"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

Tuesday, November 8, 2011

Good Timing: November JOSPT and the October Archives of Internal Medicine

The Top Five overused clinical activities published in the October 2011 Archives of Internal Medicine includes at least one activity that affects many physical therapists' patients: imaging for lower back pain.

Overused Clinical ActivityRankCost to American Patients (in millions of dollars)
Expensive Brand Name Statins for Hypercholesterolemia1$5,800
Dual X-ray (DEXA) bone scans for Osteoporosis2$527
ANY imaging for Lower Back Pain3$175
Antibiotics for Children with Viral Colds4$116
Pap Tests for Patients Under 21 years of age5$47

The "Top Five" collectively surpass $6 billion dollars in wasted healthcare dollars and, according to the study authors, the Good Stewardship Working Group of primary care physicians...
"All activities were believed to be common in primary care but of little benefit to patients."
This Archives article coincides nicely with the November Journal of Orthopedic and Sports Physical Therapists (JOSPT) in which Flynn, Smith and Chou discuss the Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder That Unnecessary Imaging May Do as Much Harm as Good.

Not only is imaging lower back pain expensive, but the patient ends up more likely to have back surgery after physicians view the image.

Further, the visualization by the patient of something "wrong" in their spine leads to avoidance of normal, healthy activity.

If the coincident publication of these two articles wasn't planned then I guess it's just good timing.

Free Tutorial

Get free stuff at BulletproofPT.com

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 .

"Make Decisions like Doctors"

Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

Share PTD with your Peers!

American Physical Therapy Association

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.