"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, February 19, 2012

"Stealing" Patients from Physicians, Part 1 of 3

Right now in America, most physical therapists accept referrals from physicians for conditions like simple ankle sprains and lower back injuries.

What if I told that soon, physical therapists will "steal" these patients from physicians' caseloads?

And, physicians will thank us for stealing their patients.

How can we do that?

How can physical therapists steal patients from physicians and get a big "Thank You" in return?

By following Clayton Christensens's "rules-based medicine".

Rules-based Medicine

"Rules-based" medicine is described in Harvard professor Clayton Christensen's Innovator's Prescription (2011)

Professor Christensen describes a clear process by which professions inevitably transform their bodies of knowledge upon which they are built from an art into a science.
Rules-based medicine is the "technological enabler" that physical therapists need to "steal" physician market share
"Work that was once intuitive and complex becomes routine, and specific rules are eventually developed to handle the steps in the process.  
Abilities that previously resided in the intuition of a select group of experts ultimately become so explicitly teachable that rules-based work can be performed by people with much less experience and training... 
The term "technology" that we use here refers to... mathematical equations (algorithms)...  
However, at the heart of this evolution of work is the conversion of complex, intuitive processes into simple rules-based work, and the handoff of this work from expensive, highly trained experts (physicians) to less costly providers (physical therapists, nurses, physician assistants, etc.)."
Clinical decision rules are available now which can help physical therapists diagnose the following patients BETTER than the unaided physician:
  • acute stroke in dizzy patient
  • foot fracture in trauma/sports patients
  • ankle fracture in trauma/sports patients
  • knee fracture in trauma/sport patients
  • pneumonia in community-based patients
  • spinal fracture in older patients with lower back pain
  • cancer in patients with lower back pain
"Stealing" market share may be an uncomfortable concept for private practice physical therapists who have been accustomed to close, collaborative relationships with family physicians.

The primary argument against Direct Access legislation is that patient are not safe to see a physical therapist without a physician referral.

"Stealing" Patients from Physicians, Part 2 of 3 will discuss who is currently "stealing" market share from our physician colleagues.

They are getting GREAT outcomes and making money, too.

Free Tutorial

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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 .

"Make Decisions like Doctors"

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

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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.