Random views seen in the last few weeks.
PT’s as Car Salesmen.
This article represents what I believe to be a not so subtle change that is vastly impacting our profession in a negative way. While some may read it and immediately pinpoint that this is only happens in a POPTS clinic and that there is a gross difference between what is charged and what is paid, I think the major point of the article is far more important. I also think this happens in far too many clinics and hospitals. We have been conditioned to plan our treatment around a patient’s insurance, visit limits, and pre-certification demands rather than the patient’s diagnosis and what is best for the patient. It’s like our whole profession is being conditioned to be car salesmen catering our product to the financial capabilities of the buyer. The unintended consequences of this in my opinion is a type of care that is anything but compassionate and empathetic. While there is no question that we have to be mindful of the benefits and limitations of a patient’s insurance, it would be more appropriate to have this conversation be between the patient and your office manager rather than the physical therapist. Great restaurants don’t handcuff their chef’s with restraints on ingredients and neither should we be limiting a PT’s decision making to a agreement between a patient and their insurance carrier.
Stooping to new levels of low.
An email was forwarded to me that was a solicitation from a PT company (national chain) to their former patients to “like” them on facebook. They will then raffle off a $25 gas card weekly to one of the former patients who responded to this solicitation and hit the like button. This is largely akin to the popular trend of paying people to write positive reviews for you on Amazon or Yelp to influence buying decisions. If you have to pay your patient’s to like you, you are clearly missing the purpose of physical therapy. Isn’t this an ethical issue?
Back to school.
I have a strong interest in higher education and have believed for many years (along with many others) that it is in a state of crises comparable to the mortgage bubble a few years back. Tuitions our becoming unaffordable and student debt has reached roughly a trillion dollars which interestingly enough is more than all of China’s national debt. I would encourage you to watch this 12 minute video that highlights some of these issues. In particular, the graph on how tuition has outpaced salaries resulting in what could be a negative ROI for those investing in education in order to obtain a career whose salary level cannot support such tuition and debt level. I think this is particularly true in physical therapy where I personally know PT’s that are paying almost $2,000 per month for repayment of student loans that are in excess of $100k. Remember, it wasn’t APTA or our profession that drove PT’s to essentially a 7 year doctoring degree-it was the schools themselves. What we need now is serious disruption in higher education generally and physical therapy schools in particular. We need high intensity programs that are better and significantly less costly to students and offer co-op so that payments can be made to students during a year long internship. This can occur if shortly after didactics, they can take a licensure exam and their services be paid by medicare and other payors (they would be granted their doctorate only on successful completion of the year internship). Ironically, many students and schools are seeing PTA programs as a much better ROI and thus they are expanding faster than twitter hashtags. My biggest fear is that the cost of PT education coupled with salaries that cannot support student debt levels will keep our best and brightest from going into our profession. Stay tuned on this one-it will be a frequent topic in the near term.
Along with most other medicare stuff-sucks. Enough said.
Blog disclosure (make my insurance agent, business partners, and attorney happy): the opinions shared on this blog are mine.