A few filings this month.
File under “Debt”
According to WSJ, Physiotherapy Associates is headed towards bankruptcy (note: WSJ link might need subscription). With 575 locations in 34 states, it is unusual for a private equity company deal, only bought 16 months ago by Court Square Capital Partners, to go south so fast. While there are rumors of misstated earnings, the bigger issue to me is the high debt load ($325 Million). While I do not know their free cash flow or EBIDTA, I would estimate that their debt to EBIDTA leverage is likely greater than 6:1 which leaves very little margin for error in order to make payments on this debt. I have heard but have no verification that part of their problem was also outsourcing billing offshore and we all know when a change in billing occurs, delays are inevitable. Couple this with downward pressure on reimbursement and medicare cuts, it is easy to see where problems can occur. Personally, I am rooting for Physiotherapy and wholeheartedly hope and believe that they emerge with a restructuring plan in place. Our profession is not benefited by anybody’s downfall-especially one that employs that many PT’s.
File under “opinion”
One of our EIM colleagues, Eric Robertson wrote a piece on Medium about CrossFit’s Dirty Secret. Medium is relatively new and fascinating platform for writing blogs. Eric’s opinion on CrossFit and rhabdomyolysis is cleverly written and insightful. However, Eric’s article is not a “science” piece nor does he claim it to be. Eric landed on Good Morning America (viewed here) where he made the point that their CAN be a link between CrossFit (or in his words any “extreme exercise” and rhabdo) and pointing out the disgusting clown cartoon depicting rhabdomyolysis from CrossFit’s own publication. Of course, criticizing CrossFit is akin to being politically incorrect and Eric is taking the heat for the combination of his opinion and correctly pointing out what can occur with extreme exercise. I commend Eric for his appearance on TV where we normally only see PT’s in soap operas or applying tape to a shoulder.
File under “Classics”
I enjoyed this article from the Atlantic on 7 Classics Every Physician Should Read. The article essentially points out that the education pendulum needs to swing a little bit from an over emphasis on scientific knowledge and clinical skills to reminders of the humanities which emphasize curiosity, insight, and compassion. I couldn’t agree more and believe that humanities should be woven into PT schools rather than just as a pre-requisite. In fact, there might even be more evidence on non clinical factors like empathy, positivity, and communication than on many of the interventions that continue to take up time and space in PT programs.
What book classics do you recommend for PT’s?