMPLE begins with a diagnosis – a diagnosis of a sick practice.

I was more eager than I was experienced when, in 2006, I bought controlling interest of my physical therapy clinics (3 of them) from our founding partners (2 of them).

After closing the sale the three of us were sitting around a large wooden conference table having a pleasant chat when one of the founders made this comment:
‘Our charts would never stand up to a Medicare audit’.

I can recall the frantic desire to find and tear into pieces my check and all the closing documents that we had just signed.

From that moment on I dedicated myself to developing a system that could reliably train and motivate my seven physical therapists and physical therapist assistants to quickly and completely create a Medicare compliant plan of care, daily note and discharge.

Most importantly, the system had to be based on the patient’s needs so that the therapist was allowed to do what the therapist does best: care for the patient.

I wanted a system that allowed the PT and the PTA to work together, using the clinical decision-making of the PT and the clinical judgment of the PTA5. I also felt the system needed to be diagnosis-driven from the start. A physical therapy diagnosis, that is.

I want to be able to share this system with my peers who own or manage their physical therapy clinics and who might not have access to a sophisticated corporate compliance department.

What I hope to present here is a standard process of measurement, diagnosis, goal setting and selection of interventions that displays both a rigorous thought process and an intuitive understanding of Medicare (and of the common needs of all third party payers, both commercial and federal).

Finally, the system should to both the experienced clinician and to the new graduate.


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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"

Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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American Physical Therapy Association

American Physical Therapy Association
Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.