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RE: Working with a chiro...
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RE: Working with a chiro... - August 2, 2007 6:29:36 PM
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Lehmkuhler
Posts: 69
Joined: December 14, 2005
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Proud,
You're obviously "too good" to work with anybody... Your skill set is superior to all other professions and they have nothing to offer you, the emperor of NMS conditions... PT's must all be business owners and work at every turn to advance the PT profession even at the sacrifice of their own careers...
Have I summed up your position accurately?
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RE: Working with a chiro... - August 2, 2007 6:32:14 PM
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aph401
Posts: 82
Joined: April 16, 2007
Status: offline
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Proud, I agree that all PTs should not feel as though they have to turn to this type of arrangement, but I guess I'm also taking into consideration the fact that this would only be a few hour a week type thing and he would still be working at the clinic he currently works at. I also think that it might be worth giving it a shot and seeing how it works out, what kind of results are being seen in the patients, etc. If it turned out to be profitable for everyone, the patients are improving and happy with the services they are receiving, and all laws are being abided by, I see no problem with it. Many people on this forum have worked in physician-owned settings and had nothing but good things to say. On the other hand, if he felt patient care was being compromised in this situation, he wouldn't have to stay in it. I guess I just feel like it's not something that should immediately be dismissed. Me personally, if I see a great money making avenue in front of me, I like to explore every option before I totally write it off.
< Message edited by aph401 -- August 2, 2007 6:38:27 PM >
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RE: Working with a chiro... - August 2, 2007 8:35:54 PM
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OAK
Posts: 183
Joined: September 1, 2003
Status: offline
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Accepting this set up means that you believe your PT education is worthless and any untrained individual (PTA) is qualified to do your job. Keep this thinking going and quess what, these clinics will bypass the PT altogether, go straight to the PTA, and there goes your great money maker avenue.
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RE: Working with a chiro... - August 2, 2007 11:36:32 PM
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aph401
Posts: 82
Joined: April 16, 2007
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OAK - PTAs aren't untrained, they have associates degrees.. just like nurses, right? Also, how could they bypass the PT altogether when they can't have a PTA on staff without a PT?
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RE: Working with a chiro... - August 3, 2007 8:20:20 AM
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JCOY
Posts: 34
Joined: April 13, 2006
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KIDPT-
quote:
Is there any billing issues when billing the P.T. codes thru the chiro tax ID?? 3) Can a P.T.A. perform tx's in the chiro setting without direct supervision of a P.T.???
What are you referring to as "P.T. codes"? I am (99%)certain that Illinois is the same as my state-> A DC is licensed to perform and bill 97XXX(physical medicine and rehabilitation) codes. A PT or PTA is NOT needed/required for these codes. 97XXX's are not owned by any speciality. I perform, bill, and am paid for 97XXX's on virtually all of my patients.
As for the PTA query......having a PT on site would not be required, since the DC is licensed for 97XXX'x. Many DCs have CAs(same as a PTA) performing therapies in their offices. And as with PTAs, CAs must be under the direct supervision of a DC. So it may be only a technicality as to what this "aide" is called. I agree with Lehmueller, to get a legal opinion, just to avoid any snafus.
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RE: Working with a chiro... - August 3, 2007 12:48:04 PM
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proud
Posts: 875
Joined: March 22, 2006
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quote:
ORIGINAL: Lehmkuhler
Proud,
You're obviously "too good" to work with anybody... Your skill set is superior to all other professions and they have nothing to offer you, the emperor of NMS conditions... PT's must all be business owners and work at every turn to advance the PT profession even at the sacrifice of their own careers...
Have I summed up your position accurately?
Well I would be placating the situation if I did not admit to feeling PT's should be ideally positioned to be "the" expert providers in everything NMSK. And so my point to KIDPT was to recognize this fact and avoid the pitfalls of aligning with ocupations of a lower profile within the medical community. It is just not a required partnership in my opinion. Making money is okay, but it appears from KIDPT's question, the motivation for the partnership is purely financial. I don't get that. If I were him/her, I would be asking myself given the outstanding upper hand provided as a PT....why am I struggling?
Ironically, at the moment, those who practice EBM actually generate less revenue than those who are incompetent and provide silly advise and passive modality treatments. Somehow this is going to be reigned at some point. You would be foolish to think otherwise. It's not efficient use of health care dollars. I suspect this will occur sooner rather than latter and the cream will rise to the top( I predict by 2012-12015). Based on population demographics.
Now, as to the tone of your post above suggesting that I am "too good" and cannot learn from other professions. That is false and I am not sure where that came from. No, I don't think we need partnerships with chiropractors. But that in no way takes away from the skills of those chiropractors who keep on track with EBM( Marc and Buddy seem to come to mind on this site). I imagine I could learn alot from them.
I truly believe that at some point, a clear provider of conservative NMSK care will need to be identified. With an aging population and health care costs skyrocketing...unfounded treatments will be the first to be eliminated for reimbursment( and yes, spinal manipulation without justifiable, evidence based cause will be eliminated...it's already starting to happen). Now, members within the eventual chosen conservative NMSK profession will be held to a certain standard of care that recognizes evidence based protocol( many PT's out there are doing some strange things at the moment..it has to stop). That profession will have strict regulatory bodies that ensure complaince with protocol. If you think this will never happen,...wait for it. I happen to think PT's on a whole, are ideally suited to fill this expert role eventually.
The "good" chiropractors could fill that role....you may be one of them. But the history of Chiropractic does it no favours. Even CMCC here in Canada which aparently does not identify with the "subluxation" still seems to graduate some individuals who go on to offer some strange stuff. Couple that with the history of chiropractic and you have a much harder time convincing those in charge of health care dollars.
It is not a comment on your skills or my ability to learn from you Lehmkuhler, rather a comment on the pending political environment sourrounding health care and where I think we should be heading. Thus the advise to kidPT.
< Message edited by proud -- August 3, 2007 2:15:47 PM >
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RE: Working with a chiro... - August 3, 2007 7:15:10 PM
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Jon Newman
Posts: 1697
Joined: April 24, 2004
From: Amherst, WI
Status: offline
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Hi Kid,
Have you made a pros/cons list? Can you share it with us? You could invite additions to either side.
Tell us a little about the chiropractor you're considering working with. Besides being a personal friend, which may itself be a con, what informs his chiropractic practice? Is he/she a subluxation believer?
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RE: Working with a chiro... - August 6, 2007 11:14:09 AM
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KIDPT23
Posts: 222
Joined: May 20, 2002
From: Illinois
Status: offline
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I understand some of your frustrations with this, however how is this any different than if I owned an outpatient P.T. clinic that was set up as a C.O.R.F. and had one of my offsite locations in this chiropractor's office and I was doing all the billing, scheduling,etc...In this example, I could do the IE's/Re-evals and have the P.T.A. carry out all the daily treatments with my supervision by phone contact...also to OAK, when did we start ripping on P.T.A.'s?? I think they are a great asset to our profession...Does that mean you think the P.T.A.'s that work in the home health care settings without direct P.T. supervision are worthless?? I think this is a pro secondary to the fact that this particular chiropractor will be doing this regardless if I am on board or not...If I am on board, I will be interviewing and in control of who gets hired as the P.T.A. plus I will be doing all the training to the P.T.A...I will perform bi-weekly reviews of all charting and billing...And yes, the money is very good compared to what I can expect to get reimbursed in a normal clinical setting...
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RE: Working with a chiro... - August 7, 2007 3:38:03 PM
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KAK
Posts: 200
Joined: December 1, 2004
Status: offline
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KidPT,
In home health or any other setting (including what you are proposing) I have an ethical problem with handing over all patients after eval to a PTA to treat. I am not saying that PTA’s are untrained or worthless. I am not saying that there are not patients for which it might be appropriate. However, to say that they can provide all the treatment to each of the patients carte blanche sells our profession short. Ethically, we are to delegate what doesn’t require our skill. “A physical therapist shall not delegate to a less qualified person any activity that requires the professional skill, knowledge, and judgment of the physical therapist.”- APTA Guide for Professional Conduct.
I am saying that as a PT, we do have additional skills which I feel are necessary to provide optimal and what I consider ethical care. Reviewing paper work twice a week does not and cannot substitute for actually seeing, touching and assessing the patient.
I noticed that several times you have justified your position by pointing out that if you didn’t do it some one else would… I don’t understand how this is pertinent to the question of weather it is legal/ethical?
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RE: Working with a chiro... - August 7, 2007 4:06:16 PM
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proud
Posts: 875
Joined: March 22, 2006
Status: offline
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quote:
ORIGINAL: KAK
KidPT,
I noticed that several times you have justified your position by pointing out that if you didn’t do it some one else would… I don’t understand how this is pertinent to the question of weather it is legal/ethical?
Agree with KAK( although I would have spelled "weather" differently...).
KidPT. Clearly you have established in your own mind that this partnership is a good idea. I don't think so.
I have provided good advice on this topic...trust me. But good luck to you in the future.
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All Forums >> [RehabEdge Forum] >> Open Forum >> RE: Working with a chiro... 
I don't think I would want to "contract" out with a chiro. Can you work out some sort of referral relationship so you can both benefit? 