Columbia Physical Therapy in Washington State has filed a lawsuit against Benton Franklin Orthopedic, a group of orthopaedic surgeons, in what figures to be the next big referral-for-profit / physician-owned battle in the physical therapy profession.  The physical therapists have an interesting set of laws on their side, the physicians have the normal repertoire of “doctor’s know best” arguments on their side.

However, the attorney for the orthopaedic group might have underscored the position of desperation his clients may be in with this quote:

“If physicians can’t employ physical therapists, nobody can, and they are used in all sorts of medical settings.”

That has to be the craziest argument in favor of physician self-referral yet.  No one can get physical therapist interventions if they are not employed by a doctor?  This assumption of employment visible in the quote underscores the widely held belief that many physicians hold about physical therapists, that they are an auxiliary service rather than an independent medical professional of similar value and capability in the care of musculoskeletal conditions.  Perhaps physical therapists’ fondness for video games assists in perpetuating this belief.

In a stone-cold logical retort, Columbia Physical Therapy’s attorney states his client’s problem with physician self-referral as he describes the practice as having the ability to “create a captive referral market where the referring physician controls both the supply and the demand for patient services.”

Captive markets are dangerous for consumers.  Does that mean that all individuals take advantage?  Not at all.  There are some high-quality physician-owned groups out there.  In fact, I met one last night!  However, the danger lies in the possibility of abuse which is something our health care system should have very little tolerance for.

ERIC