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Toni Talks about PT Today

What About the Rest of Us?

Published March 6, 2015 7:53 PM by Toni Patt

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.

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1 comments

I had briefly studied your blog about Physical Therapy issues and how Sections in the American Physical Therapy Association are competing for what is the future of Physical Therapy? I currently had a conversation with the Chairman of the county's Hospital Authority. He is a life long disabled individual with a disabled leg. He loved seeing me and complimented me for the 30 years he has known me. He served many years in the Georgia General Assembly one of the county's state representatives. Before he was asked to serve on this authority. Hospital Physical Therapy is affected by how nurses have a responsibility to the dispensary of prescribed medications. Hospital Physical Therapy becomes limited when physician admission rights and the medical director limit the prognosis of chosen medications that are conjuctive with with hospital rehabilitation. The state statutes physicians use to place diagnosis toward a patients inpatient status to prognosis while determining hospital length of stay are subjugated by the mean time patients are spending in their hospital room and whether the stroke unit nurses identify with how physicians predict the length of time prescribed medications are effective and choose not to have team meetings to support effective treatment plans to assess the efficacy of each patient's threshold to intervenious to oral ingestion of drugs that affect the orientation of each patient. Each State legislature receives the Bank notes of money that banks are required to effectively show the assets of revenue collected by fees, sales taxes and property taxes. Legislatures may choose the highest interest and volume of profit to assume which revenue best represents the direction of the state. Physicians who successfully are accepted to have a contract with a hospital to treat inpatients, confer with emergency room phsycians after ER physicians determine a patient facing a health threat is the only entry of a patient to admission into a hospital. Communicating with physicians who identify the Physical Therapy Department as a part of their choice within their contract to charge for examination by seeing the patient in person as an inpatient is also a statute the physician determines his/her ability to apply the apply the law of the state. A physician may also be limited to the number of inpatient examinations and when the patient is no longer facing a threat to their health. Patients may discover it is up to they themselves to understand the value of physical therapy. When hospitals become limited by their patient load and capacity based on the hospital's specialty's hospitals may choose to use emergency medical technicians to require them to justify what the director of pharmacy has dispensed medications to each hospital unit and use the the parameter of medications dispensed to have emergency medical technicians to establish priority orientation of medical stasis of the community it is registered to serve thereby not having the responsibility to conduct meetings to the hospital authority as the nature and reason toward it's priority over any other service in the region the hospital serves. This includes county and city services.

James Erdmanczyk March 13, 2015 12:03 AM
Warner Robins GA

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