"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

Sunday, June 27, 2010

Comparative Effectiveness Research under attack

Physical therapists who support research comparing surgical interventions with physical therapy for chronic, painful spinal stenosis are under attack.

A group of 56 congressmen have written a letter asking President Barack Obama to withdraw the nomination of Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS).

Their opposition to Dr. Berwick is based on his support of Comparative Effectiveness Research. The congressmen who wrote the letter are House Republicans not involved in Dr. Berwick's upcoming Senate confirmation meeting. They called Dr. Berwick's beliefs "rationing":
“We believe that Dr. Berwick’s recommendation for the federal government to use ration-based, cost-effective research to restrict patients’ access to medically necessary care is wrong.”
...the letter said.

But, according to White House spokesman Reid H. Cherlin,
“The fact is, rationing is rampant in the system today, as insurers make arbitrary decisions about who can get the care they need.

Don Berwick wants to see a system in which those decisions are transparent – and that the people who make them are held accountable".
The White House continues to support Dr. Berwick who was nominated April 19th. His Senate confirmation hearing has yet to be scheduled.

There is ample need for head-to-head studies examining both the indications for and the outcomes the following:
Spine fusions alone cost Medicare $575 million dollars in 2007. That money would buy a lot of physical therapy.

Who can think of other, promising areas where PT might compare favorably with dangerous and expensive surgical options?

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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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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.