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.
Stop POPTS twitter page is here.
