My New Revenue Source
According to Medicare, I'm able to work under the direction of an MD. Imagine what that could do to the outpatient market in some areas. As a PTA, I could set up a clinic, hire an MD and begin to provide care based on the MD's plan of treatment. Of course the state rules would try to prevent this but I'm pretty sure federal law trumps state law any day of the week.
I didn't see any particular rules in regard to having an MD "in the room" when I'd provide care to a patient; maybe that's only useful if I'm under the direction of a PT. I'll have to do some more research before my hypothetical clinic opens and the doc and I put you out of business.
The MD would be the one to initially see the patient and then I could perform all the treatments while the doc looks in occasionally to make sure we are making bank. With a reduction in reimbursement, the doc could see the patient, then immediately send him back for some TENs, massage, biofeedback (this pays a lot in a clinic) and exercises. All I'd need initially is enough room for a universal gym, a combo laser/e-stim/ultrasound machine and maybe a treatment table. Cost would be minimal and my proverbial doc and I would be in business.
If I give up my license as a PTA, there wouldn't be much a state board could do. And if I hire a retired MD who wants to sit around an office for six to eight hours a day doing paperwork and assessing patients, this could be quite lucrative for both me and the doc. The rules of supervision would no longer apply and I'm pretty sure I could expand my imaginative business into the realm of home health with little difficulty.
Just imagine a PTA with an MD as a supervisor; the outpatient clinics will fear me and with the doc's connections in the community, patients would flock to the clinic. Who wouldn't want to be assessed by an MD and treated under his direction? An outpatient clinic with an MD on staff overseeing the treatment -- yeah I think the patients would come, and there wouldn't be a whole lot anyone could say about it.