|
|
RE: NATA lawsuit filed against the APTA/Orthopedic section 2/1/08
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 17, 2008 7:29:49 PM
|
|
|
Tom Reeves DPT ATC
Posts: 372
Joined: March 14, 2006
Status: offline
|
I got a denial because I used the word "golf" in one of my goals. Others were ADL-functional. I clicked on the provider's website, and sure enough, there were kids rollerblading, people riding bicycles, and power walking. How's that for mixed messages (Hypocrisy??!!?!?!)
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 17, 2008 7:40:28 PM
|
|
|
SJBird55
Posts: 2242
Joined: May 10, 2004
From: Michigan
Status: offline
|
There ya have it, blast... Tom said it better than me. It is best to not include any sport goals in your functionally measurable goals. Tom, they just don't want to pay.
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 18, 2008 12:20:03 AM
|
|
|
blast7
Posts: 93
Joined: July 28, 2005
Status: offline
|
I am glad you two cleared it up and yet I am also saddened by the payers' that do not reimburse with goals like these. How much less would these payers likely pay if there subscribers were able to be more active by playing golf, or any other sport for that matter. Yikes!(FRUSTRATED)
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 18, 2008 12:43:29 AM
|
|
|
Rwantz
Posts: 84
Joined: December 10, 2004
From: Middletown, PA
Status: offline
|
Okay, so things have gotten a little heated. I didn't realize that I was going to start something this big.
HR 1846 would allow athletic trainers to practice as qualified under their scope of practice. No athletic trainer is going to go beyond their scope of practice because this bill is passed. It only allows access to patients under the scope of practice.
I do have an NPI number. I got it about 3 years ago when it was first introduced. I am not sure what was meant by that, but I assume it was supposed to be belittling or something.
Athletic trainers treat the physically active. Are injuries that workers suffer (impingement, fractures, sprains, strains) not caused by activity? I realize that a rotator cuff injury in a construction worker is completely different than in a football player (or is it really????).
I would still want a physician to have the opportunity to refer a patient to whomever they see fit. If it is based on illegal practices then the physician should be called on it. But if the physician orders athletic training then the patient should receive athletic training, from an athletic trainer. If the physician orders physical therapy then the athletic trainer should never fill the script. If it is for "therapy" I would say that that is general and that athletic trainers provide "therapy" in that it is understood that that is "rehabilitation." It would not be defined as physical therapy in my mind. Perhaps this is something that needs to be cleared up. "Therapy" to me could be filled by a PT, an OT, or an AT. Who owns the word "therapy?"
Is the only goal for a patient when they are seen by an athletic trainer to "return to golf?" Certainly there is more benefit from rehabilitation than getting them back to their sport or activity. Decrease pain. Increase range of motion and strength. Increase function. That can lead to a return to activity, which physical therapists do everyday. Athletic trainers are qualified. I assume from your diatrobe that your impression is that athletic trainers are unqualified to practice. I welcome a discussion on this, but let's please understand that nothing I said was an attack on physical therapy, the profession, or the future of the profession.
< Message edited by Rwantz -- February 18, 2008 12:48:57 AM >
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 18, 2008 8:39:37 AM
|
|
|
SJBird55
Posts: 2242
Joined: May 10, 2004
From: Michigan
Status: offline
|
Has anyone seen a referral state "therapy" on it? Most written referrals will specify "occupational," "speech," and/or "physical" prior to the word "therapy."
Athletic trainers are not listed in the AMA CPT book. The Physical Medicine and Rehabilitation codes are for physicians and therapists. The third party world also dictates who may use the codes.
In a collegiate setting, the athletic trainer has freedom to do whatever under the supervision of a physician. Athletic trainers are very well trained in treating the healthy, physically active. (key word is healthy...)
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 18, 2008 9:49:32 AM
|
|
|
Tom Reeves DPT ATC
Posts: 372
Joined: March 14, 2006
Status: offline
|
Rwantz,
Remember SJ and I were athletic trainers first. For me, it is the more fun part of my job. I personally did not take your post as an attack but you have to realize that the APTA is defending turf. I personally don't think that athletic trainers have the training to work with medicare patients or the un-well in general. I also think that noone but a certified athletic trainer should be the primary health provider for an athletic team. I get just as defensive when a high school team comes to my town and have a "certified sports chiropractic physician" as their medical team. Just last week a kid from another school inverted his ankle during a basketball game. Out rushed the DC (I am assuming) and he jerked and yanked caudally on the kid's leg. Splain that one to me.
Anyway, I worked with some outstanding athletic trainers in KC where I used to live. They are not trained to work with medical co-morbidities. (I was not trained to work with medical co-morbidities in undergrad either)
My stance on this is as follows: ATCs are THE best trained at treating well but injured athletes using many of the same skills as an orthopedic PT. PTs are NOT trained to do sideline coverage. I have always been against the NATA's recent push to get AT placement in clinics other than as an adjunct to PT. Their mission should be to get a certified athletic trainer in every high school and college in the country. I.E. fulfill their mandate, not change the mandate.
Provide athletic training services, and do it well. Don't try to be physical therapists. I will defend their right by calling out/reporting whatever anyone who claims to be the team's "trainer" who is not one. NATA can defend their skill set, so should the APTA.
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 18, 2008 10:03:12 AM
|
|
|
Rwantz
Posts: 84
Joined: December 10, 2004
From: Middletown, PA
Status: offline
|
I appreciate your opinion and I respect your opinion. I do disagree with some of it, but some of it I very much agree. To me the setting in which an athletic trainer practices is not relevant to this lawsuit. However, if I am qualified in the college, high school, or professional sports then I am equally qualified in a free standing rehabilitation clinic.
The basis behind the lawsuit is manual therapy. I believe that the NATA is fighting for the right to practice, but also to be recognized as a qualified practitioner of manual therapy.
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 18, 2008 10:35:26 AM
|
|
|
Tom Reeves DPT ATC
Posts: 372
Joined: March 14, 2006
Status: offline
|
I was really trying to speak to a larger issue than just the lawsuit. I think ATCs should be able to attend any CEU they want to. I think PTs should be able to teach anything they want to, to whomever they want to. So, I think that the Ortho section's point is silly. I also think that the NATA doesn't have a good argument. In other words, the tiime and effort and MY membership dollars to BOTH organizations could be spent in a MUCH MUCH MUCH better way than sniping at each other over these issues.
I disagree with your assertion that if ATCs are OK in college HS and Pro athletics they are ok in a free standing clinic. When you are a team trainer, you know all of your athletes. you know their medical history, their motivation, their IQ etc . . . When you are in a free standing clinic, you have to get all of that information in a 1 hour session. You have to know the right questions to ask. You have to be able to identify red flags for stroke, dementia, MI, cancer, sleep apnea, etc . . .
Yes, I know that some ATCs know that stuff. Fact of the matter is, you don't (at least I didn't) learn that stuff in school (athletic training school) PTs do. You might reply that you learn it on the job (for the record, I was all for discontinuing the internship route to certification for AT) but that does not prepare you to be in a clinic where the level of care that is expected is a bit different than in a training room.
The skills are different. ATCs have skills that PTs don't have, PTs have skills that ATCs don't have. I am not talking about manual therapy skills, I think that is an area of total overlap. The lawsuit being about manual therapy is IMHO ridiculous. The notion that ATCs are as qualified as PTs to work in a free standing clinic is not.
|
|
|
|
|
RE: NATA lawsuit filed against the APTA/Orthopedic sect... - February 18, 2008 12:06:38 PM
|
|
|
SJBird55
Posts: 2242
Joined: May 10, 2004
From: Michigan
Status: offline
|
I actually can see the ortho section's viewpoint. I don't think it was silly. The NATA making a big deal about it is what is ridiculous along with the NATA having some long letter of "the APTA said" crap and then a huge list that of required changes directed toward the APTA that has such strong wording there is no way the APTA will or would agree to any of it.
When I look into my crystal ball, I foresee that knowledge is going to be highly relevant and valuable. Manual therapy is a valuable skill (we've got the research to substantiate that manual therapy + exercise is effective) and I really think that based on the NATA website educational training and the experience I had with my training, physical therapists would be wise to keep that skill set to themselves. We can't be providers of choice if we want to devalue and allow anyone to learn from us - because when they do learn from us, you better bet they will use that information to compete with us. Over 50% of athletic trainers are not with athletes - what does that tell you? ATCs want to be able to provide services to the elderly population - no way is that appropriate or right, in my opinion.
From the NATA website itself outlining the training: http://www.nata.org/consumer/docs/educationfactsheet05.pdf
There isn't a whole lot of focus on manual intervention.
And look where athletic trainers are employed (again from the NATA website): http://www.nata.org/consumer/docs/Factsaboutathletictrainers.pdf
Over 50% work outside of school athletic settings and provide services to people of all ages! I also very much disagree with fact number 10. The AMA does state "provider" for the Physical Medicine and Rehabilitation codes. Taking the wording literally from CPT 2004... supervised modalities (CPT 97010-97028) do not require direct (one-on-one) patient contact by the provider. (Provider is not defined for supervised modalities - so fair game for anyone, I suppose, which leaves the provider allowed up to the third party payor) Constant attendance modalities (CPT 97032-97039) require direct (one-on-one) patient contact by the provider. (Again, provider is not defined, therefore, fair game for anyone, I suppose, which leaves the provider allowed up to the third party payor.) Therapeutic procedures (CPT 97110-97546) clearly states "physician or therapist required to have direct (one-on-one) patient contact. (Manual therapy falls in this category of codes.) In my opinion, the wording is very clear for therapeutic procedures that according the the AMA those codes are to only be utilized by a physician or therapist. No interpretation is required, in my opinion. Sad to say, an athletic trainer does not fall into that category. When the AMA incorporated the athletic training evaluation and athletic training re-evaluation the definition of provider was not concurrently updated. If and when that happens, then athletic trainers will be literally allowed to provide therapeutic procedures - until then, according the the AMA athletic trainers are not the provider to be providing therapeutic procedures. If a third party payor has some defining clause to allow athletic trainers, then so be it, but their defining clause did not come from the AMA or the universal CPT codes.
ATCs are the quickest, thinking on their feet provider and they need to be out on the field. ATCs understand kinesiology and power, speed, strength and can rehab an athlete awesomely (and have some great knowledge in the overload principle and specificity of training). In the clinic though, an ATC has the potential to be dangerous - just as Tom mentioned above, ATCs haven't had the training to perform differential diagnose. ATCs don't have the training to understand the relationships and the impact co-morbidities can have on health or function. The athletic trainers really don't have the manual skills that are often used in conjunction with physical therapy interventions. The setting matters and it matters a lot. The patient population is the factor. An athletic trainer is not educated enough to be competent for all ages.
Now, I definitely do not believe that any PT, even those with sport certification, have any place on the field. The best professional to be there is an ATC. Day in and day out the ATC deals with injuries that occurred 3 minutes ago. There is only a small window of time to do an evaluation before edema and spams set in and disallow for any objective information. The ATC has a definite knowledge base of knowing the probabilities of certain injuries with a particular sport and observing the event that led to an injury. The ATC can make snap decisions without second guessing and taking 45 minutes to an hour to determine the game plan. ATCs have a huge value and provide a very needed service to athletes. There should be a higher number of athletic trainers in the high school. A single athletic trainer shouldn't be responsible for the whole darn array of sports and their athletes - there need to be a few athletic trainers per school to do the job justice. A PT who has board certification in sports should be in a clinic and not on the field because an athletic trainer does more than just tape ankles.
I do definitely see value in an ATC; I'm one myself. At the same time, I know the limitations of an ATC because I have had the luxury to know the training of both a PT and an ATC. There may be overlap in some aspects of manual therapy, but reality is that I don't believe the necessary time has been taken in entry level education to practice and know indications/contraindications to adequately perform manual techniques. As a side, when I was functioning at a high school, I didn't do manual therapy... the athletes were seen day 1 of injury and progressed just fine with modalities and exercise alone. In some cases, my value was in injury prevention and yapping at coaches to change training routines because the routines were leading to increased injuries.
|
|
|
|
 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 |
|
0.109
|
Printable Version
