"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, March 13, 2011

Break Health Care in Order to Fix It

I'll introduce Professor Clayton Christensen and then I'll get out of the way...

Dr. Christensen wrote a book called The Innovators' Prescription and he wants to solve the healthcare crisis by "disrupting" it.

Dr. Christensen proposes paying doctors based on one of three "tracks" that exist in medicine:
  • Track One is like Gregory House, MD. Dr. House tries to separate the "zebras" from the "horses" - there is a high need for intuitive diagnoses. The process described brings to mind episodes of House, a TV show in which a brilliant but irascible doctor challenges a team of colleagues to find the problem before the patient dies.

    Fee for service would continue to apply to these diagnostic services.

  • Track Two is Fee for Results which would apply for treating conditions that are well understood and have a clearly defined solution -- total knee replacements, colonoscopies, laser eye surgery, implantation of stents, etc.

    These are production problems that will yield to mass production techniques used in other industries. Whether we need expensive orthopedic surgeons at $500,000 per year performing assembly line processes is an open question.

    Obviously, cost savings are available in Track Two.

  • Track Three is user networks for patients with chronic conditions or unhealthy practices to learn how they can help themselves and be motivated to do so.

I believe physical therapy will be a Track Three service that will be completely disrupted from the traditional Fee-for-Service payment model.

Physical therapists addicted to the volume model of providing "more" services will suffer like steel companies and auto companies in Dr. Christensen's video and book.

Watch it.

Let me know what you think.

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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.