Physician owned PT centers (Full Version)

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Herbie -> Physician owned PT centers (February 25, 2008 11:59:30 AM)

I want to ask this question just to get educated.  I want to know why POPTS, are not ideal for PTs?  What are the pros, and cons of working at these facilities?

Thank you



Herbie -> RE: Physician owned PT centers (February 26, 2008 9:19:24 AM)

I know this is a sensitive topic for a lot PTs, but I am not a PT(yet).  I seriously would like to know the answers to these questions.

Again, thank you in advance.
Jake



orthotherapist -> RE: Physician owned PT centers (February 26, 2008 9:42:06 AM)

I will take a stab here having previously worked in a physician owned type of situation.  Now my answers are based on my experience which was positive. 

POPTS are not ideal for PTs (at least those in private practice) because there is less fruit to pick from the tree so to speak. 

For the PT working in this setting there is immediate feedback from the physician (access to MD, medical record, imaging reports), patients are at ease (they know the physician is nearby should they have post-op questions/complications), you can focus on being a PT not a businessman/PT.

Just my quick thoughts of the experience. 





Tom Reeves DPT ATC -> RE: Physician owned PT centers (February 26, 2008 9:45:12 AM)

The pros are potentially better communication, you are always busy, and you get to learn directly from the physicians things medical and surgical.  They probably will do all of your billing and insurance call backs and pre-certifications for you

Cons:
you lose autonomy

it is bad for the profession to further the impression of the role of tech rather than professional

POPTs reduce the perceived choices of the patients as to where they can go for therapy, thereby screwing any other provider in the referral area

You are lining the pockets of the physician owners rather than your own


I know that there are more, someone else who deals with this directly will chime in soon I am sure




Herbie -> RE: Physician owned PT centers (February 26, 2008 11:27:47 AM)

So outpatient ortho. is an example of POPT then right?  What are the differences between these and working at a hospital, since this is also under the care of the MD right?



TexasOrtho -> RE: Physician owned PT centers (February 26, 2008 12:02:36 PM)

quote:

ORIGINAL: Herbie

So outpatient ortho. is an example of POPT then right?  What are the differences between these and working at a hospital, since this is also under the care of the MD right?


No.  Most outpatient PT centers are not owned by physicians, but do rely on physicians for referrals.  The difference between a POPT practice and a legitmate PT practice is the referring physician does not benefit financially from referring to a legitimate practice.  Basically, in a POPT the physician becomes the pimp and the PT is well...I'll let you fill in the rest.  



orthotherapist -> RE: Physician owned PT centers (February 26, 2008 12:11:59 PM)

I have heard a new term recently called HOPTS (hospital owned physical therapy services).  In a way they are similar to POPTS in that physicians that are employed/have a contractual relationship with a hospital will have "pressure" to refer to these services from administration. 

The key word in this is working "for" versus "with".  Most therapists would agree that working closely "with" physicians is beneficial but not working "for" physicians.




KIDPT23 -> RE: Physician owned PT centers (February 26, 2008 12:39:10 PM)

The door is open with this topic so I am going to jump in...Here is what I am seeing or have seen first hand...First, there are decent POPTS who do not take advantage of the situation and try and make it there own little cash cow...I worked at a POPTS where there were 4 physicians and they truly sent their referrals based on convenience to patient...if the patient had a place closer to them they would send them there...if they were closer to the POPTS then we would get the referrals...unless, there was a patient that would benefit from one of our therapists specialty then the doctor would try and get them to come to us...now I know personally of a POPTS that has 3 ortho docs and have an average of 15 patients each hour with only 2 P.T.s and many techs...they are seeing over 100 patients a day with 2 P.T.'s....it is so bad that we have had 2 patients taken from us because the doctor said he wanted them to be seen at his P.T. so he can keep an eye on the progress in person...this situation is clearly set up to make the doctor money and not due to his being able to personally keep an eye on his patients because 2 P.T.'s can't even keep tabs on 100 patients plus a day...



orthotherapist -> RE: Physician owned PT centers (February 26, 2008 12:55:18 PM)

Agree with KID.  Just like anything (POPTS/Private practice/hospital based/etc) there can be good and bad situations. 

The POPTS I worked in had hour evals, average 10-12 patients per day, no techs (therapists did all of the "therapy"), etc. so at the tie a good situation for me.  Learning curve was steep and I became a better clinician because of it.

I have known of POPTS that are like the clinic Kid describes. 

The main issue as I see it is the referral. 



Herbie -> RE: Physician owned PT centers (February 26, 2008 3:13:41 PM)

To the those that responded "thank you"  My next question would be insurance for the PT.  So the PT will need to find private health insurance correct?  Is there speicific health insurance just for PTs?



jesspt -> RE: Physician owned PT centers (February 26, 2008 3:58:59 PM)

The primary issue here is one of referral for profit, and whether or not you think that this type of situation is good for the patient.

Additionally, physical therapy is a profession, and as such should be owned (literally and figuratively) by those who practice it.

My two cents:
Referral for profit is bad for the health care consumer
Physical Therapy should be owned by therapists, and thus PT clinics should be owned predominantly by PTs.




aph401 -> RE: Physician owned PT centers (February 26, 2008 6:37:50 PM)

POPTS are looked down upon by the profession (and universities) because of the threat they pose to private practice. in my city, for instance, there is a huge POPTS with a group of 35 orthos/surgeons/pain management docs, and it prevents anyone from being able to start up a private practice because the vast majority of physicians in town are with this group, so all the referrals are going downstairs. that being said, i would NOT be opposed to a POPTS for a clinical rotation, because i found out while doing observation experience that it was one of my favorite places i visited, and there is a lot to learn. it was extremely busy, very varied caseload, all ultrasound/e-stim/exercises were done by PTAs and aides, and the facility was huge and beautiful. there were about 15 PTAs, 10 aides, and a handful of therapists and these were divided into "teams". one PT was seeing strictly lymphedema patients all day, one was doing nothing but mobs and manips all day, one did all new evals, all of them had ready computer access to xrays and MRIs, etc...  some PTs wouldn't like the fact that they didn't go start to finish with each patient, but that's appealing to some. very limited time with each pt. with different people seeing the same pt throughout their appt.

this is just my experience. you will be taught in school (especially if you go to my school!!!) how terrible POPT situations are, and i personally will NOT be employed in one after graduation due to my desire to see more autonomy in PT and do whatever i can to facilitate moving the profession forward, but again i would not immediately discount them for clinical sites if your school offers them. lots to learn and see.



kiwi PT -> RE: Physician owned PT centers (February 26, 2008 9:15:26 PM)

http://www.rehabedge.com/cgi-bin/ultimatebb.cgi?ubb=get_topic;f=25;t=002261;p=1

While I wouldn't say such set ups are inherently unethical there is a lot of potential for abuse.  In South Carolina POPTS are illegal. I think they should at least be required to have a disclosure of financial interest statement issued to all pts sent to therapy.


Kyle PT




blast7 -> RE: Physician owned PT centers (February 27, 2008 12:22:49 AM)

The biggest issue I see is the kickbacks that physicians receive when working for a hospital and the fiscal gain when referring to their own clinics, when not working for a hospital outpatient practice.



KIDPT23 -> RE: Physician owned PT centers (March 7, 2008 1:47:23 PM)

South Carolina made POPTS illegal...How is this enforced?? Can't the Physician's wife own it then??



jma -> RE: Physician owned PT centers (March 8, 2008 2:27:41 PM)

Herbie, this website one is endorsed by the APTA for health insurance: http://pt.healthinsurance.com/hi/



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