Re: PT Aides and 97110

[Guest guest]

Hi Steve,

i have already made one long post on this thread so I'll keep this short, please

don't take offense,just adding another perspective, you wrote:

" Who is to judge the quality of the skill I'm providing to my LBP and my

squatting pt? ME ya'll "

and

" Barking out orders, sorry had to do it, to two pts, one squatting and one doing

a plank, is that worth $18 of a 97150 or $30 of 97110? Only the

treating/evaluating PT knows "

I would disagree, and vehemently, because IT IS NOT YOU, nor the AMA, nor the

APTA who determines the value or quality of your services IT IS THE PATIENT!!!

and if I were patient A, i would not pay you my $40 co-pay to take my shirt off

in the middle of your gym so you could poke on my low back pain, ESPECIALLY if

you started barking orders to some high school kid across the gym while you were

doing it. I would find somebody who respects my privacy more than that.

and if I were patient B, I would not pay you my 20% co-insurance to do

mini-squats while being watched by some high school kid, ESPECIALLY if you had

to bark orders at him from across the gym to be sure that I was doing it right.

I would find somebody who respects my wallet more than that.

E. s, PT, DPT, OCS, FAAOMPT

www.douglasspt.com

> >

> > >

> > > Subject: RE: PT Aides and 97110

> > > To: PTManager

> > > Date: Wednesday, August 17, 2011, 2:34 PM

> > > Aides Use or not use, which is the

> > > question.

> > >

> > > Ever since I first began following PTManager on this list

> > > serve, the

> > > concepts of productivity and use of extenders has been a

> > > strong topic for

> > > discussion.  The contributions to the list serve on

> > > this topic usually fall

> > > into one of two categories.  However, the crux of the

> > > issue is money; how to

> > > make as much as possible with the staffing and patient mix

> > > in your

> > > particular clinic.

> > >

> > > On the list serve I have observed the semantics and

> > > rationalizations by both

> > > sides of the issue.  However, I never have seen anyone

> > > come out and say, " I

> > > use techs and or aides so I can do more than one patient at

> > > a time " . You

> > > know this is the reason. I know this is the reason.

> > >

> > > I have seen arguments stating that the government should

> > > not be telling me

> > > how I should run my practice.  One argument being that

> > > " I deserve 100%

> > > autonomy and use my clinical outcomes to make my case for

> > > whether I can see

> > > more than one patient at a time " .  The other side

> > > will argue that unless a

> > > PT or PTA delivers the service it is not skilled.

> > > Others state that it is

> > > the level of complexity that determines the criteria or

> > > whether or not it is

> > > skilled.

> > >

> > > I have patients report frequently, that they only see the

> > > therapist one

> > > time, are handed a set of exercises along with a timer,

> > > then shepherded to

> > > the gym where the patient reports being watched by a

> > > aide.  The patient

> > > explains that the therapist goes away, many times to wave

> > > at them from

> > > across the room while working with another patient,

> > > sometimes never to

> > > return.  Unfortunately the patient does not have

> > > knowledge of one on one

> > > codes, what skilled therapy means, nor any ideas of the 8

> > > minute rules. The

> > > patient rarely complains about this, they simply do not

> > > return.

> > >

> > > Other times I have patient report wonderful therapists that

> > > took the time to

> > > do the manual work needed to restore function and decrease

> > > pain while

> > > describing their therapists as one that took the time to

> > > explain " the why "

> > > as well as " the what " of diagnosises that they needed

> > > to be understanding.

> > >

> > > The bottom line to my long winded diatribe is that as

> > > therapist we all know

> > > what the definitions of the codes are meant to be.

> > > One on one means one on

> > > one.  Skilled means skilled.  Group means

> > > group.  Supervised means

> > > supervised.  You can rationalize as much as you want,

> > > but the meanings do

> > > not change.  The only reason to go outside of the

> > > definitions would be

> > > (simply put) to increase profit, make more money, improve

> > > your financial

> > > bottom line.

> > >

> > > I may be a one man band singing this song, but I doubt it.

> > >

> > > Steve Marcum PT

> > >

> > > Outpatient Physical Therapy

> > >

> > > Lexington, KY, 40517

> > >

> > >

> > > --

> > > " Anyone who lives a sedentary life and does not exercise,

> > > even if he eats

> > > good foods and takes care of himself according to proper

> > > medical principles,

> > > all his days will be painful ones and his strength shall

> > > wane. "

> > > Maimonides, 1199 AD

> > >

> > >

> > >