|
|
Re: Worse than POPTS?
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: Worse than POPTS? - May 6, 2005 6:23:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
There's no question, the future of the profession is private practice work.
Only then can we be truly independent and stop lining the pockets of other providers who benefit from our services.
And I'd join the Army, where clinics are already run like that.
Oh, wait, i'm already in....
:)
J
_____________________________
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**
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 8:51:00 AM
|
|
|
TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
|
Maybe this is a topic for another thread, but why is that women (and I'm speaking generally) seem not to have a problem working for self referral physicians. Maybe Holly and SJ can shed some light for me. Please don't tell me it is because you can work closely with MD's yada, yada, yada, you can do that without the MD having ownership and a self referral relationship. If it was all about care you could lease the space from the MD and basially have the same relationship without the ethical implications. I'm not trying to start a pissing contest but I have never heard an honest answer to this question from someone who is willing to work for a self referral MD. They usually justify it by saying something about having all services under the same roof etc. which doesn't jive when you can have that situation without having a subordinate role.
_____________________________
Todd
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 12:24:00 PM
|
|
|
SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
Status: offline
|
Todd, I have done it. I did work for surgeons. Clinically, it was great. Guaranteed patients, no financial risk for me, excellent equipment, I knew how each of the surgeons thought, I knew their philosophy of care, I became familiar with their surgical procedures, pretty much only dealt with the surgeons and not 20+ different referral sources. I also mentally really liked the challenge and the communication that really did occur between the physicians and myself. My continuing ed allowance was unbelievable too. You know, if done correctly, the patient is the one who will reap the rewards.
Was I in a subordinate role? To a degree, yes. Michigan is not direct access, so sure, I had to have their referral. Their orders were always generally "evaluate and treat." So, technically, I had full professional autonomy in clinical decision making. Do I care who makes money off of me, no. Through my whole career I have always had a pimp. Is there anything wrong with that? Not in my mind. I wasn't the one taking any financial risk. I will state though that in every position I have been in, I have always done what is right. I have no fear in making decisions that are different than what any person in authority thinks or desires. There isn't a single person, be it a physician or a manager, that I will blindly do whatever I am told unless I professionally agree with the actions that are being asked of me. I am someone who firmly believes in being held accountable for the choices I make.
I don't believe it is realistic for every single physical therapy practice to be owned or managed by a physical therapist. I don't believe it is realistic for every physical therapist to only work for him or herself. The push for therapists to own their own clinics is so far off base that it isn't even funny, in my opinion. Do you know what we really need? What we need are physical therapists that don't take crap from anyone. Why are there mills out there? Why is care being provided by aides and techs? Why are there situations of group occurrences in outpatient settings occurring with inappropriate billing practices? Why are patients billed for nonvisits? Why are PTs highly used for evaluative purposes only? Now, really, are POPTS the real evil?
You know what, we ourselves are our own evil. We are the bulk of the evil.
In my opinion, the more options for practice setting the greater our diversity. Should it really come down to who is making the money off our skill? If each and every one of us as professional individuals never allowed the unethical crap to occur, were not a part of the unethical crap AND took a stance and did something about the crap every time it happened, pretty soon the message would be clear that there aren't enough of us that are sleazy enough to stay in a position with a company that is unethical. Pointing the finger and blaming POPTS is never going to solve the problem. Taking action, only accepting what is right and true and never settling for anything different is the only way to create a semi-level playing field in our physical therapy world.
POPTS have no greater advantage over hospitals that have satellite clinics nested within family physician practices. No one ever screams over that issue. Maybe it's only in our area, but it's all over in our area. The hospital system has the unwritten rule that all services have to be kept "in the system." In this scenario, the physicians aren't the one raking in the dough, instead the hospital does. And, come on, does everyone really and truly believe that a physical therapist owned practice is THE best situation? Please... I can tell you stories in that area too... let's not hold our whole profession at some high level of being ethical.
My opinion heavily lies on the accountability of the individual. I really don't care where any physical therapist works or who the therapist works for. What I do care about is whether the rules and regulations are being followed.
I have met some awesome therapists that work in POPTS situations. Those therapists have full control administratively and clinically. From what they have told me, they formulated their role and the strength of their role and if the physicians want to step out of their boundaries and mess with the therapists, the therapists will walk. In fact, the ones I have met impressed me with their knowledge of rules and regulations and how strongly they followed them. More squeaky clean than any employer I've been with.
In regard to my POPTS experience... I was fired. As things got going, the physicians started meddling in the areas of scheduling and billing. I argued my view and brought supportive documentation of my stance of refusing to do what was asked - so I was fired. 7 months later... guess what? They are now running their PT clinic as I had recommended. I served as the "first born" and wore the physicians down a bit so their new therapists have an easier road to travel. :) But, the good of it is that their practice is now within the rules and regulations compared to what they started demanding of me. And, yes, if the opportunity was ever extended to me to work for physicians, I would again consider the option and potentially sign on. That's me and my beliefs though because I don't blame others for problems and I believe in accountability and responsibility.
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 1:04:00 PM
|
|
|
TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
|
SJ,
I still don't get it. Why not contract yourself out rather than be a puppet for physicians. Are POPTS evil, I say yes. Any self referral situation is bad and only leads to problems down the road. I really don't know how to get you to see the light, to see what your doing or have done only hurts the very profession you chose as a career. POPTS = noncompetition and self referral = fraud. I think the only way out of this other than what South Carolina has done, is for insurance companies to stop paying for PT services and for pt's to pay cash from a health saving account. This will basically put a strain on the average PT and those who have not positioned themselves to survive in the market through clinical expertise will definitely suffer. I know you hold yourself to a very high standard professionally I just wish I could change the way you view whats best for the PT profession and in my view it's definitely not non-competition or self referral. Anyway I think it was great what you've done with situation you found yourself in with the POPTS practice and wish you good luck with the case.
_____________________________
Todd
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 1:23:00 PM
|
|
|
dosrinc
Posts: 335
Joined: December 9, 2004
From: Bonita Springs
Status: offline
|
Doc Wagner,
I would chose #1, take meticulous notes on fraudulent activity and then make like the old guy in Texas who turned whistle-blower and was awareded 8.1 million dollars in the government's case against Healthsouth. You would then find me resting comfortably on a Sailboat in the Bahamas.
Rick
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 1:30:00 PM
|
|
|
dosrinc
Posts: 335
Joined: December 9, 2004
From: Bonita Springs
Status: offline
|
SJBird,
I too once worked for a POPTS, at first things were great and I always felt that I was in control and I had a great relationship with the physicians, later the problems set in, some of the docs weren't happy with the profit (or lack there of) and started demanding that I see all pts 3x per week for 4 weeks, then the demands that I hire a PTA, then, whenever things would slow down I would suddenly get a rash of pts. sent in for "gait and balance training", and other things that I saw as just filling the schedule. I ended up leaving and going into private practice and would now never change. I still have a great referral relationship with those docs from the practice that were more worried about quality care than profit. The others I don't here from but didn't expect to.
Rick
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 4:15:00 PM
|
|
|
SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
Status: offline
|
LOL Todd, being a puppet for the physicians would not have lead to me being fired.
You know what? I'm not going to sit around and worry about what is best for my profession. If an opportunity comes my way and I think it could be a great opportunity for me professionally, then I'm going to do it. And, when I see things that are wrong where I am employed, I will always speak up and attempt to change the processes. I've heard all the arguments against POPTS and I've heard the arguments for POPTS. Neither of them really matter to me - in my mind, it simply comes down to being accountable for one's actions and choices and not participating in unethical situations no matter who is the employer. If a patient really needs physical therapy and the physicians have a physical therapy practice and are upholding the Stark Laws, then technically there isn't anything wrong with the situation. If it is so strongly felt that the actual situation of POPTS is unethical, well, the law needs to be changed. Those against the POPTS should be putting their time, money and energy into eliminating the situation. For right now, since it is legal, then I don't feel it is reasonable to slam any therapist in that situation without knowing how that therapist is practicing. I wasn't one of those therapists that didn't educate the patients that the surgeons owned the practice AND I also would set up appointments at other facilities if the facility was more convenient for the patient. That got me into a bit of hot water too. Creating a divide in our profession based on employer category is definitely not the answer.
Todd, I'm not sorry for where I practiced. I'm also not going to change my view. Individual accountability is the heart of the matter, definitely not the employer situation. I do understand how you feel, because I'm in the process of still opening my own clinic. Did I really want to do that? No. Do I really want the risk? No. Does it bother me that the surgeons have their own practices? Nope. I have no alternative if I want to continue in this field clinically though. I refuse to work for the big national chain here locally because I know what goes on there from hearsay and one phone interview 7 years ago. There are a couple of local private practices owned by therapists, but they tend to pass patients on to assistants. I worked locally at the hospital and I got tired of communicating with corporate compliance to change policies and procedures that were fraudulent. So... either dump this profession completely and do landscaping or something OR... open my own frickin clinic. I mean, all I want to do is what I do, but it looks like the only way to do that is to have full control and with that the full financial risk and the experience of denials and the stress of fluctuating patient loads. Along with having to learn all the business crap. Technically, I can allow myself to be stupid in regard to fully understanding the business side completely because my husband has an MBA and is a self-employed consultant who deals with large companies and knows the ins and outs of the financial crap that I could care less about. Where I am weak, he is strong. And, I'm just crossing my fingers and hoping that my reputation and my belief that always doing what is right should equal success.
Yes, Rick, you know kind of exactly what I am talking about. Did I allow them to go down that path with me? No. Did I take a stance and hold firm to it? Yes. Am I just walking away from the situation and whining about what happened? No. The therapist that was director of rehab for the physicians is probably going to have some major crap coming down on him from a few different organizations. I doubt if the POPTS will be shut down, but even the physicians may have a some slight consequences. And I promise this... IF not a darn thing happens because of my persistence and being a squeaky wheel - do trust that there will be one last letter written to the state prosecuting attorney, the attorney general, my U.S. Representative, the governor and if I think of any others to include, I will. That letter will voice my disappointment in allowing fraud at any level - a little fraud here and a little fraud there adds up and having no consequences sends the message that it is okay to have fraudulent practices. It will also convey that the whining about fraud and medical costs might as well stop because no one wants to do anything about it.
Rick... if you want to be the whistle-blower... it isn't "notes" the FBI will want.... the FBI will want definite documentation, patient names, schedules, calculate the dollar amount of how it was billed versus how it should have been billed. Hmmm... and if you happened to have video taped examples of daily clinic occurrence - that might be helpful too. Of course if you do that, better get something signed by patients because of HIPAA. LOL Oh... and don't go buying that sailboat right away... better wait the years to make sure they decide to take the case AND do something about it and WIN the case. LOL
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 6:32:00 PM
|
|
|
srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
Status: offline
|
SJBird,
I have to say I agree with you on this one. If every person would be concerned with being personally ethically responsible and accountable for his/her own actions, we wouldn't have a problem in the first place. The POPTS aren't the enemy, we as a profession are our own worst enemy. The POPTs aren't "evil", capitalism isn't "evil", money isn't "evil"....but the love of money is. The motives behind the business practices are what makes something unethical, not the business itself. And how can we make a blanket statement about the motives of every POPTS owner?? I don't think such a judgment can be made so generally. Instead of pointing fingers and looking over the fence into our neighbors backyards, why don't we take a really good look at ourselves? Ok, I'm off my soapbox.
Sarah
|
|
|
|
|
Re: Worse than POPTS? - May 6, 2005 7:50:00 PM
|
|
|
TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
|
SJ,
I have no doubt that you will be tremendously successfull in your endevour and from what I've read of your postings I also have no doubt about your convictions to our profession. I wish you nothing but the best in opening your own clinic, but I seriously doubt you will need the support. In a minimum of 2 years you will be wondering why didn't I do this sooner. BTW, fighting the AMA is not an easy battle, believe me I know.
Best of wishes,
_____________________________
Todd
|
|
|
|
|
Re: Worse than POPTS? - May 11, 2005 7:52:00 AM
|
|
|
dosrinc
Posts: 335
Joined: December 9, 2004
From: Bonita Springs
Status: offline
|
SJ and Sarah,
I agree with both of you that we need to emphasize individual accountability. As I have said before ther are far too many apathetic PT's out there. I am always amazed by the # of therapist's who work in fraudulent situations, billing under their own provider numbers who either don't know or don't care that what they are billing for is unethical and illegal. By the way, the situation I was in prior to joining the POPTS was absolutely the worst as far as both legal and ethical aspects of care are concerned (they were eventually fined by medicare) and they were PHYSICAL THERAPIST OWNED. Good Luck in your practices, I know I will never go back to working for anyone else.
Rick
|
|
|
|
|
Re: Worse than POPTS? - May 11, 2005 9:45:00 AM
|
|
|
hmgross
Posts: 292
Joined: February 28, 2003
From: Minnesota
Status: offline
|
Todd
I chose #3 because I considered it the lesser of the 4 "evils"--I would prefer that scenario over one of being a "mass producer" or doing evaluations and never being able to see the patient again except for re-evals and DC (maybe not even getting the chance to see them prior to DC). That last part described the type of therapy I had been forced to do for the last 6 yrs, so I quit and went out on my own.
Rick
I agree with you and I will absolutely never work for anyone else after being out on my own. I like the feeling of being in control of what is going on and performing ethically. If I screw up somewhere along the line (documentation, billing or whatever) I will "take my lumps" and learn from it.
_____________________________
Holly Gross PT
|
|
|
|
|
Re: Worse than POPTS? - May 12, 2005 4:46:00 AM
|
|
|
USAPT
Posts: 278
Joined: January 14, 2004
Status: offline
|
FYI to all....I was sent this link yesterday at work: (hopefully it comes up). It's pretty interesting.
[URL=http://www.joeblacksphysicaltherapy.blogspot.com]www.joeblacksphysicaltherapy.blogspot.com[/URL]
this is a brief insight to the POPTS.
_____________________________
Jason, PT
|
|
|
|
|
Re: Worse than POPTS? - May 12, 2005 4:55:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
Good article, Jason.
Thanks for posting it.
I couldn't have said it better...
J
_____________________________
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**
|
|
|
|
|
Re: Worse than POPTS? - May 12, 2005 7:38:00 AM
|
|
|
dosrinc
Posts: 335
Joined: December 9, 2004
From: Bonita Springs
Status: offline
|
Thanks for the link Jason.
The only way to survive in an area like Knoxville is to get to the pt. BEFORE they get to the Orthopods office. How do we do this? First make as many contacts with internal med/family docs as possible, they are often at odds with the Ortho's who run the PT clinics, maybe it is wallet envy or maybe they really are dismayed at the lack of ethics shown by those who thrive on referral for profit. We must convince these docs that we are a great alternative for Ortho referral, we can determine surgical vs. nonsurgical candidates, we can provide effective conservative care and we can do it without a two week wait and for less money. Second, get your face out in the community. Let word of mouth spread that you are the expert in musculosketletal dysfunction, use workshops, community lectures, use your success stories. This will at least lead to phone or e-mail contacts with potential patients. Now that you have these patients in your offic pre-operatively YOU become the referral source. If you feel surgical consult is necessary YOU make the referral to the ORTHO. I have found that even the stingiest Ortho docs have a hard time insisting that pts be seen in house if I have made the referral to them in the first place (those that do insist don't tend to come up in conversation with pts in the future). This is what I see as the biggest influence direct access will have on our profession. When we become a potential referral SOURCE we are finally seen more as colleauges than as ancillary staff. Sorry for the long post.
Rick
|
|
|
|
|
Re: Worse than POPTS? - May 12, 2005 7:04:00 PM
|
|
|
tnt
Posts: 22
Joined: April 18, 2005
From: Wisconsin
Status: offline
|
Rick, I can't agree with you more. In my years working for a large corporation and for a hospital based group, all of the marketing training we received was focused on the orthopods and occ health docs. For years I have been questioning: What about the people? I believe that, as a profession, we do NOT take an active role in marketing ourselves to the public BEFORE they need our services. In building my current practice from the ground up, I have placed ads in local papers as well as in school, church and business advertisements, with one prominent phrase "YOU HAVE A RIGHT TO CHOOSE WHERE YOU RECEIVE PT". Most potential patients do not realize this and do not take an active role in their care. If only the APTA echoed my veiws and set forth a public marketing campaign to educate the public, maybe the outlook would change. In my opinion, an informed consumer will begin choosing the best available care, thus making the POPTs, large corporations, and private practices all put out a better product, or risk lower attendance. Finally, ethics, accountability and skill will win out! Idealistic? Yes, but it has worked for me on a small, local scale, and I would love to see it put in motion on a larger scale.
|
|
|
|
|
Re: Worse than POPTS? - May 12, 2005 7:33:00 PM
|
|
|
FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
Status: offline
|
when i was still someone else's employee, we were running into the trouble of orthos just realizing that they too could own a practice. Well, we marketed like crazy to the family docs, and volunteered our time at the high schools, and wrote sports med articles in local papers. Well, we became the gateway for all ortho injuries and like you said We referred to the orthos...I would send non surgical pts who needed medicine and following to the MDs who did not own PT practices, and the ones who were more surgical were sent to physicians with the best outcomes. ((Now shouldn't this be a 2 way street, shouldn't they send the pts to the PTs with the best outcomes?)) I highly recommend this change in thinking and change in paradigm of us being referred to, and let us become the referrers
|
|
|
|
|
Re: Worse than POPTS? - May 12, 2005 11:57:00 PM
|
|
|
Randy Dixon
Posts: 744
Joined: August 6, 2004
Status: offline
|
I've received a marketing newsletter from a marketing seminar provider that is pushing a "Try PT First" campaign. It sounds pretty good. Is anyone familiar with it?
|
|
|
|
|
Re: Worse than POPTS? - May 13, 2005 3:41:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
Here's some interesting information about the company that got me started talking on this thread:
http://www.veridianhealth.com/press/press2005_0426.htm
Randy-
Haven't heard that campaign, but given the demonstrated exam skills, treatment efficacy, and lower cost of a PT, I would think this is a win for everyone.
J
_____________________________
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**
|
|
|
|
|
Re: Worse than POPTS? - May 13, 2005 4:56:00 AM
|
|
|
hmgross
Posts: 292
Joined: February 28, 2003
From: Minnesota
Status: offline
|
Just yesterday, a patient was telling me about his dad, who was scheduled for surgery on his knee, and was sent to PT for strength/conditioning so he could better tolerate and recover from his procedure. You guessed it. He improved so much that he didn't need the surgery! Absolutely, why not "try PT first".
_____________________________
Holly Gross PT
|
|
|
|
|
Re: Worse than POPTS? - May 13, 2005 5:42:00 AM
|
|
|
USAPT
Posts: 278
Joined: January 14, 2004
Status: offline
|
Jason,
I read the FAQs...very interesting.
Is the equip really that bad or is he, the DC, just not satisfied with his ability to Dx w/o using it??
_____________________________
Jason, PT
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
 Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.125
|
Printable Version
All Forums >> [RehabEdge Forum] >> Open Forum >> Re: Worse than POPTS? 
