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ADVANCE Perspective: Physical Therapy & Rehab Medicine

Is Outpatient PT 'Delayed' and 'Cumbersome'?

Published February 28, 2011 4:03 PM by Jon Bassett
So here's what a Florida-based provider of urgent care clinics and worker's comp services said this week when it brought physical therapy in-house at three of its locations:

"Unlike other medical clinics, where there is little to no interaction with patients after a referral is made to an "outside" physical therapy clinic or service, [our] comprehensive physical therapy program allows [our] providers to monitor the patient's progress, stay in touch with their therapists and remain in complete control of their recovery."

Ouch.

What say you, outpatient PTs? Do you like the connotation that an "outside" physical therapy clinic is somehow out of the loop, and needs "complete control" by the referring entity? And what does it say about the professional judgment, clinical decision-making and autonomy of the PTs working there?

The release goes on. Buried under layers of corporate-speak is the money quote:

"While outside referrals to physical therapy are often delayed and cumbersome to both patients and their employers, the new streamlined physical therapy program is faster for patients, more convenient and cost-effective for the employers."

I couldn't help noticing the clash with what's currently happening in California, where the age-old issue of physician-owned physical therapy services (POPTS) has reared its head once again. A group of practice owners in that state recently banded together to fight a proposed bill that would allow physicians to refer to physical therapy services that they, themselves, own.

POPTS is seen by many to be the single-greatest threat to PT survival, and the conversation has gotten so heated on popular list serves that one therapist called the bill "organized prostitution of our profession."

Of course, fighting these arrangements often means taking on powerful associations and lobbies, and possibly damaging the referral patterns from which most practices survive. And for new grads, physician-owned entities can often offer more lucrative salaries than independently owned mom-and-pop franchises. If you're a new grad with mountains of tuition debt, how do you choose between what's best for your family, and what's best for the profession?

Physicians promoting POPTS say the PT provided "under their watch" is superior and more cost-efficient. Anti-POPTS activists say that it's cannibalizing PT autonomy by taking away clinical authority, reducing PT to a technical, "order taking" role. Where do you fall on the debate? And what would you say to a colleague who either works within such an arrangement, or is considering it?

1 comments

POPTS have been, are now, and will always seriously limit a PT's ability to have a private practice...it's that simple!

Craig Sanders, PT - DPT, Agency July 31, 2011 1:54 AM
Dallas TX

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