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Ain't Gonna Ruin My Derby Week

At first, I thought it was the greatest May fool’s joke that I have ever seen, even though May 1^st isn’t till tomorrow (In feat of symbolism this is how we celebrate it in KY-one month behind everybody else).

Of course I am talking about the front cover of the PT Magazine of Phys (can’t tell what else it says as some kid who is playing the wii’s head is covering the rest of the magazine title).  This is the glossy mag that accompanies our official Journal-Physical Therapy.

It has been posted many times here, here, here, and here about what I will now refer as “the Paris Hilton of Physical Therapy” (you know something that continues to obnoxiously show up all the time and just when you thought it was gone shows up again)-otherwise known as the Wii as in Wiihabiliation (or Wii’s gone Wild).

But, to see Paris Hilton of PT show up on a magazine produced by our professional association shows just how lost we are in any type of unified branding message.  I am sure that the conversation went something like this:

PT Magazine Idea Generator:  “Why don’t we run our cover story on minority diversification, women’s health,  or PT cash practices?”

Colleague of Idea Generator:  “Uhh, because we run that cyle every quarter?”

Idea Generator: “No, I mean something really different this time!  Let’s run them all three together!  It will be the biggest issue of all time and amass record sales.”.

Colleague of Idea Generator:  “Uhh, well, the magazine is free so sales won’t matter but I am sure your idea will make or advertisers and their mother’s proud-let’s go with it”.

Idea Generator:  “Great!  Wait!  I really got it-let’s throw in a Wii into the picture!”

I am quite confident that is how we got this month’s cover.  We hit the trifecta again (pardon the horse pun).

Just a few questions:  is this ther ex or group?  Does it matter if the kid is on medicare? Do you have to have a DPT or a tDPT to play (I mean facilitate one one one)?

Most interesting thing to the whole debacle?  Right below is “Also inside:“ with the first bullet point being about 21^st Century Marketing for PTs.  Hope the Idea Generator reads it for next month.

But, it ain’t gonna ruin my Derby Week!

larry@physicaltherapist.com

What PT looks like without medicare and regulations?

At Least We are #5 on Somebody's list.

From the Tehran Times, Iran’s leading International Daily in an article entitled: Need a less stressful career? Here are eight secrets to work

5. Physical therapy assistant Whether giving and receiving backrubs at a massage therapy school, or practicing flexibility techniques in a physical therapy assisting program, you can learn how to help people maximize relaxation. And if you incorporate some of these exercises into your own daily routine, you could have a recipe for a tension-free workday.

My favorite- help “people maximize relaxation”.

I wish I could make this stuff up.

larry@physicaltherapist.com

Looking for a Brand - Nice Job AHRQ!

Check out the new PSAs from the US Dept. of Health and Human Services' Agency for Healthcare and Research and Quality (AHRQ), and the Ad Council.  The tag line: "Real Men Wear Gowns" is catchy.  The website link from the ads states:

"Whether it’s time for you to get a blood test or that test,you’re not just doing it for yourself. You’re doing it for your family and loved ones, because Real Men Know the Facts:

• One in 5 American men has heart disease.
• One in 3 American adults has high blood pressure.
• Three in 4 American men are overweight.
• Nine in 10 lung cancer deaths are caused by cigarette smoking.

The single most important way you can take care of yourself and those you love is to actively take part in your healthcare. Educate yourself on health care and participate in decisions with your doctor—even if it means wearing an examination gown. This site will help you get started"

This ad campaign was explained at PRWeek:

Objective: The effort aims to make men more savvy healthcare consumers and get them into the doctor's office more often. The most recently released AHRQ Medical Expenditure Panel Survey (2005) found that men are 25% less likely than women to have yearly checkups. According to Ellyn Fisher, Ad Council director of corporate communications, "It's all about starting a dialogue."

The key demographic targeted is US men over 40. "We went out and talked to men," she added, "and found in our conversations and focus groups that the reason [they] weren't going is they think they can handle things on their own."

Idea: The campaign centers on PSAs and strategic media relations, which use a humorous tone while encouraging men to seek out doctors. Examples include a man in a doctor's gown walking his daughter down the aisle. Al Lazar, director of AHRQ's Office of Communication and Knowledge Transfer, emphasized that the communications team sought to maintain a positive focus by attaching the campaign to upbeat promotions, such as Father's Day and National Men's Health Week.

Tools: In addition to the PSAs, the AHRQ launched a new Web site, www.ahrq.gov/realmen/quiz.htm, which provides preventative testing tips, referrals, a quiz, and videos. Former NBA star Sam Perkins will headline an SMT with the groups' leaders. The effort is also reaching out to bloggers and social media. Internally, PR materials were provided to AHRQ staff, partners, and constituents.

Measurement: The team is monitoring the number and quality of titles that cover it, as well as Web site hits. Organizers believe the effort had already reached more than 5.3 million people in the first few days through its SMT, b-roll distribution, and other coverage.

Company: US Dept. of Health and Human Services' Agency for Healthcare and Research and Quality (AHRQ), and the Ad Council
Campaign: Real Men Wear Gowns
PR Team: Internal teams
Launch: April 21
Budget: About $100,000 (PR)

From the April 28, 2008 Issue of PRWeek

APTA - Are you paying attention??

ACN/United want the Tricare Contract

I received the following message on a PT listserve:

I received a letter from ACN/UNITED stating they are bidding for
management of TRICARE.

If you think it's a good idea to let TRICARE know of your experiences
with the American Chiropractic Network (ACN) and UNITED, write a real
quick letter of recommendation, or lack thereof, to the TRICARE address
below. Action must be taken now as the contract is awarded "mid
2007." No one will act for you.

TRICARE MANAGEMENT ACTIVITY
SKYLINE 5
SUITE 810
5111 LEESBURG PIKE
FALLS CHURCH, VA 22041-3206

I must commend ACN/United on their moxie to send a letter to PT providers.  They are perhaps the most universally hated insurance company by PT providers in the US.

Personally, while I think ACN represents a well intended and conceptually on track approach to physical therapy via provider profiling, tiering, outcomes, etc. their execution is a complete disaster.  This is mostly due to their “parent” UHC having the final say in the ever important “reimbursement” part of the equation with areas of the US getting a $45 per visit take it or leave it approach.  Therefore, ACN is really United’s attempt to be a provider “feel good” department and is the epitome of hypocrisy. 

That’s just my thoughts-what’s yours?  Don’t forget to let Tricare know them as well.

Larry@physicaltherapist.com

 

 

One way

To buck the trend toward insurance companies decreasing reimbursement.  How did this clown end up with 4 clinics?

larry@physicaltherapist.com

PT Whore of the Month Club #3

The PT "Whore of the Month" Club continues to be received with great fanfare, despite some strong objections to the label we have put on what has turned out to be a very popular feature. In light of our very transparent disclaimer below regarding which definition of "Whore" we are intending, we have elected to stay with the current title. Feel free to continue hammering us in your comments if you disagree, but plain language works well here and frankly the definition could not be more apropos.

We were delinquent in publishing a March winner so will be catching up in the coming weeks. The belated March 2008 winner of the PT Whore of the Month Club is...drumroll please...

Alan Tyson, PT, SCS, ATC-L, CSCS

Mr. Tyson teaches a course through CIAO seminars titled "A Business Model to a Better Private Practice." CIAO's course description boasts that the course will teach us how to increase the number of referrals to our clinic and ways to compete against physician-owned practices. Mr. Tyson's philosophy is that practice representatives should position themselves as experts on a subject by providing several pieces of new educational information that are valuable and practical to either a potential client or referring physician. Because the therapist has positioned him/herself as an expert in the eyes of the intended audience, the potential client or physician will seek out that therapist when PT treatment is needed at a later time.

This philosophy is fine and appropriate to teach during the course; however, Mr. Tyson apparently spends much of the time positioning himself as an expert on dietary supplements with the hope that participants will stay after the course and listen to his business model about how you can peddle his products in your clinic.

And what do you learn about competing against physician-owned practices? Nada. There is actually no mentioning of it during his entire presentation. Although it is difficult to tell, it appears he may actually be employed in a physician-owned practice himself. Even if he somehow runs an independent PT practice on their behalf, peddling supplements alone is sufficient to make him worthy of the award.

So, save your $275 or spend it on your loved ones lest you be scammed out of a previous Saturday of weekend leisure.

Keep sending in your ideas via email at info@evidenceinmotion.com or feel free to post as comments!

The EIM Team

 

Previous PT Whore of the Month Winners:

Jan 2008 - WebPT - PT Whore of the Month Club #1

Feb 2008 - Paul Duxbury - PT Whore of the Month Club #2

Disclaimer:

In the event that anyone is concerned with our use of the word "Whore", we are referring to definition #4 below.

whore-

1. a woman who engages in promiscuous sexual intercourse, usually for money; prostitute; harlot; strumpet.

2. to act as a whore.

3. to consort with whores.

–verb (used with object)

4. Obsolete. to make a whore of; corrupt; debauch.

Wii are Human Movement Specialists?

As many of you are aware, the APTA has recently undertaken a strategic planning effort, which we have previously blogged about here (and are big proponents of its getting done). However, there is some early feedback about intentions to brand PTs as practitioners of choice for "human movement disorders" rather than using plain language that consumers and payers will actually understand. Think about it. Go ask 20 of your neighbors what a "human movement disorder" is and if they've ever had one. It's rather silly actually.

I don't want to be too critical until we see the final version of the strategic plan, but I will confess to getting that sickening feeling again that we're about to cave to a vocal minority so that we can be all things to all people and not offend anyone with the use of practitioners of choice for “musculoskeletal conditions” terminology (neuromusculoskeletal works well too)…never mind that’s a phrase that resonates wildly with consumers and payers.

If we are correct that "human movement" is about to be the centerpiece of our brand (I am hoping for a bad dream), only PTs can stare an epidemic of musculoskeletal conditions like LBP in the face (LBP accounts for 2% of all physician office visits…only routine examinations, hypertension, and diabetes result in more office visits) and try to carve out a new nebulous term that says our problem is actually human movement disorders. What is the ICD-9 code? Does it lead to sexual dysfunction?

All the while, the cost of managing LBP increased 65% (adjusted for inflation) to $6096 in 2005 compared to $4695 per case in 1997, outpacing every other rate of increase in health care. Yet our problem is "human movement"?

A marketing campaign around "human movement" will be difficult at best. We need Branding 101 to get enacted here quickly (Felicity, have you started yet?...we need you to save us from ourselves!). "Human movement" is analogous to watching the typical business owner market to themselves...mostly clueless about the customer and what our brand needs to mean to the customer.

Unless we come to our senses, here are some possible brand tag lines for our "human movement" campaign.

1) Wii Are Human Movement
2) Got Human Movement?
3) PT: For When Your Movements Are No Longer Human
4) Absolutely, Positively, Human Movement
5) PT:  The Missing Link in the Human Movement

We will also need to revise our top diagnoses as seen by APTA to the following:
1) Blackberry Thumb
2) Back Pack Pain
3) Human Movement Disorder

For all three, the preferred treatment is Wii Therapy.

Ok, enough ranting here, and we welcome anyone from APTA to suggest we're way off base (and pray dearly that we've got this one completely wrong). Regardless, we have to get the economics right on this one. At the current rate of decline in reimbursement, and considering the 5% per year decrease projected for Medicare, by the year 2020, we will be an organization of volunteer "human movement specialists" who are asked to pay dues for the privilege of working for free....what a deal!

What we need is a major marketing campaign that targets real direct access for real conditions with which payers and consumers identify, LBP being the biggest one. We can only hope that common sense will prevail.

Just an initial reaction. Your thoughts?

The EIM Team

More Fuel For the Primary Care Physician Fire

For those of you following, I have had multiple posts here, here, and here regarding an initiative that I think we need to get aggressive on-branding with primary care physicians for musculoskeletal exam and treatment.  This is due in large part to the shortage of primary care docs that will be around for awhile as well as the transition of our own profession to direct access and autonomous providers.  Others, namely nurses are aggressively pushing this extender position and we need to put ourselves in a similar position.

This blog post appropriately titled, The End of the Primary Care Physician further adds fuel to this fire.  It references and links several op-ed pieces including 2 WSJ  pieces including one on Dr. Nurses) and a JAMA commentary.

We need mass promotion of our transition to doctorate and our expertise in musculoskeletal medicine.

We need to be leaders in helping Primary Care Medicine new definition.  This fits well into the medical home model as well.

thoughts?

Larry@physicaltherapist.com

 

Attention Physical Therapists- Speak Truth to Power

I was hoping to sit down to a glass of wine and relax tonight...but the recent issue of JAMA has raised my blood pressure and reversed the positive health effects of moderate alcohol intake.  I encourage all members of the MyPhysicalTherapySpace community to read the 2 recent papers on the continuing saga of Merck, Vioxx, and a pharmaceutical industry that continues to place profits over patients.   The first paper describes the disturbing fact that of a number of clinical trial manuscripts related to rofecoxib (Vioxx) were authored by Merck employees but often the first authorship was attributed to academically affiliated investigators who did not disclose industry financial support. It was even more rampant when it came to review manuscripts which the industry employees would write and subsequently attributed authorship to the academically affiliated investigators who would just happen to forget to  disclose industry financial support (go figure).   The second paper is more alarming in that Merck as early as April 2001, had clearly identified an increased risk of mortality associated with rofecoxib among patients in the Alzheimer disease trials, yet they faild to submit these disturbing findings to the FDA until 2003.    As physical therapists we must continue to speak truth to our patients.  We should distrust pharmaceutical interventions of chronic musculoskeletal conditions. 

Tim

Evidence for High Resistance AND Low Resistance

Most of you probably contemplate new evidence as it becomes published.  What factors do you consider relevant if you determine to implement the evidence?

The recent research comparing high resistance and low resistance exercise intensity for patients with knee osteoarthritis has me reflecting on how this could be implemented while considering all the stakeholders.  It's great to know that exercise resistance at 80% of 1 repetition maximum (performing 3 sets of 8 repetitions) OR at 10% of 1 repetition maximum (performing 10 sets of 15 repetitions) both have favorable outcomes.  On the surface it appears to be a win/win situation when making a clinical decision (effectiveness and evidence supporting the decision), but is it a win/win situation?

In analyzing the win/win, other factors may be relevant in making a decision.  The high resistance exercise intensity requires 30 minute sessions with a patient with knee osteoarthritis to acquire the reported results.  The low resistance exercise intensity requires 50 minute sessions to acquire the reported results.  Location of provision of services may clinically determine which option is more realistic to provide.  Does the physical therapy cap apply for the practice setting?  Does the patient have a high copay based on percentage of allowable?  Does the patient have a preference?

Selena