Post Series: Leveraging Technology for Research, Evidence, and Discussion

Via What is RSS? Click image to link to post!

This week I will be giving a lecture in the Scientific Inquiry course at the Physical Therapy Program of the University of Colorado Anschutz Medical Campus. Recently Mike Pascoe posted about Papers a Mac based application that allows for streamlined organization of PDF’s.

My talk will focus on how to utilize Real Simple Syndication (RSS) Feeds and Readers (such as Google Reader) to improve access and engagement of information. This includes information from journals, blogs, websites, and even pub-med searches pushed directly to you. I have written about this topic before at the AAOMPT Student Special Interest Group in a post entitled Information to You! RSS Feeds and RSS Readers. That post detailed how to set up Google Reader and gave a list of some blogs/journals.

Afterwards, I will also publish a series of posts about how to utilize various RSS tools. It will focus on RSS feeds and readers from set up through advanced use. I will also outline why you should be following and reading specific journals. Then, I will provide critiques of various blogs. Twitter and Physiopedia will be briefly discussed. Lastly, I will outline how we can improve our discussion and scientific debate through these tools with an eye towards the future. This is not a new topic, but I hope to bring a lot of information together to aid in how YOU leverage online tools for learning, debate, and collaboration. If you have any specific requests, please comment!

These tools allow individuals from around the world and across various disciplines/specialities to share information. Further, as Mike Pascoe mentioned in his recent talk regarding twitter, journal articles are being critiqued before the print version has even been released!

Via Flickr: Courtesy of Laurel Papworth & Gary Hayes at and

We are truly in an exciting time. Online tools and collaboration in medicine and health are approaching a tipping point. We can leverage these tools to improve physical therapy, medicine, and the entire health care system from education to research to patient care to patient education to documentation to inter-professional communication…

The AB783 Story Continues

PT in Motion News Now now alerted me that AB783 has been re-scheduled for hearing on Monday June 27th. This bill will be heard in the California Senate Standing Committee on Business, Professions, and Economic Development.

The drama surrounding AB783 has taken some interesting turns over the past few weeks.

  • June 13th: AB783 fails to pass out of committee with 3 yes votes, 2 NO votes, and 4 abstains
  • June 20th: Mary Hayashi pulls the bill from reconsideration. Oddly, she states she would like to meet to work something out with the California Chapter of the American Physical Therapy Association [Rumor has it this never happened]
  • June 27th: AB783 is again slated for reconsideration. If it fails to pass out committee AGAIN, it can can not be re-heard until 2012 [which if history is any indication, it will be back]

Luckily, NBC LA continues to provide top notch coverage and analysis of the issues in their THIRD article entitled Caution: State Laws Hazardous to Your Health. In the comments section Johnny Chen makes a great point:

There is a reason why doctors are not allowed to own pharmacy clinics/establishments. It’s called conflict of interest. The same should apply to physical therapy clinics. Hayashi should be ashamed of herself — why would she support a bill that takes the power out of the consumer’s hand and costs taxpayers/health care system.

Unfortunately, there is a very, very easy cure to this legislation and ongoing POPTS battle:

Physical therapists need to stop working for Physician Owned Physical Therapy Clinics.

Remember the Stop POPTS Campaign has a website, Twitter, Facebook, and You Tube Channel. Read, follow, friend, and watch! Then spread the word.

Also, please take a few moments to read the 3 NBC LA Articles and leave your comments + feedback.

  1. Physician Run Physical Therapy Clinics Scrutinized
  2. Physical Therapy Bill Delayed
  3. Caution: State Laws Hazardous to Your Health

The truth is incontrovertible, malice may attack it, ignorance may deride it, but in the end; there it is.                            –Winston Churchill

The ‘continuity of care’ argument is dead. It is hard for me to get a hold of a physician when I page them in a hospital, or call them from the private physical therapy practice I practice within. They are busy. We are busy.

The issues surround physician employment, and ownership, of physical therapists are fairly simple: conflict of interest and referral for profit. What makes legislators, payors, and the public believe this will improve communication, care, and patient outcomes?

The American Physical Therapy Association doesn’t support it. The American Academy of Orthopaedic Manual Physical Therapists doesn’t support it. In fact, the American Medical Association ethics committee doesn’t support it.

The data doesn’t support it. Human behavior and psychology research don’t support it. Logic doesn’t support it. Ethics doesn’t support it.

Dear Assemblywoman Hayashi: Physical Therapists, data, logic, ethics, and human behavior all say NO! This is a bad idea!

But, physicians support it and say it is best, so it must be true…right?

AB783 and the California Campaign to STOP POPTS

On Monday, June 13th California Assembly Bill AB783 failed to pass out of committee in the California Legislature. The bill, which would explicitly allow physicians to employ physical therapists, would have been in stark contrast to current State of California Legislative Counsel opinion which states that it is illegal for physical therapists to be employed by physicians.  The bill has been pushed by Mary Hayashi, who not surprisingly receives quite a bit of campaign money from physician groups.

Recently, the issue has received increased attention as physical therapists and activists have taken to twitter and facebook to spread the word. Even more impressive, NBC LA has now run two articles critiquing the bill: Doctor Run Physical Therapy Clinics Scrutinized and Physical Therapy Bill Delayed.

Some sources have reported that supporters of AB783 have spent upwards of 2 million dollars while physical therapists and the CA Private Practice Section have spent a mere 57 thousand dollars. I think the relative success of the PT campaign illustrates the importance of viral, social medial in the form of Facebook, Twitter, and an online presence. Most notable is the Stop POPTS campaign which I have written about previously in the post Anti-POPTS Movement goes Web 2.0. But, even the California Private Practice Section has been slamming their website with information and announcements

But, in the end, I think it also illustrates the fact that the bill is grossly illogical as it promotes a huge conflict of interest in medicine: referral for profit. I wrote an extensive piece about a year ago on conflict of interest and POPTS which can be found on the AAOMPT Student Special Interest Group Blog.

Interestingly, the Medical Code of Ethics States:

“[u]nder no circumstances may physicians place their own financial interests above the welfare of their patients.”

And, what about The American Medical Association (AMA) Council on Ethics and Judicial Affairs (CEJA)?

“physicians should not refer patients to a health care facility which is outside their office practice and at which they do not directly provide care or services when they have an investment interest in that facility.”

Please, take a few minutes to read the articles. Then comment and share. Tweeps on twitter are using the hashtags #StopPOPTS  and #VoteNoOnAB783. The more physical therapists continue to articulate the many problems with referral for profit and physician employment/ownership of physical therapy the more press it will receive. Both articles have already received countless comments from individuals regarding the problem with POPTS.

What are you waiting for?

  1. Doctor Run Physical Therapy Clinics Scrutinized
  2. Physical Therapy Bill Delayed

The continued success of the anti-POPTS movement hinges on involvement from the bottom up. Every comment, like, tweet, and shared link are useful. Every mention in conversations with patients and the public add up. A big thank you to all the physical therapists who have gone to capitol to meet with legislators and testify. And of course, the importance of  the California Private Practice Section and California Section of the APTA can not be underestimated.

Continue to spread the word!

Physician Owned Physical Therapy Services (POPTS) in California. The anti-POPTS movement goes Web 2.0

Physical Therapists in California are taking to all forms of the web and utilizing Web 2.o Principles to oppose recent efforts by the California Medical Association and Legislator Mary Hayashi to LEGALIZE Physician Owned Physical Therapy Services in California through AB783. This bill would provide explicit language legalizing the employment of physical therapists by physicians. Those who have followed the POPTS debate in California are left scratching their heads because…

Interestingly, the State of California Legislative Counsel recently rendered an opinion on September 29, 2010 that it is illegal for PTs to be employed by any professional corporation except for those owned by physical therapists. The California Physical Therapy Association provides details

The opinion from Legislative Counsel confirms that, because the California Corporations Code does not specifically include physical therapists on the list of those who may be employed by a medical corporation, a physical therapist is prohibited from providing physical therapy services as an employee of a medical corporation and may be subject to discipline by the Physical Therapy Board of California for doing so.

Now in response to this new, proposed legislation the California Physical Therapy Association released an electronic memo opposing the new bill.

But, a group of concerned consumers (and I am assuming physical therapists) has leveraged technology and taken the movement to a whole new level. They have crated a campaign entitled “Stop POPTS.” So, what Web 2.0 tools are they utilizing? Well here is the list:

But, wait, that is not all! They have also created a Stop POPTS iPetition which currently has over 880 electronic signatures. They were able to amass over 500 within the first 24 hours of creation!

While it is important for our professional organizations to disseminiate opinions, information, and press releases on the national, state, and local level I am always left wondering: Are they effective? Do they even reach, and more importantly affect, the target audiences: the public, legislators, and other health care professionals? Now, the California Medical Association has been able to provide some information through news paper articles and other publicity. Unfortunately, they are able to use their clout as physicians in such outlets, and Joe Public will likely accept what they present at face value (with little questioning or skepticism). Which is a point we sometimes miss. Yes, it is important to spread this information to our PT colleagues, but we need to be reaching the public, legislators, and other health care professionals. Patients, small business owners, and legislators should be outraged! And WE need to light that fire.

Maybe the APTA, the CPTA, AAOMPT, and other organizations should take notes from the Stop POPTS Campaign in California. They are leveraging the web and technology to spread this information virally and aggressively. I believe such an approach is more effective. So, if you support the profession of physical therapy and oppose POPTS please spread the word via facebook, twitter, you tube, and even sign the petition! The Stop POPTS website has an abundance of great information.

Want more Information about POPTS?

Tim Richardson of the blog Physical Therapy Diagnosis recently wrote a post entitled Is Physical Therapy in California a Zero Sum Game?

Last year I authored a long post about POPTS and Referral for Profit on the AAOMPT Student Special Interest Group Blog detailing current rulings in Washington State as well as providing links and information about Stark Laws. The post has a TON of links to other information including APTA press releases and the American Academy of Orthopaedic Surgeons (misguided) view points.

What’s your story and opinion about POPTS? How do we spread it? Can we empower patients to tell their stories?

A Simple Solution:

Eric's PosterousI get asked by quite a few physical therapists about the best way to establish some sort of online identity for themselves or, more often, their business. While my gut reaction is to suggest a WordPress, this does take at least some footwork to get off the ground and to look nice. Another option which, due to the insanely simple process of setting it up, maybe more palatable to some folks is

Posterous allows everyone to make a blog on the fly, and they take care of images, hosting, posting, etc. All the user has to do is to remember the email address to post something (, find something of value on the web worth sharing, or write down some thoughts, and click send. That’s it!

This article by Guy Kawasaki does a great job explaining how one can use Posterous to it’s full potential, including simultaneously posting to several social media sites and blogs.