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Spine Flu

NPR has reported that despite the fact that Swine Flu is not a foodborne illness, pork sales are down and pork producers are getting worried.  In my opinion, pigs are getting a bad rap. As a card-carrying Feline I would like to express inter-species solidarity with my Porcine brethren. (Hang tough, Arnold Ziffel and Miss Piggy!)

I propose a constructive (though politically incorrect) use of such public misperception by reframing the current pandemic of spine surgery  as “Spine Flu.” Then the general public will be appropriately alarmed and maybe even the CDC will take notice.  As the CDC is being politically correct by  referring  to “Swine Flu” by its more scientific designation “H1N1, ”  I predict that it will soon designate "Spine Flu" as “L1S1.” 

In the meantime, I'm Smokey the Evidenced-Based Cat, recommending that we all keep our paws clean.

NY Insurer CEO doubles salary in concurrent attempt at making PT Extinct

HIP/EMBLEM a NY insurer that covers 4 million lives of government workers primarily has just reduced the global fee from $55 to $45 statewide citing that it is “in line with patterns in the industry” and that the old reimbursement rate of $55 was “well above the industry norm”.

Help me out here Mr. Anthony Watson (CEO) and show anybody any kind of data that $55 or $45 is within any norm in the industry. The only published benchmark is CMS data and an extrapolation of that data for New York and in particularly in the city where rents are $30–$40 more approximates $90 and industry trends and work comp are negotiated above CMS rates.  I promise we can show you more data of CEO’s taking reduction in compensation versus doubling their take home.

The fundamental question is how can this happen?  The conventional wisdom is “cause they can”.  This is unfortunately true if too many unwise providers accept rates that will make them go the way of Shakers.  Perhaps HIP/EMBLEM and their bloated CEO don't remember the mass providers who finally said no to the ridiculous rates by the former ACN division of UHC.

It’s a good thing PT’s like Dr. Dimitrios are not afraid to go public and is going one step further by leading his staff to HIP offices in NYC to protest this impending 20% reductions.

Watch Dick Brennan’s TV report here.

larry@physicaltherapist.com

 

 

 

A Physical Therapist in New York Goes "Public"

About 1 year ago, I attended the Michigan Physical Therapy Association spring meeting and brought up a very valid concern about Blue Cross Blue Shield of Michigan.  Blue Cross Blue Shield of Michigan is a non-profit insurance company that continually increases premiums, continually pays its administrators high annual salaries and by switching most of its insurance plans to PPO plans continues to pay less to providers.  Of course, I haven't heard a darn thing with regard to what the MPTA has done in researching how BCBSM can elevate premiums yet concurrently maintain or decrease the fee schedule.  Providing insurance coverage should be a risk... subscribers pay to reduce their financial medical bill risk and insurance companies should be somewhat gambling in determining their premium amounts and fee schedules.  This isn't the case though because BCBSM wins and has complete control - look at the amount of profits made by BCBSM - it is sickening.

I contacted an attorney who was involved with a case against BCBSM.  A case that was brought up by 2 subscribers who could not afford to pay the higher and higher premiums.  Attorneys have zero sympathy for providers because providers decide to "participate." 

Apparently, it all started with a letter... a simple letter.  A letter that I'm sure had a strong visceral reaction - a 20% reduction in the fee schedule beginning May 1, 2009.  I saw this article and of course clicked on it because I was interested in the details.  The thing scared the dickens outta me too!  There is a YouTube video at the bottom that begins playing almost immediately.  (That WAS a good thing because it meant I wasn't crazy and hearing voices in my head!)

I think we all should be interested in how this situation pans out.  How will you respond if one of your payers sent you a letter like that?  Can you and the members in your state mobilize quickly?  What strategy would you use to alter the course?

~Selena

Will Mayo Clinic Have the Foresight to Suggest Physical Therapists?

We've all experienced the current model of health care delivery.  I'm also sure we have experienced, or know someone who has experienced, the lack of communication between health care providers.  We know that more and more people are turning to the internet for assistance in making health care decisions.

What happens when Mayo Clinic teams up with Microsoft Healthvault?  The partnership exists.  Automatically, there will be a  predominant feeling of trust.   The final product is so much more than Mayo Clinic offering a personal health record... this partnership includes a product that will provide guidance on managing the patient and the patient's family's health.

So, I wonder... I wonder if the guidance is evidence-based?  I wonder... I wonder if physical therapists are recommended for neuromusculoskeletal conditions?  Are the recommendations the same old, same old drug and surgery options?

If key guidance is based on the same old, same old recommendations, is there a possibility of lending a helping hand and sharing the role of physical therapists for neuromusculoskeletal conditions?

~Selena

 

The Impact a Physical Therapist Can Have

Even though we have a high focus on research, outcomes and the whole idea of Moving Forward, don't ever forget the power of your words.

Trisha Meili obviously didn't forget.  20 years later she is able to credit the role her physical therapist had in assisting with her return to running, "The physical therapist knew just how to push me. There was a chapter of Achilles at Gaylord Hospital in Wallingford, Conn., where I was treated, that met on Saturday mornings. The head of the physical therapy department asked me if I wanted to join."

~Selena

The Great PT Plankton Awakening

I know many of you may have seen this clip already from the hit show Britain's Got Talent, but if this does not inspire you towards excellence, then nothing will. Take just a few minutes to view in its entirety if you have not. You won't regret it.

In a strange way, this clip reminds me of the secret that physical therapists remain as a positive force for change in health care reform...a sleeping giant ready to be unleashed upon the health care system. The Plankton PT days need to cease. It's time for an all out frontal assault. Be and live the change.

Great weekend to all.

John

The CPR and Shades of Gray

I am an evidenced-based cat. How did I get that way? Like many of my human colleagues, I started out as a stray, wandering here and there, looking for something substantial to sink my teeth into.  Then, one cold December morning in 2005 a PT tech rescued me from under his front porch and took me to work. That was my first day of clinical education. Of course, my patient contact was limited by those pesky Medicare regulations, and so I was relegated to assisting the tech with folding laundry. (I still have a soft spot in my heart for warm towels just out of the dryer.) The boss named me Smokey (that’s Smokey with an “e;” the “e” stands for evidence)  and she took me home, where I proceeded to disrupt the entire household, especially the two older pre-existing cats. I entered the house and the other cats “educated” me. This is what is meant by entry-level education. The PT is now my guardian. (Guardian is a politically correct euphemism for “the lady who pays the mortgage, buys my food, and changes the litter box.) Anyway, I settled in and worked very hard to  earn the  respect of my older siblings. Then my guardian decided that we should enroll in the Regis tDPT program, and I became her mentor. And here we are.

One of my main areas of interest is the lumbar spine. (If you had 7 lumbar vertebrae, you would be interested in the lumbar spine, too.) Anyway, I am particularly interested in the nuances of the clinical decision making process, and so I am well versed in the CPR that everyone is talking about. I am speaking of course of the Cat Prediction Rule, which states that if you have one cat, you will be happy, if you have two cats, you will be happier, and if you have 3 or more cats, you will be happiest.  The evidence is quite clear on this—just check the litter-ature. 

So, the Obamas should get a cat, right? In fact, the CPR says they should get 3 or more cats. Right? Alas, no, and here is where the “conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” comes in. (Please, no jokes about thinking “outside the box” as   that is a bit of a sore spot at home.)  It seems that little Malia is allergic to  cats and dogs, and so a hypoallergenic dog was required.  So, despite the Cat Prediction Rule that shows that the vast majority of people would be happy with a cat, and the more cats the happier, in this instance a cat is simply contraindicated. And some day, when stem cell research helps find a cure for feline dander allergy, Malia and Sasha can finally get those cats!  On a personal note, I would like to point out that Bo sports a tuxedo look and two white front paws remarkably similar to my own. As a fellow quadruped, I wish Bo Obama well, and I hope he is able to remain above the political fray, avoiding any White House leaks, unwanted stimulus "packages," or other adverse outcomes. (A word to the wise, Bo--finding evidence and leaving evidence are two entirely different concepts.)  And,  The New York Times reports that  Bo is actually named after an Obama relative’s cat—now that’s what I call reaching across the aisle!

I'm Smokey the Evidence-Based Cat, and these are Shades of Gray.

 

Mayo's Version for Fixing Broken Health Care

If ever there was a case besides Virginia Mason’s example in savings in healthcare, it is this one from the guru’s themselves-Mayo Clinic.

Patient’s don’t go to traditional primary care because it is inconvenient, located poorly, long wait times, etc. etc.  Set up convenient centers in strategically located areas and Voila!  This customer service expectation is carried out in most PT practices.

Now, if only Mayo staffed these convenience centers with PT’s for direct access of musculoskeletal concerns and left the mid-level practitioners to do what they can do well they would really have the ultimate solution.

It is interesting that enlightened systems and companies are finding out the best solutions are those that allow practitioners to act within the scope of their own license and standards of care.  Sure wish the PT beaurocrats and CMS, out of some misguided sense of paternalism, would learn the same thing instead of imposing “protective” rules and regulations that are clearly out of synch with licensure and economics of health care.

larry@physicaltherapist.com

Executive Program in Private Practice Management

"The first 8 weeks of this program have, indeed, exceeded my expectations.  For the first time, ever, I feel like I have a group of expert advisors (instructors and classmates) that can provide relevant feedback to help me grow my practice beyond its current boundaries (as well as my own boundaries)."

Jennifer M. Gamboa, DPT, OCS, MTC, President, Body Dynamics

"Larry Benz and the EIM team are raising the bar again!   Now there is another option (perhaps the Best First Choice) for physical therapy practice owners that not only want to earn their DPT but also want to go deeper into the business of physical therapy.   With EIM's Executive Management Program you'll learn about strategy, marketing, management, technology, much more and of course the important knowledge and skills necessary to obtain your transitional DPT (if you choose this option).  It's affordable and online.  EIM gets it - you need to balance your business, family and fun and you can earn your degree too.  I'm going through it now and my peers are some of the best in our profession!  I highly recommend this program.

David Straight, PT, MPT, OCS, President, E-rehab, LLC

 
Application deadline is May 1. 

For more information contact 888-709-7096 or info@evidenceinmotion.com.

 

 

In Partnership with

888.709.7096    www.evidenceinmotion.com    www.myphysicaltherapyspace.com

Look what PT practice owners and managers are saying about the Executive Program in Private Practice Management with optional tDPT in partnership with PPS...

 

"This kind of practice management MBA style education is exactly what private practice PT owners are asking for to improve their business acumen and improve the success of their practices.  It takes much more knowledge in today's healthcare environment to run an efficient and compliant practice.  Mistakes are much more costly today than in the past.  If more PT's are educated in this area through this type of format, the better our profession will be and ultimately patients will benefit from superiorly run healthcare facilities."

Stephen E. Anderson
Immediate Past President of the APTA Private Practice Section and Executive Program Participant

Direct Access for Physical Therapists in Calif

Yes, he discloses immediately that his wife is a private practice PT, however, this judge’s op-ed piece has all the background information that you need.

This is a critical issue for Calif PT’s and they need all the support we can give them.  For more information on how you can help go to this great site put together by Dave Straight of E-Rehab.

larry@physicaltherapist.com