"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

Thursday, October 22, 2009

Three reasons why POPTs will give way to PTPP in 2010

Just this week three things have happened that lead me to question the survivability of the physician-owned physical therapy (POPT) model in 2010.

By the way, none of this seems to be directly affected by the direction of the health care reform debates - whichever way reform goes the POPT outcome seems destined to happen.


A Medicare Payment Advisory Commission (MedPAC) meeting October 8th listened to APTA testimony on physician ownership of physical therapy clinics. MedPAC addressed concerns about Medicare PT volume growth and ownership of PT.

Physicians who own services, like PT, to which they refer have a conflict of interests (their interests vs. their patients' best interests).

MedPAC outlined these concerns in a PowerPoint presentation by staffer Ariel Winter whose concerns are the following:
  1. Could lead to higher overall volume through greater capacity and financial incentives.

  2. Several studies find that physician self-referral is associated with higher volume.

  3. Unclear whether additional services are appropriate or contribute to improved outcomes.

Jim Needham, former CEO of a Florida POPT, predicts a sell-off due to difficulty with compliance and transparency requirements especially small physician practices that employ physical therapists.

Jim does suggest that costs (the subject of the current debate) are the primary driver of new physician compliance legislation.

You can sign up to hear Jim's presentation in Palmetto, Florida on November 7th or November 21st at BulletproofPT.com.


My phone has been ringing off the hook from business brokers and 'principals' (guys and gals with money) who all of a sudden want to invest in outpatient physical therapy practices.

My phone rings because I sold two clinics in two separate transactions in the last two years so I'm on a list somewhere. Lucky me.

Do they know something we don't?

Maybe it's just a thaw in the frozen credit markets but physical therapy business sales are getting hot once more.

The other consideration is that investors perceive increased future expected cash flows to Physical Therapists in Private Practice (PTPP) and they see PTPPs selling for all-time historically low valuations and they want a bargain.

Maybe 2010 will be the year of the PTPP.

My advice to PTPP owners - hang tight, this may be your year.

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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 .

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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.