"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

Wednesday, July 14, 2010

Physician´s Losing Political Clout is an Old Story

The American Medical Association appears to lack the ability to effect political change during this time of crisis and opportunity.  The AMA spent $6.2 million dollars in 2010 but was unable to move forward anything better than a 6-month "doc fix" that will expire on December 1, 2010 - after the mid-term elections.
“For the amount of money that AMA spends, it doesn’t seem to get the bang for their buck,”
...said a senior Republican health staffer who has worked with the group and was quoted at Politico.com .

Physician´s have been losing political clout for almost 40 years. For historical perspective re-read Robert Sandstrom´s The Meaning of Autonomy for Physical Therapy from PTJ 2007.

In his article, Dr. Sandstrom predicts health care reform as inevitable from society´s perspective:
"The position of near absolute control and authority over the health care system by organized medicine bred over time an insularity that ultimately led to a significant reduction in its dominance. As Krause remarked,
“No profession in our sample has flown quite as high in guild power and control as American medicine and few have fallen as fast.”
"The position of unfettered authority results in professional insularity, evidenced by a mission to protect itself, not the public and ultimately to lose support from policy elites.

Although medicine developed and implemented scientific changes that brought improvements in health, sometimes spectacularly, these gains brought significant other social costs.

While medicine maintains an important position of authority in the health care system, the response to this circumstance has been increasing involvement in health care by bureaucracies and weakened professional autonomy."
The AMA has traditionally strong ties to the Republican party but the Association itself is officially non-partisan. The AMA dealt it´s relationship with Republicans a severe blow in late 2009 with it´s early support for Democratic healthcare reform.

"Rep. Michael Burgess (R-Texas), a physician and AMA member, said the AMA’s early support for the Democrats’ health reform legislation tied his hands when he proposed health reform amendments to repeal the Medicare formula and put medical malpractice reforms in place." (Politico.com)
With the AMA on the ropes is it possible that physical therapists can rally to effect political change from the patients´ perspective and best interests?

Can the American Physical Therapy Association pool our efforts and dollars to improve healthcare and gain the trust of the "policy elites" that ultimately make the purchasing decisions in healthcare?

Could the APTA trade political support for the AMA for acquiesence on issues important to physical therapists? (eg: POPTs)

Do physical therapists have an opportunity to gain professional autonomy in this time of crisis?

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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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