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RE: Why You Need to Join the APTA
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RE: Why You Need to Join the APTA - January 22, 2008 12:23:55 PM
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TexasOrtho
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I agree with SJ on all counts, but do feel somewhat conflicted at times. I agree with what was stated on another thread that the Physical Therapy and even JOSPT are becoming less fascinating to me as my level of practice has evolved over the years.
I hope I can find enough tangible reasons to see value in the APTA and plan to reevaluate my reasons for not being a member. Truthfully however, I will need to see some significant action (vs plans) on the part of our national and state organizations to move me back toward membership.
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Why You Need to Join the APTA - January 22, 2008 1:56:43 PM
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Shill
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From: Madison WI USA
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Im a member, and have been shelling out $$ for all but one or two years of my 14+ year carreer. Id sure like to see clinically relevant research be emphasized. Research is a good priority, clinically useful research is better. Id like to see far LESS emphasis on the DPT, and far more emphasis on tossing out traditional treatments that show no benefit. Perhaps an outline of the actual plan behind Vision 2020. The when and how, not just the vision statement.
Id like to see far fewer flyers on how I can save money on my car insurance, and far more emphasis on standards of practice.
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RE: Why You Need to Join the APTA - January 22, 2008 2:15:06 PM
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jesspt
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From: Illinois
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Maybe I'm in the minority, but I think that PTJ and JOSPT have actually become more useful in the last few years. The Bottom Line feature in PTJ as well as the podcasts have been interesting features that have been added over the last year or so.
_____________________________
Jess Brown, PT
Board Certified in Orthopaedic Physical Therapy
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RE: Why You Need to Join the APTA - January 23, 2008 7:53:57 AM
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SJBird55
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From: Michigan
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Rod, I think that is the problem. All sorts of "planning" and "talking" and no doing. I would think that with technology, chat room capability and netmeeting capability, issues could be resolved more expediently. Does the face to face really have to occur at meetings to get stuff done, or can technology be utilized to expedite manners yet increase productivity? If you noticed in the strategy, all sorts of meetings, but no roll out plan. Leadership needs to make decisions. Technology can be used to have members involved in decisions too - blast emails, polls, voting on multimedia stuff via YouTube. Our world is so much smaller nowadays with technology, we need to step up and use it. I will admit though, this is the first time I have seen any game plan shared with membership with unmeasurable goals shared. It is a good start... unsure where it will lead though.
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RE: Why You Need to Join the APTA - January 23, 2008 8:35:32 AM
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PTupdate.com
Posts: 1433
Joined: October 8, 2001
From: Pittsburgh, PA USA
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A proposal: It appears that between these discussions, and even the petition, that many PT's are concerned about the profession, it's future, it's image, and it's leadership. So, why don't we band together as a group with common concerns and try to exact some change? We coluld be the "RehabEdge Renegades", vote SJ for president (she's got my vote as well) and use a collective voice to find an ally within the organization to be a liason, and push for what we want.
Would David A. give us our own section in the forum menu to communicate? Would we insist on APTA membership to be a part of this "section"? Can we ban "lurkers" and only involve active participants? Would anybody in the APTA even give a rats-ass what we think/want? We won't know until we try.
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Why You Need to Join the APTA - January 23, 2008 12:01:29 PM
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SJBird55
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From: Michigan
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#1: No organization is ever going to make 100% of it's members happy. I firmly believe those 8 things below are highly relevant for private practice or outpatient physical therapy practitioners. I can and will assume that there is just as much crap that goes on in home health, inpatient, school systems and rehab facilities. I have no clue about that world of practice. I would tend to bet and assume (but would need numbers to verify) that the bulk of physical therapists practice in an outpatient or a private practice setting. With any changes or direction, the majority need to be satisfied first and THEN work on the minority groups (and when I say minority, I don't mean women or racial issues - I mean the other practice settings).
quote:
Firstly - reimbursement should either increase or at least stay status quo. How is it that there isn't ever a fight for an increase in reimbursement? (And I'm not just talking Medicare.) Secondly - why do we not own the CPT codes for our professional services? Thirdly - why do we not have an educational code - sure, there IS an educational code, but the requirements to use that code to not generally apply to the type and level of education we provided. Fourthly - why did the association not take the Virginia Mason Medical Center information and dig into it and run with it? Fifthly - do the ICD-9 codes truly reflect what we are treating? Could there be a better system in place? Sixthly - the fee schedule system for reimbursement sucks. Why isn't the APTA highly involved with brainstorming a win-win system for payors, patients AND providers? Seventhly - physical therapy and physical therapists aren't "new" to the world - why don't consumers know what the heck we do? Eighthly - Why are shake and bakes AND mills allowed to stay in existence?
With each and every one of those issues that need to be tackled, we need to know the stakeholders involved. Who would support the change outside of physical therapists. Who would oppose a change? Who has the most money and financial backing and best interest in supporting the change?
For example, an increase in reimbursement... heaven forbid. We aren't going to get a walk in the park agreement on that... but if we use the Virginia Mason Medical Center information - start speaking to those within that organization, to Starbucks, to Aetna and gather more data and their insight and learn the dollars that were saved by implementing that type of strategy... I would think that most 3rd party payors might listen because they would be strategically placing themselves into a position to save money (huge diagnostic testing costs). Our value and our rationale for increasing our reimbursement rates is because we save them money by putting us first! Then... IF we are put first... guess what? THAT initiates a change in policies too where third party payors just might determine that a $50-80 office visit with a physician really isn't quite as necessary as originally believed, in particular with musculoskeletal conditions AND we have research data to PROVE it. We also have data upon data of the liability risk of implementing physical therapists first - professional liability companies KNOW our risk and KNOW when lawsuits happen and why!
Who is going to be against physical therapists, occupational therapists, and speech therapists owning rehabilitation codes??? Chiropractors and physicians... who might back us with that? Third party payors! If we can prove that by allowing physicians to utilize those codes, third party payors are increasing their probability of increasing their costs because the likelihood of a "true" package of physical therapy actually occurring OR an unqualified person providing a modality OR a conflict of interest to increase revenue for a physician may occur - it's almost a no-brainer. I would think that by looking at claims, seeing that chiropractors as a whole tend to plant the need a chiropractor for life kind of mentality that chiropractors are probably increasing costs also and let chiropractors have their own codes for manipulation of the spine and limit reimbursement to that specific category for them because that IS their speciality.
The ICD-9 situation.. I have no clue how to begin tackling that. We all play the ICD-9 code though to get paid.... that system has no value to define what we are actually addressing. Believe it or not, if I have a patient that is at risk of falling and has an unsteady gait, BCBSM does not recognize that code! That's a problem!
I do not have an answer for a better payment system. I actually did like parts of what Dennis Hart presented last year at the CSM. I like the idea of a tier based system and the idea of capturing more reimbursement for quality with quality combining # of visits and outcome numbers. His system is screwed though because it was based on ICD-9 codes (if I recall) AND he doesn't have enough data for the geriatric population and the slew of co-morbidities that do impact rehabilitation outcomes to risk adjust that population adequately.
The APTA IS addressing marketing and branding. We need it desperately. There is no deadline for when it will be completed (that's always an issue with me if I'm working on a project - always gotta have a deadline to get it done in a reasonable amount of time). I would also hope there would be a high amount of transparency in sharing findings and allow members to vote and comment BEFORE the final product is rolled out. WE can help tweak it too! We shouldn't leave it to just the delegates or some highly paid company! That crap that got rolled out last year on Blackberry Thumb and Couch Potato crap was embarrassing and DIDN'T send a favorable message about us as a profession OR what we really offer.
The Shakes and Bakes and Mills will become less and less as transparency increases AND as the public is educated on expectation of services! Shoot... if the APTA used YouTube in the non-profit category... we could have a TON of fun creating videos of what is NOT acceptable!
All I know is that sitting back and talking... making darn sure the "proper" chain of communication is followed... making sure the "rules" of meetings are followed and taking all the energy for that kind of administrative crap isn't going to get crap done... oh, and let's not forget not allowing members to speak on member listserves for very, very weak reasons! The HOD can have all sorts of guidelines and comments and whatever they officially call those things residing at the APTA site... they can't SIT there, legislation needs to change, third party payor regulations need to change to stay up with what the HOD thinks and says! I see the little APTA world not connecting with the world in which we live. THAT is what has to change. There are lots of statements and guidelines and whatever created, but they aren't in the real world.
Those are my more detailed thoughts...
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RE: Why You Need to Join the APTA - January 25, 2008 8:09:11 AM
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SJBird55
Posts: 2292
Joined: May 10, 2004
From: Michigan
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Yesterday I did have a conversation with John Barnes, CEO of the APTA. Although the letter response from the BOD on the petition had a larger focus on communication within the organization and between organizational departments, John did discuss the marketing and branding aspect with me. My perspective/impression from the conversation is that our diversity is both an advantage and a disadvantage (which we already know) and although that is the case, our identity problem is solvable. No definitive plans are in place as to how members will have a say; I believe the board of directors will have a final say in the matter with regard to marketing and branding.
I really would like to see a formalized strategy that includes feedback on the created product from members by the end of 3rd quarter 2008. He did substantiate my belief that the majority of APTA members practice in a predominantly orthopaedic practice setting.
I did my best to determine where the board of directors listed in response to the petition practiced. (There were 15 of them listed at the bottom of the letter response to the petition.) 3 of them I have no clue (couldn't determine via their email address or in Find a PT, so I would assume they are in academia); 7 of them are in academia (based on their email address); 3 are in orthopaedic practice; 2 of them do consulting or reimbursement type activities. If my calculations/assumptions are accurate, there will be 10 members who have a predominant role in academia supposedly being our voice and speaking for us - can they REALLY do that? Was the petition clear enough for them to really and truly understand the state of affairs in the clinical world? We can't be an advocate for consumers if consumers aren't aware of our role. I don't think the members of the board have the same experience as we do working in the trenches and dealing with the public.
A definitive timeline for finalized marketing/branding wasn't discussed, but my impression was that the marketing/branding project might not truly be completed until end of 4th quarter 2008 or 1st quarter 2009. (This was just my impression, John did not set any timeframe.)
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RE: Why You Need to Join the APTA - January 25, 2008 11:07:18 AM
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Kaden
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Wow SJ, great stuff and thanks for your thouroughness in this matter. I completely agree and have stated in a previous post that with the APTA leaders primarily stemming from the academic world they cannot appropriately represent those of us in private practice.
I would even take it one step further and say that it may be against there interest to do so. In the academic world, continuing to push the DPT, expand class sizes, and increase the overall length of education are all ways for those in academia to improve there bottom dollar. Now if I were in the academia world I can't say I wouldn't do the same, but being in the outpatient world I can say for certain an academia dominated professional association does not represent mine or my colleagues best interests.
The problem is, how do we change it?
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RE: Why You Need to Join the APTA - January 25, 2008 2:14:33 PM
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jlharris
Posts: 468
Joined: April 12, 2006
From: Nebraska
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quote:
I did my best to determine where the board of directors listed in response to the petition practiced. (There were 15 of them listed at the bottom of the letter response to the petition.) 3 of them I have no clue (couldn't determine via their email address or in Find a PT, so I would assume they are in academia); 7 of them are in academia (based on their email address); 3 are in orthopaedic practice; 2 of them do consulting or reimbursement type activities. If my calculations/assumptions are accurate, there will be 10 members who have a predominant role in academia supposedly being our voice and speaking for us - can they REALLY do that? Was the petition clear enough for them to really and truly understand the state of affairs in the clinical world? We can't be an advocate for consumers if consumers aren't aware of our role. I don't think the members of the board have the same experience as we do working in the trenches and dealing with the public.
Wow, really makes the picture clear doesn't it? No wonder we have to deal with blackberry thumb and couch potato marketing plans. Too small of a voice as to what really is important in the out patient world.
Exciting to hear you were able to have a good conversation with John Barnes himself. I feel a greater impact can occur that way.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
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RE: Why You Need to Join the APTA - January 25, 2008 3:18:04 PM
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buckeye
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Great thread - let's hope the PT political heads read.
SJ - To what group are you referring regarding the HPA president? I am not familiar with the intials HPA.
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RE: Why You Need to Join the APTA - January 25, 2008 4:34:04 PM
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SJBird55
Posts: 2292
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From: Michigan
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buck... I'm a member of the Health Policy and Administration (HPA) section of the APTA. This section has a listserve for members and the role of the listserve is for networking and communicating. The president of that section still has me "moderated." That means I can take time out of my day to post a comment, but he WILL read it first and determine if my post is allowed to be shared with all membership on the listserve. The only reason that he is doing that is because "I can't be trusted" and that was because on the listserve we are supposed to disclose our full name, credentials and location. I forgot to do that and broke the rules... so now, I am "moderated." (psst... there just happen to be about 3 therapists that don't post ALL the required information and they aren't moderated) AND... the last post I wrote wasn't accepted because I asked him to discuss why he did not believe the Virginia Mason articles/information wouldn't be beneficial in assisting physical therapists in our endeavors to prove our value. (He and I had gone round and round months ago in private since he resides in MI also and I do not like the current state of affairs of reimbursement here in MI.) He disagrees with me and has decided that my line of questioning is not respectful because I used his name... whatever. I can see that here in MI nothing is going to change because no one wants to talk about the difficult topics or to even problem solve a different strategy to change reimbursement patterns. Sad... So, Jason, you can see, I have "tested" the waters. MI isn't ready for an SJ OR ready to be proactive OR ready to change anything.
Only time will tell, Jason. For once there is a strategy. Jason, that is the reason I definitely believe that members should be involved in at least voting on the options created. Of course, I'm sure, those 10 would say that they were connected with the clinical world... blah, blah, blah... but they really aren't, in my opinion. I don't live in the world of academia and I don't know what their lives are like. Sure, I could teach a class, definitely, but I'm not going to sit here and assume that I could step in and function as optimally in that particular world because I am very sure that their world is so much more than just teaching a class or two. I would hope that they would realize that our world may not be as they experienced OR as they do experience during their 8 "clinical" hours a week (just tossing out a number) in a clinic. Doing research is great.. but that still doesn't mean that the person doing the research understands the politics or the reimbursement crap or the simple fact that consumers have no clue what we do.
I did ask who or what party was responsible for the previous marketing attempts. John was not involved with those attempts because they were initiated before he began with the APTA. He really didn't respond to that line of questioning.
John seemed very open to speaking to members. Anyone could attempt to contact him.
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RE: Why You Need to Join the APTA - February 3, 2008 1:31:45 PM
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blast7
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quote:
ORIGINAL: SJBird55
I did my best to determine where the board of directors listed in response to the petition practiced. (There were 15 of them listed at the bottom of the letter response to the petition.) 3 of them I have no clue (couldn't determine via their email address or in Find a PT, so I would assume they are in academia); 7 of them are in academia (based on their email address); 3 are in orthopaedic practice; 2 of them do consulting or reimbursement type activities. If my calculations/assumptions are accurate, there will be 10 members who have a predominant role in academia supposedly being our voice and speaking for us - can they REALLY do that? Was the petition clear enough for them to really and truly understand the state of affairs in the clinical world? We can't be an advocate for consumers if consumers aren't aware of our role. I don't think the members of the board have the same experience as we do working in the trenches and dealing with the public.
Interesting...I suppose I never truly took the time to look at the BOD but with the seemingly main focus of the APTA and vision 2020 being the DPT it does not seem surprising. Our Demographics as of June 2007 are as follows by practice setting:
n=45406 PT's
Private out-patient office or group practice=41.5%
Health system or hospital based out-patient facility or clinic=14.5%
Acute care hospital=13.1%
Patient's home/home care=7.9%
SNF/ECF/ICF=5.6%
Academic Institution (post secondary)=4.8%
School System(preschool,primary, secondary)=4.1%
Sub-acute rehab hospital (inpatient)=3.5%
Health and wellness facility=0.8%
Industry=0.5%
Research Center=0.3%
Other=3.4%
n=3604 PTA's
Private out-patient office or group practice=36.6%
SNF/ECF/ICF=16.2%
Health system or hospital based out-patient facility or clinic=13.6%
Acute care hospital=12.1%
Patient's home/home care=6.6%
Sub-acute rehab hospital (inpatient)=5.3%
School System(preschool,primary, secondary)=2.5%
Academic Institution (post secondary)=2.4%
Health and wellness facility=1.4%
Industry=0.4%
Research Center=0.1%
Other=2.8%
Is it perhaps that those involved with academia are just more involved in the professional organization. Why are there others not stepping up?
< Message edited by blast7 -- February 3, 2008 1:40:00 PM >
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RE: Why You Need to Join the APTA - February 5, 2008 11:00:40 PM
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TexasOrtho
Posts: 423
Joined: December 22, 2007
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Holy crap...I almost renewed my membership and I have forgotten how hard it is to plop down $500 bones for this. Remind me again why I'm doing it? This doesn't even include an extra PAC donation I'd like to lay down. The installment plan makes it a slightly less bitter pill but...$500????
I've proudly announced this as one of my PT resolutions on my latest blog entry, so I need to stick to my word. Based on how much we're laying on the table, I better give and get my money's worth. Almost...there....about to hit...submit....button....
< Message edited by TexasOrtho -- February 5, 2008 11:04:22 PM >
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Why You Need to Join the APTA - February 9, 2008 3:24:42 PM
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TexasOrtho
Posts: 423
Joined: December 22, 2007
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quote:
renewed my membership and I have forgotten how hard it is to plop down $500 bones for this. Remind me again why I'm doing it? This doesn't even include an extra PAC donation I'd like to lay down. The installment plan makes it a slightly less bitter pill but...$500????
Joined...also plopped down extra cheese for ortho and sports sections. It's funny but spending this money actually makes me want to be that much more active. If I just sit back and wait for the membership to pay for itself, I'm pretty sure I'll be sadly disappointed.
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Why You Need to Join the APTA - February 12, 2008 11:13:34 PM
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David Adamczyk
Posts: 292
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From: Cleveland
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Duffy,
We think an APTA discussion forum is a great idea. Nicole has already agreed to be our moderator. We can't ban"lurkers", but we can make if viewable only if you are logged in.
I like your suggestion that APTA membership be a requirement. I have another, you must include your real name and credentials in your signature (or username if it's already there).
Any other suggestions?
Dave
< Message edited by David Adamczyk -- February 12, 2008 11:21:44 PM >
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RE: Why You Need to Join the APTA - February 13, 2008 8:20:38 AM
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Sebastian Asselbergs
Posts: 1105
Joined: September 29, 1999
From: Barrie, Canada
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Dave, are you saying that - being Canadian and a non-member of APTA - I would not be able to read/lurk or occasionally comment? Which is of course, your right to do - but I think it would help me and my association to learn/contribute/brainstorm
_____________________________
Mundi vult decipi
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RE: Why You Need to Join the APTA - February 13, 2008 8:39:44 AM
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PTupdate.com
Posts: 1433
Joined: October 8, 2001
From: Pittsburgh, PA USA
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David and Nicole: Thanks for being supportive of such a project. Perhaps the next step is to find out the interest level. How many RehabEdge members are going to commit to such a project? I am NOT currently a member, but would join the APTA / re-new for such a project. But, I'm not going to shell out $500 if just 3 people are going to make the effort.
Sebastian: Personally, I'd prefer that only active members/participants of that section be able to post and even lurk. I would not want the discussions to be confused, agitated, and interfered with by those who aren't involved. Nothing personal. Maybe postings on our progress and project could be made on the general forum, where discussion could occur, and newbies and even lurkers could realize the importance of their input.
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Why You Need to Join the APTA - February 13, 2008 1:47:22 PM
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SJBird55
Posts: 2292
Joined: May 10, 2004
From: Michigan
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Duffy, I bet if you emailed Childs over at MyPhysicalTherapySpace, he'd be willing to set up a "member only" group for what you are suggesting. (Duff, you've been commenting on the blog part of it, but there is a networking part to it too - not sure if you've clicked on that tab and checked out that area.) That networking site has the capability for a group t be created with someone to be a "moderator" and only allow "members" to participate because a password clearance is required. Scroll down the list of "groups" over there... for example, TexPTS has its own group... EIM faculty/lab has it's own group (these are locked groups that require "membership" because you see the little lock).... there are others, but those two are the first that come to my mind. If and when you set it up, you could have interested potential members email you with their APTA member ID and you could verify the member ID through the membership directory at the APTA site.
Now the down side to what is being suggested is that delegates have already been pissed off over the petition. I still haven't heard what occurred during delegate meetings during CSM. I know for a fact that the delegates did not appreciate one bit that members chose to sign a petition versus working within their chapters to communicate the marketing/branding topic. I, personally, am a rebel. What is in place obviously doesn't work and something needs to change - I honestly don't care what the delegates thought about the route taken to voice an opinion. The end result is what matters - but politically, only having a group discussing won't cut it. We have to be able to stroke the delegate's egos a bit and hold their hands to bring them into this current day in age where transparency can be good and written communication can be good. Real voices/thoughts might be provided more readily within an engaging group via a networking group with multiple people participating in a discussion - the question is, are delegates ready to lose a bit of the hierarchy that has traditionally been in place? Are delegates ready for real discussions and real problem-solving from therapists in the trenches that deal with all sorts of situations on a day in and a day out basis? Are delegates ready to realize that just because I am not formally involved at some elected level that I should definitely be able to have a voice and definitely be able to take action and definitely expect action without having some huge laundry list CV to supposedly substantiate that I know what I'm talking about? The way I see it, there are problems and there should be solutions to the problems - toss out the CVs and tackle the issues - problem-solve together while considering the real world reality.
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