PT Aides and 97110

[Guest guest]

Posted on behalf of a PTManager who does not want to be ID'd

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Thanks Rick and others,

The focus on one on one care is killing our profession and will be the final

nail in the coffin of our profession.

Is it a skilled activity to have a PT or PTA stand by grandma and count her reps

so you can bill 97110 rather than group? The PT determined the need for the

activity, set the parameters of the exercise and fully observes it's set up by a

(you fill in the blank).

We all hear, and repeat, how great we are but that clinic down the street

doesn't spend time with the patient, blah, blah, blah. Remember the knife cuts

both ways. For the respondents to this post and others in a similar vein I have

a few questions: Do you collect objective, standardized, risk adjusted outcomes

as well as patient satisfaction data? Justify your " quality of care " with data,

if you can't the rest is just hot air. Time does not equal quality or ethics.

What about the OP clinics where the PT is there on a Monday doing evaluations

and PTA co-visits for the week not to return till the following Monday to do it

all over again. Who is making the program changes, progressions, modifications

when the PT is not on site for the remainder of the week? On the other hand the

OP clinic with a full time PT/owner, onsite 50 hours/week, with an aide or two.

This PT is in constant contact with knowledge of what each patient's status and

makes program changes daily.

My heart goes out to the younger PT's that have huge student loans with

expectations of big salaries. My heart also goes out to the facilities whose

individual PT productivity doesn't " cover their nut " , " you want me to see >10

visits/day and do an eval but what about the ethical one on one care? " Time does

not equal quality or ethics. The tipping point that our profession will be a

loss leader when health care contracts are signed is close at hand.

Meanwhile, EP and ATC's do " functional testing " for cash with less training

quoting PT research to justify their conclusions. What do we do, " hey they

can't do that " . Yet these groups also get referrals from physicians for post op

" rehab " at your local gym. Why? Simple answer, many of us are too passive with

our interventions. What do we do as PTs? Complain and cry foul but are

unwilling to consider alternative practice settings or adding these skills to

our tool box.

Quoting Norm from the old TV show CHEERS. " its a dog eat dog world out their and

I'm wearing milk bone shorts " . We are wearing the shorts and giving away more

milk bones. When are we going to turn around and take on the dogs?

The leaders of our profession have put us into the " one on one treatment " box

which is completely unsustainable. Now its a mantra tied to quality and ethics.

Time does not equal quality or ethics. State boards are there to police the

fraud, overutilization, and improper care issues so let them.

As a profession we need to raise our productivity, and consider alternative

practice settings to meet the needs of the consumer and market place, or lower

our expectations of pay and benefits. There are other groups out there more

than willing to step in for PT. Profit is not a bad thing but is hard to

justify the hours and stress for 6%.

, I would ask that you withhold my name and email from this post. As a

fellow private practice clinician/owner in the killing fields day in and day out

for the past 20 years I feel that I am jousting with windmills some days. If you

can not withhold I understand, then do not post. We are far too passive as a

profession.