"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

Monday, January 9, 2012

Provocative Position by American College of Physicians Calls for "Parsimonious Care"

The American College of Physicians (ACP) issued first-of-its-kind guidelines specifically calling for "parsimonious care" Monday.

Listen to the National Public Radio (NPR) interview here.

The 6th Edition of the ACP Ethics Manual is not a Clinical Practice Guideline so no direct implications are implied for physicians' practice patterns.

In other words, physical therapists shouldn't expect the kind of dramatic shifts in patient referral patterns suggested by the Virginia Mason/Aetna or the Intel/Cigna critical pathways much discussed lately.

But, this is the first time that ANY medical society has advised their physician members to consider cost when making patient care decisions. From the Manual:

"In making recommendations to patients, designing practice guidelines and formularies, and making decisions on medical benefits review boards, physicians considered judgments should reflect the best available evidence in the biomedical literature, including data on the cost-effectiveness of different clinical approaches."
Some people are concerned about the word "parsimonious". They are concerned that this word has a negative conotation that, in the polarized debate over heathcare reform, could be associated with rationing care. As used in the Manual...
"Parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available."
For physical therapists, information on the most efficient care will most likely come from comparative effectiveness studies.

In high-volume conditions such as lower back pain and arthritis guidelines will likely support a shift away from routine imaging, invasive testing and surgical treatment.

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.