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

Check Out the Upcoming EIM Courses!!!

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

Download WhatIsMyEIM.pdf

Download ArticulateFormat.pdf

***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

Aug 4-5, 2007***
San Luis Obispo, CA (USA)

Sep 15, 2007
Medford, NJ (USA)

Sep 29-30, 2007***
Evansville, IN (USA)

Nov 3-4, 2007***
Hawthorne, NY (USA)

Nov 17-18, 2007***
Greenville, SC (USA)

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

Aug 17-18, 2007***
Davenport, IA (USA)

Aug 18, 2007***
Russellville, KY (USA)

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

Sep 15-16, 2007***
Houghton, MI (USA)

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

Oct 27-29, 2007***
Evansville, IN (USA)

Nov 3-4, 2007***
San Luis Obispo, CA (USA)

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

Oct 26-27, 2007***
Ft. Lauderdale, FL (USA)

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

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

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

Nov 10-11, 2007
New York, NY (USA)

Evidence-based Examination and Selected Interventions for Patients with Knee Disorders

Aug 25-26, 2007***
Bronx, NY (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

RFP - Get the Picture?

Here's an example of an RFP relationship that not only doesn't serve patients, but clearly serves the financial and control needs of the physician portion of the "partnership"  (and I use this term loosely).

Physiatry and Physical Therapy Facility in Jersey

One of the primary arguments of those who support RFP (referral for profit) initiatives is that a closeness breeds communication and understanding. Perhaps supports could tell me whether this quote could be any clearer regarding what is really going on in these facilities:

"Doctors, Liss noted, diagnose and are schooled in the efficacy of medications and therapies. In other words, according to Liss, doctors know "what can be accomplished by physical therapy."

"Thus, a patient who arrives at PM&R suffering from a spinal, skeletal or muscular ailment enters the center through the waiting room, walks a short distance to a doctor's office, gets diagnosed, and then crosses the hall to a therapist's office to begin devising a treatment plan."

You've got to love the tangible monetary benefits of being the middleman. When high quality evidence exists regarding the efficacy of physical therapy for a wide variety of ailments, when evidence clearly shows patients are very infrequently offered these options, when evidence shows the superior diagnostic and treatment skills of therapists, and when therapists still engage in these relationships ceding control and management to others, we know we still have serious problems with professionalism in our own backyard.

Any supporter of RFP want to step up and explain how this helps either the patients or our profession?

What's Next Physical Therapy Clinics in Toys R Us?

I am normally an upbeat optimistic guy-probably because I seldom watch the news and the news that I read is in RSS chunks.  However, pessimism has prevailed recently in the PT news department.

First we had our hoola hoop experience.

Then we had a “proactive” PT group that believes PT’s sole purpose is home exercise programs and is so “concerned” about co-pays that they are posting their exercises so that patients can come in for fewer visits.

And, just when I thought it couldn’t get worse, we now have Wii games in rehab clinics which appeared in USA Today).  Wonder who wins between the PT’s and OT’s?  (BTW, please send me the CPT codes for the golf game which is my favorite).

Is there any wonder we have credibility problems?

Thoughts?

Larry

"...a good physical therapist is...more valuable than a horde of chiropractors."

The very popular Science Blogs network had a surgeon check in with those very words included in his commentary of a very recent ruling in NJ that limited the scope of chiropractors.  I often find that good surgeons are often physical therapy's greatest fans.  I'm glad for the positive press, although sad for that woman's knee!

Alternatively, the NJ APTA may need some help soon.  The chiropractic association is in the midst of some intense lobbying to have their practice act altered during the next legislative session.  I would think with a court ruling behind them,  NJAPTA's task might have just gotten a little easier.  Either way, any NJ readers out there:  Join Up!

Finally, I must point out that not all of the chiropractors in New Jersey must have heard about the AAOMPT's slogan of, "You've got drugs, you've got surgery, or you've got us."  A chiropractor quoted in one of the above articles seems to have left something out:

"...patients who once were helped by less costly chiropractic treatments have no choice but to turn to more costly injections and surgeries."

Check Out the Upcoming EIM Courses!!!

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

Download WhatIsMyEIM.pdf

Download ArticulateFormat.pdf

***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

Jul 21, 2007***
New Braunfels, TX (USA)

Aug 4-5, 2007***
San Luis Obispo, CA (USA)

Sep 15, 2007
Medford, NJ (USA)

Sep 29-30, 2007***
Evansville, IN (USA)

Nov 3-4, 2007***
Hawthorne, NY (USA)

Nov 17-18, 2007***
Greenville, SC (USA)

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

Aug 17-18, 2007***
Davenport, IA (USA)

Aug 18, 2007***
Russellville, KY (USA)

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

Sep 15-16, 2007***
Houghton, MI (USA)

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

Oct 27-29, 2007***
Evansville, IN (USA)

Nov 3-4, 2007***
San Luis Obispo, CA (USA)

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

Oct 26-27, 2007***
Ft. Lauderdale, FL (USA)

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

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

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

Evidence-based Exercise for the Management of Musculoskeletal Disorders

Jul 28-29, 2007***
Charlotte, NC (USA)

Sep 15-16, 2007
Manitowoc, WI (USA)

Evidence-based Examination and Selected Interventions for Patients with Knee Disorders

Aug 25-26, 2007***
Bronx, NY (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

If Kim Says There's a Problem...

Yep, if Kim over at Cube Farm says there are healthcare issues, there are definitely healthcare issues.  Kim knows LOTS of things....

http://www.youtube.com/watch?v=WPXBd2Mp43g

Reading the Fine Print

Per our previous post, July 10th was the deadline to submit comments to the Committee on Ways & Means regarding Medicare’s payment policy for outpatient therapy services.  I gave mine and hopefully many of you also submitted (of course that is if you weaved your way around the directions).

I decided to peruse thru comments of various national organizations that PT is an “interested party”.  Imagine my surprise when the headline this past friday’s APTA digest read “APTA Urges Therapy Cap Repeal to House Committee”.  I thought this is exactly what we need.

Until of course, I read the fine print (available for members only here.  If your not a member, you should be so join here) in which it details that the cap should be repealed beginning January 2011!  In the interim, they should refine the cap exceptions process.  You have got to be kidding right.  Is anybody that actually goes thru the exceptions process writing this?

I have mentioned many times on this blog that the exceptions process is a complete waist of time that only increases our cost (thereby effectively reducing our reimbursement) and does not serve the purpose that it was intended due mostly to “gaming” the rules.  Why should we not be so bold to call it what it is and end the cap and the exception process immediately?

Lest you think I am beating up our beloved national organization up too much, let me also cite that the vast majority of the comments made by APTA were outstanding and strategic (except the self-served recommendation to integrate OPTIMAL as a standard assessment instrument-I will leave criticism of that for another time).

For example, APTA recommends elimination of “ancillary” and “in office” exemption (essentially eradicating POPTS).  A bold proposition (why couldn’t we be bold enough to completely repeal the cap and exception process?) that the majority of our membership supports.  As justification for this recommendation, their rational included the obvious perverse financial incentives for self-referral (even associating in-house PT with other self-referral culprits-labs, and imaging) and the 2004 OIG study that showed that the majority of referrals to in-house do not meet standards of outpatient therapy.

Furthermore, the recommendation that all medicare data be provided by independent supplier status (essentially every PT’s medicare claims being tracked to that individual) supports the notion of PT as autonomous and accountable.  I recommended that data by practice type by tracked so that we can differentiate medicare data by PT in private practice from POPTS and I believe the coupling of this with APTA’s recommendation would be immensely helpful.

I hope many of this blog sent comments to CMS.  We are all in this together.

Thoughts?

 

Larry

A Marketing Dilemma

Dilemma: an argument presenting two or more equally conclusive alternatives against an opponent.

As regular readers of this blog well know, I am often critical about the Physical Therapy Profession's marketing efforts, namely that of the APTA. I recently authored a post entitled, "What should we do with this window?" which sparked a heated debate among Evidence in Motion readers.

The debate centered around two camps trying to resolve a question of marketing return on investment and a scope of practice. One group felt that it is our right and duty to advertise our scope of practice, and if we are able to provide bike fitting advice for example, then we should. The other group felt that we should focus marketing dollars in the area which has the greatest potential to steer consumers our way. I suggest reading through the conversation to get the full picture of the debate. Also check out, Rob Wainner's most recent post, "Market this."

Today, I want to look at another marketing dilemma within the profession. The fact that the majority of outpatient Physical Therapy consumers are a result of physician referrals. Aligning with the medical community has long helped Physical Therapy to grow and achieve the position we now cling to in the health care marketplace. But, there is a down side.

When a Physical Therapy practice markets their services, they would do well to market mostly to their physician referral sources, as they are the gate keeper for their services. However, this marketing can be costly and narrow in scope. Too often I hear of PT's subscribing the the "Drug Rep Lunch" concept, or spending $$ to take doctors out for dinner. Physicians' attention to marketing is a highly competitive venture, and Physical Therapists always stand to lose for the simple fact that we are not backed by billion dollar pharmaceutical companies and the drug rep lunches will always be nicer than ours.

When too much of this time is spent marketing to physicians for fear that marketing elsewhere will not yield a positive return on investment, the ability to educate consumers about the Physical Therapy product is harmed. I can drive around all day in my region listening to the radio, looking at billboards, and buying up newspapers. I'm likely to only see a couple ads targeting consumers from outpatient rehab providers.

Here is the dilemma: I have trouble arguing that a private Physical Therapist should spend more $$ marketing to the consumer. It simply is true, that every dollar spent on a physician has the potential to yield many more customers when compared to $$ spent on consumers. Even if the marketing was of sound quality, when a patient is steered by their physician towards a different therapy provider, that money is lost and the competition stands to benefit from your efforts.

So, what is the solution? Should Physical Therapists altruistically and futilely spend $$ on consumer marketing? Can the APTA reform their marketing into something more effective, perhaps with a focus of immediacy for the consumer rather that a prevention perspective? Or, is a wholly new strategy required of our profession? New strategy you say?

Let's imagine and debate the concept of a separate, non-profit business entity, whose sole purpose is to raise cash, and market the profession to the consumer:

The PT Publicity Project.

If we cannot individually market to consumers effectively, perhaps our collective efforts could yield a greater gain for all. Instead of one practice reaping benefits, we all do!

Photo by Sullest.

"Hi, I'm Dr. Robertson and I'd like to teach you to hula hoop!"

"Hoop Dreams- Physical Therapist ... turns the hula hoop into fitness fun!" was the tag line of this news scoop I came across.

Even though this reminded me very much of a recent APTA marketing effort on the subject of gardening, rest assured this is a completely independent marketing venture.

For anyone who's interested and lives near Washington Square Park in NYC, you can learn hula hoop from this recent NYU Graduate.

                                                                                                            

Which begs the question: Perhaps you do need a degree to teach hula hoop? Maybe that's why I'm no good at it!

Bed Rest is Bad!

How bad is bed rest for your back? 

So bad that it can make a healthy back go bad!  Yet surprisingly, many general practitioners, and even the APTA's own website prescribe exactly this for an onset of low back pain.

The study I'm linking to had healthy subjects spend weeks in bed.  After only 14 days, these otherwise healthy people had serious muscle deficiencies consistent with what is seen with back pain.  Keep those backs moving!