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Re: "Medical" Massage Therapists
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Re: "Medical" Massage Therapists - June 1, 2005 2:37:00 AM
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JLS_PT_OCS
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Yes, the marketing debate is another thread entirely.
But agreed with points that have been made.
To return to the massage issue....
Let's not assume that because a couple of PTs are debating this in a forum that the only thing going on is "debating minutiae". That is not the case. The APTA is well aware of this and is working in our interests as we speak. While this may be an issue gathering steam, it certainly is not an immediate threat to our profession, unlike restrictions on reimbursement or practice scope are. So I think this is a prioritization issue as well.
Let's not forget that the DPT is accompanied by more than "banter" but by continued modernization of practice acts, successful defense of practice scope (with one obvious exception), and a stream of research of impeccable quality demonstrating the effectiveness of our interventions.
No other profession has made as much progress and gained as much ground (from a research, education, and practice standpoint) as PTs have lately.
Marketing and political ground is good, but it needs to be based on a solid foundation of quality and effectiveness, in my opinion. Consumers are getting smarter, they are asking more questions and doing more research (like William Shatner says on the commercial "Shop and compare, before you buy?"). Have you checked the internet lately? See the "DCs" thread if you haven't. Who do you think is looking better and who is looking worse?
The health care market is evolving, and the PTs and the LMTs seem to be the only ones actively moving around and improving their position. I don't sweat that kind of competition. And I'd hire one for my clinic also.
You'll get no argument that the DCs and the LMTs do a better job of marketing than we do. If you control your autonomy and the profits from your work get reinvested in your business, then you can afford to take out cool yellow page ads. Simple economics. If you want to know what's up with this, ask the PTs working in POPTS situations, they're a big part of the problem.
Certainly the PTs have the education and research edge, but if they remain stuck in old referral and autonomy patterns, it really doesn't matter as much. This next generation will be key in sorting out the market and usage patterns. I always try to remember that there are enough painful problems out there to keep all of us employed...
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**
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Re: "Medical" Massage Therapists - June 1, 2005 6:27:00 AM
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TMondale
Posts: 131
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From: Newton-Wellelsley Hospital
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Greg,
It is not only condescending but very short sighted. If there is a profession defined by being "too good for something" especially soft tissue work, or the importance of exercise, or non-misleading marketing, it would be yours. Ours has a long and primary history with the understanding of how soft tissues can affect overall musculoskeletal health.
PT's shouldn't waste energy trying to restrict other professions from doing what their practice acts allow, but rather continue on our tack of improving ourselves as a respected profession that supports it's endevours with evidence. The consumers will figure it out.
We do need to be better promoters of ourselves, but that will come.
Greg, You get more rediculous with each post. The LMT's with more political clout than PT's? Where do you get this. You judge political clout by the number of silly modalities you can restrict from others: that's your professions way. It will be an interesting day when the LMT's gain the right to manipulate.
Jason is right we shouldn't be affraid to compete with anyone.
Tim
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Re: "Medical" Massage Therapists - June 1, 2005 7:33:00 AM
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Yogi
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From: San Antonio, Tx., USA
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Tim, agree or not, Greg did say he's "trying to encourage you here". Well-meaning advice is sometimes ridiculous, in the mind of the recipient. I will credit you with publicly stating your opinion, and to Greg's "face". I, personally, enjoy and value all of Greg's posts, and I would not like to see him offended here. Of course, this could be nothing, and I wouldn't want to be overreacting, if so, I apologize to all for wasting time.
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Re: "Medical" Massage Therapists - June 1, 2005 7:44:00 AM
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Yogi
Posts: 403
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From: San Antonio, Tx., USA
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Dr. Wagner. Good point about the purely therapeutic vs. solve the problem. In a modality class my instructor clearly explained palliative vs. curative (modalities mostly being considered palliative). That could be another thread discussion, on the proper utilization and overlap, if any, if anyone is interested in following up.
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Re: "Medical" Massage Therapists - June 1, 2005 9:22:00 AM
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JLS_PT_OCS
Posts: 1684
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From: USA
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Greg isn't on the Arkansas Board of Chiropractic Examiners, so let's not shoot the messenger, here.
He has a valuable outsider's view.
He may be right about political clout in terms of marketing and being more aggressive about getting what they want. Certainly their practice acts are much freer than ours.
And some PTs may have the "too good to do massage" mindset, but it may have as much to do with workload as anything else.
Tim, I agree that we need to let others go their own way and focus on improving our own profession, but I do think part of advocacy for us means making sure the playing field is level for everyone, as I mentioned before.
I say let the LMTs do what they want, but they better be subject to the same restrictions as we are, it's the only fair way to do it. Right now they enjoy a nearly free market with very little training, while we have had to constantly evolve and increase educational requirements to even make small moves toward market access. As it is now, we have to compete with our hands tied behind our backs. The Yellow Pages comparison Zack made is a good indicator of this.
But when the rope is untied, it will be a whole new ball game...
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**
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Re: "Medical" Massage Therapists - June 1, 2005 9:25:00 AM
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TMondale
Posts: 131
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From: Newton-Wellelsley Hospital
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Yogi,
To each his own; in this case I felt like Greg overstepped his bounds in criticizing our profession. I'm sure he'll survive it to post again. I think he adds perspective in many cases, and will continue to do so in the future.
Sorry for the misspell.
Tim
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Re: "Medical" Massage Therapists - June 1, 2005 9:49:00 AM
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chiroortho
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Hey Tim, I understand, no offense taken. I guess the bottom line for me is that in some states PTs have to get a script to perform massage therapy if they're inclined to do so, yet LMTs don't. It doesn't seem right to me. This kind of limitation is dealt with best via PR (marketing) and grass roots legislation (making some noise to the APTA).
Yes, chiropractic has lots of problems. Learn from them. Your profession has some advantages that chiropractic does not, and make sure that your national association keeps its focus on issues of importance, not tangential issues. The American Chiropractic Association does a pretty good job of this, but from time to time gets weighed down in silly, nonimportant issues. Then they hear from the rank and file DC, which gets them back on track. That's what I'm suggesting. I'm only trying to help.
_____________________________
Greg Priest, DC, DABCO
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Re: "Medical" Massage Therapists - June 1, 2005 3:17:00 PM
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TMondale
Posts: 131
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From: Newton-Wellelsley Hospital
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Greg,
I couldn't agree with you more about the direct access issue( I know a topic from long ago). It doesn't make a whole lot of sense, and we have to work legislatively toward autonomy in all states.
Even when I take issue your input is still greatly appreciated.
Tim
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Re: "Medical" Massage Therapists - June 1, 2005 3:51:00 PM
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Dr.Wagner
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From: Indianapolis
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Guys, I think this board is lucky to have a guy like Chiroortho...open minded and never starts battles.
This is a guy anyone would be lucky to work with. To be honest, when making partnership decisions or employment decisions...look at the person NOT only the situation (DC employing a PT). This is a guy that would make a good employer amoung other things.
Me on the other hand, well, I am a hard ass. I don't allow lunch breaks and I kick you in the shin if you get to close to me.
_____________________________
Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: "Medical" Massage Therapists - June 2, 2005 8:13:00 AM
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TLB
Posts: 353
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From: Arizona
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That's great Doc, promote and expand the profession by suggesting a PT go to work FOR a DC (I hope that's not what your saying). We will never get direct access with that kind of mindset.
Back to the subject at hand. What would happen if someone didn't renew their licensure, continued treating on a cash pay only basis and advertised Rehab/massage as the chiropractors do. You could even state the # of years you were a licensed PT and the reasons you left. I would think you wouldn't be held to any higher standard than an LMT and you would enjoy much more freedom than is currently available. Any thoughts?
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Todd
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Re: "Medical" Massage Therapists - June 2, 2005 9:58:00 AM
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paulpt
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TLB: If that person did not renew their license, treated on cash pay, and advertised rehab/ massage, then maybe they would not be violating any law. Maybe they would be.
This might violate the massage practice act, and it might violate the PT practice act. But if nobody reported the action...
(boy dont you love the slippery slope?)
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Re: "Medical" Massage Therapists - June 2, 2005 2:27:00 PM
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TLB
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From: Arizona
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As far as I know personal trainers and ATC's do the same thing without any problems. If you have a client base that is willing to pay cash, what good does being licensed do you?
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Todd
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Re: "Medical" Massage Therapists - June 2, 2005 3:29:00 PM
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jma
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From: NY
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If something goes wrong, then the penalties may be more severe if one is unlicensed as compared to being licensed.
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Re: "Medical" Massage Therapists - June 2, 2005 5:34:00 PM
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james097
Posts: 178
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From: West Vancouver BC
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Can American PTs get malpractice insurance if not licenced? What is the deal on not getting direct access. Why do you not just change your Acts Rules or Regulations and get on with it,Land of the Free and all that. PTs in Canada never had any trouble getting Regulations adjusted to have self referred patients.
Jim McGregor
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Re: "Medical" Massage Therapists - June 2, 2005 8:23:00 PM
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Randy Dixon
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I think that is the point chiro, I and few others are trying to make. Their hasn't been much provision made for self referred patients because there hasn't been many patients wanting to self-refer. If you want access all you need is enough people wanting your services.
PT's despite their progress, seem intent on focusing their attention inward in their quest for DA. For example, I now realize that PT's in TX have the option of treating "asymptomatic" individuals, but I don't see anyone doing this or using this to their advantage.
In my opinion the argument and political expediency of being allowed DA from treating asymptomatic patients to treating new symptomatic patients seems much easier than trying to convince the medical community and doctors that the post surgical and injured patients they are referring now don't really need them.
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Re: "Medical" Massage Therapists - June 2, 2005 9:46:00 PM
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james097
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From: West Vancouver BC
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Randy you say "There hasn't been much provision made for self referred patients because there hasn't been many patients wanting to self refer"
But how can you know that. Patients can't be that much different in America from those in other countries. Chiropractors and Massage practitioner are reliant on self referreds. If a patient has had previous PT treatments then they know that a referral is needed. Once they have a self referral then they automatically return for other suitable conditions. If it is true that between a quarter to a third of a GPs patients are suffering from Musculoskeletal pain many patients who would benefit from PT never reach your office. If a self referred patient is not suitable for treatment then we all know how to deal with that and often to our advantage.
Why would you want to convince the medical community and Doctors of anything. Surely by now
with the training PTs have you should all be much more independant.
Jim McGregor
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Re: "Medical" Massage Therapists - June 3, 2005 1:40:00 AM
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JLS_PT_OCS
Posts: 1684
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From: USA
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Independent of thought, Jim, yes.
Independent of action... now that's another matter.
Look at the legislative history. Who opposes direct access?
Patients? Individual providers? No.
The AAOS (american academy of orthopedic surgeons) and some physiatry groups.
Those from other countries who want to know why we can't just "get the rules changed", ask yourself what the median income is for an american physician (esp Ortho or Physiatry) and then the median income of a PT. Multiply that difference by they money to be gained/lost in lobbying efforts, and you have the whole story right there on a platter.
Randy makes a good point here, in that I think a lot of people from outside the profession view direct access as "Ha, ha, they don't need you, they can come right to us" and not what it really is, "People have a right to come straight to us if they'd like."
Like any other business in the whole world, I think most clients come through referral, via another professional or via word of mouth and personal recommendation.
I don't think anyone is surviving by "walk in off the street" business based on advertising alone.
Referral sources consist of both professional (other healthcare providers) and nonprofessional (laypeople and word of mouth) sources. LMTs can get patients both ways, yet PTs still cannot get referrals from nonprofessional sources in some places despite our obvious superiority in education, practice, and research.
I think that's really the take-home message here.
I really don't think direct access is about telling other providers that patients don't need them. It's about the playing field being level for everyone. From physicians to PTs to DCs to LMTs, it should be the same basic rules. The problem is that it's not like that right now.
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**
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Re: "Medical" Massage Therapists - June 3, 2005 6:54:00 AM
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matotoms
Posts: 57
Joined: February 16, 2005
From: nbn
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Pt has gone after the typical 3rd party payor market as most of traditional healthcare has.
what primary advantage does PT have for the avg every day OP patient with musculoskeletal pain over an LMT?
is it education? is it professionalism? is it outcomes? is it patient satisfaction? or is it cost?
there is zero doubt in my mind that cost is the overriding factor. Our ability to accept ins. reimbursement is a marketing coup for our profession and so much as we bitch about lack of DA, this has been our golden edge.
[QUOTE]Their hasn't been much provision made for self referred patients because there hasn't been many patients wanting to self-refer. If you want access all you need is enough people wanting your services.[/QUOTE]totally wrong argument there.............all you have to do is google search 'money spent on alternative health' to see the astronomical rise of people willing to pay cash for health services.....from LMT to yoga to personal training...alll areas that PT can claim in one form or another. all these folks self refer.
the key is that cash based services in the past have been offered a cheaper rate than the 80 avg visit we get from 3 rd party payors....as reimbursement dips and copays skyrocket, we are more and more on the level of the cash acceptors.
there is zero reaon why PT cannot be greedy and be hugely successful in going after the entire continuum...from cash paying well body massage seekers to DA insurance reimbursed acute/chroninc NMS patients.
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Re: "Medical" Massage Therapists - June 3, 2005 7:07:00 AM
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JLS_PT_OCS
Posts: 1684
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From: USA
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Yes, weaning from the insurance teat is possibly PTs biggest issue as far as competition goes...but if practice acts and state laws still restrict access, none of that weaning will matter...
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**
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Re: "Medical" Massage Therapists - June 3, 2005 7:11:00 AM
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matotoms
Posts: 57
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From: nbn
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the folks in states still without DA need to get on the ball witht he help of APTA.......its ridiculous they still do not have it
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