Read this WSJ article first on our ever getting closer to breaking Medicare program. The key sentence regarding possible solutions:
"Another innovative example: Virginia Mason Medical Center in Seattle offers a new approach to the treatment of back pain, a source of considerable medical spending nationwide. Under the old system, a patient would often first receive an MRI scan or specialty consultation and other tests before referral to a physical therapist. Under the new system -- which cuts the cost of treatment in half -- patients are first seen by a physical therapist unless additional diagnostic measures are clearly indicated, and receive an MRI scan only if the therapy doesn't work and symptoms persist."
In case you've lived under a rock for the last 20 years, back pain is a huge problem and disastrously managed in the US, with perverse incentives that encourage gross overutilization of very costly procedures like drugs, surgery, and imaging, a majority of which are completely unnecessary.
Given this disaster and the opportunity for physical therapists, we have been ranting about the need for physical therapists to lay claim to our being the preferred experts in managing patients with musculoskeletal conditions ever since we started blogging in 2005. There are way too many posts to link, but suffice it to say this topic has been a major theme woven throughout virtually every post ever made on the blog. If there is nothing else we market or do as a profession, we should do this well. All the other niche areas of practice will ride extremely long muculoskeletal "coattails" that benefit them far more than any isolated marketing campaign could ever do.
Why such a heavy and one-sided focus? The answer is very simple. Unlike 90% of the professional advocacy and lobby activity that take place on Capitol Hill, the clinical and economic data are completely on our side. Our interests are 100% aligned with government's interests, primarily how to get control over a rapidly spiraling out of control Medicare spending that will soon be the only government program.
I have absolutely no faith that our elected officials will do anything until the system is just on the verge of completely breaking, but once this happens, they will swoop in to be our heroes (tounge-in-cheek of course since special interests drive the problem of ever getting meaningful reform in the first place). Nonethess, we have to be ready to answer the call to action. We will see demand for physical therapist services increase more dramatically in the next 20 years because of the aging population and the disastrous health care system than we have seen in our entire history combined. The question is not whether the system will change to orient patients directly to physical therapists. The issue is really whether we will be ready to meet the challenge. That remains to be seen.
John
