Just this weekend I attended the Running Conference at the University of Florida Orthopedics and Sports Medicine Institute in Gainesville.
There, one of the presenters claimed to have helped his patient, a 75 year-old runner, continue marathon training and racing despite Grade IV 'bone-on-bone' knee arthritis with bi-annual injections of hyaluronic acid (chicken cartilage) into the knee joint space.
Irrespective of testosterone-laden "atta-boys!" or of wry head-shaking at old ages' folly I still want to know this:
How was it paid for?
75 year-olds generally have Medicare.
Medicare usually pays for one course (3 or 5 injections) of viscosupplementation every six months in Florida.
Hyaluronic Acid (aka viscosupplementation) pays fairly well for the course of treatment: ~$250 for specialist surgeons and ~$150 for non-specialist physicians.
I, as a physical therapist, have to show that my 75 year-old patients need physical therapy to prevent progressive disablement, loss of independence or institutionalization.
For example, I can't say that one of my patient's goals is to...
- Run a Marathon!
That is, racing marathons wont necessarily keep grandpa out of the old folks home.
Why (apparently) does Medicare pay orthopedic and sports medicine doctors to keep 75 year-olds running marathons when Medicare wont pay physical therapists to keep 75 year-olds running marathons.
Is there some evidence that chicken cartilage is more cost effective than physical therapy?