"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, February 16, 2010

PT Managers can now use TBC to set Long Term Goals

Physical therapy managers are always trying to find ways to:
  • reduce paperwork (and spend more face-time with your patient)
  • speed up productivity (and make more money)
  • lower the costs of care (and make more money)
  • see more patients (and keep your job)
  • get the patients better (and get good outcomes)
  • get the right stuff in the chart (for Medicare compliance)
Treatment based classification (TBC) uses a parsimonious (brief) set of tests to identify who will get better with which treatment.

For example, the Cervical Traction classification uses these tests (predictor variables) to identify patients who will respond well to cervical traction:
  • Peripheralization with the C4-7 mobility test
  • Age> 55
  • Positive shoulder abduction test
  • Positive cervical distraction test
  • Positive Median nerve tension test A
The modifiable findings are in bold. Age is not modifiable. The others may change as a result of your care. The test results are expressed as percentages:
  • The baseline chance of being in the cervical traction group is 44%.

  • Three-of-five (3/5) positive tests implies a 79.2% chance of success with cervical traction.

  • Four-of-five (4/5) positive tests implies a 94.8% chance of success with cervical traction.

  • Five-of-five (5/5) positive tests implies a 100% chance of success with cervical traction.
What if we set up our goal in quantitative terms? Reduce the risk of needing cervical traction to the baseline level of 44%.

The long term goal would be written like this:
"Improve cervical traction risk classification from 94.8% to 44% in four weeks"
The goal is objective, quantifiable and easy to implement.

If you use TBC Templates, available here, you can check your patient's status with simple check boxes weekly.

Attach the template to your electronic documentation and eliminate lengthy, narrative descriptions of 'skilled therapy'.

Treatment based classification holds the promise of better physical therapy outcomes at lower cost.

Now, you can use templated (electronic or paper) TBC checklists to reduce your paperwork and speed up your productivity, too.

Free Tutorial

Get free stuff at BulletproofPT.com

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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