The Big Rip-Off

Linking to this NYT’s editorial about the lawsuit between the State of NY and Ingenix seems the thing for PT blogs to do today, so I will not disappoint.

"Mr. Cuomo and the American Medical Association, which has a
long-standing suit filed against Ingenix and various UnitedHealth
companies, claim that the data is manipulated. They claim that health
insurers and Ingenix disproportionately eliminate high charges, thus
skewing the numbers for customary charges downward."

But NPA is a Think Tank, and so linking to this editorial is simply not enough.  We need an original thought on the topic.  Here it is:

Where is the APTA on this lawsuit?  Jump on board with the AMA and, in an act of altruistic cooperation, invoke reform of the slimy health insurance nation that surrounds us.

Am I asking too much?  Maybe.  But I’m please to see this issue getting some press.
ERIC

Physical Therapists Now Eligible for Debt Relief

Last week legislation was approved to finally include physical therapists in the list of health

providers eligible for student loan forgiveness.  

"This amendment provides valuable incentives to enter the profession of
physicalDebt_2 therapy and help meet the high demand for physical therapists
that exists across the nation," said American Physical Therapy
Association (APTA) President R Scott Ward, PT, PhD. "Physical
therapists often begin their careers with significant levels of student
loan debt. Offering forgiveness will help enhance physical therapy
availability for children, adolescents and veterans, and provide
lasting health benefits in these areas."

Indeed!  Physical therapists, does this legislation effect you?  It doesn’t help me, but I am only one.  Check in with a comment!

ERIC

The weather hates the APTA

Nashvilletornadowarning

Last year at this time I was anxiously watching the forecast as I waited for my flight to CSM in Boston which was eventually canceled.  My flight, not CSM.  Although, the annual Combined Sections Meeting took place with quite a few PT’s left at home (including me) due to a heavy winter ice storm in the northeast.

This year, Nashville is in trouble with a tornado warning.  Severe storms have caused much havoc in Tennessee today already.  Yikes!  I hope everyone is safe in Nashville, but I have to wonder why the weather gods have become upset with the APTA.

ERIC

Evolution of a profession?

The proposed changes for specialty certification in orthopaedics were sent out this week.  The basic premise is a move towards a requirement for completing a Residency in order to obtain board certification.  This is a model proven in the medical field, and described well here at the EIM blog.

But, John writes:

"Therefore, none of this will lead to immediate changes in compensation,
nor does having a DPT or residency training itself make you immediately
deserving of a high salary. However, standardizing our training around
a medical model with legitimate post graduate residency training that
is so common you wouldn’t seriously consider practicing as a physical
therapist without it (and no consumer would want to see a non board
certified PT), will go a long ways in improving our brand,
differentiating physical therapists as experts in managing patients
with musculoskeletal conditions. PT compensation will adjust
upwards once we lay claim to our brand…"

I agree, but in the short-term there is a real incentive problem.  Is specialty certification so valuable to the individual that they are willing to lay out even more cash than they already have in obtaining a DPT in a profession with a real ceiling on income?  The result of the extra training is a very, very well educated Physical Therapist, but one who probably has quite a bit more outstanding student debt with NO increased ability to repay.  The answer to my question is, "not unless the process of residency training is so ubiquitous (among other specialty certifications as well) that no other way is an option." 

Until that time happens, employers will need to step up and support new graduates in their residency training.  The incentive for graduates is to seek out these employers.

In a sense, I stand against ANY alternative Continuing Education-based option for board certification.  I know that’s the plan here, and I get that professional evolution must be a deliberate process, but until the "CEU" actually correlates with learning or evidence-based practice, we must be on guard against questionable continuing education providers

In the mean time, I will keep promoting Residency training and hope employers and students have some sense of altruism for the evolution of the physical therapist.

ERIC

Kendall Scholarship Winners

Cash
Congrats to the latest round of winners of the Florence P Kendall Doctoral Scholarships, which are awarded by the Foundation for Physical Therapy.

The scholarship recipients are Eric Allen, PT, MPT, University of
Iowa; Stacey DeJong, PT, MPT, Washington University in St. Louis; Adam
Goode, PT, DPT, Duke University; Christine Malecka, PT, MPT, DPT,
University of Delaware; Amee Seitz, PT, DPT, Virginia Commonwealth
University, and William Thompson, PT, DPT, University of Delaware.

Good Job, everyone!

ERIC

"Every American is our patient…" Really?!!!

Or, I could have entitled this blog post: 

I went to school for a lot of years, got a doctorate degree, learned your anatomy inside and out and for that, I can tell you "Go out and play an hour a day."

It just seemed a little wordy.

These were the words of Rear Admiral Penelope Slade Royall, PT, MSW, as part of her keynote address Wednesday night at PT 2007, the annual conference of the APTA.  The headline of the speech was her "telling the considerable crowd that physical therapists are public health’s "first responders" for fitness."  Royall is the US Deputy Assistant Secretary for Health in the US Department of  Health and Human Services.

Well, is EVERY American our patient?  Is physical fitness our specialty?  Will Physical Therapists speaking as one voice about physical activity guidelines really help our profession and our patients?  I’m not so sure.

Or, is the ideal set forth by the Evidence in Motion working group, "that to improve our caliber as a profession, we have to shrink our role and be identified as experts in neuromusculoskeletal medicine" one that will help our profession and our patients?

Reading headlines such as "PTs: First Responders to Physical Fitness" seems to me to be suggesting our role to Americans is really one of a personal trainer.  Personal trainers do physical fitness better than Physical Therapists.  Perhaps this is because they specialize in it.

This goes back to an old question of strategy:  Should one try to do everything well, or should one do just a few things expertly?

You know, thinking more about the contents of the keynote address, I really feel like Royall is speaking about Physical Therapists in a light that will further her own agenda (and here) rather than our profession’s agenda.  I would do the same in her position; so would most.  If a government representative like Royall views Physical Therapists as Physical Fitness Responders, then what are we really?

This post is more questions than answers.  This is deliberate, as I think a public debate about how PT’s are marketing their profession is required.  We should all spend some time asking ourselves some questions about this issue.

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What should we do with this window?

Rockefeller Plaza is some pretty valuable real estate. It looks like the APTA has got their hands on 115 square feet of it for the month of June in the form of a picture window. The window’s content is about Physical Therapists’ ability to help prevent diabetes:

"The oversized panels also explain how physical therapists can help people with type 2 diabetes by designing a safe and thorough physical activity regimen that meets individual needs. The centerpiece of the window display is a life-sized female mannequin, who demonstrates the proper "fit walking," technique. She is standing in front of a video illustrating the various ways people incorporate physical activity into their daily lives."

Fit Walking Technique??? Well, at least my membership dues didn’t pay for this. The window space was donated by Executive Health Exams International. Which is also interesting.

In other news, an angry mob of internists was seen accosting a group of APTA members near Alexandria, VA. As the attack was taking place, the internists could be heard chanting, "You’re experts in muscles and bones, leave the diabetes to us…"

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