MyPhysicalTherapySpace.com - A part of the 1T - the "One Thing" you need for PT practice.

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Check out upcoming Evidence in Motion courses currently open for registration! Learn more about MyEIM and our new Articulate course format!

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***Indicates course open for internal registration only. Contact facility POC listed on website.

Evidence-based Examination and Selected Interventions for Patients with Lumbopelvic Spine and Hip Disorders

Mar 31-Apr 1, 2007
Burlington, NC (USA)

May 18-19, 2007***
Cary, NC (USA)

Evidence-based Examination and Selected Interventions for Patients with Cervical Spine Disorders

Mar 9-10, 2007***
W. Palm Beach, FL (USA)

Mar 10-11, 2007***
New York, NY (USA)

Sep 15-16, 2007
Burlington, NC (USA)

Sep 29, 2007***
Everett, WA (USA)

Evidence-based Examination and Selected Interventions for Patients with Upper Extremity Disorders

May 4-5, 2007***
Navarre, FL (USA)

May 12-13, 2007***
Jacksonville, FL (USA)

Evidence-based Examination and Selected Interventions for Patients with Lower Extremity Disorders

Mar 30-31, 2007***
Palm Harbor, FL (USA)

Aug 25-26, 2007***
Jacksonville, FL (USA)

Sep 8-9, 2007***
Concord, NH (USA)

Evidence-based Introduction to Rehabilitative Ultrasound Imaging of the Lumbopelvic Region as an Adjunct to Treatment of those with Lumbopelvic Disorders

Mar 10-11, 2007***
Marshalltown, IA (USA)

The Pre-Participation Physical Exam: Evidence-based Muskuloskeletal Screening and Injury Prevention Strategies

Apr 20-21, 2007
Evansville, IN (USA)

We encourage early registration to insure a seat. Extensive hands-on lab sessions are included.  Visit us on the web at www.evidenceinmotion.com to get more details, learn about other 2007 course dates and locations. Register online today!

Feel free to email us at courses@evidenceinmotion.com if you have any questions or need additional information. Consider passing this post on as an email to your colleagues who might benefit from this information. Hope to see you at an Evidence in Motion course in 2007! We sincerely thank you for joining with us to translate evidence into practice.

The Evidence in Motion Team

 
 

CCN to Air Chiros Insurance Complaints

I came across an announcement that Anderson Cooper 360 on CNN this Monday at 10pm EST there will be an interview with a Dr. Mathis (DC) who worked inside the no-fault insurance companies for years and is now revealing the inner workings of a software program called Colossus that is designed to inappropriately deny payments.  Here is an excerpt from the email:

"Most doctors do not even know that Colossus exists, much less how it operates and what you can do to beat it. Mathis is fast becoming know as the Colossus Buster, training doctors and attorneys how the program works and how to win with Colossus.

This is not the first time Mathis has been a part of a CNN or other news media reports on this insurance fraud issue. He was featured on the first insurance fraud report on the Anderson Cooper 360 show a couple of weeks ago. The report received so much interest, CNN has interviewed Mathis for several hours and is planning two additional reports on this issue, the first of which is this coming Monday evening at 7:00 PST.

Mathis has also been interviewed on this issue by over 20 different media sources including NBC, Newsweek, Business Week, Wall Street Journal, US News & World Report and more. He has been deposed or offered expert opinion in over 55 individual lawsuits including several class action suits as well."

I went to the website promoting this http://www.ebcseminars.com/ - you can scroll down to the section on Colossus to read more.  Note the ebc stands for Evidence Based Chiropractic.  While I encourage all professions to embrace EBP, it concerns me when you read their definition - and then read why they say to use EBC (the first right hand box -the last bullet) says: "Validates any technique and supports chiropractic philosophy"  I don't think that is what embracing EBP is all about!

So you may want to TiVo or watch this to see what is being reported (i believe it is a 2 part series) - Jeff

Starting a grass fire.

I am an entrepreneur and novice in the world of business. One of the ways I have tried to acclimate to this strange world has been to read several business periodicals such as Inc. Magazine

I am also a fairly inexperienced manager of a growing physical therapy company so it should come as no surprise that a recent article in Inc. Magazine profiling Firefox’s Mitchell Baker as perhaps the "best manager in America" caught my attention. 

Baker, who’s title is “Chief Lizard Wrangler”, leads a not for profit company who’s product is free, the work force is largely volunteer, and it’s meetings are open to anyone on the globe. (To participate in Firefox’s strategic planning or operations meetings check out the schedule and conf. call numbers.)

Most of her contributors don’t have a salary or title, but do it for the respect, accomplishment and for the change. Firefox  is a web browser that has established itself as a serious competitor to Microsoft’s Internet Explorer (IE) and has been downloaded more than 200 million times making it one of the hottest high-tech products in history grossing 70 Million last year. The industry standard IE was headed for an unopposed monopoly. If everyone used Explorer, Microsoft could dictate technical standards for websites and could then in theory have proprietary approach to Web browsing.  As per Inc. Magazine due to IE flaws the public, and corporate networks, became plagued with viruses, endless pop-up windows, and spyware.

Sounds vaguely familiar to what we're facing with our 3rd party payors doesn't it? How did Firefox make their impact?  By making browsing safer and more effective for their consumers. The marketing goal: 1 Million downloads within 10 days of the program’s release. The company created a website to “spread Firefox”. Users added links to their webpages and blogs…Firefox had 1 Million downloads by the 4th day and the 10 Million within 30 days. Then a volunteer made a suggestion of getting 10,000 users to throw in $30 to take out an add in the New York Times…within 2 weeks the needed quota was met and the New York Times carried a 2 page ad.

So what does Firefox and myphysicaltherapyspace have in common? Making our unique industries safer for our public. Whether it is web browsing or browsing for medical care, this unique approach is our future. Perhaps our infamous “hair-product-using” AAOMPT president and his joint marketing team should consider what “You’ve got drugs, you’ve got surgery, or you’ve got US” might look like plastered across a full page ad in the New York Times… 

In a previous post Jeff Hathaway talked about partnering to achieve the change we all are asking for. I agree with you, Jeff, but perhaps it's not Big Insurance that we should partner with, but rather the public. Firefox has recognized ways that communities can drive organizations by getting consumers not to merely accept marketing pitches and buy products, but to also help design, shape, and disseminate products. It has forced Microsoft to change IE (now available with many Firefox-like features).  This community is in a place to launch a significant movement for changing our healthcare. By putting links to myphysicaltherapyspace on other blogs, webpages, community forums, even other professional’s web pages…perhaps even linking to a consumer focused page to express EBP as we know it that can then be broadcast.  And by partnering with other PTs, other medical providers, and the medical care CONSUMERS I believe we can see it happen.

Our readership list is now about 1,500 members. The APTA more than that.  I'd donate some of my personal dollars to take out an add in the New York Times...but we still need a few thousand people with similar feelings. 

I'm going to start by putting a link to myphysicaltherapyspace on my clinics website and I have a few friends who may be willing to do it as well.

Ready to spread a Fire(fox).
ab

Chiropractors named in Jim Black case

The three chiropractors who paid Jim Black nearly $30,000 were named today by The Charlotte Observer. One of the chiropractors, Steve Willen, was sitting on the North Carolina State Board of Chiropractic Examiners (until Tuesday, 2/20/07). Another chiropractor, Fletcher Keith, is a past Board member. The third chiropractor, Tom Brown, works in one of Keith's 5 North Carolina offices. The post from the Observer (http://www.charlotte.com/mld/charlotte/news/16745255.htm)

ILLICIT CASH

Court documents on Tuesday detailed illegal payments from

three chiropractors to Jim Black:

Fletcher Keith
Charlotte: Gave $8,000

Steve Willen
Greensboro: Gave $11,000

Tom Brown,
Charlotte: Gave $10,000

Another piece from the Observer, 2/21/07:
"Willen quits board seat

Tuesday's proceedings quickly rippled through the state capital. Willen resigned from the State Board of Chiropractic Examiners. Willoughby said the chiropractors cooperated and will not be charged with any crime."

So, the chiropractors will not be charged with a crime (after turning state witnesses), and, most likely, they will not be purged by their associations....life will go on, business and corruption as usual. Physical Therapist beware, and be politically active. The scenario could be played out in any state in the Union.

Britt

Insurance Co's - Enemy or Ally

Insurance companies can raise the ire of almost any Physical Therapist just by the thought of them, let alone an interaction with one.  This perspective that we have of them and the one they have of us, may simply be a lack of understanding by both sides that we in fact should be allies of each other not enemies or necessary evils.  Could it be that the positions we have each taken in solving the healthcare issues we are faced with are inherently incompatible (lower reimbursement versus higher or respectable reimbursement)?  The predetermined solutions they have come up with are an independent effort to get their interests met.  The current paradigm is that we don't pro actively help them reach or achieve their interests.  An assumption is made that our interest must be incompatible.  I believe the opposite is true!

If we step back and look at the motivators behind why the insurance companies have chosen their positions or solutions (less reimbursement, restricted visits, increased paperwork, middle managers - ACN's of the world) to the issues in general within our profession, it is possible to understand why they have chosen the positions or solutions they have.  First lets identify their motivators:  I believe they are to reduce over utilization, reduce costs, improve outcomes and improve their bottom line.  What are our motivators (as EBP outpatient practitioners)?  How about better outcomes, proper utilization, improved access to more acute conditions, and improved bottom lines.  Are these motivators (also called interests) incompatible?  Or are they different, similar and/or compatible?  Maybe we are seeing things only from each others positions instead of ours/their interests or motivators?  What would happen if we got on the same side of the problem and found different solutions that met all our interests?  Can we meet their interests and our interests at the same time?  I think if you understand EBP and its capabilities to affect change in line with the interests of both parties, you can see more hope.  We need to change the dance steps - shift the paradigm - by opening their eyes to the common and compatible motivators that we share.  Think about how the WSJ article is a microcosm of how our interests can be compatible with theirs!! 

Thoughts and comments?

- Jeff

Where Oh Where

We now have a directive and a CMS web site regarding the 1.5% “bonus” or financial incentive for quality reporting.  This was all done under the Tax Relief and Health Care Act of 2006 (TRCHA).

As PT’s we are eligible for a reporting a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007 subject to a cap for covered Medicare physician fee schedule services.  The initiative is for traditional medicare fee-for-service and not applicable to Medicare Advantage Plans.

The website lists 66 quality measures.  None of them are related to outpatient PT.

Just Where Oh Where they are remains to be seen. 

Larry

 

 

Consumer Driven Health Care Has Arrived

You know that the era of consumer driven health care has arrived when your spouse sends you a link to a a highly relevant article dealing evidence-based practice before any of your professional colleagues. This is an article worth reading that I would not have likely seen had my wife Amy not sent it to me. The lesson to me in the brief email that my wife sent to me was that the days of the physician with the halo over their head are over. Consumers are often more informed than their providers, know what treatments work and those that do not, and will increasingly be skeptical of expert opinion. Listen to your patients (and certainly your spouse!)...you may just learn something. Thanks, Amy. I know more today about EBP than I did yesterday.

John

An amusing commentary on chiropractors bribing state legislators

I came across this amusing piece from 'Wonkette' on the website: http://wonkette.com/politics/bribery/corrupt-nc-legislator-stands-up-straight-and-pleads-guilty-237390.php

The author writes in the middle of the piece: "As a sad illustration of how penny-ante state-level politics are, the bribes amounted to all of $29,000 over two years, which is less than a third of what William Jefferson keeps in his freezer at any given time. The sinister chiropractors’ aims were similarly modest, requesting only that North Carolina law set their insurance co-pays to be equal to those of real doctors. If they had coughed up more money, they maybe could have gotten thrice-weekly adjustments made mandatory for public school kids, or a new state office of the Chiropractor General, complete with a ludicrous, epaulet-festooned paramilitary uniform, established."

Funny, but a sad state-of-affairs, indeed. Remember, PTs now have restrictions on the practice of manipulation requiring a physician prescription/direction before performing 'the act' in North Carolina.

Britt

Breaking news: Chiropractors bribe speaker of the House in North Carolina

Dateline: 2/16/07

RALEIGH, N.C. (AP) - Former North Carolina House Speaker Jim Black pleaded guilty Thursday to accepting nearly $30,000 from three chiropractors while pushing for legislation they supported.

One day after resigning from the House, a somber Black appeared in a federal courtroom to plead guilty to a single count of accepting things of value in connection with the business of state government. The charge carries a maximum sentence of 10 years in prison and a fine of $250,000.

  .....`Legislative leaders accepting cash payments from special interests is unacceptable,'' said U.S. Attorney George Holding.

Prosecutors said Black intended ``to be rewarded'' for the business of state government, and specifically cited three laws chiropractors sought at the General Assembly. One dealt with insurance premiums and another limited who, other than chiropractors, can provide chiropractic services [Read as restricting PT use of manipulation].

http://www.charlotte.com/mld/observer/16710963.htm

I understand, from Bob Limone, That the N.Carolina legislation has restricted the use of manipulation by PTs to only when prescribed by a physician. The speaker has accepted monies from the chiropractors up to in order to push forward their legislative agenda in the State House of Representatives. The chiropractors and their political arm has contributed > $125, 000 to Jim Black since 1999 (40% of his total campaign contributions in Dec 2005 ) according to the Charlotte Observer, 2/16/07.

Part of the Observer piece:

"Black's biggest chiropractic donor was Fletcher Keith, who operates five Charlotte-area clinics. Keith has given Black $18,500 since 1999, records show. That's $500 more than the N.C. Chiropractic Association's political action committee gave during that time.

"Keith and three chiropractors with ties to his clinics accounted for nearly a quarter of chiropractors' $36,000 in donations to Black following the fundraiser at uptown's Capital Grille.

"Keith was called to testify before N.C. State Board of Elections hearings last year on Black's campaign finances. He was not named in court documents Thursday. Keith declined comment Wednesday and did not return calls Thursday.

"A dozen Charlotte-area chiropractors who contributed to Black after fundraisers where he admitted taking illegal payments did not return calls Thursday.

"Bob Hall, research director for watchdog Democracy North Carolina, said chiropractors donate as though they "want to be a bigger player" in the legislature.

"It looks like somehow they got a message that they need to pay to play," he said. In addition to the co-pay change, Black backed two unsuccessful measures that would have sent more business to chiropractors, according to court records.

"Hall expects a slowdown in donations from N.C. chiropractors and their trade association to lawmakers.

"They had already slowed for Black. He received $150 from chiropractors in 2006 -- down 99.6 percent from the previous year.

Contributions

Total reported contributions to ex-N.C. House Speaker Jim Black from chiropractors and the N.C. Chiropractic Association's political action committee:

1999 $36,200

2000 $9,450

2001 $16,000

2002 $11,850

2003 $1,000

2004 $12,700

2005 $39,029

2006 $150

Read it yourself at http://www.charlotte.com/mld/charlotte/news/16710984.htm

Thanks, Britt

Poster Childs Seen at CSM

It has been a day of sightings at the Combined Sections Meeting in Boston.   Despite the purported benefits of couch potato exercises I typically exercise by running.  Fortunately living in Colorado I understand that there are temperature changes when traveling from south to north in the US and I prepare by bringing the appropriate attire.  It was a great morning to run in Boston, at least if you like to run on treachorous streets in single digit temperatures.  As I slipped my way down the beantown sidewalks I was surprised to see these two EIM southern exposure bloggers with teeth chattering.

 

 

 

 

 

 

However the biggest sighting of the day occurred on the way to the convention center.  I stumbled across a regular EIM contributor paying homage to a poster of himself!  It is important to remember that this Poster Childs has previously blogged (exposing his insecurities and thinly veiled jealousy) about my hairstyle.  So it was not without some pleasure that I was at the right place to snap this photo.