"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

Saturday, February 26, 2011

Is Physical Therapy in California a Zero Sum Game?

Is physical therapy in California a zero sum game?

Will all patients, providers and payers rise together or will we all fall together?

By definition, zero sum situations are conflict situations where winners' gains are offset by losers' losses.

Conflict is the case in California where physicians and podiatrists are in a fight with physical therapists and the public.

The physicians are trying to earn kickbacks on referrals to physical therapy services they own.

The California Physical Therapy Association (CPTA) is fighting the profit-oriented physicians with a website called Stop POPTS

The physicians are supporting a bill sponsored by Assembly Member Mary Hayashi (D - Hayward), called AB 783 which...
...would legalize the employment of physical therapists by physicians and podiatrists in their professional corporations by adding physical therapists to the list of healing arts practitioners who may be "shareholders, officers, directors, or professional employees of a medical corporation or a podiatric medical corporation."
The American Physical Therapy Association has the position that professionals supervising other professionals is poor public policy since many studies have demonstrated increased costs under the self-referral model.

Here is a members-only APTA white paper from 2005 discussing the anti-POPTS policy.

Here you can hear California Senator Aanested, an oral surgeon, calling the doctors' professional association "disingenuous" for lobbying to include physical therapists as physician employees.

The Office of the Inspector General determined in 2010 that 91% of the services billed in physicians' offices were improperly documented.

Both sides claim superior outcomes but little published evidence supports physical therapy outcomes in either setting.

The California Assembly-person sponsoring AB 783 is, in turn, sponsored by the California Medical Association (CMA).

The CMA donated $22,608 to Assembly member Mary Hayashi in 2010.

Healthcare reform will be difficult for all parties but physical therapists and physicians can maintain professional integrity by focusing on patient care first and by avoiding situations where conflicts between care and profit may confuse professional decision making.

In situation like AB 783, where the two sides vehemently disagree on policy, physicians have the obligation to avoid these business arrangements rather than seek them out.

Putting patients first can keep health care from becoming a zero sum game.

You can support the California Physical Therapy Association by signing this petition against POPTS.

Stop POPTS twitter page is here.

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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
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.