RE: Re: wait times to new evaluations

[Guest guest]

Doug,

Having also worked in the private practice setting in which there are multiple

local OP hospital departments myself made me wonder....

Have you had any " marketing " success/ significant referral base from any of

those physicians who do receive production bonuses for referring " in house. "

If so, how did you build that rapport despite their gaining financially by

referring elsewhere?

And, a question for the group at large, how is this hospital production bonus

practice still " legal? " A private practice PT can hardly have coffee with a

friend who also happens to be an MD without someone yelling " referral for

profit!l

Thanks!

Hill, PT, DPT

Doctor of Physical Therapy/ Staff Physical Therapist

Sta-home Health & Hospice

Sent via BlackBerry by AT & T

Re: wait times to new evaluations

Your response is noted.

Our clinic policy is 48 hours or less. Patients can request a longer time frame

to start care. We are 90% successful in our policy. Post operative cases take

precedent and can be same day if necessary. Off work workers compensation cases

are 48 hours or less. This requires an efficient front office obtaining

authorizations at time of referral.

The hospital 8000 sq ft hospital out patient clinic down the road typically has

a 2-3 week wait. This leads to patient/physician/insurance carrier frustration.

Physicians who are employees of hospitals gain production bonuses for using

hospital based services get very angry when their employer is unable to fulfill

promises made.

Go USA women's soccer, beat Japan.

Roll PT

www.ptcos.com

>

> Matt,

> I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

>

> Lindberg, PT

> Avista Adventist Hospital

> Louisville, CO

>

[Guest guest]

Doug,

Having also worked in the private practice setting in which there are multiple

local OP hospital departments myself made me wonder....

Have you had any " marketing " success/ significant referral base from any of

those physicians who do receive production bonuses for referring " in house. "

If so, how did you build that rapport despite their gaining financially by

referring elsewhere?

And, a question for the group at large, how is this hospital production bonus

practice still " legal? " A private practice PT can hardly have coffee with a

friend who also happens to be an MD without someone yelling " referral for

profit!l

Thanks!

Hill, PT, DPT

Doctor of Physical Therapy/ Staff Physical Therapist

Sta-home Health & Hospice

Sent via BlackBerry by AT & T

Re: wait times to new evaluations

Your response is noted.

Our clinic policy is 48 hours or less. Patients can request a longer time frame

to start care. We are 90% successful in our policy. Post operative cases take

precedent and can be same day if necessary. Off work workers compensation cases

are 48 hours or less. This requires an efficient front office obtaining

authorizations at time of referral.

The hospital 8000 sq ft hospital out patient clinic down the road typically has

a 2-3 week wait. This leads to patient/physician/insurance carrier frustration.

Physicians who are employees of hospitals gain production bonuses for using

hospital based services get very angry when their employer is unable to fulfill

promises made.

Go USA women's soccer, beat Japan.

Roll PT

www.ptcos.com

>

> Matt,

> I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

>

> Lindberg, PT

> Avista Adventist Hospital

> Louisville, CO

>

[Guest guest]

Doug,

Having also worked in the private practice setting in which there are multiple

local OP hospital departments myself made me wonder....

Have you had any " marketing " success/ significant referral base from any of

those physicians who do receive production bonuses for referring " in house. "

If so, how did you build that rapport despite their gaining financially by

referring elsewhere?

And, a question for the group at large, how is this hospital production bonus

practice still " legal? " A private practice PT can hardly have coffee with a

friend who also happens to be an MD without someone yelling " referral for

profit!l

Thanks!

Hill, PT, DPT

Doctor of Physical Therapy/ Staff Physical Therapist

Sta-home Health & Hospice

Sent via BlackBerry by AT & T

Re: wait times to new evaluations

Your response is noted.

Our clinic policy is 48 hours or less. Patients can request a longer time frame

to start care. We are 90% successful in our policy. Post operative cases take

precedent and can be same day if necessary. Off work workers compensation cases

are 48 hours or less. This requires an efficient front office obtaining

authorizations at time of referral.

The hospital 8000 sq ft hospital out patient clinic down the road typically has

a 2-3 week wait. This leads to patient/physician/insurance carrier frustration.

Physicians who are employees of hospitals gain production bonuses for using

hospital based services get very angry when their employer is unable to fulfill

promises made.

Go USA women's soccer, beat Japan.

Roll PT

www.ptcos.com

>

> Matt,

> I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

>

> Lindberg, PT

> Avista Adventist Hospital

> Louisville, CO

>

[Guest guest]

It sounds like a pretty clear Stark violation to me. I run 4 outpatient hospital

clinics. We have affiliations with community docs, mostly and some joint

ventures. We are on the same level competitive playing field with outside PT

practices for referrals. We can market our own practices just like our

competitors. The hospital can't give any incentives (or threats) to prod docs

into referring internally. We have to prove ourselves with the quality of our

services, even to our own docs. If we don't do that successfully, we can lose

even our own docs to another practice.

If this " incentive " practice is truly going on in your area, then it sounds like

something reportable.

Meryl Freeman, MS PT

Rex Outpatient Rehab

NC

Meryl W. Freeman, MS PT

Manager, Outpatient Rehab

(919)784-4676 (office)

(919)621-3787 (cell)

From: hilljeremy@...

Sent: Friday, July 15, 2011 02:33 PM

To: PTManager <PTManager >

Subject: Re: Re: wait times to new evaluations

Doug,

Having also worked in the private practice setting in which there are multiple

local OP hospital departments myself made me wonder....

Have you had any " marketing " success/ significant referral base from any of

those physicians who do receive production bonuses for referring " in house. "

If so, how did you build that rapport despite their gaining financially by

referring elsewhere?

And, a question for the group at large, how is this hospital production bonus

practice still " legal? " A private practice PT can hardly have coffee with a

friend who also happens to be an MD without someone yelling " referral for

profit!l

Thanks!

Hill, PT, DPT

Doctor of Physical Therapy/ Staff Physical Therapist

Sta-home Health & Hospice

Sent via BlackBerry by AT & T

Re: wait times to new evaluations

Your response is noted.

Our clinic policy is 48 hours or less. Patients can request a longer time frame

to start care. We are 90% successful in our policy. Post operative cases take

precedent and can be same day if necessary. Off work workers compensation cases

are 48 hours or less. This requires an efficient front office obtaining

authorizations at time of referral.

The hospital 8000 sq ft hospital out patient clinic down the road typically has

a 2-3 week wait. This leads to patient/physician/insurance carrier frustration.

Physicians who are employees of hospitals gain production bonuses for using

hospital based services get very angry when their employer is unable to fulfill

promises made.

Go USA women's soccer, beat Japan.

Roll PT

www.ptcos.com

>

> Matt,

> I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

>

> Lindberg, PT

> Avista Adventist Hospital

> Louisville, CO

>

[Guest guest]

It sounds like a pretty clear Stark violation to me. I run 4 outpatient hospital

clinics. We have affiliations with community docs, mostly and some joint

ventures. We are on the same level competitive playing field with outside PT

practices for referrals. We can market our own practices just like our

competitors. The hospital can't give any incentives (or threats) to prod docs

into referring internally. We have to prove ourselves with the quality of our

services, even to our own docs. If we don't do that successfully, we can lose

even our own docs to another practice.

If this " incentive " practice is truly going on in your area, then it sounds like

something reportable.

Meryl Freeman, MS PT

Rex Outpatient Rehab

NC

Meryl W. Freeman, MS PT

Manager, Outpatient Rehab

(919)784-4676 (office)

(919)621-3787 (cell)

From: hilljeremy@...

Sent: Friday, July 15, 2011 02:33 PM

To: PTManager <PTManager >

Subject: Re: Re: wait times to new evaluations

Doug,

Having also worked in the private practice setting in which there are multiple

local OP hospital departments myself made me wonder....

Have you had any " marketing " success/ significant referral base from any of

those physicians who do receive production bonuses for referring " in house. "

If so, how did you build that rapport despite their gaining financially by

referring elsewhere?

And, a question for the group at large, how is this hospital production bonus

practice still " legal? " A private practice PT can hardly have coffee with a

friend who also happens to be an MD without someone yelling " referral for

profit!l

Thanks!

Hill, PT, DPT

Doctor of Physical Therapy/ Staff Physical Therapist

Sta-home Health & Hospice

Sent via BlackBerry by AT & T

Re: wait times to new evaluations

Your response is noted.

Our clinic policy is 48 hours or less. Patients can request a longer time frame

to start care. We are 90% successful in our policy. Post operative cases take

precedent and can be same day if necessary. Off work workers compensation cases

are 48 hours or less. This requires an efficient front office obtaining

authorizations at time of referral.

The hospital 8000 sq ft hospital out patient clinic down the road typically has

a 2-3 week wait. This leads to patient/physician/insurance carrier frustration.

Physicians who are employees of hospitals gain production bonuses for using

hospital based services get very angry when their employer is unable to fulfill

promises made.

Go USA women's soccer, beat Japan.

Roll PT

www.ptcos.com

>

> Matt,

> I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

>

> Lindberg, PT

> Avista Adventist Hospital

> Louisville, CO

>

[Guest guest]

It sounds like a pretty clear Stark violation to me. I run 4 outpatient hospital

clinics. We have affiliations with community docs, mostly and some joint

ventures. We are on the same level competitive playing field with outside PT

practices for referrals. We can market our own practices just like our

competitors. The hospital can't give any incentives (or threats) to prod docs

into referring internally. We have to prove ourselves with the quality of our

services, even to our own docs. If we don't do that successfully, we can lose

even our own docs to another practice.

If this " incentive " practice is truly going on in your area, then it sounds like

something reportable.

Meryl Freeman, MS PT

Rex Outpatient Rehab

NC

Meryl W. Freeman, MS PT

Manager, Outpatient Rehab

(919)784-4676 (office)

(919)621-3787 (cell)

From: hilljeremy@...

Sent: Friday, July 15, 2011 02:33 PM

To: PTManager <PTManager >

Subject: Re: Re: wait times to new evaluations

Doug,

Having also worked in the private practice setting in which there are multiple

local OP hospital departments myself made me wonder....

Have you had any " marketing " success/ significant referral base from any of

those physicians who do receive production bonuses for referring " in house. "

If so, how did you build that rapport despite their gaining financially by

referring elsewhere?

And, a question for the group at large, how is this hospital production bonus

practice still " legal? " A private practice PT can hardly have coffee with a

friend who also happens to be an MD without someone yelling " referral for

profit!l

Thanks!

Hill, PT, DPT

Doctor of Physical Therapy/ Staff Physical Therapist

Sta-home Health & Hospice

Sent via BlackBerry by AT & T

Re: wait times to new evaluations

Your response is noted.

Our clinic policy is 48 hours or less. Patients can request a longer time frame

to start care. We are 90% successful in our policy. Post operative cases take

precedent and can be same day if necessary. Off work workers compensation cases

are 48 hours or less. This requires an efficient front office obtaining

authorizations at time of referral.

The hospital 8000 sq ft hospital out patient clinic down the road typically has

a 2-3 week wait. This leads to patient/physician/insurance carrier frustration.

Physicians who are employees of hospitals gain production bonuses for using

hospital based services get very angry when their employer is unable to fulfill

promises made.

Go USA women's soccer, beat Japan.

Roll PT

www.ptcos.com

>

> Matt,

> I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

>

> Lindberg, PT

> Avista Adventist Hospital

> Louisville, CO

>

[Guest guest]

Really, we have never been booked 2-3 weeks out but we have been booked a 7-10

days out.

That being said, if you work extra hard for 2-3 weeks and get those clients in

and " catch up " so to speak, you won't have the back log. Yes, we on occasion

have to have a new client in a 30 minute slot but no one is double booked and we

can start that client to feeling better. I have always been under the opinion

that a new eval does not have to be completed on the first visit. You just need

to get a good start and an idea of what's happening. The next visit whatever

was missed eval-wise can be completed. The clients appreciate getting started

on the road to recovery.

APC

> I have long wanted to ask, how do those of you that get new evaluations in the

door within " 48 hours or less " do it? I have 7 therapists on staff and we are

often booked out for 2-3 weeks or more during our busiest season. Even if I was

able to convince a therapist to stay late or start early (they are already

working ten hour days this time of year) I would have no spots to schedule that

new patient's follow up visits. So how do you do it? Do you double book?, triple

book?, shift another patient to a tech or an aides " schedule " , double book a

PTA? Is this new patient getting a quality evaluation? I know that I see

patients every day who are amazed that I actually take the time to do an

evaluation, they relay stories of being " seen " but not examined and instead

simply started on an exercise protocol pulled out of a drawer at their previous

PT. Are we devaluing our profession and underserving our patients in the name of

pleasing our referral sources? Does it benefit the patient more to be seen right

away in a haphazard manner or to wait for someone who will actually take the

time to do a quality evaluation and design an individual treatment plan with

adequate follow up visits actually performed by the individual who did the

evaluation? I don't know the answers to these questions but I do know that we

see patients in our clinic everyday who are willing to wait for the latter,

especially if they have already been through the prior. I appreciate the

discussion.

>

> E s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

>

> > >

> > > Matt,

> > > I take some offense with your assumption that hospital based OP therapy

depts don't strive to get people in quickly. I work in that world and we strive

to do the same thing for patients that you do.

> > >

> > > Lindberg, PT

> > > Avista Adventist Hospital

> > > Louisville, CO

> > >

> >

>

>

[Guest guest]

Really, we have never been booked 2-3 weeks out but we have been booked a 7-10

days out.

That being said, if you work extra hard for 2-3 weeks and get those clients in

and " catch up " so to speak, you won't have the back log. Yes, we on occasion

have to have a new client in a 30 minute slot but no one is double booked and we

can start that client to feeling better. I have always been under the opinion

that a new eval does not have to be completed on the first visit. You just need

to get a good start and an idea of what's happening. The next visit whatever

was missed eval-wise can be completed. The clients appreciate getting started

on the road to recovery.

APC

> I have long wanted to ask, how do those of you that get new evaluations in the

door within " 48 hours or less " do it? I have 7 therapists on staff and we are

often booked out for 2-3 weeks or more during our busiest season. Even if I was

able to convince a therapist to stay late or start early (they are already

working ten hour days this time of year) I would have no spots to schedule that

new patient's follow up visits. So how do you do it? Do you double book?, triple

book?, shift another patient to a tech or an aides " schedule " , double book a

PTA? Is this new patient getting a quality evaluation? I know that I see

patients every day who are amazed that I actually take the time to do an

evaluation, they relay stories of being " seen " but not examined and instead

simply started on an exercise protocol pulled out of a drawer at their previous

PT. Are we devaluing our profession and underserving our patients in the name of

pleasing our referral sources? Does it benefit the patient more to be seen right

away in a haphazard manner or to wait for someone who will actually take the

time to do a quality evaluation and design an individual treatment plan with

adequate follow up visits actually performed by the individual who did the

evaluation? I don't know the answers to these questions but I do know that we

see patients in our clinic everyday who are willing to wait for the latter,

especially if they have already been through the prior. I appreciate the

discussion.

>

> E s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

>

> > >

> > > Matt,

> > > I take some offense with your assumption that hospital based OP therapy

depts don't strive to get people in quickly. I work in that world and we strive

to do the same thing for patients that you do.

> > >

> > > Lindberg, PT

> > > Avista Adventist Hospital

> > > Louisville, CO

> > >

> >

>

>

[Guest guest]

Really, we have never been booked 2-3 weeks out but we have been booked a 7-10

days out.

That being said, if you work extra hard for 2-3 weeks and get those clients in

and " catch up " so to speak, you won't have the back log. Yes, we on occasion

have to have a new client in a 30 minute slot but no one is double booked and we

can start that client to feeling better. I have always been under the opinion

that a new eval does not have to be completed on the first visit. You just need

to get a good start and an idea of what's happening. The next visit whatever

was missed eval-wise can be completed. The clients appreciate getting started

on the road to recovery.

APC

> I have long wanted to ask, how do those of you that get new evaluations in the

door within " 48 hours or less " do it? I have 7 therapists on staff and we are

often booked out for 2-3 weeks or more during our busiest season. Even if I was

able to convince a therapist to stay late or start early (they are already

working ten hour days this time of year) I would have no spots to schedule that

new patient's follow up visits. So how do you do it? Do you double book?, triple

book?, shift another patient to a tech or an aides " schedule " , double book a

PTA? Is this new patient getting a quality evaluation? I know that I see

patients every day who are amazed that I actually take the time to do an

evaluation, they relay stories of being " seen " but not examined and instead

simply started on an exercise protocol pulled out of a drawer at their previous

PT. Are we devaluing our profession and underserving our patients in the name of

pleasing our referral sources? Does it benefit the patient more to be seen right

away in a haphazard manner or to wait for someone who will actually take the

time to do a quality evaluation and design an individual treatment plan with

adequate follow up visits actually performed by the individual who did the

evaluation? I don't know the answers to these questions but I do know that we

see patients in our clinic everyday who are willing to wait for the latter,

especially if they have already been through the prior. I appreciate the

discussion.

>

> E s, PT, DPT

> Orthopedic Clinical Specialist

> Fellow American Academy of Orthopedic Manual Physical Therapists

> www.douglasspt.com

>

>

> > >

> > > Matt,

> > > I take some offense with your assumption that hospital based OP therapy

depts don't strive to get people in quickly. I work in that world and we strive

to do the same thing for patients that you do.

> > >

> > > Lindberg, PT

> > > Avista Adventist Hospital

> > > Louisville, CO

> > >

> >

>

>

[Guest guest]

Hi Dean:

Well, usually, the volume tends to be cyclical. And, working for a

hospital, justifying a new FTE and then actually getting it posted is an

act of god, especially with cyclical volume. Next to impossible. So we

try to suck it up and work pretty hard until the volumes subside- we

also use prn therapists during overage times.

With that being said, however, if the volumes stay up on a consistent

basis (say 3-4 months) or if we are starting a new program that we know

will increase volume, then we have a better case for justification. I

actually got a new FTE this year because of changing rehab requirements

for Cancer Center re-accreditation.

Meryl W. Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

Raleigh, NC

From: PTManager [mailto:PTManager ] On

Behalf Of ptdean

Sent: Monday, July 18, 2011 2:44 AM

To: PTManager

Subject: Re: wait times to new evaluations

Just curious.....

If any clinic, hospital-based or other, has a waiting list of 2-3 weeks

to see a new referral: why are they not hiring more therapists?

Seems to me that having too much business is a far better " problem " to

have than having too little.

Am I missing something?

Dean, PT

> >

> > Matt,

> > I take some offense with your assumption that hospital based OP

therapy depts don't strive to get people in quickly. I work in that

world and we strive to do the same thing for patients that you do.

> >

> > Lindberg, PT

> > Avista Adventist Hospital

> > Louisville, CO

> >

>

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This e-mail and any attached documents contain confidential information

belonging to the sending entity, Rex Healthcare, and is intended only for the

use of the individual(s) or entity(s) associated with the recipient addresses

listed in the message header. The authorized recipient of this information is

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attachments is strictly prohibited. If you received this e-mail transmission in

error, please notify the sender immediately to arrange for return or

destruction of this information.

To report abuse or inappropriate use, please email abuse@....(

[Guest guest]

I worked in a hospital also and I know for a fact that there was a difference.

The patient had to go through a central scheduling process and then that had to

be okayed by the PT unit clerk and then it got posted. Then the insurance

verification was not done on the PT unit but at another dept and then relayed to

PT dept. which created more delay.

Speaking to PT's that work at that hospital, it has become more streamlined but

they say it is still usually two days from the time the patient calls.

I think it would be interesting if somebody did a study. If there were no

difference I would be surprised but would accept the results. I wouldn't be

mad.

Matt Capo, PT

Accelerated Physical Therapy and Occupational Health, Inc.

Bay St. Louis and Diamondhead, Mississippi

Re: wait times to new evaluations

Matt,

I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

Lindberg, PT

Avista Adventist Hospital

Louisville, CO

[Guest guest]

Most of the MD's that I know of that have the 'in-house' bonus are employees of

the hospital. They have sold their practices and receive a salary and then

production bonus, just like any other employee/employer relationship.

Matt Capo, PT

Accelerated Physical Therapy and Occupational Health, Inc.

Bay St. Louis and Diamondhead, MS

Re: wait times to new evaluations

Your response is noted.

Our clinic policy is 48 hours or less. Patients can request a longer time frame

to start care. We are 90% successful in our policy. Post operative cases take

precedent and can be same day if necessary. Off work workers compensation cases

are 48 hours or less. This requires an efficient front office obtaining

authorizations at time of referral.

The hospital 8000 sq ft hospital out patient clinic down the road typically has

a 2-3 week wait. This leads to patient/physician/insurance carrier frustration.

Physicians who are employees of hospitals gain production bonuses for using

hospital based services get very angry when their employer is unable to fulfill

promises made.

Go USA women's soccer, beat Japan.

Roll PT

www.ptcos.com

>

> Matt,

> I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

>

> Lindberg, PT

> Avista Adventist Hospital

> Louisville, CO

>

[Guest guest]

Dean and all-

Thanks for the questions and comments. This is why I wanted to start this

dialogue! Having too much business is obviously great problem to have, yet not

always a simplistic problem to solve. Hiring more therapists may be one

approach, but I would like to hear from those meeting the 48 hour window what

other solutions they've implemented to decrease wait times. I am looking for

out of the box thinking that preserves quality yet improves access to services.

I am hopeful we all can learn from each other, regardless if the setting is

private practice or facility based. If anyone is willing to share their

strategy, that would be great for continued dialogue.

Thanks!

Jeanne Bradshaw, PT, OCS

Director of Rehabilitation Services

Appalachian Regional Healthcare System

phone

fax

P Please consider the environment before printing this e-mail

From: PTManager [mailto:PTManager ] On Behalf Of

ptdean

Sent: Monday, July 18, 2011 2:44 AM

To: PTManager

Subject: Re: wait times to new evaluations

Just curious.....

If any clinic, hospital-based or other, has a waiting list of 2-3 weeks to see a

new referral: why are they not hiring more therapists?

Seems to me that having too much business is a far better " problem " to have than

having too little.

Am I missing something?

Dean, PT

> >

> > Matt,

> > I take some offense with your assumption that hospital based OP therapy

depts don't strive to get people in quickly. I work in that world and we strive

to do the same thing for patients that you do.

> >

> > Lindberg, PT

> > Avista Adventist Hospital

> > Louisville, CO

> >

>

This document may contain information covered under the Privacy Act, 5 USC

552(a), and/or the Health Insurance Portability and Accountability Act (PL

104-191) and its various implementing regulations and must be protected in

accordance with those provisions. Healthcare information is personal and

sensitive and must be treated accordingly. If this correspondence contains

healthcare information it is being provided to you after appropriate

authorization. You, the recipient, are obligated to maintain it in a safe,

secure and confidential manner. Redisclosure without additional patient consent

or without legal basis is prohibited. Unauthorized redisclosure or failure to

maintain confidentiality subjects you to application of appropriate sanctions.

If you have received this correspondence in error, please notify the sender at

once and destroy any copies you have made.

[Guest guest]

Our hospital system has 30 clinics in the greater Portland area. We have

insurance specialists who perform prior authorization functions for those

patients who require it prior to their first visit. Each clinic schedules

their own patients but can schedule at any clinic in order to get a patient in

ASAP. We are often able to see patients on the day they call for an

appointment and do fit in post op patients immediately. Our standard is a 60

minute eval but we are able to perform evals for appropriate patients in 30

minutes and send them home with a program to work on until their next visit.

Staffing requires a delicate balance…sometimes you are short handed and

sometimes you are hoping the phone rings. We do have employed physicians and

they are free to refer wherever they choose. We do have to offer high quality

care to retain their referrals and they do not receive any kind of bonus for

referring to our clinics. That type of bonus would not support the core values

of our health system.

From: PTManager [mailto:PTManager ] On Behalf Of

acceleratedptbsl@...

Sent: Monday, July 18, 2011 6:59 AM

To: PTManager

Subject: Re: Re: wait times to new evaluations

I worked in a hospital also and I know for a fact that there was a difference.

The patient had to go through a central scheduling process and then that had to

be okayed by the PT unit clerk and then it got posted. Then the insurance

verification was not done on the PT unit but at another dept and then relayed to

PT dept. which created more delay.

Speaking to PT's that work at that hospital, it has become more streamlined but

they say it is still usually two days from the time the patient calls.

I think it would be interesting if somebody did a study. If there were no

difference I would be surprised but would accept the results. I wouldn't be mad.

Matt Capo, PT

Accelerated Physical Therapy and Occupational Health, Inc.

Bay St. Louis and Diamondhead, Mississippi

Re: wait times to new evaluations

Matt,

I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

Lindberg, PT

Avista Adventist Hospital

Louisville, CO

[Guest guest]

We had a similar problem. One thing we did was change hourly appointments to 45

minutes each for all return and new evals. This helped us get an additional 2

patients per therapist in per day.

Granato

Hospital

Naperville, Illinois

From: PTManager [mailto:PTManager ] On Behalf Of

Jeanne Bradshaw

Sent: Monday, July 18, 2011 11:30 AM

To: PTManager

Subject: RE: Re: wait times to new evaluations

Dean and all-

Thanks for the questions and comments. This is why I wanted to start this

dialogue! Having too much business is obviously great problem to have, yet not

always a simplistic problem to solve. Hiring more therapists may be one

approach, but I would like to hear from those meeting the 48 hour window what

other solutions they've implemented to decrease wait times. I am looking for out

of the box thinking that preserves quality yet improves access to services. I am

hopeful we all can learn from each other, regardless if the setting is private

practice or facility based. If anyone is willing to share their strategy, that

would be great for continued dialogue.

Thanks!

Jeanne Bradshaw, PT, OCS

Director of Rehabilitation Services

Appalachian Regional Healthcare System

phone

fax

P Please consider the environment before printing this e-mail

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf

Of ptdean

Sent: Monday, July 18, 2011 2:44 AM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: Re: wait times to new evaluations

Just curious.....

If any clinic, hospital-based or other, has a waiting list of 2-3 weeks to see a

new referral: why are they not hiring more therapists?

Seems to me that having too much business is a far better " problem " to have than

having too little.

Am I missing something?

Dean, PT

> >

> > Matt,

> > I take some offense with your assumption that hospital based OP therapy

depts don't strive to get people in quickly. I work in that world and we strive

to do the same thing for patients that you do.

> >

> > Lindberg, PT

> > Avista Adventist Hospital

> > Louisville, CO

> >

>

This document may contain information covered under the Privacy Act, 5 USC

552(a), and/or the Health Insurance Portability and Accountability Act (PL

104-191) and its various implementing regulations and must be protected in

accordance with those provisions. Healthcare information is personal and

sensitive and must be treated accordingly. If this correspondence contains

healthcare information it is being provided to you after appropriate

authorization. You, the recipient, are obligated to maintain it in a safe,

secure and confidential manner. Redisclosure without additional patient consent

or without legal basis is prohibited. Unauthorized redisclosure or failure to

maintain confidentiality subjects you to application of appropriate sanctions.

If you have received this correspondence in error, please notify the sender at

once and destroy any copies you have made.

[Guest guest]

Okay, case in point. Had a patient telephone us Monday and schedule an

appointment. We offered Tuesday but he chose to come in Wednesday. I normally

start seeing patient';s at 8 am and close at 7pm, three days a week. But to

accommodate I offered to take this eval at 6:30 (probably keeping me here until

7:30 pm with treatment, not including the paperwork at the end of the day), and

he said " Thank you, the hospital's therapy dept. said they could not get me in

until July 28th " .

Matt Capo, PT

Accelerated Physical Therapy and Occupational Health, Inc.

Bay St. Louis and Diamondhead, Mississippi

Re: wait times to new evaluations

Matt,

I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

Lindberg, PT

Avista Adventist Hospital

Louisville, CO

[Guest guest]

Hello,

Our Hospital Outpatient Department Reception team sends me an Excel Grid sheet

DAILY, on our referrals for the day. I study it and note time of call and how

fast we scheduled the patient for care. I never want to lose any business! My

Team prides themselves on same day service when possible and always care within

four days or less..if more than that, they must write a justification to me and

our CEO... We strive to be atypical! Good to Great! And want our referring

MD’s to be happy and especially our patients to get immediate pain relief and

care asap. This daily business metric has been very, very helpful to my team.

E. Lynn MS PT

Director of Rehabilitation

Marlton Rehabilitation Hospital

92 Brick Rd.

Marlton, NJ 08055

ext 4204

From: PTManager [mailto:PTManager ] On Behalf Of

acceleratedptbsl@...

Sent: Wednesday, July 20, 2011 12:51 PM

To: PTManager

Subject: Re: Re: wait times to new evaluations

Okay, case in point. Had a patient telephone us Monday and schedule an

appointment. We offered Tuesday but he chose to come in Wednesday. I normally

start seeing patient';s at 8 am and close at 7pm, three days a week. But to

accommodate I offered to take this eval at 6:30 (probably keeping me here until

7:30 pm with treatment, not including the paperwork at the end of the day), and

he said " Thank you, the hospital's therapy dept. said they could not get me in

until July 28th " .

Matt Capo, PT

Accelerated Physical Therapy and Occupational Health, Inc.

Bay St. Louis and Diamondhead, Mississippi

Re: wait times to new evaluations

Matt,

I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

Lindberg, PT

Avista Adventist Hospital

Louisville, CO

[Guest guest]

Your point is well taken Matt. I do agree that some PT’s who work for

hospitals (and some private practices) do not have the private practice owner

commitment that you have just shared. I was in private practice myself and my

patients appreciated it when I came in early or stayed late. I don’t think

this should become an argument over who is better. There are good PT’s and

bad PT’s everywhere.

From: PTManager [mailto:PTManager ] On Behalf Of

acceleratedptbsl@...

Sent: Wednesday, July 20, 2011 9:51 AM

To: PTManager

Subject: Re: Re: wait times to new evaluations

Okay, case in point. Had a patient telephone us Monday and schedule an

appointment. We offered Tuesday but he chose to come in Wednesday. I normally

start seeing patient';s at 8 am and close at 7pm, three days a week. But to

accommodate I offered to take this eval at 6:30 (probably keeping me here until

7:30 pm with treatment, not including the paperwork at the end of the day), and

he said " Thank you, the hospital's therapy dept. said they could not get me in

until July 28th " .

Matt Capo, PT

Accelerated Physical Therapy and Occupational Health, Inc.

Bay St. Louis and Diamondhead, Mississippi

Re: wait times to new evaluations

Matt,

I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

Lindberg, PT

Avista Adventist Hospital

Louisville, CO

[Guest guest]

,

Great idea with the excel sheet...You guys must have had Studer training if you

know good to great

Hodges, MPT

Clinic Manager

Sacred Heart Rehabilitation Center at Panama City Beach

fax

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Lynn

Sent: Wednesday, July 20, 2011 1:05 PM

To: 'PTManager '

Cc: Ken Turley

Subject: RE: Re: wait times to new evaluations

Hello,

Our Hospital Outpatient Department Reception team sends me an Excel Grid sheet

DAILY, on our referrals for the day. I study it and note time of call and how

fast we scheduled the patient for care. I never want to lose any business! My

Team prides themselves on same day service when possible and always care within

four days or less..if more than that, they must write a justification to me and

our CEO... We strive to be atypical! Good to Great! And want our referring MD's

to be happy and especially our patients to get immediate pain relief and care

asap. This daily business metric has been very, very helpful to my team.

E. Lynn MS PT

Director of Rehabilitation

Marlton Rehabilitation Hospital

92 Brick Rd.

Marlton, NJ 08055

ext 4204

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf

Of acceleratedptbsl@...<mailto:acceleratedptbsl%40aol.com>

Sent: Wednesday, July 20, 2011 12:51 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: Re: Re: wait times to new evaluations

Okay, case in point. Had a patient telephone us Monday and schedule an

appointment. We offered Tuesday but he chose to come in Wednesday. I normally

start seeing patient';s at 8 am and close at 7pm, three days a week. But to

accommodate I offered to take this eval at 6:30 (probably keeping me here until

7:30 pm with treatment, not including the paperwork at the end of the day), and

he said " Thank you, the hospital's therapy dept. said they could not get me in

until July 28th " .

Matt Capo, PT

Accelerated Physical Therapy and Occupational Health, Inc.

Bay St. Louis and Diamondhead, Mississippi

Re: wait times to new evaluations

Matt,

I take some offense with your assumption that hospital based OP therapy depts

don't strive to get people in quickly. I work in that world and we strive to do

the same thing for patients that you do.

Lindberg, PT

Avista Adventist Hospital

Louisville, CO

[Guest guest]

If profit margins were higher, we could create models like they do in other

fields such as law firms which allow for multiple partnerships.

Meli

In a message dated 7/21/2011 7:52:27 P.M. Eastern Daylight Time,

jsppleasant@... writes:

,

My point, which must have been missed, was that owners and employees are

(and always have been) different animals.

If employed therapists were in the exact same situation (risks, rewards,

etc.) as an owner, they would more likely behave like owners.

Lastly, and respectfully, If you reread my previous post, you will see

that I did not advocate (as you asserted) that owners should pay the therapist

full reimbursement for staying late.

I simply made an IF – THEN scenario followed by the sentence, " I know this

is unrealistic. "

An employed PT is not " bad " simply because they do not behave in the same

manner as an owner.

Jon Mark Pleasant, PT

Methodist Medical Center

> > >

> > > Your point is well taken Matt. I do agree that some PT’s who work

for hospitals (and some private practices) do not have the private

practice owner commitment that you have just shared. I was in private practice

myself and my patients appreciated it when I came in early or stayed late. I

don’t think this should become an argument over who is better. There are

good PT’s and bad PT’s everywhere.

> > >

> > > From: _PTManager _ (mailto:PTManager )

[mailto:_PTManager _ (mailto:PTManager ) ]

On Behalf Of acceleratedptbsl@

> > > Sent: Wednesday, July 20, 2011 9:51 AM

> > > To: _PTManager _ (mailto:PTManager )

> > > Subject: Re: Re: wait times to new evaluations

> > >

> > >

> > >

> > > Okay, case in point. Had a patient telephone us Monday and schedule

an appointment. We offered Tuesday but he chose to come in Wednesday. I

normally start seeing patient';s at 8 am and close at 7pm, three days a week.

But to accommodate I offered to take this eval at 6:30 (probably keeping me

here until 7:30 pm with treatment, not including the paperwork at the end

of the day), and he said " Thank you, the hospital's therapy dept. said they

could not get me in until July 28th " .

> > >

> > > Matt Capo, PT

> > > Accelerated Physical Therapy and Occupational Health, Inc.

> > > Bay St. Louis and Diamondhead, Mississippi

> > >

> > > Re: wait times to new evaluations

> > >

> > > Matt,

> > > I take some offense with your assumption that hospital based OP

therapy depts don't strive to get people in quickly. I work in that world and

we strive to do the same thing for patients that you do.

> > >

> > > Lindberg, PT

> > > Avista Adventist Hospital

> > > Louisville, CO

> > >

> > > [Non-text portions of this message have been removed]

> > >

> > > ________________________________

> > > This message is intended for the sole use of the addressee, and may

contain information that is privileged, confidential and exempt from

disclosure under applicable law. If you are not the addressee you are hereby

notified that you may not use, copy, disclose, or distribute to anyone the

message or any information contained in the message. If you have received this

message in error, please immediately advise the sender by reply email and

delete this message.

> > >

> > > [Non-text portions of this message have been removed]

> > >

> > > [Non-text portions of this message have been removed]

> > >

> > >

> > > ________________________________

> > > This message is intended for the sole use of the addressee, and may

contain information that is privileged, confidential and exempt from

disclosure under applicable law. If you are not the addressee you are hereby

notified that you may not use, copy, disclose, or distribute to anyone the

message or any information contained in the message. If you have received this

message in error, please immediately advise the sender by reply email and

delete this message.

> > >

> > >

> > > [Non-text portions of this message have been removed]

> > >

> >

>

[Guest guest]

If profit margins were higher, we could create models like they do in other

fields such as law firms which allow for multiple partnerships.

Meli

In a message dated 7/21/2011 7:52:27 P.M. Eastern Daylight Time,

jsppleasant@... writes:

,

My point, which must have been missed, was that owners and employees are

(and always have been) different animals.

If employed therapists were in the exact same situation (risks, rewards,

etc.) as an owner, they would more likely behave like owners.

Lastly, and respectfully, If you reread my previous post, you will see

that I did not advocate (as you asserted) that owners should pay the therapist

full reimbursement for staying late.

I simply made an IF – THEN scenario followed by the sentence, " I know this

is unrealistic. "

An employed PT is not " bad " simply because they do not behave in the same

manner as an owner.

Jon Mark Pleasant, PT

Methodist Medical Center

> > >

> > > Your point is well taken Matt. I do agree that some PT’s who work

for hospitals (and some private practices) do not have the private

practice owner commitment that you have just shared. I was in private practice

myself and my patients appreciated it when I came in early or stayed late. I

don’t think this should become an argument over who is better. There are

good PT’s and bad PT’s everywhere.

> > >

> > > From: _PTManager _ (mailto:PTManager )

[mailto:_PTManager _ (mailto:PTManager ) ]

On Behalf Of acceleratedptbsl@

> > > Sent: Wednesday, July 20, 2011 9:51 AM

> > > To: _PTManager _ (mailto:PTManager )

> > > Subject: Re: Re: wait times to new evaluations

> > >

> > >

> > >

> > > Okay, case in point. Had a patient telephone us Monday and schedule

an appointment. We offered Tuesday but he chose to come in Wednesday. I

normally start seeing patient';s at 8 am and close at 7pm, three days a week.

But to accommodate I offered to take this eval at 6:30 (probably keeping me

here until 7:30 pm with treatment, not including the paperwork at the end

of the day), and he said " Thank you, the hospital's therapy dept. said they

could not get me in until July 28th " .

> > >

> > > Matt Capo, PT

> > > Accelerated Physical Therapy and Occupational Health, Inc.

> > > Bay St. Louis and Diamondhead, Mississippi

> > >

> > > Re: wait times to new evaluations

> > >

> > > Matt,

> > > I take some offense with your assumption that hospital based OP

therapy depts don't strive to get people in quickly. I work in that world and

we strive to do the same thing for patients that you do.

> > >

> > > Lindberg, PT

> > > Avista Adventist Hospital

> > > Louisville, CO

> > >

> > > [Non-text portions of this message have been removed]

> > >

> > > ________________________________

> > > This message is intended for the sole use of the addressee, and may

contain information that is privileged, confidential and exempt from

disclosure under applicable law. If you are not the addressee you are hereby

notified that you may not use, copy, disclose, or distribute to anyone the

message or any information contained in the message. If you have received this

message in error, please immediately advise the sender by reply email and

delete this message.

> > >

> > > [Non-text portions of this message have been removed]

> > >

> > > [Non-text portions of this message have been removed]

> > >

> > >

> > > ________________________________

> > > This message is intended for the sole use of the addressee, and may

contain information that is privileged, confidential and exempt from

disclosure under applicable law. If you are not the addressee you are hereby

notified that you may not use, copy, disclose, or distribute to anyone the

message or any information contained in the message. If you have received this

message in error, please immediately advise the sender by reply email and

delete this message.

> > >

> > >

> > > [Non-text portions of this message have been removed]

> > >

> >

>