Re: Reply: Re: wait times to new evaluations

[Guest guest]

Don,

Absolutely, if a patient chooses to follow a therapist to his or her new place

of work I would facilitate that transition. I don't have ownership of that

patient, we are here to meet their needs, not the other way around. What would I

gain from refusing to divulge that information to somebody who really wanted it?

I would make it very well known that if they wish to stay with our practice we

will do everything in our power to make the transition to a new therapist as

smooth as possible but if they wish to follow their prior therapist they are

obviously free to do so.

E s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy Orthopedic Manual Physical Therapists

www.douglasspt.com

>

>

> Hi Jon & ,

>

> So I'm just curious.

>

> " ... So if it is 's patient that needs to be seen late or has a new issue

> that needs to be adresssd acutely then it is 's professional

responsibility

> to see that patient, not the clinic owner's... "

>

> This of course means that if a PT were to leave your employ, then you would

> rapidly forward that patient to where the PT is now employed or give them the

> means to contact the PT that has this " Professional Responsibility. " Right?

>

> Have a great day!

> Don, PT

> MI-AZ

>

>

>

> ________________________________

>

> To: PTManager

> Sent: Fri, July 22, 2011 1:28:05 PM

> Subject: Re: wait times to new evaluations

>

>

> ,

> I think more clinics should look into creating compensation packages similar

to

> what you describe. Your program sounds like it would attract, motivate and

> improve retention. In addition, your therapists are probably more engaged and

> feel less like mere employees.

>

> Kudos to you for creating an atypical environment in a competitive market.

> Subsidized behavior repeats itself.

>

> Jon Mark Pleasant, Pt

>

>

> > > > > > > >

> > > > > > > > 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]

I noticed a strong connection between two concurrent PTManager threads---about

evaluation delays, and ACOs...

Regarding evaluation delays, Jon Mark Pleasant correctly remarked:

" A consumer purchasing any type of service has every right to decide how and

where they spend their money. "

Very true! But we need to remember that the " consumer " in today's medical-care

marketplace is almost always a third party, i.e. an insurance company. The

patient pays only indirectly, and generally pays out of proportion (in one

direction or the other) to the services he receives (a system that perversely

incentivizes patients to utilize medical care in order to make the most of their

insurance). So... in this distorted " market " what exactly are the implications

of Jon Mark's statement? More important, what is the implication of his

follow-up question, " Would you want a business enterprise of any kind to

facilitate your desires [as a consumer] or to be a roadblock? "

Some perspective may be gained from the thread on Accountable Care

Organizations, which are part of CMS's attempt to act like a customer watching

his expenditures. Through the mechanism of the ACO, CMS wants to shift provider

focus " from delivering services for patients to managing quality and cost for a

population " (CMS's words). The ACO message is, " Stop spending so much money! "

and it's a message that won't be changing anytime soon, since, according to the

Congressional Budget Office, " ...projections suggest that in the absence of

changes in federal law, total spending on health care [will] rise from 16

percent of gross domestic product (GDP) in 2007 to 25 percent in 2025, 37

percent in 2050, and 49 percent in 2082. " (In this case, by the way, " changes in

federal law " means price controls, utilization controls, or both.)

Providers and payers clearly consider each other to be " roadblocks " that are

uninterested in " facilitating the others' desires. " The result is the endless

maneuvering, manipulating, and bickering that today mark medical care's

consumer/provider relationships.

Can there ever be a solution as long as the patient is not the consumer?

Dave Milano, PT, Rehabilitation Director

Laurel Health System

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

jonmarkpleasant

Sent: Saturday, July 23, 2011 8:56 AM

To: PTManager

Subject: Reply: Re: wait times to new evaluations

Don,

A consumer purchasing any type of service has every right to decide how and

where they spend their money.

Put yourself in the patients' shoes for a moment and ask yourself what you would

want if you were in the situation you proposed.

Would you want a business enterprise of any kind to facilitate your desires or

to be a roadblock?

Jon Mark Pleasant, PT

> > > > > > > >

> > > > > > > > Your point is well taken Matt. I do agree that some PTââ'¬â " ¢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

donââ'¬â " ¢t think

> >this should become an argument over who is better. There are good PTââ'¬â " ¢s

and bad

> >PTââ'¬â " ¢s everywhere.

> > > > > > > >

> > > > > > > > From:

PTManager <mailto:PTManager%40yahoogroups.com>

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

> >On Behalf Of acceleratedptbsl@

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

> > > > > > > > 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]

Which is right in line with an earlier comment that the best trick the insurance

industry ever pulled was getting medical providers to file claims. I remember

when the patient would pay the provider, get the receipt and file it themselves.

The patient then knew what things cost. If the insurance company balked, they

were messing with the insured and they listened to complaints much more

attentively.

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]

Matt,

That's a good point! In fairness, however, we should note that both insurers and

providers benefitted from the change. Inserting more insulation between patients

and medical care costs helped increase utilization, and made it easier to

increase prices as well. The insulation factor is one of the reasons medical

care utilization has steadily increased on a per capita basis while costs have

concomitantly outpaced the overall rate of inflation. A war, with both sides

winning! (Sort of like Democrats fighting Republicans. The two sides can't agree

on how to spend money, but government steadily grows anyway.)

Dave

Dave Milano, PT, Rehabilitation Director

Laurel Health System

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

acceleratedptbsl@...

Sent: Tuesday, July 26, 2011 12:20 PM

To: PTManager

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

Which is right in line with an earlier comment that the best trick the insurance

industry ever pulled was getting medical providers to file claims. I remember

when the patient would pay the provider, get the receipt and file it themselves.

The patient then knew what things cost. If the insurance company balked, they

were messing with the insured and they listened to complaints much more

attentively.

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

> > > > > > > >

> > > > > > > >