The Results of One Court Case Will Affect the Nation

Is an orthopaedic surgeon a "qualified health care provider" with regard to providing physical therapy services?

According to the Kentucky Supreme Court, yes, an orthopaedic surgeon can provide physical therapy services and is a qualified health care provider. What can I say? Over the last 6 years, the case went through the whole darn court system and a final ruling occurred in the Kentucky Supreme Court. The result... since section (1) proviso allows orthopaedic surgeons the authorization to provide physical therapy services, but since section (3) disallows the orthopaedic surgeon from referring to the services as physical therapy either directly or indirectly - an "absurd" situation is created. Apparently, the General Assembly wanted the statute to be considered as a whole and for all pieces within the statute to be relevant. The General Assembly would not want an absurd statute.  It all comes down to it being absurd that an orthopaedic surgeon can't offer and bill for physical therapy services provided by an athletic trainer using CPT 97001 and 97002.

Personally, I find it not only absurd but also illogical that an orthopaedic surgeon would be allowed to provide physical therapy services without a physical therapist providing services.

If we put some practicality into the situation... first of all, an orthopaedic surgeon is not in the clinic every day of the week.  The "surgeon" will have 1 or 2 days (or more) per week in an operating room, right?  So, when the surgeon is operating, the surgeon really can't be supervising any physical therapy services that might be concurrently provided within the surgeon's clinic right?  We'll forget about that reality for a minute.  When the surgeon IS in the clinic, what is the surgeon doing?  If we guesstimate the surgeon has an 8 hour working day, then that means the surgeon has basically 480 minutes.  Of that 480 minutes, the surgeon will probably have 20% downtime - waiting for radiographs or MRI results or conversing with other colleagues or documenting... that leaves 364 patient contact minutes.  Approximating an average of 10 minutes of surgeon-to-patient contact, a full day would be approximately 36.4 patients.  In that full day of surgeon-to-patient contact, does it seem reasonable that a surgeon would have the time to adequately address and supervise the provision of physical therapy services being provided by an athletic trainer?

Until third party payers eliminate referral for profit situations, the Kentucky Supreme Court opinion just may create ripples across the nation substantiating the legal right for physicians to provide physical therapy services.  Until consumers care enough to compare before they seek a physical therapist for their condition, the situation won't change.

Is it possible for physical therapists to create a viral message?  Physical therapy isn't physical therapy without a physical therapist. Put the PT in physical therapy. 

What are your thoughts?

~Selena