Re: Therapy extenders

[Guest guest]

First of all --

We have laws to uphold.

Those not licensed in the field of physical therapy should not be practicing

it -- or that which is defined without the scope of physical therapy. It does

not matter how smart anyone thinks that person is. It is illegal to perform

or bill for physical therapy that does not occur within the parameters of the

law.

And --- billing Medicare and other insurers for services that do not happen

within the law is fraud.

Of course we can get along -- but not by slip-sliding around the reality of

the law.

Lucy Buckley PT

[Guest guest]

Do you document that an extender or and ATC is performing a portion or " most

of the care " ? Also, the person who responded previously stated the ATC did

the note etc. When did the ATC fall under the category to provide a physical

therapy assessment and treatment plan for the patient?

I am sorry, I must agree with . Physical therapy is just that. If an

ATC or exercise physiologist wants to do what a physical therapist does, why

did you get a different education - my feelings are that it's an easier way

to a degree. Sorry, but most couldn't get into the program or complete it so

the next best thing was ATC or Ex Phys. I know that is not the case for

everyone, but why did you choose a field that has such a problem with

employment? When you can't get a job, you want to say you can do things that

you are not qualified to do. A weekend course does not qualify you to treat

a patient. Athletic training is just that - acute athletic injury. They are

best qualified to perform quick rehab, push the athlete and prepare them to

function at their highest possible level for the game. They are much better

qualified at the acute injury/first aide aspect than myself. My education is

the next step - rehab. We do all fit in a area, but recognize that area and

don't try to push the envelope and think you are qualified in areas you are

not.

[Guest guest]

ATC's are educated in and do have excellent skills in rehab of injuries.

Their education and practice act extends beyond acute injury assessment.

The issue is not what other professions want to do or think they should do.

There will likely come a time when we will compete in the market place on a

level playing field to provide rehab and wellness services.

At this time PT's have an edge because we are a more established profession

and we have had the support of a good national organization that fights for

our rights and protection. ( even though less than 20% of the PT population

are members, how freaking sad is that). I wont say that our edge is that

we are necessarily better educated, or better skilled, we could argue that

forever. Our edge, is that the people paying for rehab, (which 90% of the

time not the person receiving rehab, ie medicare and insurance companies)

generally choose to pay us and not other professions like ATC, LMT, EP.etc

for rehab services. Perhaps they think we are better educated and better

skilled, perhaps we have more money to throw at lobbyists and lawmakers, it

doesnt matter why, it just is, at this point.

anyway i dont think there are a lot of ATCs out there operating an

independent practice and providing treatments and billing insurance and

medicare for Physical therapy. But, I can guarantee there are a boatload of

Physical therapist owned practices and Physical therapy clinics out there

that are using ATCs and other non-PT personnel in the provision of therapy

services even though in a lot of cases this violates practice acts, is

usually fraud, and always goes against what the APTA recommends.

So who is to blame? The ATC who has worked in a PT clinic and treated

patients under the " supervision " of a PT and had a PT " co sign " the note and

bill for it. The LMT who spends 30 to 45 minutes providing hands on care to

a patient for 15 to 25 bucks and hour while the PT writes the note and bills

25- 30 bucks per 15 minute increment. Or even better, the therapy tech who

sees and treats 10 or 15 of the 30-35 patients per PT , that roll through

your typical Mctherapy clinic a day. I do not blame these guys, why shouldnt

they feel they deserve a slice, they are already providing PT

services....................

I blame the PT who allows this to happen, whether it is happening under their

own roof or the clinic down the road.

rick coleman PT, PBK

[Guest guest]

When I was a physical therapy aide working in an outpatient clinic I knew

just about as much as the old physical therapist that was working there and

probably a little more. By the time I graduated with my masters degree I

was suprised at how much that old physical therapist learned while I was

going to school. Not to steal too much from Mark Twain, but it was only

after many years of education that I learned how stupid I was and how my

ignorance probably hurt, misinformed or delayed the recovery of an injured

patient. I came out of college much more cautious and much less bold. I

would not dare step a foot on a football field or try to get a healthy

athlete to Olympic status for fear of causing more harm than good, but I

know what I know and more importantly know when to refer a patient out when

their needs exceed my scope of practice. I work with doctors,

chiropractors, occupational and speech therapist and the biggest difference

between the good ones and the bad ones is the good ones ask for help and

refer to the specialist that can help them as soon as possible. The bad

ones try to do everything themselves and screw everything up.

Hurst MPT

> Do you document that an extender or and ATC is performing a portion or " most

> of the care " ? Also, the person who responded previously stated the ATC did

> the note etc. When did the ATC fall under the category to provide a physical

> therapy assessment and treatment plan for the patient?

>

> I am sorry, I must agree with . Physical therapy is just that. If an

> ATC or exercise physiologist wants to do what a physical therapist does, why

> did you get a different education - my feelings are that it's an easier way

> to a degree. Sorry, but most couldn't get into the program or complete it so

> the next best thing was ATC or Ex Phys. I know that is not the case for

> everyone, but why did you choose a field that has such a problem with

> employment? When you can't get a job, you want to say you can do things that

> you are not qualified to do. A weekend course does not qualify you to treat

> a patient. Athletic training is just that - acute athletic injury. They are

> best qualified to perform quick rehab, push the athlete and prepare them to

> function at their highest possible level for the game. They are much better

> qualified at the acute injury/first aide aspect than myself. My education is

> the next step - rehab. We do all fit in a area, but recognize that area and

> don't try to push the envelope and think you are qualified in areas you are

> not.

>

[Guest guest]

When I was a physical therapy aide working in an outpatient clinic I knew

just about as much as the old physical therapist that was working there and

probably a little more. By the time I graduated with my masters degree I

was suprised at how much that old physical therapist learned while I was

going to school. Not to steal too much from Mark Twain, but it was only

after many years of education that I learned how stupid I was and how my

ignorance probably hurt, misinformed or delayed the recovery of an injured

patient. I came out of college much more cautious and much less bold. I

would not dare step a foot on a football field or try to get a healthy

athlete to Olympic status for fear of causing more harm than good, but I

know what I know and more importantly know when to refer a patient out when

their needs exceed my scope of practice. I work with doctors,

chiropractors, occupational and speech therapist and the biggest difference

between the good ones and the bad ones is the good ones ask for help and

refer to the specialist that can help them as soon as possible. The bad

ones try to do everything themselves and screw everything up.

Hurst MPT

> Do you document that an extender or and ATC is performing a portion or " most

> of the care " ? Also, the person who responded previously stated the ATC did

> the note etc. When did the ATC fall under the category to provide a physical

> therapy assessment and treatment plan for the patient?

>

> I am sorry, I must agree with . Physical therapy is just that. If an

> ATC or exercise physiologist wants to do what a physical therapist does, why

> did you get a different education - my feelings are that it's an easier way

> to a degree. Sorry, but most couldn't get into the program or complete it so

> the next best thing was ATC or Ex Phys. I know that is not the case for

> everyone, but why did you choose a field that has such a problem with

> employment? When you can't get a job, you want to say you can do things that

> you are not qualified to do. A weekend course does not qualify you to treat

> a patient. Athletic training is just that - acute athletic injury. They are

> best qualified to perform quick rehab, push the athlete and prepare them to

> function at their highest possible level for the game. They are much better

> qualified at the acute injury/first aide aspect than myself. My education is

> the next step - rehab. We do all fit in a area, but recognize that area and

> don't try to push the envelope and think you are qualified in areas you are

> not.

>

[Guest guest]

Kdelsol17@...

When I asked my trainers " why did you not go to PT school? " They told me

that they did not want to be a PT. One of them stated that their idea of a

wound or grandma Jo's back problem was not for them. They desired to work

with the physically active, which tend to have higher motivation that

grandma. They do not want to do joint mobs or treat osteoporosis or

chronic pain. They want to see the athletes and those injured performing

an athletic activity. In my opinion and the opinion of the Texas Athletic

Trainers Act they are allowed to see these individuals. All they desire,

as I now sound like a broken record, is to be reimbursed for the work they

already perform.

The Texas Athletic Trainers Act can be found @

http://www.tdh.texas.gov/hcqs/plc/at.htm.

Parks

Director of Sports Medicine

Parkview Regional Hospital

600 S. Bonham

Mexia, TX 76667

254/562-5332 ext. 1712

[Guest guest]

At 09:31 AM 12/8/01 -0600, Parks writes of athletic trainers:

>They desired to work with the physically active, which tend to have higher

>motivation than grandma.

This attitude toward " grandma, " that she is " less motivated " than the

actively athletic patient is grossly unfair. I understand that this is what

the ATC says, not Parks.

Motivation, desire, potential ability and willingness to work aren't more

likely to be found amongst those in any particular population unless a

conscious or unconscious prejudice is present. ATCs might think that

courage and willingness to work through pain is more likely to exist in

athletes, but I can't imagine anyone more motivated than the worker trying

to feed his or her family or the " grandma " desirous of the strength to play

with her grandchildren. It makes more sense to suggest that ATCs enjoy

competition and the thrill of the game more that the humdrum of ordinary

life with all its warts, failures and small, unrecognized triumphs. I'm not

judging that, just pointing out that PTs and ATCs respond differently in

the same setting, and saying it is the nature of the patient's motivation

is simply not true.

Barrett L. Dorko, P.T.

<http://barrettdorko.com>

[Guest guest]

At 09:31 AM 12/8/01 -0600, Parks writes of athletic trainers:

>They desired to work with the physically active, which tend to have higher

>motivation than grandma.

This attitude toward " grandma, " that she is " less motivated " than the

actively athletic patient is grossly unfair. I understand that this is what

the ATC says, not Parks.

Motivation, desire, potential ability and willingness to work aren't more

likely to be found amongst those in any particular population unless a

conscious or unconscious prejudice is present. ATCs might think that

courage and willingness to work through pain is more likely to exist in

athletes, but I can't imagine anyone more motivated than the worker trying

to feed his or her family or the " grandma " desirous of the strength to play

with her grandchildren. It makes more sense to suggest that ATCs enjoy

competition and the thrill of the game more that the humdrum of ordinary

life with all its warts, failures and small, unrecognized triumphs. I'm not

judging that, just pointing out that PTs and ATCs respond differently in

the same setting, and saying it is the nature of the patient's motivation

is simply not true.

Barrett L. Dorko, P.T.

<http://barrettdorko.com>