Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Hi Jeff, I would suggest checking with your state statutes. In Florida we are allowed to accept a referral from a chiropractor. Hope this helps. Jill Piazza, PT, MSPT Florida Hospital Deland ---- jeff nolder wrote: ============= Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center _________________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2008 Report Share Posted January 21, 2008 Jeff, I am also in Illinois.. and as I read the IL Practice act regarding referral.. it states: (6) " Referral " means a written or oral authorization for physical therapy services for a patient by a physician, dentist, advanced practice nurse, physician assistant, or podiatrist who maintains medical supervision of the patient and makes a diagnosis or verifies that the patient's condition is such that it may be treated by a physical therapist. Here is the link: Illinois Physical Therapy Practice Act. Illinois General Assembly. Retrieved 1/21/08 from http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbsp%3B ILCS%26nbsp%3B90%2F & Chap> & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap I do not see Chiropractors anywhere in our practice act. Could you please let me know where you find your statement " The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals " ? Thanks. Rhoda Astronomo, PT President R.A. Physical Therapy, PC Gibson City, IL From: PTManager [mailto:PTManager ] On Behalf Of BROWN,JEFF Sent: Monday, January 21, 2008 4:20 PM To: ptmanager Subject: Re: chiropractors Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder <nolderj@... <mailto:nolderj%40hotmail.com> > 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2008 Report Share Posted January 22, 2008 Rhonda, You will need to contact them. I also interpreted the Practice Act as you did and I ran into an " issue " with a local Chiropractor who referred to us. It was further complicated by our then Rehab. med director (who was in name only, he had absolutely no interchange with us) stated we absolutely could not see off chiropractic referral. This is when I went to the IPTA and it was their position that chiropractor was covered by the word " physician " in the statement you quoted from the Practice Act. I urge you to contact the IPTA as well and let me know if this is changed or just plain wrong. ly, I would not like to have our referral sources open to chiropractors. As I mentioned in my previous message it is my opinion that this has been more trouble than it is worth. We have been educating MD's, nurses, etc... for years as to what we can do, when, how much and have with great effort finally gotten the trust and respect we deserve. This has been gained with positive outcomes based on our (Physical Therapist) knowledge and skill, as well as constant communication with the rest of the medical community as to what we do. With my chiropractic referrals the POC has often been changed, negated, and on occation belittled. I know I am preaching to the chior and this is not anything you don't know or haven't been through yourself. This issue has always been a burr in my saddle. Again I urge you to contact the IPTA and let me know if I was in the wrong. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> " Rhoda Astronomo " 01/21/08 5:41 PM >>> Jeff, I am also in Illinois.. and as I read the IL Practice act regarding referral.. it states: (6) " Referral " means a written or oral authorization for physical therapy services for a patient by a physician, dentist, advanced practice nurse, physician assistant, or podiatrist who maintains medical supervision of the patient and makes a diagnosis or verifies that the patient's condition is such that it may be treated by a physical therapist. Here is the link: Illinois Physical Therapy Practice Act. Illinois General Assembly. Retrieved 1/21/08 from http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbsp%3B ILCS%26nbsp%3B90%2F & Chap> & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap I do not see Chiropractors anywhere in our practice act. Could you please let me know where you find your statement " The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals " ? Thanks. Rhoda Astronomo, PT President R.A. Physical Therapy, PC Gibson City, IL From: PTManager [mailto:PTManager ] On Behalf Of BROWN,JEFF Sent: Monday, January 21, 2008 4:20 PM To: ptmanager Subject: Re: chiropractors Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder <nolderj@... <mailto:nolderj%40hotmail.com> > 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2008 Report Share Posted January 22, 2008 We have been under the impression that since Chiro's are listed as Chiro Physician, we do have the ability to see them. Doesn't happen very much in Lincoln but if it does, we usually do see them. We will generally recommend that the pt go see their primary and confirm the dx and get a referral from them. Todd Mourning, PT Abraham Lincoln Memorial Hospital Lincoln, IL ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Rhoda Astronomo Sent: Monday, January 21, 2008 5:42 PM To: PTManager Subject: RE: chiropractors Jeff, I am also in Illinois.. and as I read the IL Practice act regarding referral.. it states: (6) " Referral " means a written or oral authorization for physical therapy services for a patient by a physician, dentist, advanced practice nurse, physician assistant, or podiatrist who maintains medical supervision of the patient and makes a diagnosis or verifies that the patient's condition is such that it may be treated by a physical therapist. Here is the link: Illinois Physical Therapy Practice Act. Illinois General Assembly. Retrieved 1/21/08 from http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbsp%3B ILCS%26nbsp%3B90%2F & Chap> & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap I do not see Chiropractors anywhere in our practice act. Could you please let me know where you find your statement " The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals " ? Thanks. Rhoda Astronomo, PT President R.A. Physical Therapy, PC Gibson City, IL From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf Of BROWN,JEFF Sent: Monday, January 21, 2008 4:20 PM To: ptmanager <mailto:ptmanager%40yahoogroups.com> Subject: Re: chiropractors Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder <nolderj@...<mailto:nolderj%40hotmail.com> <mailto:nolderj%40hotmail.com> > 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2008 Report Share Posted January 22, 2008 In MT we are able to accept referrals from a chiropractor, however, Medicare will not reimburse for a referral from a chiropractor. In addition to checking your state practice act, I would check with your fiscal intermediary. Holly Ferguson, PT Director of Rehab Services St Healthcare Re: chiropractors Hi Jeff, I would suggest checking with your state statutes. In Florida we are allowed to accept a referral from a chiropractor. Hope this helps. Jill Piazza, PT, MSPT Florida Hospital Deland ---- jeff nolder <nolderj@... <mailto:nolderj%40hotmail.com> > wrote: ============= Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j an <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ jan> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2008 Report Share Posted January 22, 2008 We have never accepted referrals from a chiropractor. My understanding is that the term " physician " refers only to those licensed as an MD or DO. Also, since chiropractors have historically distanced themselves from the medical community, I would question whether they " maintain medical supervision of the patient " , as stated in our practice act. Vickie Roeser, PT Richland Memorial Hospital Olney, IL Re: chiropractors Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder <nolderj@... <mailto:nolderj%40hotmail.com> <mailto:nolderj%40hotmail.com> <mailto:nolderj%40hotmail.com> > 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j an <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ jan> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2008 Report Share Posted February 1, 2008 Here's my take. If you are going to treat a patient referred from a chiropractor make sure its a referral and that you are responsible for the evaluation and the treatment that follows and that during this period the chiropractor is not engaged in treating the patient. Do not accept a prescription for modalities especially while the chiropractor continues with his/her administrations. Stanley Paris ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Mourning, Todd Sent: Tuesday, January 22, 2008 9:48 AM To: 'PTManager ' Subject: RE: chiropractors We have been under the impression that since Chiro's are listed as Chiro Physician, we do have the ability to see them. Doesn't happen very much in Lincoln but if it does, we usually do see them. We will generally recommend that the pt go see their primary and confirm the dx and get a referral from them. Todd Mourning, PT Abraham Lincoln Memorial Hospital Lincoln, IL ________________________________ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of Rhoda Astronomo Sent: Monday, January 21, 2008 5:42 PM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: RE: chiropractors Jeff, I am also in Illinois.. and as I read the IL Practice act regarding referral.. it states: (6) " Referral " means a written or oral authorization for physical therapy services for a patient by a physician, dentist, advanced practice nurse, physician assistant, or podiatrist who maintains medical supervision of the patient and makes a diagnosis or verifies that the patient's condition is such that it may be treated by a physical therapist. Here is the link: Illinois Physical Therapy Practice Act. Illinois General Assembly. Retrieved 1/21/08 from http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs p%3B <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs p%3B> ILCS%26nbsp%3B90%2F & Chap> & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap I do not see Chiropractors anywhere in our practice act. Could you please let me know where you find your statement " The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals " ? Thanks. Rhoda Astronomo, PT President R.A. Physical Therapy, PC Gibson City, IL From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] On Behalf Of BROWN,JEFF Sent: Monday, January 21, 2008 4:20 PM To: ptmanager <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com> Subject: Re: chiropractors Jeff, The Illinios Physical Therapy Assoc. states that our Practice Act allows for PT's to eval/treat from Chiropractic referrals. This has been all that we have needed to see these patients in our hospital system. As far as the reimbursement issue there have been so few that I have not gotten word from our business office as to not having coverage. The one thing I have been most concerned about is the dual treatment of our service and the chiropractors treatment. My personal experience is that this has not been very successful. I have found more often than not that my plan of care has been altered, added too, or negated. Take this for what it is worth. Jeff Brown PT Director of Rehabilitation Decatur Memorial Hospital Decatur, Illinois >>> jeff nolder <nolderj@... <mailto:nolderj%40hotmail.com> <mailto:nolderj%40hotmail.com> <mailto:nolderj%40hotmail.com> > 01/21/08 3:20 PM >>> Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help Jeff Nolder, PT Director of Physical Medicine and Rehab Cherokee Regional Medical Center __________________________________________________________ Climb to the top of the charts! Play the word scramble challenge with star power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_j an <http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_ jan> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2008 Report Share Posted February 6, 2008 PT and chiropractic are not similar. They are 2 distinct professions with distinct bodies of knowledge. Without being schooled as a chiro, how do you even know what they know? 2 professions with 2 different viewpoints can both benefit a patient at the same time. Even 2 PTs collaborating in a single clinic can benefit a single patient..Why not another professional? Its tiring to hear so many of my fellow PT collegues be so negative to another medical profession. Just do your best work and let the rest unfold. Cheeers, keith bisesi wrote: It's not really an evidence based practice or research based comment. It's simply not necessary. If you're seeking two similar treatment options, how do you know which is helping? I wouldn't have two mechanics co-repair my car's engine. It would be similar to an MD referring a patient to an OT and to a PT for a wrist injury - I would advise a patient to see one or the other. Regarding the chiropractic referral example, I would have the patient begin PT when the chiropractic care was complete. I wouldn't try to take the patient away from the chiro who referred him/her. Bisesi MPT COMT Winter Haven, Fl --- Schweitzer wrote: > There is no evidence that I know of in the > literature that co-treating a patient with another > manual-based clinican such as a chiropractor is > detrimental to the patient. > > Schweitzer > > " Dogma is the curse of learning. " - Laurie Hartman > > > > keith bisesi wrote: > I completely agree. I posted a similar > opinion a few > weeks ago. I often see chiropractors refer to us > assuming we are to perform the exercise portion of > rehab while they do the manual work. I always advise > my patients to not do both chiropractic and physical > therapy simultaneously. > > Bisesi MPT COMT > Winter Haven, Fl > > --- Stanley Paris wrote: > > > Here's my take. If you are going to treat a > patient > > referred from a > > chiropractor make sure its a referral and that you > > are responsible for > > the evaluation and the treatment that follows and > > that during this > > period the chiropractor is not engaged in treating > > the patient. Do not > > accept a prescription for modalities especially > > while the chiropractor > > continues with his/her administrations. > > Stanley Paris > > > > ________________________________ > > > > From: PTManager > > [mailto:PTManager ] On > > Behalf Of Mourning, Todd > > Sent: Tuesday, January 22, 2008 9:48 AM > > To: 'PTManager ' > > Subject: RE: chiropractors > > > > > > > > We have been under the impression that since > Chiro's > > are listed as Chiro > > Physician, we do have the ability to see them. > > Doesn't happen very much > > in Lincoln but if it does, we usually do see them. > > We will generally > > recommend that the pt go see their primary and > > confirm the dx and get a > > referral from them. > > > > Todd Mourning, PT > > > > Abraham Lincoln Memorial Hospital > > Lincoln, IL > > > > ________________________________ > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> ] > > On Behalf Of Rhoda Astronomo > > Sent: Monday, January 21, 2008 5:42 PM > > To: PTManager > > <mailto:PTManager%40yahoogroups.com> > > Subject: RE: chiropractors > > > > Jeff, > > > > I am also in Illinois.. and as I read the IL > > Practice act regarding > > referral.. it states: > > > > (6) " Referral " means a written or oral > authorization > > for physical > > therapy > > services for a patient by a physician, dentist, > > advanced practice nurse, > > physician assistant, or podiatrist who maintains > > medical supervision of > > the > > patient and makes a diagnosis or verifies that the > > patient's condition > > is > > such that it may be treated by a physical > therapist. > > > > Here is the link: > > > > Illinois Physical Therapy Practice Act. Illinois > > General Assembly. > > Retrieved 1/21/08 from > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > > p%3B> > > ILCS%26nbsp%3B90%2F & Chap> > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > I do not see Chiropractors anywhere in our > practice > > act. Could you > > please > > let me know where you find your statement " The > > Illinios Physical Therapy > > Assoc. states that our Practice Act allows for > PT's > > to eval/treat from > > Chiropractic referrals " ? > > > > Thanks. > > > > Rhoda Astronomo, PT > > > > President > > > > R.A. Physical Therapy, PC > > > > Gibson City, IL > > > > > > > > From: PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com> > > [mailto:PTManager > > <mailto:PTManager%40yahoogroups.com> > > <mailto:PTManager%40yahoogroups.com>] On Behalf > > Of BROWN,JEFF > > Sent: Monday, January 21, 2008 4:20 PM > > To: ptmanager > > <mailto:ptmanager%40yahoogroups.com> > > <mailto:ptmanager%40yahoogroups.com> > > Subject: Re: chiropractors > > > > Jeff, > > The Illinios Physical Therapy Assoc. states that > our > > Practice Act allows > > for > > PT's to eval/treat from Chiropractic referrals. > This > > has been all that > > we > > have needed to see these patients in our hospital > > system. As far as the > > reimbursement issue there have been so few that I > > have not gotten word > > from > > our business office as to not having coverage. > > > > The one thing I have been most concerned about is > > the dual treatment of > > our > > service and the chiropractors treatment. My > personal > > experience is that > > this > > has not been very successful. I have found more > > often than not that my > > plan > > of care has been altered, added too, or negated. > > > > Take this for what it is worth. > > > > Jeff Brown PT > > Director of Rehabilitation > > Decatur Memorial Hospital > > Decatur, Illinois > > > > >>> jeff nolder <nolderj@... > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > <mailto:nolderj%40hotmail.com> > > > 01/21/08 3:20 PM >>> > > > > Hello group, we are a small town hospital with > three > > chiropractic > > clinics in > > town. We have recently seen an increase in > referrals > > from chiropractic > === message truncated === __________________________________________________________ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs --------------------------------- Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2008 Report Share Posted February 8, 2008 I have been following this post for a few days, reading the comments from everyone and I think that there are many valid points. Co-treating with any professional (in the eyes of many consumers, chiropractors are professionals) can be a difficult challenge. However, if a patient were seeing a DO who was performing manipulation would you insist that he discontinue his care with that particular provider? Do you think that it is possible to co-treat with the DO? It seems to me, and this is just my opinion, that if we are making a professional stand that we are unwilling to work with the chiropractor because he is performing manipulations, we should be carrying that across to other professionals as well. I will agree that the DO has a much broader education and may be able to make better decisions in terms of when he may choose to manipulate. But, I think that most of the arguments for co-treating that have been posted would have to be the same. I think that it is important for PTs to work towards autonomy, but I feel that there are many healthcare professionals that we need to work with, even the ones that threaten our profession (maybe forging positive relationships and educating them could be a good thing?). I strongly agree with Tom, that many patients are not going to stop going to their chiropractors and that very good relationships can be developed between our professions. Of course, we will always have providers on both sides of this issue who will not see it this way. I think that this is unfortunate for our patients. We, as PTs, especially if we are looking for autonomy, have to think a little bigger. Healthcare is becoming more and more consumer driven. I know that I have had several patients, after seeing a chiropractor that is very anti-PT, decide not to continue with their chiropractic care. Often it is just because of the closed minded stance of the chiropractor. I would not want this to be the case in reverse. Many PTs have such an adversarial relationship with chiropractors. It is certainly much more of a turf battle. I am not saying that I agree with everything that a chiropractor does, however, I think that, as we fight in many states for the legal right to perform manipulations, we may want to better examine our motives. And, as Tom much more eloquently stated, it is about the patient, not our own egos. Sorry if my views offend, however, I do love a good discussion. Sincerely, Don Levine, PT RI **************Biggest Grammy Award surprises of all time on AOL Music. (http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp00300000002\ 5 48) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2008 Report Share Posted February 8, 2008 My 10 million dollar question: Keeping all our collective hands-on experience in perspective, do patients really need their spine " cracked up " i.e. forcefully manipulated? Hiten Dave' PT -------------- Original message -------------- Hi everyone, As I said in my earlier posts, I understand the passion and emotions that PT's have regarding chiropractors and I don't begrudge you them. I accept that you disagree with our philosophy. I do feel like I have to explain our philosophy a bit farther. While I do not agree with in depth chiropractic philosophy, I do agree that manipulation of the spine is an appropriate and research based approach in many of the third party cases I was referring to earlier where chiropractic is involved. If my evaluation shows that manipulation of the spine is not appropriate, I educate my patient/client on my findings. Ultimately it is up to the informed patient/client to decide. I do not double up on spinal manipulation if the patient/client is receiving manipulation from the chiropractor. Instead I focus on other areas of physical therapy that may help, based on the evaluation. (exercise, soft tissue work, education, back school, ergonomics etc) The treatment is then coordinated with the chiropractor. If the patient/client is educated about their treatment (which we always do), about the differences between chiropractic and physical therapy (which we always do) and then still feels they are being helped by the chiropractor, who am I to stop them? Our first priority is to the patient/client not to our own biases. All we can do is educate and give the patient/client the tools to make an informed decision. The fact is many clients will continue with both chiropractic and physical therapy. Whether I like it or not is irrelevant. Instead we have looked past the negatives and made it a positive thing by coordinating care, educating patient/clients and chiropractors and focusing on what we can do to promote recovery within the system we are given. Look I know that you may still disagree and I will not continue to belabor this. I appreciate that you may think this is wrong. We do not. If anything, I hope that I have made you think a bit on this Friday on February! With all respect, Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellpt@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2008 Report Share Posted February 8, 2008 Good point Dave. I had a chiropractor tell me recently that he's been " enlightened " in that cracking a spine is of no more benefit or corrective permanence than one cracking their knuckles. It just pops back until the root problem is corrected. Good food for thought. Doug Doug Sparks Advanced Physical Therapy Concepts / APTC www.aptc.biz<http://www.aptc.biz/> doug@... Re: chiropractors My 10 million dollar question: Keeping all our collective hands-on experience in perspective, do patients really need their spine " cracked up " i.e. forcefully manipulated? Hiten Dave' PT -------------- Original message -------------- > Hi everyone, As I said in my earlier posts, I understand the passion and emotions that PT's have regarding chiropractors and I don't begrudge you them. I accept that you disagree with our philosophy. I do feel like I have to explain our philosophy a bit farther. While I do not agree with in depth chiropractic philosophy, I do agree that manipulation of the spine is an appropriate and research based approach in many of the third party cases I was referring to earlier where chiropractic is involved. If my evaluation shows that manipulation of the spine is not appropriate, I educate my patient/client on my findings. Ultimately it is up to the informed patient/client to decide. I do not double up on spinal manipulation if the patient/client is receiving manipulation from the chiropractor. Instead I focus on other areas of physical therapy that may help, based on the evaluation. (exercise, soft tissue work, education, back school, ergonomics etc) The treatment is then coordinated with the chiropractor. If the patient/client is educated about their treatment (which we always do), about the differences between chiropractic and physical therapy (which we always do) and then still feels they are being helped by the chiropractor, who am I to stop them? Our first priority is to the patient/client not to our own biases. All we can do is educate and give the patient/client the tools to make an informed decision. The fact is many clients will continue with both chiropractic and physical therapy. Whether I like it or not is irrelevant. Instead we have looked past the negatives and made it a positive thing by coordinating care, educating patient/clients and chiropractors and focusing on what we can do to promote recovery within the system we are given. Look I know that you may still disagree and I will not continue to belabor this. I appreciate that you may think this is wrong. We do not. If anything, I hope that I have made you think a bit on this Friday on February! With all respect, Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID howellpt@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2008 Report Share Posted February 10, 2008 As far as I understand, the last CMS clarification excludes chiros from being accepted referrers. > > > Hello group, we are a small town hospital with three chiropractic clinics in town. We have recently seen an increase in referrals from chiropractic offices. In the past we have not allowed these and need a referral from a family doc to treat. We have found that most of these patients will not go to the family doc and are just staying with the chiropractors. We would like to be able to see these patients and do not want to exclude a referral source. Our policy at the hosiptal is that every pateint needs to have a doctors referral to be seen. I would like to see these patients but unsure how to go about doing this? Secondary to liability issues and payment issues for multiple insurances, do anyone have a good solutions or ideas how to fix this problem? thanks for the help > > Jeff Nolder, PT > Director of Physical Medicine and Rehab > Cherokee Regional Medical Center > > _________________________________________________________________ > Climb to the top of the charts! Play the word scramble challenge with star power. > http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 11, 2008 Report Share Posted February 11, 2008 I do not disagree with your points at all that it can be done to benefit the patient. My concern is our coflicting philosphy with manual therapy and a chiro. As a manual therapist, my evaluation dictates whether I feel a patient needs, a gr 1-2-3-4 or 5 mobilization/manipulation while a chiro feels a gr 5 is a cure-all. I'll admint I'm very biased being a manual specialist. I wouldn't feel I was contributing with exercise prescription if I didn't agree with the rationale behind the manual therapy provided. However, at least the chiropractor is utilizing PT. He could be letting a CA exercise patients and billing for PT instead of you. Overall its a positive. . --- Matt Dvorak wrote: > , > I have co-treated multiple times with a > chiropractor, as I rent space out of a chiro > clinic.....interesting, I know. When I read two > seperate postings stating not to treat > simultaneously with PT, my question is, why not? I > am an orthopedic PT and I do not perform > manipulations. If chiro can assist with some pain > relief when I cannot, why not? My patients thank me > over and over for the insight of suggesting a chiro. > These patients have usually used chiro in the past > and are open to the idea. I continue with exercise > and modalities as needed. Works for me, and also > for some of my patients. Maybe seeing how two > different professions can work together can be of > benefit to a patient after all. > Matt Dvorak, PT > Yankton, SD > > ________________________________ > > From: PTManager on behalf of keith > bisesi > Sent: Tue 2/5/2008 9:18 PM > To: PTManager > Subject: RE: chiropractors > > > > It's not really an evidence based practice or > research > based comment. It's simply not necessary. If you're > seeking two similar treatment options, how do you > know > which is helping? I wouldn't have two mechanics > co-repair my car's engine. It would be similar to an > MD referring a patient to an OT and to a PT for a > wrist injury - I would advise a patient to see one > or > the other. Regarding the chiropractic referral > example, I would have the patient begin PT when the > chiropractic care was complete. I wouldn't try to > take > the patient away from the chiro who referred > him/her. > > Bisesi MPT COMT > Winter Haven, Fl > > --- Schweitzer <ericschweitzer2@... > <mailto:ericschweitzer2%40yahoo.com> > wrote: > > > There is no evidence that I know of in the > > literature that co-treating a patient with another > > manual-based clinican such as a chiropractor is > > detrimental to the patient. > > > > Schweitzer > > > > " Dogma is the curse of learning. " - Laurie Hartman > > > > > > > > keith bisesi <kbisesi@... > <mailto:kbisesi%40yahoo.com> > wrote: > > I completely agree. I posted a similar > > opinion a few > > weeks ago. I often see chiropractors refer to us > > assuming we are to perform the exercise portion of > > rehab while they do the manual work. I always > advise > > my patients to not do both chiropractic and > physical > > therapy simultaneously. > > > > Bisesi MPT COMT > > Winter Haven, Fl > > > > --- Stanley Paris <sparis@... > <mailto:sparis%40usa.edu> > wrote: > > > > > Here's my take. If you are going to treat a > > patient > > > referred from a > > > chiropractor make sure its a referral and that > you > > > are responsible for > > > the evaluation and the treatment that follows > and > > > that during this > > > period the chiropractor is not engaged in > treating > > > the patient. Do not > > > accept a prescription for modalities especially > > > while the chiropractor > > > continues with his/her administrations. > > > Stanley Paris > > > > > > ________________________________ > > > > > > From: PTManager > <mailto:PTManager%40yahoogroups.com> > > > [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> ] On > > > Behalf Of Mourning, Todd > > > Sent: Tuesday, January 22, 2008 9:48 AM > > > To: 'PTManager > <mailto:%27PTManager%40yahoogroups.com> ' > > > Subject: RE: chiropractors > > > > > > > > > > > > We have been under the impression that since > > Chiro's > > > are listed as Chiro > > > Physician, we do have the ability to see them. > > > Doesn't happen very much > > > in Lincoln but if it does, we usually do see > them. > > > We will generally > > > recommend that the pt go see their primary and > > > confirm the dx and get a > > > referral from them. > > > > > > Todd Mourning, PT > > > > > > Abraham Lincoln Memorial Hospital > > > Lincoln, IL > > > > > > ________________________________ > > > From: PTManager > <mailto:PTManager%40yahoogroups.com> > > > <mailto:PTManager%40yahoogroups.com> > > > [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> > > > <mailto:PTManager%40yahoogroups.com> ] > > > On Behalf Of Rhoda Astronomo > > > Sent: Monday, January 21, 2008 5:42 PM > > > To: PTManager > <mailto:PTManager%40yahoogroups.com> > > > <mailto:PTManager%40yahoogroups.com> > > > Subject: RE: chiropractors > > > > > > Jeff, > > > > > > I am also in Illinois.. and as I read the IL > > > Practice act regarding > > > referral.. it states: > > > > > > (6) " Referral " means a written or oral > > authorization > > > for physical > > > therapy > > > services for a patient by a physician, dentist, > > > advanced practice nurse, > > > physician assistant, or podiatrist who maintains > > > medical supervision of > > > the > > > patient and makes a diagnosis or verifies that > the > > > patient's condition > > > is > > > such that it may be treated by a physical > > therapist. > > > > > > Here is the link: > > > > > > Illinois Physical Therapy Practice Act. Illinois > > > General Assembly. > > > Retrieved 1/21/08 from > > > > > > http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319> > > > > > > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs> > > > > p%3B > > > > > > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs > <http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319 & ChapAct=225%26nbs> > > > > p%3B> > > > ILCS%26nbsp%3B90%2F & Chap> > > > & ChapAct=225%26nbsp%3BILCS%26nbsp%3B90%2F & Chap > > > > > > I do not see Chiropractors anywhere in our > > practice > > > act. Could you > > > please > > > let me know where you find your statement " The > === message truncated === ________________________________________________________________________________\ ____ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
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