What About the Rest of Us?
Last week, I went to a meeting of the Texas Physical Therapy Association Southeast District. Mike Conners, the TPTA president, was speaking. His topic was the future of physical therapy and increasing awareness of legislative action in the Texas congress.
He touched on all the usual topics: direct access, reimbursement for outpatient services, the therapy cap, concussion management and defining the brand of physical therapy. The APTA wants us to be known as movement specialists. He cited examples of other disciplines trying to infringe on our area of expertise.
Those are important issues. But as I sat there, I realized they have little direct effect on me. With the exception of the therapy cap, every issue Mr. Conners touched on concerns outpatient therapists. I say except the therapy cap because that contributes to limitations my patients face after discharge. Had a non-therapy person been in attendance, that person would never suspect PTs do anything but outpatient therapy.
I work in a hospital with sick patients. I need physician input as to whether my patients are ready and able to tolerate therapy. The same is true for PTs who work in SNFs, AFLs and the school system. I lack adequate medical knowledge to make that decision.
Restructuring the reimbursement system for outpatient treatment also means little to me. It is a problem. So are flat salaries, increasing therapist-to-patient ratios in facilities and shorter lengths of stay. Reimbursement for what I do comes out of a chunk payment the facility receives.
Everyone agrees our healthcare system is broken. Nowhere is it more evident than in hospitals and long-term care facilities. Reimbursement cuts have taken their toll on every aspect of patient care and care-providing. I'm not going to get a raise this year. I'm just happy my pay isn't going to be cut. I always have more patients on my caseload than I can treat if I spend just 30 minutes with each one.
Where are the APTA and TPTA on those issues? Why aren't they lobbying legislators to fix the broken healthcare system? They spend hundreds of thousands of dollars lobbying for things that affect only a fraction of our practitioners.
If those laws ever come to pass, therapists who work in outpatient settings will benefit. What about the rest of us? Salaries aren't keeping up with the cost of education. Adequate staffing has long been a thing of the past. I could continue. The list is long. One of the reasons given for not being an APTA member is not getting anything out of membership. Maybe this is one of the reasons why people feel that way.