AB 1152 And Physician-Owned PT Services

We interrupt our regularly scheduled programming at this time for a special announcement of the Elite Sports Physical Therapy Broadcasting System............

Assembly Bill 1152 (AB 1152) is scheduled to be heard in the Senate Committee on Business, Professions, and Economic Development on Monday, July 6th in CA. This bill would make it clear in the law that physicians and podiatrists may employ physical therapists in their professional corporations. Though many of these clinicians argue that by providing in-house rehabilitation services they are better able to oversee the physical therapy their patients receive, there are a few facts they are leaving out.

Referral For Profit Is About The $$$$

These physicians are billing for the physical therapy services provided; and therefore, they are profiting from them. Studies have shown that this poses an inherent conflict of interest for the patient, as the physician may be more likely to refer them for in-house physical therapy versus an independent physical therapist practitioner who may be better qualified.

In a June 16, 2009 Wall Street Journal article, the independent commission that advises Congress in Medicare payments said that "when physicians have a financial interest in imaging equipment, they are more likely to order imaging tests and incur higher overall spending in their patients' care." So could that also apply to physicians who own physical therapy practices? Could they continue to refer patients to their own in-house physical therapy even if it is unnecessary or outcomes are less than optimal?

In this article, in the Journal of the American Medical Association (JAMA), they found that utilization, charges per patient, and profits were higher when physical therapy and rehabilitation facilities are owned by referring physicians.

In one more article posted in Medical Care, they found that after a physician group took ownership of a specialty hospital, there was a 650% increase inn patients referred for "complex" spinal fusion surgery. 650% people!!! At the same time, they decreased their referrals for "simple" spinal fusion surgeries, compared to an increase in such referrals from non-owners.

Physician Owned Physical Therapy Is Not About The Care

The JAMA article also discovered some interesting service characteristics of the physician owned PT practices in their study. They found that the physician PT facilities employed fewer licensed physical therapists and licensed physical therapist assistants to perform physical therapy, so that those licensed professionals that were employed spent significantly less time per treating visit with the patient. So not only may you be getting a less qualified PT (remember a highly qualified PT will cost the doctor more $$ to employ them), but you are also probably going to spend less time with the PT you do get to see in these physician owned facilities.

This would be in stark contrast to a freestanding physical therapist owned clinic, that needs to earn the respect and trust of the medical practitioners and citizens of the community with their quality of care because referrals for them are not "automatic."

So What Does This Mean?

As consumers in the healthcare system, we need to be vigilant in preventing any inherent conflicts of interest that get in the way of quality of care. For AB 1152, you can do either or both of the following:

1. Please make a phone call and send a letter of opposition to your local state Senator. To find your state senator, click here and enter your zip code. Click on the state senator's name to access their contact information. Please make your phone calls of opposition to the senator's Sacramento/capitol office.

2. Fax a personalized letter of opposition to the fax number also found on the state senator's site through the above link. For a sample form letter or more details, you can go to the CPTA Legislative Action Center here.

REMEMBER, you need to be the person taking care of your own health. YOU are your best patient advocate. And that includes ensuring that those delivering your care, are doing it for no other reason than to see you get better.

Once again, we apologize for this interruption. We will return you to your regularly scheduled broadcasting shortly.........