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BillW -> RE: mad as hell and not going to take it anymore!!! (November 3, 2007 11:49:38 AM)
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This has been an interesting thread with good points from multiple different stand points. I have been a PT for 8 years working primarily out-patient ortho in Illinois. While I certainly like the positive job market that we are experiencing, I think the profession of PT is experiencing one of its most troublesome times that I have known, with no real end in sight.
I can remember approx 4 years ago telling my wife that things were going to get bad in PT for a while, and I believe I have seen this occur. The resurgence of physician owned practices (POP's) and nearly uncontested control that insurance companies have, have our profession in a precarious position. My view points come more from the aspect of private practice than that of a staff PT. In our area, nearly every ortho group now has its own PT, as do many GP's. While the demand for PT has grown, the increase in PT clinics has outgrown the demand. We have gone from 4 clinics in our area, to nearly 15. In the last 3 years, I have lost much of the referral base from my top 3 sources due to POP's. The reasons of where to send patients is more about buisness than quality of care.
We have Blue Cross Blue Shield for our insurance provider. Over the last 5 years, we have recieved double digit percentage increases in the cost of our insurance, while they decreased our reimbursement by $1 for every 15 minute charge over the same time period. Cost of living continues to rise, but reimbursement does not. Medicare also continues to be a huge problem. Hospital based PT clinics have no limit, but all non hospital based clinics continue to have a cap, with threats of a reduced cap still looming.
Chiropractors in our area are also jumping on the PT badwagon, opening their own clinics left and right. In Illinois, they are considered chiropractic physicians, and are able to have non PT's doing treatment and charge for PT as long as they are present (of course not medicare). I know that it happens in multiple clinics in the area, as I have friends who work at some of these places. Some of the clinics even have personal trainers doing the work and charging ther ex codes.
Sure, our demand is growing, but we are losing more and more control of OUR profession. If you are happy to be a staff PT in a Dr's office, then none of this should be alarming. However, if we want to continue to have and improve on our own autonomy, then we really need to emphasize a push for legislation that limits POP's and improves our control, or we will continue to see our autonomy fade.
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