The intellectual downhiller


This story about professional mountain biker Neven Steinmetz, caught my eye for sure.  I have a special place in my heart for downhill mountain bikers, people who survive smashing into things, intellectual pursuits and stories about physical therapy.  This one has it all! An inspiring tale of what a driven person can accomplish.  I’m so inspired, I’m going to start commuting to work on my downhill bike!

Steinmetz has been nominated to represent the United States at the upcoming 2007 UCI Mountain Bike World Championships in Fort William, Scotland, Sept. 3-9.  I will be watching her results for sure!

As an interesting note, this woman suffered a head injury that went undiagnosed, a very popular story in the media right now as it relates to injured troops.

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Will consumers fix healthcare?

All the rage of late in the medical business world is about retail medical clinics (or more aptly named, "convenience health clinics").  For Wall Street Journal readers, you know what I’m talking about.  You may also know that the American Medical Association has declared war on these clinics.  You may read their declaration here.

 

So far, customer satisfaction for this clinics has been high, around 97%.  Its not surprise then, that this business model is taking off, with clinics popping up in Walgreen’s and Wal-Marts all over the country.  It is obvious that the AMA’s opposition to these clinics is simply a turf battle and not legitimately about patient care quality.  It reminds me of physician’s opposition to direct access to physical therapists, and the battle over referral for profit arrangements; both battles also fought under the guise of physician’s altruism.

The all-seeing Seth Godin, had a nice post a while back on "Stuck Systems."  Here is a quote from that post:

"So, the marketer faces a challenge similar to the disruption challenge that most marketers face–how do you take a system filled with an inefficient, annoying, time-consuming, wasteful and yes, even stupid task and make it better in a way that serves all sides? 

If it were me, I’d focus on being cheap and fast and viral. And the more you break the system, the better your upside."

 

Healthcare is a stuck system.  I don’t think it can stay that way for long.  In the end, consumer choice of convenient services will rule the day.  It could be an incredibly ironic moment in the upcoming presidential election, where health policy is expected to play such a large role, that consumers have already chosen their "fix" for healthcare in the marketplace.

Physical Therapists must acknowledge they are part of a stuck system!  Third-party payment, regulatory woes, and limited access characterize our jobs.  The convenience model needs greater attention.  We are continually growing the research evidence base to support this model for physical therapist practice.  We might think about acting quickly, it could be embarrassing for a physical therapist to get beat in a race by a nurse practitioner!

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Some good science reading


The LA Times is in the third installment of a series entitled, "Chasing Memory."  I have enjoyed the stories, although a bit length.  They chronicle neuroscientist Gary Lynch at UC Irvine.  Here is my favorite Lynch quote so far:

"If you’re good, if you’re any good at all, you put yourself in a situation where reality could come around and — WHACK! — knock you down. That’s what you really are afraid of. If you don’t have that, you’re not playing science,"

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The next big advance?

At one point in time, scientists did not know that germs caused disease.  The reason:  they were not able to see the germs.  Well, as optical technology improved, it became easy to study and examine the little buggers causing our body harm.  The knowledge now seems commonplace today.

One lasting barrier to all imaging is the ability to see inside living cells.  An MRI can image tissue well, but not at a cellular level. A study in the online journal, Nature Methods, discusses a technology that could change the way we think about how our bodies work.  Scientists have been able to construct an view of the inner workings of living cells in your body!

Tomographic Phase Microscopy.

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Dr Google and Dr Microsoft

Here is another update on the evolving role of our our nation’s two big software powerhouses in the healthcare arena.

"By combining better Internet search tools, the vast resources of the Web and online personal health records, both companies are betting they can enable people to make smarter choices about their health habits and medical care."

Hmmm.  Enabling people to make smarter choices about healthcare sounds like a good thing.  Now, how do we figure out, as a medical community, what those smarter choices really are?  One of the biggest barriers these types of efforts will face is being able to assess performance and outcomes from various health practices and medical care.  Is physical therapy superior to surgery for back pain?  In what cases is this so?  Is all physical therapy the same, or does it vary widely, preventing an across the board recommendation as to its effectiveness?

Well, I know the answers, but how does Google or Microsoft know the answer?

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"…a good physical therapist is…more valuable than a horde of chiropractors."

The very popular Science Blogs network had a surgeon check in with those very words included in his commentary of a very recent ruling in NJ that limited the scope of chiropractors.  I often find that good surgeons are often physical therapy’s greatest fans.  I’m glad for the positive press, although sad for that woman’s knee!

Alternatively, the NJ APTA may need some help soon.  Included in this same article is information that the chiropractic association is in the midst of some intense lobbying to have their practice act altered during the next legislative session.  I would think with a court ruling behind them, the NJAPTA’s task might have just gotten a little easier.  Either way, any NJ readers out there:  Join Up!

Finally, I must point out that not all of the chiropractors in New Jersey must have heard about the AAOMPT’s slogan of, "You’ve got drugs, you’ve got surgery, or you’ve got us." A chiropractor quoted in one of the above articles seems to have left something out:

"…patients who once were helped by less costly chiropractic treatmentshave no choice but to turn to more costly injections and surgeries."

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A Marketing Dilemma

Dilemma:
an argument presenting two or more equally conclusive alternatives against an opponent.

As regular readers of this blog well know, I am often critical about the Physical Therapy Profession’s marketing efforts, namely that of the APTA. I recently authored a post entitled, “What should we do with this window?” which sparked a heated debate among Evidence in Motion readers.

The debate centered around two camps trying to resolve a question of marketing return on investment and a scope of practice. One group felt that it is our right and duty to advertise our scope of practice, and if we are able to provide bike fitting advice for example, then we should. The other group felt that we should focus marketing dollars in the area which has the greatest potential to steer consumers our way. I suggest reading through the conversation to get the full picture of the debate. Also check out, Rob Wainner’s most recent post, “Market this.”

Today, I want to look at another marketing dilemma within the profession. The fact that the majority of outpatient Physical Therapy consumers are a result of physician referrals. Aligning with the medical community has long helped Physical Therapy to grow and achieve the position we now cling to in the health care marketplace. But, there is a down side.

When a Physical Therapy practice markets its services, it would do well to market mostly to its physician referral sources, as they are the gatekeeper for their services. However, this marketing can be costly and narrow in scope. Look into https://ful.io/ site who are not only offering the best deals on marketing tools and services but is also well recognized for the work that they do in this field. Too often I hear of PT’s subscribing the the “Drug Rep Lunch” concept, or spending $$ to take doctors out for dinner. Physicians’ attention to marketing is a highly competitive venture, and Physical Therapists always stand to lose for the simple fact that we are not backed by billion dollar pharmaceutical companies and the drug rep lunches will always be nicer than ours.

When too much of this time is spent marketing to physicians for fear that marketing elsewhere will not yield a positive return on investment, the ability to educate consumers about the Physical Therapy product is harmed. I can drive around all day in my region listening to the radio, looking at billboards, and buying up newspapers. I’m likely to only see a couple ads targeting consumers from outpatient rehab providers.

Here is the dilemma: I have trouble arguing that a private Physical Therapist should spend more $$ marketing to the consumer. It simply is true, that every dollar spent on a physician has the potential to yield many more customers when compared to $$ spent on consumers. Even if the marketing was of sound quality, when a patient is steered by their physician towards a different therapy provider, that money is lost and the competition stands to benefit from your efforts.

So, what is the solution? Should Physical Therapists altruistically and futilely spend $$ on consumer marketing? Can the APTA reform their marketing into something more effective, perhaps with a focus of immediacy for the consumer rather that a prevention perspective? Or, is a wholly new strategy required of our profession? New strategy you say?

Let’s imagine and debate the concept of a separate, non-profit business entity, whose sole purpose is to raise cash, and market the profession to the consumer:

The PT Publicity Project.

If we cannot individually market to consumers effectively, perhaps our collective efforts could yield a greater gain for all. Instead of one practice reaping benefits, we all do!

Photo by Sullest.

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"I'm Dr. Robertson, and I'd like to teach you to hula hoop."

"Hoop Dreams- Physical Therapist … turns the hula hoop into fitness fun!" was the tag line of this news scoop I came across.

Even though this reminded me very much of a recent APTA marketing effort on the subject of gardening, rest assured this is a completely independent marketing venture.

For anyone who’s interested and lives near Washington Square Park in NYC, you can learn hula hoop from this recent NYU Graduate.

Which begs the question: Perhaps you do need a degree to teach hula hoop? Maybe that’s why I’m no good at it!

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