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CA DC's do "physical therapy"
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Re: CA DC's do "physical therapy" - March 27, 2006 5:02:00 AM
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FLAOrthoPT
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From: West Palm Beach
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I hadn't realized that they changed this website to "PT/Chiro Wars" Episode II.
Thanks for letting me know
Ben
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Re: CA DC's do "physical therapy" - March 27, 2006 7:30:00 AM
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chiroortho
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DC Student,
Your intentions seem to be good, but I think folks here are weary of the 'Call Your Board Immediately And Protest!!' types of post.
It's my impression that they'd much rather hear some useful information about how they can serve their patients better.
Maybe your enthusiasm would be more productive if sent to the various PT Boards.
Greg
_____________________________
Greg Priest, DC, DABCO
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Re: CA DC's do "physical therapy" - March 27, 2006 2:36:00 PM
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Lehmkuhler
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Is that why I was warned against using the word "physiotherapy" to describe, well, physiotherapy? I wouldn't ever try to use "Physical Therapy", or even "Physiotherapy", but for crying out loud what do you collectively call modalities, rehab, manual soft tissue work, etc... Seems that the PT board "owns" the word, even though it's written into the chiro law as well. Fortunately, physiotherapeutic is OK...
Talk about getting nit picky over words...
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Re: CA DC's do "physical therapy" - March 27, 2006 4:01:00 PM
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Andrew M. Ball PT PhD
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Depends on the state. "Physical Agents," or "Physical Modalities" tend to be used in most states.
Drew
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Dr. Andrew M. Ball, PT, DPT, Ph.D.
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Re: CA DC's do "physical therapy" - March 27, 2006 6:33:00 PM
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hmgross
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From: Minnesota
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It is not "nit picky"--it is a protected term, at least it is here in Minnesota. We refer to the modalities as PAMs (Physical Agent Modalities) and it most certainly should not be confused with Physiotherapy or Physical Therapy. This subject keeps coming up and I am bored with it and obviously need a vacation because I sound a bit cranky.
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Holly Gross PT
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Re: CA DC's do "physical therapy" - March 27, 2006 8:49:00 PM
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JDMBBuilder
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From: Long Island
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PTs as a whole should have some sort of backbone and take this issue seriously...we need to fight these "wars" instead of ignoring it while chiros go full force in their lobbying efforts...
that 'laxed attitude is exactly why our profession is getting hit hard in terms of reimbursement...
as part of the next generation of physical therapists, I intend to remain as politically active as possible...after all it is MY chosen profession...why not protect it?!
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"Anyone can throw you on a "state of the art" machine and call it physical therapy. The only high-tech equipment I need are my brain and two hands..." -JSDPT
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Re: CA DC's do "physical therapy" - March 27, 2006 10:02:00 PM
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goodlooks58
Posts: 425
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From: CA
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JDM: I wholeheartedly agree to your enthusiasm. We need fresh blood to continue the fight. PTs on this site are getting worn down by the POPTS, chiros in the 'hood, doing "tricks" for ins cos "pimps" and become slaves to whatever ins cos thows their way. I am utterly disgusted with the backbone shown by the CA chapter of APTA against the workers comp SB 899 and the BS!! Direct Access we have in CA. Moreover, how come no one talks about the BS scam artist Acupuncture clinics popping up in my area?! I do not know where these Acupuncturist come from with fake degrees from Asian countries. I have 3 patients lately from a few of these clinics who have been seriously injured by poking needles at wrong places.
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Re: CA DC's do "physical therapy" - March 28, 2006 2:02:00 AM
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SJBird55
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In the chiropractic demonstration project with CMS (Medicare), I swear when I glanced through some email that physical therapy was included in that project... meaning chiropractors could bill out for physical therapy services. Granted, state laws would supercede CMS... but CMS language is definitely not protective of who provides what service. AND that is inconsistent with some of the Stark stuff they rolled out that has indicated that they do want physical therapists providing the care.
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Re: CA DC's do "physical therapy" - March 28, 2006 4:18:00 AM
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drbuddy
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I've mentioned it before, but there is no such thing as "physical therapy services".
There are physical medicine codes, which can be performed and billed by any provider that has those services within their scope of practice.
The only codes unique to any profession are the OT and PT eval codes, osteopathic manip codes, and chiropractic manip codes.
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Re: CA DC's do "physical therapy" - March 28, 2006 6:35:00 AM
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JLS_PT_OCS
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Buddy-
We agree on this. I don't think we're discussing billing codes, but rather what sorts of services we provide to patients and how we advertise and represent those services to the public. I think you'll agree there's a big difference.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: CA DC's do "physical therapy" - March 28, 2006 7:10:00 AM
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dosrinc
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SJ, while the medicare demonstration project for Chiro's does state that they can bill for PT it also states that it must be performed by either a PT or PTA (under the supervision of a PT) who has graduated from an accredited program. This is the same rule that has applied to POPTS since March of '05
Rick
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Re: CA DC's do "physical therapy" - March 28, 2006 8:00:00 AM
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drbuddy
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Right, but I was responding to this statement,
"I swear when I glanced through some email that physical therapy was included in that project... meaning chiropractors could bill out for physical therapy services."
I just wanted to clarify that statement. The chiropractors in that project wouldnt be billing for "physical therapy services" per se, but they would be billing the physical medicine codes. I know it's just a technicality, but I've seen the mistake made more than a few times on this site.
The CMS rule requiring a PT or PTA to perform the services is superceded by the demo rule, since CMS also says that the only covered services provided by chiros is CMT.
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Re: CA DC's do "physical therapy" - March 28, 2006 10:13:00 AM
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JLS_PT_OCS
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I agree Buddy, I think that's a worthwhile point. Nobody owns physical medicine codes certainly. As long as it's not represented as "physical/physiotherapy", no big deal for my money.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: CA DC's do "physical therapy" - March 29, 2006 6:34:00 AM
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JLS_PT_OCS
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However, by that line of reasoning, I suppose I could advertise as providing "chiropractic services" or "chiropractic care" as long as I didn't use the chiro manipulation codes, then, right? If the codes are the only thing that are restricted.
Or might it be something else? Might it be what I professionally represent myself and my services as?
Yes, I think that's that issue.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: CA DC's do "physical therapy" - March 29, 2006 6:48:00 AM
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Diane
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Jason, that is exactly the issue.
(Of course, why would we do that, why exactly? If we thought it would lend something akin to credibility to our work? I doubt it, which is why we don't bother. For chiropractic, it (i.e., appearing to offer "physical/physio therapy) does, which is why they do bother.
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Re: CA DC's do "physical therapy" - March 29, 2006 8:04:00 AM
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drbuddy
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From: Pennsylvania
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Not sure what you are saying, Jason. I agree, chiros shouldnt say they provide physical therapy, and PT's shouldnt say they provide chiropractic services. However, chiros can say they perform physical medicine, physical rehab, and modalities, and PTs can say they perform manipulation.
The coding issue I was correcting is totally different issue. I was just trying to say that there are no such thing as physical therapy codes, other than the PT eval codes, just as there is no such thing as chiro codes, other than the CMT codes. Sorry about the confusion.
Diane, I know it's hard, but can you at least try to keep your anti chiro bias out of these discussions?
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Re: CA DC's do "physical therapy" - March 29, 2006 10:34:00 AM
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TLB
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Buddy,
I've never seen or heard of a PT say or advertise that they offer chiropractic care (doesn't mean it hasn't happened but I've never seen it), however I have seen and heard many chiros advertise and tell their pt's that they provide physical therapy. I believe everyone hear knows that no one owns the codes and they aren't PT codes per say.
I believe what Diane is saying and I agree with her to a certain extent is that Chiros have more to gain by advertising that they offer Physical Therapy than a PT would by advertising they offer chiropractic care. This is why some use the term physical therapy as part of their marketing, advertising, etc.
I frequently have pt's tell me they have had physcial therapy in the chiro's office, I will take this opportunity to educate the pt. about physcial therapy and that only physical therapists can perform PT. Then I will always follow up the DC and shoot an email to my local assoication. Go to your local yellow pages and search physical therapy and see how chiro offices pop up, this happens more than one would think.
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Todd
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Re: CA DC's do "physical therapy" - March 29, 2006 11:48:00 AM
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drbuddy
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From: Pennsylvania
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You are misinterpreting what I am trying to say. I am speaking only of the CPT manual. I'm not saying that PT as a profession is not unique or does not provide a unique service.
Get out a CPT manual, can you refer me to the "physical therapy codes" other than the PT eval codes? I was just trying to correct another post above when someone said that chiros were billing for physical therapy services. That is an incorrect statement unless they were billing the PT eval codes.
With all due respect, your opinion is misinformed. Chiros have been using modalities and rehab since the early 1900's. As early as 1906, National College of chiropractic began teaching modalities and rehab. BJ Palmer (son of the founder of chiropractic) was said to have one of the largest rehab clinics in the States at the time and he practiced in the 1920's.
Perhaps more chiros are including rehab in recent years because we as a profession are attempting to become more evidence based. Since we (chiro and PT) treat a similar population of patients and we are both trying to use the best evidence available, it's only logical that our methods of treating patients will converge and begin to overlap.
I dont know why this has to be an issue of my profession versus your profession. Other than the title, why should you have any more of a problem with me than another PT down the street? If a chiro is trained properly to do soemthing and it is within the scope of practice, why should you have a problem with that?
What is it with all of this us vs them attitude? We are all clinicians trying to do the best for our patients.
Todd, to briefly address your post, I do agree that chiros are more prone to say they perform PT than visa versa. Some may be trying to decieve the public by appearing to offer a wider variety of services, but for most I feel it is just a misunderstanding. Most mistakenly group modalities and exercise into the term 'physical therapies', which they are if you think about it. It just so happens there is a profession with the same name, which we do need to recognize.
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Re: CA DC's do "physical therapy" - March 29, 2006 12:18:00 PM
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chiroortho
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When I use the term PT in my practice, I am referring to modalities. To say to my staff 'this patient needs physical medicine modalities' is silly. I say 'this patient needs PT', and I write down the modalities/parameters that the patient needs.
Not for even a New York minute do I consider that I am showing disrespect to a PT, nor do I have any sense that I'm 'adding respectability' to my services by using the term. I'm just moving from one patient to the next, within the Florida Board of Chiropractic Medicine parameters.
Now let's examine the converse position. 100% of DCs are proficient in the utilization of manipulative therapy upon graduation. 100%. So we have some PTs (but not all by any means) that are proficient in manipulative therapy. I'm satisfied that some PTs may even be better at SMT than me.
But I have to wonder about all of the animus about the use of the term physiotherapy or physical therapy.
DCs as a whole view the use of PT as the use of modalities, and this is how we were trained. Even PTs argue amongst themselves as to 'what' PT is these days. But why all of the hassle. The Arkansas DC Board nailed the PT. The Pennsylvania PT Board nailed the DC. Wonderful.
What a complete waste of time. I still send my patients to PTs for rehab, and still treat PTs as patients. But I don't recall the last time a PT sent me a patient. Do I care? NO. We do what we do.
_____________________________
Greg Priest, DC, DABCO
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