Guest guest Posted March 7, 2008 Report Share Posted March 7, 2008 This is interesting: Go to the American Chiropractic website http://www.acatoday.org/ and click on Presidental Race. You'll find a letter from Senator Clinton and Obama stating their support of doctors of Chiropractic. Obama also filled out a questionaire asking more direct questions regarding his supportive position on their field. Is APTA seeking this kind of written support for PT? Why arent there any letters from potential presidents on our website? Did we send them a questionaire about support for physical therapy? Do they know we exist? Schweitzer, DPT Florida Jordan wrote: Armin I like you man. You have a spine. I could not agree more. I wish 70,000 APTA members had the guts to stand together to fight the ridiculous suppression we face and DEMAND changes! Way too many in our profession choose to fold like cheap suits and say " just follow the rules. " Rob Jordan Sent from iPhone On Mar 6, 2008, at 4:14 PM, " jonmarkpleasant " wrote: > > Armin, > > Most of us can relate to your frustration in regard to all of the > rules > and regulations. However, we cannot pick the rules we want to follow > and ignore the others simply because it's different in another country > or because we don't see the logic in them. We, as a profession, should > direct our efforts towards changing the rules that we collectively > want > changed. The APTA is our voice. > > We should try and follow the lead of dentisits if we feel that only > PT's > should own PT clinics. We should try and change the CPT definitions to > include tech/ATC delivery of one-to-one care if we believe this will > add > benefit to our profession. Etc. etc. etc. > > Ignoring the rules we don't agree with is not the answer. > > Thanks, > > Jon Mark Pleasant, PT > > > > > > Matt: > > > > Nice to read the various opinions that come across this server. > > It is really great, so we all learn to disagree. > > And off course we all hear about the wonderful POPTs that are out > there, and just how they are truly motivated solely by the > betterment of > their patients and the entire healthcare. > > As a matter a fact, I just got approached by a physician like that 2 > days ago. True story! Now. Keep in mind that he practices on the space > next to mine. Sends me 2 patients per year, but now offers me a full > case load if I open practice inside of his new building. > > Have you considered why is illegal for physicians to own MRIs, Labs > etc? > > Now, consider this: why wouldn't they open a dental office there as > well? Wouldn't that make a wonderful, one-stop-shop, place for the > betterment of their patients? > > The reason for that is because, UNLIKE THE PHYSICAL THERAPISTS, > dentists stood up for themselves, united, and nowadays only dentists > are > legal practice owners of dental practices. > > Unfortunately, at least in this country, history has not served us > well. Only 200 years after the creation of the profession, we decide > to > take a vision of our own (Vision 2020) and decide to become > independent. > > Just to find out that a good bunch of " us " still consider the " need " > to remain a technician - named physical therapist. > > 200 years later, we are still trying to find out if we can bill for > Iontophoresis if the milliseconds don't add up right, we are still > having to fight to bill evaluations (like in BCBS of NJ). > > And most of all, some colleagues like you are outraged of some of us > that treat two patients simultaneously. Without getting into the > minutia > of this last statement, which could take all gigabytes of this server > for sure, have you considered the fact that statements like yours > " ...as > well as billing for two patients seen at the same time is also more > alarming to me " are not guided by clinical decision but by some > centenary rule, which is not universal by the way, but Medicare > imposed. > > When you see your dentist, is he billing one of the 4 clients he has > in different stages of his care, only because you are all present at > the > same time in his office? > > Or perhaps, the surgeon moving back and forth between surgeries > (2) is > not getting paid by one of them? Or the anesthesiologist as well? > > I just miss to see the ethical misconduct to perform manual PT in > one > patient while I have another one in HP and E-stim, and I find it even > more ludicrous to not be able to bill it. I am not saying for us to > break medicare rules, but I am certainly criticizing such arguments as > being the holy ground of ethical behavior. Because, to drag my feet to > add extra seconds of Ionto treatment sure sounds like unethical if you > ask me. > > I have been practicing for 16 years in this country. Before that, I > practiced for one year in mine. And I am afraid I am yet to see one > physical therapy carrying a stop watch, adding minutes. I have > worked in > large and small hospitals, large and small SNFs, large hospital based > rehabs, Home Health, PT owned private practices, Corporate > outpatient PT > clinics, " amateur " owned PT Clinics, I staffed a POPT once long ago > (shame on me!), I rented space inside a Chiro's office, which kind of > resembles a COPT if you think about it - this one deserves > explanation: > in my country at the time we did not have chiros, therefore I had no > clue what they were. Needless to say, less than 4 weeks into it, we > almost had a fist fight...(just thought this would be entertaining for > some of you...) > > All in all, realize the monopoly the AMA wants to have in > healthcare. > You may think its ok. But the proof is in the fact that if orthos' > cannot have their POPTs, they are just as happy to back up NATA and > have > the ATCs or the PTAs or whomever, just as long as they can bill like > PT. > > Another shocking fact! I just realized this now that I am in private > practice: The MD owned PT clinic gets paid much better rates (MUCH > BETTER!) than I get as a private practice owner. Explain that one! > (retorical). > > Why are we billing our services based on the antiquated AMA model? > > These should be the questions asked. > > Why should I decide, per se, Ionto is clinically necessary to my > patient, use a set of electrodes that cost me 7.00 and not be able to > bill for it? > > These should be the questions asked. > > Why physicians/chiros/etc etc can bill PT if I am the PT and not > them? > > These should be the questions asked. > > Why is it a problem to treat two patients simultaneously? Are you > incapable of such multitasking? And if so, didn't you provided the > service just like the dentist did? Is the dentist going to let you go > for free? > > We don't need to break medicare rules, but we need to change them! > > Dentists have dental fee schedules. Not AMA fee schedules. > > When are we going to rebel against this system of subservience and > free ourselves to do what's best for our patients and be compensated > with dignity without everyone and their cousin encroaching on our > profession? > > When not one more PT think and act like a tech! > > These are my 99 cents! > > Chew me back, I can take it. But take no offense. Lets rebel > together! > > > > > > > > > > > > > > Armin Loges, P.T. > > Tampa, FL > > > > > > > > > > > > > > From: Matt Dvorak > > Sent: Tuesday, March 04, 2008 5:53 PM > > To: PTManager > > Subject: RE: from the Orthopedic surgeons journal... > > > > > > Rob, > > I am a PT working in a hospital based practice and have been a PT > for > near 19 years, therefore, I feel I can speak the following. I know > several PTs working in physician owned practices who practice > ethically > and practically. I say this only for the fact that not all PTs are > practicing unethically, as you state, and not all of these practices > are > " cherry picking " . I say this to emphasize the fact that our > association > would harm these PTs and their livlihood as well as those you > describe. > I want to stick up for these PTs who are hard working and ethical in > their practices. Mark my word...there are many hospital based PT > departments as well as privately owned practices out there who are > practicing as you described. There are hospital based departments who > are part of a hospital organization who own their own insurance > company > and limit who their clients can see for therapy. I suffer from this. I > also have issue with physician offices having ATCs seeing patients and > billing these as PT services. This is more alarming to me. PTs using > aides and billing for PT services as well as billing for two patients > seen at the same time is also more alarming to me. These are issues we > need to address along with our association. In my experience, the > abuse > of utilizing and billing for aides and ATCs time with the patients has > done more for the prediciment our profession is in since the BBA of > 98. > Insurances and patients want a PT working with them not aides and > ATCs. > This needs to be our first concern. My two cents. > > Matt Dvorak, PT > > Yankton, SD > > > > ________________________________ > > > > From: PTManager on behalf of Jordan > > Sent: Thu 2/28/2008 12:03 PM > > To: PTManager > > Subject: RE: from the Orthopedic surgeons journal... > > > > , > > > > You are absolutely correct. Unfortunately, you are preaching to the > choir. > > The problem is that the AMA and AAOS are powerful lobbying groups > and > > present themselves in Washington as being the shepherds of the > " unfortunate > > patients who need someone to protect their interests. " We all know > the > > truth is that these MDs are concerned about one thing only...their > bottom > > line. The problem I am seeing is that they are able to control > referrals to > > make their own outcomes look better. Recently, our Association met > with the > > Board of Directors of Blue Cross Blue Shield of Arkansas. Keep in > mind, the > > Boards of most large insurance carriers is composed of physicians > and > bean > > counters. We were trying to make the argument that BCBS should > consider > > refusing to pay for any PT services provided in a physician's office > due to > > the data you provided. We argued that abuse in POPTS (Referral for > > Profit)should be a serious concern. Unfortunately, the data > collected > by > > BCBS does not suggest abuse (on the surface anyway). Their data > suggested > > that PT provided in a physician's office was less costly and > consisted, on > > average, of less visits to the PT. A survey of patient satisfaction > and > > functional outcomes seemed to support the assertion that patients > were > > better off being seen in the RFP arrangement. At first, we were > shocked. > > But upon later examination, that made perfect sense. The physicians > > controlled the referrals, so they were able to " cherry pick " the > patients > > who had the best insurance, the best potential outcomes, and the > shortest > > anticipated durations of care. All of the most complicated, > troublesome > > patients are referred out to private providers or hospitals. The > RFPs > > operate on pure volume and tend to select the cases who can be seen > three > > times per week for 30 minutes at a time and discharged in less > than 3 > weeks. > > Modalities and hands-on treatment are seldom utilized and exercise > is > the > > preferred means of treatment. RFPs tend to avoid Medicare patients > since > > the regulations are cost-prohibitive and the potential for > scrutiny is > high. > > > > It is my belief that we are at a defining point in our profession's > > evolution. Physician ownership of PT and suppression by insurance > companies > > and Medicare are pushing us backward. Surprisingly, though, many PTs > show > > very little concern for what is happening. APTA is a very effective > > lobbying organization, yet only a fraction of PTs are members of the > > Association. Still fewer contribute to our PAC, whos sole function > is > to > > protect the interests of PT in Washington, D.C. Many PTs have no > idea > who > > their Senators or Congressmen are and even fewer know who their > state > > legislative representatives are. We are facing a nationwide shortage > of PT > > talent and it is not uncommon for a PT to float from one job to > another, > > simply trying to make a few more bucks. Yet, when they do make more > money, > > they still can't seem to afford APTA dues. How rational is that? > > > > RFPs are unethical and the therapists who work in them are > practicing > > unethically. We need to face that fact. If we, as a profession, > don't > > stand up and shine a light on this unethical situation, and call it > what it > > is, we will all be working for doctors one day. Our profession has > been > > suppressed by physicians for so long that we seem to have lost our > will to > > fight. Currently, 45 states have some form of direct access, yet > most > PTs > > do not promote direct accessibility to their patients. We must > adopt a > > mindset that allows us to " market " our services directly to the > public. And > > we must develop a means of providing services to patients on a cash > basis so > > that we no longer continue the subservient relationship with > physicians, > > Medicare and insurance companies. > > > > Rob Jordan, PT, MPT, GCS, OCS > > President, ArPTA > > > > _____ > > > > From: PTManager <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager% > 40yahoogroups.com> ] > On Behalf > > Of PATowne@... <mailto:PATowne%40aol.com> > > Sent: Wednesday, February 27, 2008 11:16 PM > > To: PTManager <mailto:PTManager%40yahoogroups.com> > > Subject: Re: from the Orthopedic surgeons journal... > > > > This is pure rubbish. If one looks at the studies done by the GAO it > is > > evident that POPTS do not comply to Medicare standards and fail > miserably by > > 78% > > and 91% respectfully with the 1994 and 2005 studies. Who is behind > the > > legislative efforts to allow ATC's and personal trainers to treat > and > charge > > as > > physical therapists but the Ortho's. No, it is pure GREED and we > should not > > be lulled into believing that they are SO concerned about their > patients > > that > > they need to CONTROL the use and amount of PT their patients > require. > > > > Having practiced 50 years, I would say that the referrals received > were > > basically worthless regarding anything more than a simple Dx scans > any > real > > direction. > > > > I would love to see a real study of the charges, utilization > patterns > and > > comparison of outcomes by all providers using the 97000 CPT codes. > Let's get > > > > the real facts on the table. > > > > A. Towne, PT > > > > ************-**Ideas to please picky eaters. Watch video on AOL > Living. > > (HYPERLINK > > > " http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campo > \ > s-du > <http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campo > \ > s-du> > > > ffy/ " http://living.-aol.com/video/-how-to-please--your-picky--eater/rach > \ > el-- > <http://living.-aol.com/video/-how-to-please--your-picky--eater/rachel-- > \ > > > > campos-duffy/ > > 2050827?NCID=-aolcmp0030000000-2598) > > > > Quote Link to comment Share on other sites More sharing options...
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