Critical observations of health, science, and the physical therapy profession.
Modalities is a topic in physical therapy that tends to be controversial. There is research saying that certain modalities (ultrasound especially) really do not have any scientific leverage. Other modalities (dry needling for example) have more support behind them. Do you think modalities help add value to PT or is it a waste of time for us and the patient? Do you learn modalities in school? If so, what do you learn?
Let’s talk about it Wednesday, September 4, at 9pm EST!
Creating value for the cost of treatment is necessary in the field of PT- especially with limited insurance reimbursements and the expansion of self-pay or cash based PT practices. Jerry Durham (@Jerry_Durham) will be our guest this Wednesday to discuss creating value for the cost of physical therapy. You can read some of his posts, as well as Ann Wendel’s (@PranaPT) regarding the business side of PT here. This is certainly going to be a great #DPTstudent chat!
Also, a huge welcome to all of the new DPT students that just started classes not too long ago! I hope you will join in our chats!
One of the many things that drew me to PT as a career is that upon graduation, I could choose to go in so many different directions! Maybe I’ll specialize, maybe I’ll travel, or do research, or start a fellowship or residency program. Perhaps I will love working in a hospital setting, or a skilled nursing facility or maybe an outpatient clinic will better suit my needs. The options are endless!
This week’s chat will be moderated by TJ Janicky (@TJ_Janicky) and Dr. Ben Fung (@drbenfung) so tune in on Wednesday, August 7, 9pm EST!
I think we all hear the talk and excitement surrounding CSM each year, but what about the National Student Conclave (NSC)? A whole weekend just for DPT and PTA students! This Wednesday we will be talking about what the conference is, why you should go and how to network while you are there. You can find out more about the conference here: https://www.apta.org/nsc/
And by the way- this weeks #DPTstudent chat will be hosted by TJ Janicky so be sure to follow him @TJ_Janicky !
It’s almost August which means most programs have first years just starting! I was in the same position at this time last year and I remember having so many questions, fears and concerns. This Wednesday we invite the new students to ask us anything and everything they can think of from how to study, how to balance life and school, and how to stay sane while in PT school. See ya at 9pm EST on Wednesday July 17!
For a young and unattached recent grad a traveling PT gig can be really appealing- you get to see new places, meet new people and often times the salary is higher and some or all of your cost of living is covered. Sounds pretty sweet! Are there downsides to being a traveling PT? Would you lose out on mentorship as a new grad if you continually moved about or could you still get the mentoring you need if you put the effort in? What to clinics think of a traveling PT when you finally decide to settle down in one spot- are you regarded highly because of your travel experience or not as highly because you were never in one place for long enough?
Let’s talk about it! See you Wednesday, July 10 at 9pm EST!
There is a ton happening in Salt Lake City right now! The APTA House of Delegates has been meeting daily for the past few days discussing the new vision and other motions. You can read up on it here: http://www.apta.org/HOD/2013/
Talk to you on Wednesday night at 9pm EST about the APTA HOD!
One of the main points of the APTA’s Vision 2020 (which is now being revamped!) is autonomous practice which means having Physical Therapists be seen by the general public as the ‘practitioners of choice’. With the title of doctor, we are able to refer out to other healthcare providers as well as refer out for diagnostic tests. However, is that enough to be considered a primary care provider? What are some of the obstacles in our way to get to that point?
How great would it be if we could get to the point where once a year (or even more!) a patient comes in just for a check up regarding any muscle or movement deficiencies! Or better yet, we never had to discharge a patient, but instead could tell them we would like to see them in a few weeks.
You can read more about the APTA’s definition of autonomous practice here.
Talk to you Wednesday at 9pm EST!
In theory, the Medicare Payment Advisory Commission (MedPAC) advises Congress on the best actions to take to ensure both the long term survival of the Medicare program, and that health care needs are met for Medicare beneficiaries. This is a tough task, as tipping too far to one side or another can result in wildly out of control costs, or decisions that harm the public health overall. It’s a tough assignment for MedPAC. Some decisions have been good, such as the overall shift to quality-based reimbursements. Others, like the arbitrary cap on physical therapy services haven’t been so smart. The cap limit has required action by Congress on an annual basis for over a decade to ensure there is an exceptions process.
MedPAC released their report to Congress this month. You can find the June 2013 report here. In the report, there are two recommendations suggested that negatively impact patients with Medicare through burdens placed on physical therapy providers. First, the cap limit has been recommended to be reduced from $1900 per year to $1200 per year. Remember, this is a cap that is shared with Speech and Language Pathologists. Imagine how quickly this goes away if a Medicare beneficiary has a stroke. Unlimited reimbursement can’t be a realistic thing, but minuscule caps on reimbursement demonstrates the continued poor value MedPAC places on physical therapy services.
The second recommendation is one of those curious things in healthcare. The recommendation concerns the multiple procedure payment reduction (MPPR) that went into effect in 2012. The MPPR basically says that if more than one unit of something is billed, the second unit will be billed at some percentage less. For 2013, MedPAC suggests that the MPPR be increased to 50%. Essentially, the first 15 minutes of therapeutic exercise is magically worth more than the second 15 minutes. Since the MPPR’s inception, a decline in payment for therapy services has resulted, further squeezing outpatient therapy services that already have a high administrative burden to treat Medicare beneficiaries. This further reduction will make this much worse.
In a letter from the American Physical Therapy Association (APTA) about the 2013 MedPAC recommendations, president Paul Rockar Jr, PT, DPT, MS, referred to the recommendations as “akin to doubling down on a bad policy.” I have to concur. It seems MedPAC has shifted too far on the mission of “save money” and isn’t considering the affect this has on patients with Medicare.
The APTA has an advocacy page, www.apta.org/Advocacy, where you can learn more about this, and members can take action and let their representatives in Congress know about the negative impact these recommendations have for their constituents with Medicare. The APTA remains in dialogue with policy makes and MedPAC, as well as continuing in advocacy efforts in Congress, but the collective public needs to raise a loud cry against these proposed changes.
This is my presentation given at Evidence In Motion's Manipalooza 2013 Symposium held in Aurora, CO.
http://manipalooza.com
I was traveling at the time but the organizers graciously allowed me to submit my talk as a recorded video. Therefore, you will be experiencing the talk just as the symposium participants did!