"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

Monday, September 21, 2009

An open letter to the American Physical Therapy Association

This letter was sent to a contact at the APTA on September 21, 2009.

This letter is intended to initiate a discussion and propose a course of action that is in the best interests of Medicare physical therapy beneficiaries, the American healthcare system and physical therapists everywhere.

Why do Medicare auditors assess 'skilled therapy' as a criteria of payment? Because they lack an alternative measure of value.

Evidence based physical therapy, such as classification decision rules, have been shown to improve outcomes, decrease expensive testing, medication use and invasive procedures.

Can physical therapists avoid arbitrary, punitive Medicare audit denials by documenting the use of classification predictor variables and decision rules in the plan of care, daily notes and discharge?

Couldn't a commitment from Medicare to "immunize" physical therapists who document evidence based therapy from the 'skilled therapy' criteria of Medicare audits prompt a sea-change in clinician behavior to adopt evidence-based methods more quickly?

Medical doctors and legislators have sought a similar immunization, based on evidence based care, from the current administration as regards defensive medicine.

Why couldn't physical therapists, the only doctoring profession subject to time-based CPT codes, put forth similar argument as regards Medicare audits?

Thank you for your consideration,

Tim Richardson, PT

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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.
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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.