RE: FW: physician ownership

[Guest guest]

" I have patients who live very close to me... "

Barker;

Are you a PT? If not, how are these your patients? Aren't they the PTs'

patients? You see my point, yes?

Regards,

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Re: FW: physician ownership

>

> Russ it comes to values. I would urge you to read more on the topic thru

> your professional association and fully understand the negative impact

POPTS

>

> have on the image of the profession, the lack of support it gives to your

> colleagues work in trying to gain a clear, unquestioned position in the

> health care

> service community, and frankly, that many of these types and for profit

> types of practice environments are the antithesis of where this profession

> is

> heading.

>

> Naive, I can assure you I am not. Take long look at what you have wrote

and

>

> ask yourself where your decisions have benefitted the goals of your

> profession

> Jim Dunleavy Pt, MS

>

>

[Guest guest]

" I have patients who live very close to me... "

Barker;

Are you a PT? If not, how are these your patients? Aren't they the PTs'

patients? You see my point, yes?

Regards,

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Re: FW: physician ownership

>

> Russ it comes to values. I would urge you to read more on the topic thru

> your professional association and fully understand the negative impact

POPTS

>

> have on the image of the profession, the lack of support it gives to your

> colleagues work in trying to gain a clear, unquestioned position in the

> health care

> service community, and frankly, that many of these types and for profit

> types of practice environments are the antithesis of where this profession

> is

> heading.

>

> Naive, I can assure you I am not. Take long look at what you have wrote

and

>

> ask yourself where your decisions have benefitted the goals of your

> profession

> Jim Dunleavy Pt, MS

>

>

[Guest guest]

" I have patients who live very close to me... "

Barker;

Are you a PT? If not, how are these your patients? Aren't they the PTs'

patients? You see my point, yes?

Regards,

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Re: FW: physician ownership

>

> Russ it comes to values. I would urge you to read more on the topic thru

> your professional association and fully understand the negative impact

POPTS

>

> have on the image of the profession, the lack of support it gives to your

> colleagues work in trying to gain a clear, unquestioned position in the

> health care

> service community, and frankly, that many of these types and for profit

> types of practice environments are the antithesis of where this profession

> is

> heading.

>

> Naive, I can assure you I am not. Take long look at what you have wrote

and

>

> ask yourself where your decisions have benefitted the goals of your

> profession

> Jim Dunleavy Pt, MS

>

>

[Guest guest]

Case in point.

I know of a therapist who is excellent and was covering for another

therapist at a different clinic for the same group of outpatient private

practices. He had a student with him to boot. The student noticed in the

last PT note that the patient was to be discharged in 2 more visits. My

buddy asked the student what the significance of the " 2 more visits " was and

she did not know. She found out that the patient will have been seen by the

therapist for the 100th visit and the insurance dictated this information.

Upon further investigation of the shoddy treatment notes, the subjective of

each of the last 50 or so treatment visits were the words, " no change, " and

nothing else; objective included the treatment procedures in different

handwriting, Assessment included: " pt tol well " ; Plan included: " Cont PT. "

Not only is this disgraceful PT practice from documentation, to treatment,

to customer service to everyone involved, it is in direct violation of our

practice act, in fact, several passages of it. Furthermore, no one is

watching or caring about this guy and the sick parts of is that this patient

thinks that this is physical therapy and the physician thinks PT doesn't

work and he or she thinks he or she can do it better and will open a clinic

with PT in it! The insurance company keeps on paying (you have to assume

that because the patient would have, of course, been cut off if they weren't

paying despite the progress good or bad). My point is this, bad practices

go on all over the place, even in private practices who are against

POPTS...I can't think of one private practitioner who supports it. I in

fact do not support it for all the right reasons, BUT...KUDOS to those in

POPTS who appropriately evaluate, appropriately treat, appropriately

document, appropriately refer and communicate, and appropriately discharge

patients. Shame on those in any practice in the physical therapy profession

who do not do these things. You hurt the medical system, you hurt the

patients (first and foremost), you support higher insurance premiums and

lower payments to yourself and your colleagues, you will ultimately hurt

your own reputation, not to mention the entire profession of physical

therapy. When I hear about these kinds of things, I, if I may be so bold,

would like to beat those PT's into submission. We have to realize that the

short term gain does not even come close to matching the long term

consequences to our patients, our profession, and our families. I am not

being dramatic, I am being pragmatic. I am a one horse show who treats

patients 1 every 45-60 minutes. I get excellent results and I am ethical,

functional, and skilled. If insurance payments keep getting cut, I either

have to see more patients sacrificing quality, or I have to find something

else to do.

Unfortunately, the poor practitioners are not involved in great list-serves

like this one.

Deadly serious,

Connolly, PT

Owner of PT Plus of Burlington

ptplus@...

FW: physician ownership

>

>

>

>

>

> Hi everyone,

>

>

>

> Many of you have read the following synopsis from PT Bulletin:

>

>

>

>

> " A study

>

<http://www.aha.org/aha/key_issues/niche/content/effectslimitedservicehosp.p

> df> by town University economist M , PhD, released

last

> week by the American Hospital Association (AHA), concludes that the

> emergence of physician-owned limited-service hospitals in Oklahoma led to

an

> increase in utilization of high-cost procedures. Looking at more than

> 250,000 workers' compensation claims, found the incidence of

> complex spinal fusion surgeries and other highly paid procedures in

Oklahoma

> City and Tulsa rose following the emergence of physician-owned facilities,

> even though the number of worker injuries declined. AHA executives noted

> that the findings raise " serious concerns about conflict of interest,

> implications for patient care and unnecessary increases in health care

> spending, " and urged Congress to make permanent the ban on physician

> referral to new limited-service hospitals they own. "

>

> For those that are still defending physician owned practices of any type,

> here is yet another study that is showing physician ownership =

unnecessary

> increased in health care spending. Please think about it. As the

evidence

> mounts, can we as a profession continue to support it??

>

> One caveat, I do understand that PT owned rehab practices may be just as

> guilty of over utilization and overcharging. Let these studies continue

to

> be a wake up call to all of us to do better.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, ID

>

> ptclinic@...

>

>

>

>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

>

>

>

>

[Guest guest]

Case in point.

I know of a therapist who is excellent and was covering for another

therapist at a different clinic for the same group of outpatient private

practices. He had a student with him to boot. The student noticed in the

last PT note that the patient was to be discharged in 2 more visits. My

buddy asked the student what the significance of the " 2 more visits " was and

she did not know. She found out that the patient will have been seen by the

therapist for the 100th visit and the insurance dictated this information.

Upon further investigation of the shoddy treatment notes, the subjective of

each of the last 50 or so treatment visits were the words, " no change, " and

nothing else; objective included the treatment procedures in different

handwriting, Assessment included: " pt tol well " ; Plan included: " Cont PT. "

Not only is this disgraceful PT practice from documentation, to treatment,

to customer service to everyone involved, it is in direct violation of our

practice act, in fact, several passages of it. Furthermore, no one is

watching or caring about this guy and the sick parts of is that this patient

thinks that this is physical therapy and the physician thinks PT doesn't

work and he or she thinks he or she can do it better and will open a clinic

with PT in it! The insurance company keeps on paying (you have to assume

that because the patient would have, of course, been cut off if they weren't

paying despite the progress good or bad). My point is this, bad practices

go on all over the place, even in private practices who are against

POPTS...I can't think of one private practitioner who supports it. I in

fact do not support it for all the right reasons, BUT...KUDOS to those in

POPTS who appropriately evaluate, appropriately treat, appropriately

document, appropriately refer and communicate, and appropriately discharge

patients. Shame on those in any practice in the physical therapy profession

who do not do these things. You hurt the medical system, you hurt the

patients (first and foremost), you support higher insurance premiums and

lower payments to yourself and your colleagues, you will ultimately hurt

your own reputation, not to mention the entire profession of physical

therapy. When I hear about these kinds of things, I, if I may be so bold,

would like to beat those PT's into submission. We have to realize that the

short term gain does not even come close to matching the long term

consequences to our patients, our profession, and our families. I am not

being dramatic, I am being pragmatic. I am a one horse show who treats

patients 1 every 45-60 minutes. I get excellent results and I am ethical,

functional, and skilled. If insurance payments keep getting cut, I either

have to see more patients sacrificing quality, or I have to find something

else to do.

Unfortunately, the poor practitioners are not involved in great list-serves

like this one.

Deadly serious,

Connolly, PT

Owner of PT Plus of Burlington

ptplus@...

FW: physician ownership

>

>

>

>

>

> Hi everyone,

>

>

>

> Many of you have read the following synopsis from PT Bulletin:

>

>

>

>

> " A study

>

<http://www.aha.org/aha/key_issues/niche/content/effectslimitedservicehosp.p

> df> by town University economist M , PhD, released

last

> week by the American Hospital Association (AHA), concludes that the

> emergence of physician-owned limited-service hospitals in Oklahoma led to

an

> increase in utilization of high-cost procedures. Looking at more than

> 250,000 workers' compensation claims, found the incidence of

> complex spinal fusion surgeries and other highly paid procedures in

Oklahoma

> City and Tulsa rose following the emergence of physician-owned facilities,

> even though the number of worker injuries declined. AHA executives noted

> that the findings raise " serious concerns about conflict of interest,

> implications for patient care and unnecessary increases in health care

> spending, " and urged Congress to make permanent the ban on physician

> referral to new limited-service hospitals they own. "

>

> For those that are still defending physician owned practices of any type,

> here is yet another study that is showing physician ownership =

unnecessary

> increased in health care spending. Please think about it. As the

evidence

> mounts, can we as a profession continue to support it??

>

> One caveat, I do understand that PT owned rehab practices may be just as

> guilty of over utilization and overcharging. Let these studies continue

to

> be a wake up call to all of us to do better.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, ID

>

> ptclinic@...

>

>

>

>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

>

>

>

>

[Guest guest]

Case in point.

I know of a therapist who is excellent and was covering for another

therapist at a different clinic for the same group of outpatient private

practices. He had a student with him to boot. The student noticed in the

last PT note that the patient was to be discharged in 2 more visits. My

buddy asked the student what the significance of the " 2 more visits " was and

she did not know. She found out that the patient will have been seen by the

therapist for the 100th visit and the insurance dictated this information.

Upon further investigation of the shoddy treatment notes, the subjective of

each of the last 50 or so treatment visits were the words, " no change, " and

nothing else; objective included the treatment procedures in different

handwriting, Assessment included: " pt tol well " ; Plan included: " Cont PT. "

Not only is this disgraceful PT practice from documentation, to treatment,

to customer service to everyone involved, it is in direct violation of our

practice act, in fact, several passages of it. Furthermore, no one is

watching or caring about this guy and the sick parts of is that this patient

thinks that this is physical therapy and the physician thinks PT doesn't

work and he or she thinks he or she can do it better and will open a clinic

with PT in it! The insurance company keeps on paying (you have to assume

that because the patient would have, of course, been cut off if they weren't

paying despite the progress good or bad). My point is this, bad practices

go on all over the place, even in private practices who are against

POPTS...I can't think of one private practitioner who supports it. I in

fact do not support it for all the right reasons, BUT...KUDOS to those in

POPTS who appropriately evaluate, appropriately treat, appropriately

document, appropriately refer and communicate, and appropriately discharge

patients. Shame on those in any practice in the physical therapy profession

who do not do these things. You hurt the medical system, you hurt the

patients (first and foremost), you support higher insurance premiums and

lower payments to yourself and your colleagues, you will ultimately hurt

your own reputation, not to mention the entire profession of physical

therapy. When I hear about these kinds of things, I, if I may be so bold,

would like to beat those PT's into submission. We have to realize that the

short term gain does not even come close to matching the long term

consequences to our patients, our profession, and our families. I am not

being dramatic, I am being pragmatic. I am a one horse show who treats

patients 1 every 45-60 minutes. I get excellent results and I am ethical,

functional, and skilled. If insurance payments keep getting cut, I either

have to see more patients sacrificing quality, or I have to find something

else to do.

Unfortunately, the poor practitioners are not involved in great list-serves

like this one.

Deadly serious,

Connolly, PT

Owner of PT Plus of Burlington

ptplus@...

FW: physician ownership

>

>

>

>

>

> Hi everyone,

>

>

>

> Many of you have read the following synopsis from PT Bulletin:

>

>

>

>

> " A study

>

<http://www.aha.org/aha/key_issues/niche/content/effectslimitedservicehosp.p

> df> by town University economist M , PhD, released

last

> week by the American Hospital Association (AHA), concludes that the

> emergence of physician-owned limited-service hospitals in Oklahoma led to

an

> increase in utilization of high-cost procedures. Looking at more than

> 250,000 workers' compensation claims, found the incidence of

> complex spinal fusion surgeries and other highly paid procedures in

Oklahoma

> City and Tulsa rose following the emergence of physician-owned facilities,

> even though the number of worker injuries declined. AHA executives noted

> that the findings raise " serious concerns about conflict of interest,

> implications for patient care and unnecessary increases in health care

> spending, " and urged Congress to make permanent the ban on physician

> referral to new limited-service hospitals they own. "

>

> For those that are still defending physician owned practices of any type,

> here is yet another study that is showing physician ownership =

unnecessary

> increased in health care spending. Please think about it. As the

evidence

> mounts, can we as a profession continue to support it??

>

> One caveat, I do understand that PT owned rehab practices may be just as

> guilty of over utilization and overcharging. Let these studies continue

to

> be a wake up call to all of us to do better.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, ID

>

> ptclinic@...

>

>

>

>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

>

>

>

>

[Guest guest]

;

Did this PT report these violations? I would not expect a student to do so,

given their status as a non-licensee. If the PT did not, they are not only

perpetuating the problem, they are contributing to it. In fact, they are in

violation of several ethical principles, and likely in violation of several

laws. If your message was read by an enforcement official, they may be

contacting you, as you appear to have knowledge of this situation.

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Re: FW: physician ownership

Case in point.

I know of a therapist who is excellent and was covering for another

therapist at a different clinic for the same group of outpatient private

practices. He had a student with him to boot. The student noticed in the

last PT note that the patient was to be discharged in 2 more visits. My

buddy asked the student what the significance of the " 2 more visits " was and

she did not know. She found out that the patient will have been seen by the

therapist for the 100th visit and the insurance dictated this information.

Upon further investigation of the shoddy treatment notes, the subjective of

each of the last 50 or so treatment visits were the words, " no change, " and

nothing else; objective included the treatment procedures in different

handwriting, Assessment included: " pt tol well " ; Plan included: " Cont PT. "

Not only is this disgraceful PT practice from documentation, to treatment,

to customer service to everyone involved, it is in direct violation of our

practice act, in fact, several passages of it. Furthermore, no one is

watching or caring about this guy and the sick parts of is that this patient

thinks that this is physical therapy and the physician thinks PT doesn't

work and he or she thinks he or she can do it better and will open a clinic

with PT in it! The insurance company keeps on paying (you have to assume

that because the patient would have, of course, been cut off if they weren't

paying despite the progress good or bad). My point is this, bad practices

go on all over the place, even in private practices who are against

POPTS...I can't think of one private practitioner who supports it. I in

fact do not support it for all the right reasons, BUT...KUDOS to those in

POPTS who appropriately evaluate, appropriately treat, appropriately

document, appropriately refer and communicate, and appropriately discharge

patients. Shame on those in any practice in the physical therapy profession

who do not do these things. You hurt the medical system, you hurt the

patients (first and foremost), you support higher insurance premiums and

lower payments to yourself and your colleagues, you will ultimately hurt

your own reputation, not to mention the entire profession of physical

therapy. When I hear about these kinds of things, I, if I may be so bold,

would like to beat those PT's into submission. We have to realize that the

short term gain does not even come close to matching the long term

consequences to our patients, our profession, and our families. I am not

being dramatic, I am being pragmatic. I am a one horse show who treats

patients 1 every 45-60 minutes. I get excellent results and I am ethical,

functional, and skilled. If insurance payments keep getting cut, I either

have to see more patients sacrificing quality, or I have to find something

else to do.

Unfortunately, the poor practitioners are not involved in great list-serves

like this one.

Deadly serious,

Connolly, PT

Owner of PT Plus of Burlington

ptplus@...

FW: physician ownership

>

>

>

>

>

> Hi everyone,

>

>

>

> Many of you have read the following synopsis from PT Bulletin:

>

>

>

>

> " A study

>

<http://www.aha.org/aha/key_issues/niche/content/effectslimitedservicehosp.p

> df> by town University economist M , PhD, released

last

> week by the American Hospital Association (AHA), concludes that the

> emergence of physician-owned limited-service hospitals in Oklahoma led to

an

> increase in utilization of high-cost procedures. Looking at more than

> 250,000 workers' compensation claims, found the incidence of

> complex spinal fusion surgeries and other highly paid procedures in

Oklahoma

> City and Tulsa rose following the emergence of physician-owned facilities,

> even though the number of worker injuries declined. AHA executives noted

> that the findings raise " serious concerns about conflict of interest,

> implications for patient care and unnecessary increases in health care

> spending, " and urged Congress to make permanent the ban on physician

> referral to new limited-service hospitals they own. "

>

> For those that are still defending physician owned practices of any type,

> here is yet another study that is showing physician ownership =

unnecessary

> increased in health care spending. Please think about it. As the

evidence

> mounts, can we as a profession continue to support it??

>

> One caveat, I do understand that PT owned rehab practices may be just as

> guilty of over utilization and overcharging. Let these studies continue

to

> be a wake up call to all of us to do better.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, ID

>

> ptclinic@...

>

>

>

>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

>

>

>

>

[Guest guest]

;

Did this PT report these violations? I would not expect a student to do so,

given their status as a non-licensee. If the PT did not, they are not only

perpetuating the problem, they are contributing to it. In fact, they are in

violation of several ethical principles, and likely in violation of several

laws. If your message was read by an enforcement official, they may be

contacting you, as you appear to have knowledge of this situation.

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Re: FW: physician ownership

Case in point.

I know of a therapist who is excellent and was covering for another

therapist at a different clinic for the same group of outpatient private

practices. He had a student with him to boot. The student noticed in the

last PT note that the patient was to be discharged in 2 more visits. My

buddy asked the student what the significance of the " 2 more visits " was and

she did not know. She found out that the patient will have been seen by the

therapist for the 100th visit and the insurance dictated this information.

Upon further investigation of the shoddy treatment notes, the subjective of

each of the last 50 or so treatment visits were the words, " no change, " and

nothing else; objective included the treatment procedures in different

handwriting, Assessment included: " pt tol well " ; Plan included: " Cont PT. "

Not only is this disgraceful PT practice from documentation, to treatment,

to customer service to everyone involved, it is in direct violation of our

practice act, in fact, several passages of it. Furthermore, no one is

watching or caring about this guy and the sick parts of is that this patient

thinks that this is physical therapy and the physician thinks PT doesn't

work and he or she thinks he or she can do it better and will open a clinic

with PT in it! The insurance company keeps on paying (you have to assume

that because the patient would have, of course, been cut off if they weren't

paying despite the progress good or bad). My point is this, bad practices

go on all over the place, even in private practices who are against

POPTS...I can't think of one private practitioner who supports it. I in

fact do not support it for all the right reasons, BUT...KUDOS to those in

POPTS who appropriately evaluate, appropriately treat, appropriately

document, appropriately refer and communicate, and appropriately discharge

patients. Shame on those in any practice in the physical therapy profession

who do not do these things. You hurt the medical system, you hurt the

patients (first and foremost), you support higher insurance premiums and

lower payments to yourself and your colleagues, you will ultimately hurt

your own reputation, not to mention the entire profession of physical

therapy. When I hear about these kinds of things, I, if I may be so bold,

would like to beat those PT's into submission. We have to realize that the

short term gain does not even come close to matching the long term

consequences to our patients, our profession, and our families. I am not

being dramatic, I am being pragmatic. I am a one horse show who treats

patients 1 every 45-60 minutes. I get excellent results and I am ethical,

functional, and skilled. If insurance payments keep getting cut, I either

have to see more patients sacrificing quality, or I have to find something

else to do.

Unfortunately, the poor practitioners are not involved in great list-serves

like this one.

Deadly serious,

Connolly, PT

Owner of PT Plus of Burlington

ptplus@...

FW: physician ownership

>

>

>

>

>

> Hi everyone,

>

>

>

> Many of you have read the following synopsis from PT Bulletin:

>

>

>

>

> " A study

>

<http://www.aha.org/aha/key_issues/niche/content/effectslimitedservicehosp.p

> df> by town University economist M , PhD, released

last

> week by the American Hospital Association (AHA), concludes that the

> emergence of physician-owned limited-service hospitals in Oklahoma led to

an

> increase in utilization of high-cost procedures. Looking at more than

> 250,000 workers' compensation claims, found the incidence of

> complex spinal fusion surgeries and other highly paid procedures in

Oklahoma

> City and Tulsa rose following the emergence of physician-owned facilities,

> even though the number of worker injuries declined. AHA executives noted

> that the findings raise " serious concerns about conflict of interest,

> implications for patient care and unnecessary increases in health care

> spending, " and urged Congress to make permanent the ban on physician

> referral to new limited-service hospitals they own. "

>

> For those that are still defending physician owned practices of any type,

> here is yet another study that is showing physician ownership =

unnecessary

> increased in health care spending. Please think about it. As the

evidence

> mounts, can we as a profession continue to support it??

>

> One caveat, I do understand that PT owned rehab practices may be just as

> guilty of over utilization and overcharging. Let these studies continue

to

> be a wake up call to all of us to do better.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, ID

>

> ptclinic@...

>

>

>

>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

>

>

>

>

[Guest guest]

;

Did this PT report these violations? I would not expect a student to do so,

given their status as a non-licensee. If the PT did not, they are not only

perpetuating the problem, they are contributing to it. In fact, they are in

violation of several ethical principles, and likely in violation of several

laws. If your message was read by an enforcement official, they may be

contacting you, as you appear to have knowledge of this situation.

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Re: FW: physician ownership

Case in point.

I know of a therapist who is excellent and was covering for another

therapist at a different clinic for the same group of outpatient private

practices. He had a student with him to boot. The student noticed in the

last PT note that the patient was to be discharged in 2 more visits. My

buddy asked the student what the significance of the " 2 more visits " was and

she did not know. She found out that the patient will have been seen by the

therapist for the 100th visit and the insurance dictated this information.

Upon further investigation of the shoddy treatment notes, the subjective of

each of the last 50 or so treatment visits were the words, " no change, " and

nothing else; objective included the treatment procedures in different

handwriting, Assessment included: " pt tol well " ; Plan included: " Cont PT. "

Not only is this disgraceful PT practice from documentation, to treatment,

to customer service to everyone involved, it is in direct violation of our

practice act, in fact, several passages of it. Furthermore, no one is

watching or caring about this guy and the sick parts of is that this patient

thinks that this is physical therapy and the physician thinks PT doesn't

work and he or she thinks he or she can do it better and will open a clinic

with PT in it! The insurance company keeps on paying (you have to assume

that because the patient would have, of course, been cut off if they weren't

paying despite the progress good or bad). My point is this, bad practices

go on all over the place, even in private practices who are against

POPTS...I can't think of one private practitioner who supports it. I in

fact do not support it for all the right reasons, BUT...KUDOS to those in

POPTS who appropriately evaluate, appropriately treat, appropriately

document, appropriately refer and communicate, and appropriately discharge

patients. Shame on those in any practice in the physical therapy profession

who do not do these things. You hurt the medical system, you hurt the

patients (first and foremost), you support higher insurance premiums and

lower payments to yourself and your colleagues, you will ultimately hurt

your own reputation, not to mention the entire profession of physical

therapy. When I hear about these kinds of things, I, if I may be so bold,

would like to beat those PT's into submission. We have to realize that the

short term gain does not even come close to matching the long term

consequences to our patients, our profession, and our families. I am not

being dramatic, I am being pragmatic. I am a one horse show who treats

patients 1 every 45-60 minutes. I get excellent results and I am ethical,

functional, and skilled. If insurance payments keep getting cut, I either

have to see more patients sacrificing quality, or I have to find something

else to do.

Unfortunately, the poor practitioners are not involved in great list-serves

like this one.

Deadly serious,

Connolly, PT

Owner of PT Plus of Burlington

ptplus@...

FW: physician ownership

>

>

>

>

>

> Hi everyone,

>

>

>

> Many of you have read the following synopsis from PT Bulletin:

>

>

>

>

> " A study

>

<http://www.aha.org/aha/key_issues/niche/content/effectslimitedservicehosp.p

> df> by town University economist M , PhD, released

last

> week by the American Hospital Association (AHA), concludes that the

> emergence of physician-owned limited-service hospitals in Oklahoma led to

an

> increase in utilization of high-cost procedures. Looking at more than

> 250,000 workers' compensation claims, found the incidence of

> complex spinal fusion surgeries and other highly paid procedures in

Oklahoma

> City and Tulsa rose following the emergence of physician-owned facilities,

> even though the number of worker injuries declined. AHA executives noted

> that the findings raise " serious concerns about conflict of interest,

> implications for patient care and unnecessary increases in health care

> spending, " and urged Congress to make permanent the ban on physician

> referral to new limited-service hospitals they own. "

>

> For those that are still defending physician owned practices of any type,

> here is yet another study that is showing physician ownership =

unnecessary

> increased in health care spending. Please think about it. As the

evidence

> mounts, can we as a profession continue to support it??

>

> One caveat, I do understand that PT owned rehab practices may be just as

> guilty of over utilization and overcharging. Let these studies continue

to

> be a wake up call to all of us to do better.

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Tom Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, ID

>

> ptclinic@...

>

>

>

>

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of

its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If

you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

>

>

>

>

>

[Guest guest]

Jim, Ron, Ken, et. al. --

We recently had an event which points up several of your points. To

summarize, someone was violating their practice act, and several licensed

people were aware of it. After the smoke cleared away, several of them said

they didn't know that they were required to report violations of practice

acts by others.

I'm in Florida, and our law includes, under section 456, a requirement that

any health care practitioner licensed in Florida is required to report such

violations by others, even in another discipline. Sometimes, since our

practice act is more specifically covered under section 468, people are

unaware of all of the requirements.

So, if a Doc across the river really is using a PTA to see 64 patients a day

(as reported), I don't " know " that they're both violating the law... unless

they're using something other than 97150 Group Therapy for the billing. If

I " knew " that to be the case, I'd be violating the law if I failed to report

them.

Dick Hillyer

Cape Coral, FL

Re: FW: physician ownership

It is interesting to listen to the different threads coming through on this

topic. While I am not a Physical, Speech or Occupational Therapist, I am

certified in my occupation (or certifiable, I can't remember which). One

thing

that is interesting to hear is the comment that, " I noticed another

therapist

treating in an unethical or illegal manner. "

Others jump in and ask if the particular therapist was reported. The next

comment is usually along the lines of if you didn't report it, you are

enabling

the practice to continue and my be a party to the problem.

I would like to jump on my righteous horse and say that I would stand up and

do the right thing if I caught behavior like this in my own profession. If

the truth were told, I'm not sure what I would do and hope I never get

caught in

that situation. However, I do want to point at my own profession as an

example. CPA's in Houston, TX were auditing Enron corporation. While there

might

have been one or two bad apples at the top of the food chain, there were

several other fish in that food chain that could have stood up and said

something

before the major scandal broke. Obviously, that didn't happen. As a

result,

the entire CPA industry received a huge black eye, the largest CPA firm and

the

one with the most sterling reputation when I came out of college is now

devastated and done!

At the height of the Enron scandal, my nephew wanted to know if he could

intern for the summer with me. His goal was to build a resume to work for a

large

national accounting firm. I told him I could certainly teach him how to

shred-after all, I was in a medical office going paperless. If that

couldn't get

him a big time CPA job, I didn't know what could.

I guess I would like to encourage anyone who is caught in a quandry to

consider talking with peers about how they would handle a situation like the

one

described today and move forward to get the therapist help. Otherwise, you

might

find your industry with a black eye like the one my industry is suffering

from.

Jim Hall, CPA <///><

Rehab Management Services, LLC

Cedar Rapids, IA

[Guest guest]

Jim, Ron, Ken, et. al. --

We recently had an event which points up several of your points. To

summarize, someone was violating their practice act, and several licensed

people were aware of it. After the smoke cleared away, several of them said

they didn't know that they were required to report violations of practice

acts by others.

I'm in Florida, and our law includes, under section 456, a requirement that

any health care practitioner licensed in Florida is required to report such

violations by others, even in another discipline. Sometimes, since our

practice act is more specifically covered under section 468, people are

unaware of all of the requirements.

So, if a Doc across the river really is using a PTA to see 64 patients a day

(as reported), I don't " know " that they're both violating the law... unless

they're using something other than 97150 Group Therapy for the billing. If

I " knew " that to be the case, I'd be violating the law if I failed to report

them.

Dick Hillyer

Cape Coral, FL

Re: FW: physician ownership

It is interesting to listen to the different threads coming through on this

topic. While I am not a Physical, Speech or Occupational Therapist, I am

certified in my occupation (or certifiable, I can't remember which). One

thing

that is interesting to hear is the comment that, " I noticed another

therapist

treating in an unethical or illegal manner. "

Others jump in and ask if the particular therapist was reported. The next

comment is usually along the lines of if you didn't report it, you are

enabling

the practice to continue and my be a party to the problem.

I would like to jump on my righteous horse and say that I would stand up and

do the right thing if I caught behavior like this in my own profession. If

the truth were told, I'm not sure what I would do and hope I never get

caught in

that situation. However, I do want to point at my own profession as an

example. CPA's in Houston, TX were auditing Enron corporation. While there

might

have been one or two bad apples at the top of the food chain, there were

several other fish in that food chain that could have stood up and said

something

before the major scandal broke. Obviously, that didn't happen. As a

result,

the entire CPA industry received a huge black eye, the largest CPA firm and

the

one with the most sterling reputation when I came out of college is now

devastated and done!

At the height of the Enron scandal, my nephew wanted to know if he could

intern for the summer with me. His goal was to build a resume to work for a

large

national accounting firm. I told him I could certainly teach him how to

shred-after all, I was in a medical office going paperless. If that

couldn't get

him a big time CPA job, I didn't know what could.

I guess I would like to encourage anyone who is caught in a quandry to

consider talking with peers about how they would handle a situation like the

one

described today and move forward to get the therapist help. Otherwise, you

might

find your industry with a black eye like the one my industry is suffering

from.

Jim Hall, CPA <///><

Rehab Management Services, LLC

Cedar Rapids, IA

[Guest guest]

Jim, Ron, Ken, et. al. --

We recently had an event which points up several of your points. To

summarize, someone was violating their practice act, and several licensed

people were aware of it. After the smoke cleared away, several of them said

they didn't know that they were required to report violations of practice

acts by others.

I'm in Florida, and our law includes, under section 456, a requirement that

any health care practitioner licensed in Florida is required to report such

violations by others, even in another discipline. Sometimes, since our

practice act is more specifically covered under section 468, people are

unaware of all of the requirements.

So, if a Doc across the river really is using a PTA to see 64 patients a day

(as reported), I don't " know " that they're both violating the law... unless

they're using something other than 97150 Group Therapy for the billing. If

I " knew " that to be the case, I'd be violating the law if I failed to report

them.

Dick Hillyer

Cape Coral, FL

Re: FW: physician ownership

It is interesting to listen to the different threads coming through on this

topic. While I am not a Physical, Speech or Occupational Therapist, I am

certified in my occupation (or certifiable, I can't remember which). One

thing

that is interesting to hear is the comment that, " I noticed another

therapist

treating in an unethical or illegal manner. "

Others jump in and ask if the particular therapist was reported. The next

comment is usually along the lines of if you didn't report it, you are

enabling

the practice to continue and my be a party to the problem.

I would like to jump on my righteous horse and say that I would stand up and

do the right thing if I caught behavior like this in my own profession. If

the truth were told, I'm not sure what I would do and hope I never get

caught in

that situation. However, I do want to point at my own profession as an

example. CPA's in Houston, TX were auditing Enron corporation. While there

might

have been one or two bad apples at the top of the food chain, there were

several other fish in that food chain that could have stood up and said

something

before the major scandal broke. Obviously, that didn't happen. As a

result,

the entire CPA industry received a huge black eye, the largest CPA firm and

the

one with the most sterling reputation when I came out of college is now

devastated and done!

At the height of the Enron scandal, my nephew wanted to know if he could

intern for the summer with me. His goal was to build a resume to work for a

large

national accounting firm. I told him I could certainly teach him how to

shred-after all, I was in a medical office going paperless. If that

couldn't get

him a big time CPA job, I didn't know what could.

I guess I would like to encourage anyone who is caught in a quandry to

consider talking with peers about how they would handle a situation like the

one

described today and move forward to get the therapist help. Otherwise, you

might

find your industry with a black eye like the one my industry is suffering

from.

Jim Hall, CPA <///><

Rehab Management Services, LLC

Cedar Rapids, IA

[Guest guest]

And, there's also the " known " or " should have known " verbiage all through

the OIG's guidance. Basically, if a person knows or if a reasonable person

should have known of a violation and he/she makes the decision to turn a

blind eye to it, that person could be held partially responsible if the

violation were discovered and investigated. That means that even if you

didn't participate or didn't yourself commit the violation, if you KNEW it

was going on, you could be at risk.

Something to think about... you may not WANT to be involved and may want to

stay out of it. But, there's always a risk that you'll be pulled into it

anyway.

Tessa

Tessa L. Chenaille, CHC, CHP

President & CEO

Chenaille Compliance Consulting, LLC

5 Ross Street, Medford, Massachusetts 02155

P: F:

W: www.chenailleconsulting.com

Re: FW: physician ownership

It is interesting to listen to the different threads coming through on this

topic. While I am not a Physical, Speech or Occupational Therapist, I am

certified in my occupation (or certifiable, I can't remember which). One

thing

that is interesting to hear is the comment that, " I noticed another

therapist

treating in an unethical or illegal manner. "

Others jump in and ask if the particular therapist was reported. The next

comment is usually along the lines of if you didn't report it, you are

enabling

the practice to continue and my be a party to the problem.

I would like to jump on my righteous horse and say that I would stand up and

do the right thing if I caught behavior like this in my own profession. If

the truth were told, I'm not sure what I would do and hope I never get

caught in

that situation. However, I do want to point at my own profession as an

example. CPA's in Houston, TX were auditing Enron corporation. While there

might

have been one or two bad apples at the top of the food chain, there were

several other fish in that food chain that could have stood up and said

something

before the major scandal broke. Obviously, that didn't happen. As a

result,

the entire CPA industry received a huge black eye, the largest CPA firm and

the

one with the most sterling reputation when I came out of college is now

devastated and done!

At the height of the Enron scandal, my nephew wanted to know if he could

intern for the summer with me. His goal was to build a resume to work for a

large

national accounting firm. I told him I could certainly teach him how to

shred-after all, I was in a medical office going paperless. If that

couldn't get

him a big time CPA job, I didn't know what could.

I guess I would like to encourage anyone who is caught in a quandry to

consider talking with peers about how they would handle a situation like the

one

described today and move forward to get the therapist help. Otherwise, you

might

find your industry with a black eye like the one my industry is suffering

from.

Jim Hall, CPA <///><

Rehab Management Services, LLC

Cedar Rapids, IA

[Guest guest]

And, there's also the " known " or " should have known " verbiage all through

the OIG's guidance. Basically, if a person knows or if a reasonable person

should have known of a violation and he/she makes the decision to turn a

blind eye to it, that person could be held partially responsible if the

violation were discovered and investigated. That means that even if you

didn't participate or didn't yourself commit the violation, if you KNEW it

was going on, you could be at risk.

Something to think about... you may not WANT to be involved and may want to

stay out of it. But, there's always a risk that you'll be pulled into it

anyway.

Tessa

Tessa L. Chenaille, CHC, CHP

President & CEO

Chenaille Compliance Consulting, LLC

5 Ross Street, Medford, Massachusetts 02155

P: F:

W: www.chenailleconsulting.com

Re: FW: physician ownership

It is interesting to listen to the different threads coming through on this

topic. While I am not a Physical, Speech or Occupational Therapist, I am

certified in my occupation (or certifiable, I can't remember which). One

thing

that is interesting to hear is the comment that, " I noticed another

therapist

treating in an unethical or illegal manner. "

Others jump in and ask if the particular therapist was reported. The next

comment is usually along the lines of if you didn't report it, you are

enabling

the practice to continue and my be a party to the problem.

I would like to jump on my righteous horse and say that I would stand up and

do the right thing if I caught behavior like this in my own profession. If

the truth were told, I'm not sure what I would do and hope I never get

caught in

that situation. However, I do want to point at my own profession as an

example. CPA's in Houston, TX were auditing Enron corporation. While there

might

have been one or two bad apples at the top of the food chain, there were

several other fish in that food chain that could have stood up and said

something

before the major scandal broke. Obviously, that didn't happen. As a

result,

the entire CPA industry received a huge black eye, the largest CPA firm and

the

one with the most sterling reputation when I came out of college is now

devastated and done!

At the height of the Enron scandal, my nephew wanted to know if he could

intern for the summer with me. His goal was to build a resume to work for a

large

national accounting firm. I told him I could certainly teach him how to

shred-after all, I was in a medical office going paperless. If that

couldn't get

him a big time CPA job, I didn't know what could.

I guess I would like to encourage anyone who is caught in a quandry to

consider talking with peers about how they would handle a situation like the

one

described today and move forward to get the therapist help. Otherwise, you

might

find your industry with a black eye like the one my industry is suffering

from.

Jim Hall, CPA <///><

Rehab Management Services, LLC

Cedar Rapids, IA

[Guest guest]

And, there's also the " known " or " should have known " verbiage all through

the OIG's guidance. Basically, if a person knows or if a reasonable person

should have known of a violation and he/she makes the decision to turn a

blind eye to it, that person could be held partially responsible if the

violation were discovered and investigated. That means that even if you

didn't participate or didn't yourself commit the violation, if you KNEW it

was going on, you could be at risk.

Something to think about... you may not WANT to be involved and may want to

stay out of it. But, there's always a risk that you'll be pulled into it

anyway.

Tessa

Tessa L. Chenaille, CHC, CHP

President & CEO

Chenaille Compliance Consulting, LLC

5 Ross Street, Medford, Massachusetts 02155

P: F:

W: www.chenailleconsulting.com

Re: FW: physician ownership

It is interesting to listen to the different threads coming through on this

topic. While I am not a Physical, Speech or Occupational Therapist, I am

certified in my occupation (or certifiable, I can't remember which). One

thing

that is interesting to hear is the comment that, " I noticed another

therapist

treating in an unethical or illegal manner. "

Others jump in and ask if the particular therapist was reported. The next

comment is usually along the lines of if you didn't report it, you are

enabling

the practice to continue and my be a party to the problem.

I would like to jump on my righteous horse and say that I would stand up and

do the right thing if I caught behavior like this in my own profession. If

the truth were told, I'm not sure what I would do and hope I never get

caught in

that situation. However, I do want to point at my own profession as an

example. CPA's in Houston, TX were auditing Enron corporation. While there

might

have been one or two bad apples at the top of the food chain, there were

several other fish in that food chain that could have stood up and said

something

before the major scandal broke. Obviously, that didn't happen. As a

result,

the entire CPA industry received a huge black eye, the largest CPA firm and

the

one with the most sterling reputation when I came out of college is now

devastated and done!

At the height of the Enron scandal, my nephew wanted to know if he could

intern for the summer with me. His goal was to build a resume to work for a

large

national accounting firm. I told him I could certainly teach him how to

shred-after all, I was in a medical office going paperless. If that

couldn't get

him a big time CPA job, I didn't know what could.

I guess I would like to encourage anyone who is caught in a quandry to

consider talking with peers about how they would handle a situation like the

one

described today and move forward to get the therapist help. Otherwise, you

might

find your industry with a black eye like the one my industry is suffering

from.

Jim Hall, CPA <///><

Rehab Management Services, LLC

Cedar Rapids, IA

[Guest guest]

Here is a quote I keep plastered to the front of my computer - and when our

market gets hot with questionable activities and the staff wants to jump in - I

quote this from JC Watts

" Character is doing the right thing when nobody's looking. There are too many

people who think that the only thing that's right is to get by, and the only

thing that's wrong is to get caught. "

I think this may have been posted on this list serve some time back. It is

noteworthy.

Laurie B , OTR/L, MSHS

Director of Rehabilitation Services

Beaufort Memorial Hospital

lmartin@...

Re: FW: physician ownership

It is interesting to listen to the different threads coming through on this

topic. While I am not a Physical, Speech or Occupational Therapist, I am

certified in my occupation (or certifiable, I can't remember which). One

thing

that is interesting to hear is the comment that, " I noticed another

therapist

treating in an unethical or illegal manner. "

Others jump in and ask if the particular therapist was reported. The next

comment is usually along the lines of if you didn't report it, you are

enabling

the practice to continue and my be a party to the problem.

I would like to jump on my righteous horse and say that I would stand up and

do the right thing if I caught behavior like this in my own profession. If

the truth were told, I'm not sure what I would do and hope I never get

caught in

that situation. However, I do want to point at my own profession as an

example. CPA's in Houston, TX were auditing Enron corporation. While there

might

have been one or two bad apples at the top of the food chain, there were

several other fish in that food chain that could have stood up and said

something

before the major scandal broke. Obviously, that didn't happen. As a

result,

the entire CPA industry received a huge black eye, the largest CPA firm and

the

one with the most sterling reputation when I came out of college is now

devastated and done!

At the height of the Enron scandal, my nephew wanted to know if he could

intern for the summer with me. His goal was to build a resume to work for a

large

national accounting firm. I told him I could certainly teach him how to

shred-after all, I was in a medical office going paperless. If that

couldn't get

him a big time CPA job, I didn't know what could.

I guess I would like to encourage anyone who is caught in a quandry to

consider talking with peers about how they would handle a situation like the

one

described today and move forward to get the therapist help. Otherwise, you

might

find your industry with a black eye like the one my industry is suffering

from.

Jim Hall, CPA <///><

Rehab Management Services, LLC

Cedar Rapids, IA

[Guest guest]

Matt, I work for an integrated health care system. We do have physician groups

as a part of the system and the system does have an insurance company. The

physicians may refer patients wherever they want and of course, we would prefer

that they refer to our clinics. The difference between this and a physician

owned practice is that there is no financial incentive/reward for the physicians

if they refer to our clinics and no punitive action against them if they refer

outside of the system. I see this as a huge difference. Physicians owning PT

clinics is an avoidable conflict of interest. I find it interesting that the

only patients sent to us by physicians who own PT clinics are patients that have

insurance that do not allow them to go to that physician's office, patients who

have no insurance or patients who have Medicaid and the Medicaid does not pay

for PT. We have had patients tell us that their physician will not write them

an order for PT unless the have the PT in the physician's office.

Zarosinski, PT, MS

Providence Health System

Portland, OR

Re: FW: physician ownership

Russ it comes to values. I would urge you to read more on the topic thru

your professional association and fully understand the negative impact POPTS

have on the image of the profession, the lack of support it gives to your

colleagues work in trying to gain a clear, unquestioned position in the health

care

service community, and frankly, that many of these types and for profit

types of practice environments are the antithesis of where this profession is

heading.

Naive, I can assure you I am not. Take long look at what you have wrote and

ask yourself where your decisions have benefitted the goals of your

profession

Jim Dunleavy Pt, MS

[Guest guest]

Matt, I work for an integrated health care system. We do have physician groups

as a part of the system and the system does have an insurance company. The

physicians may refer patients wherever they want and of course, we would prefer

that they refer to our clinics. The difference between this and a physician

owned practice is that there is no financial incentive/reward for the physicians

if they refer to our clinics and no punitive action against them if they refer

outside of the system. I see this as a huge difference. Physicians owning PT

clinics is an avoidable conflict of interest. I find it interesting that the

only patients sent to us by physicians who own PT clinics are patients that have

insurance that do not allow them to go to that physician's office, patients who

have no insurance or patients who have Medicaid and the Medicaid does not pay

for PT. We have had patients tell us that their physician will not write them

an order for PT unless the have the PT in the physician's office.

Zarosinski, PT, MS

Providence Health System

Portland, OR

Re: FW: physician ownership

Russ it comes to values. I would urge you to read more on the topic thru

your professional association and fully understand the negative impact POPTS

have on the image of the profession, the lack of support it gives to your

colleagues work in trying to gain a clear, unquestioned position in the health

care

service community, and frankly, that many of these types and for profit

types of practice environments are the antithesis of where this profession is

heading.

Naive, I can assure you I am not. Take long look at what you have wrote and

ask yourself where your decisions have benefitted the goals of your

profession

Jim Dunleavy Pt, MS

[Guest guest]

Matt, I work for an integrated health care system. We do have physician groups

as a part of the system and the system does have an insurance company. The

physicians may refer patients wherever they want and of course, we would prefer

that they refer to our clinics. The difference between this and a physician

owned practice is that there is no financial incentive/reward for the physicians

if they refer to our clinics and no punitive action against them if they refer

outside of the system. I see this as a huge difference. Physicians owning PT

clinics is an avoidable conflict of interest. I find it interesting that the

only patients sent to us by physicians who own PT clinics are patients that have

insurance that do not allow them to go to that physician's office, patients who

have no insurance or patients who have Medicaid and the Medicaid does not pay

for PT. We have had patients tell us that their physician will not write them

an order for PT unless the have the PT in the physician's office.

Zarosinski, PT, MS

Providence Health System

Portland, OR

Re: FW: physician ownership

Russ it comes to values. I would urge you to read more on the topic thru

your professional association and fully understand the negative impact POPTS

have on the image of the profession, the lack of support it gives to your

colleagues work in trying to gain a clear, unquestioned position in the health

care

service community, and frankly, that many of these types and for profit

types of practice environments are the antithesis of where this profession is

heading.

Naive, I can assure you I am not. Take long look at what you have wrote and

ask yourself where your decisions have benefitted the goals of your

profession

Jim Dunleavy Pt, MS

[Guest guest]

,

I agree with you that physicians sending patients exclusively to their own

provider is wrong. I think you misunderstood my point. I undertand your

position as I have been there. My question is where are the hospitals in this

conflict of interest? I don't see the difference with a hospital owned

insurance company exclusively sending their clients to their own hospitals,

especially when they refuse contracts with competing clinics like mine. The

patients can come to my clinic, but only when they pay " out of network fees " .

It is for financial gain, on the part of the healthcare system. I know that the

physicians do not gain from this, unless they are employed by the hospital, but

the hospital organization sure gains from this. If we are looking at fairness,

let's look at the physicians who unethically refer as well as all others like

hospitals. This obviously touches a nerve with me, as this is going on in this

community. I compete against a POPTS, and a hospital in this situation.

Fairness is choice that the patient has to make up their own mind where they

want to go. Many POPTS, hospitals, clinics have exclusive agreements which is

unfair. My point is that this issue is bigger than just the POPTS, and to go

after and eliminate one entity is going the wrong direction.

________________________________

From: PTManager on behalf of Zarosinski,

Sent: Wed 5/25/2005 12:44 PM

To: PTManager

Subject: RE: FW: physician ownership

Matt, I work for an integrated health care system. We do have physician groups

as a part of the system and the system does have an insurance company. The

physicians may refer patients wherever they want and of course, we would prefer

that they refer to our clinics. The difference between this and a physician

owned practice is that there is no financial incentive/reward for the physicians

if they refer to our clinics and no punitive action against them if they refer

outside of the system. I see this as a huge difference. Physicians owning PT

clinics is an avoidable conflict of interest. I find it interesting that the

only patients sent to us by physicians who own PT clinics are patients that have

insurance that do not allow them to go to that physician's office, patients who

have no insurance or patients who have Medicaid and the Medicaid does not pay

for PT. We have had patients tell us that their physician will not write them

an order for PT unless the have the PT in the physician's office.

Zarosinski, PT, MS

Providence Health System

Portland, OR

Re: FW: physician ownership

Russ it comes to values. I would urge you to read more on the topic thru

your professional association and fully understand the negative impact POPTS

have on the image of the profession, the lack of support it gives to your

colleagues work in trying to gain a clear, unquestioned position in the health

care

service community, and frankly, that many of these types and for profit

types of practice environments are the antithesis of where this profession is

heading.

Naive, I can assure you I am not. Take long look at what you have wrote and

ask yourself where your decisions have benefitted the goals of your

profession

Jim Dunleavy Pt, MS

[Guest guest]

,

I agree with you that physicians sending patients exclusively to their own

provider is wrong. I think you misunderstood my point. I undertand your

position as I have been there. My question is where are the hospitals in this

conflict of interest? I don't see the difference with a hospital owned

insurance company exclusively sending their clients to their own hospitals,

especially when they refuse contracts with competing clinics like mine. The

patients can come to my clinic, but only when they pay " out of network fees " .

It is for financial gain, on the part of the healthcare system. I know that the

physicians do not gain from this, unless they are employed by the hospital, but

the hospital organization sure gains from this. If we are looking at fairness,

let's look at the physicians who unethically refer as well as all others like

hospitals. This obviously touches a nerve with me, as this is going on in this

community. I compete against a POPTS, and a hospital in this situation.

Fairness is choice that the patient has to make up their own mind where they

want to go. Many POPTS, hospitals, clinics have exclusive agreements which is

unfair. My point is that this issue is bigger than just the POPTS, and to go

after and eliminate one entity is going the wrong direction.

________________________________

From: PTManager on behalf of Zarosinski,

Sent: Wed 5/25/2005 12:44 PM

To: PTManager

Subject: RE: FW: physician ownership

Matt, I work for an integrated health care system. We do have physician groups

as a part of the system and the system does have an insurance company. The

physicians may refer patients wherever they want and of course, we would prefer

that they refer to our clinics. The difference between this and a physician

owned practice is that there is no financial incentive/reward for the physicians

if they refer to our clinics and no punitive action against them if they refer

outside of the system. I see this as a huge difference. Physicians owning PT

clinics is an avoidable conflict of interest. I find it interesting that the

only patients sent to us by physicians who own PT clinics are patients that have

insurance that do not allow them to go to that physician's office, patients who

have no insurance or patients who have Medicaid and the Medicaid does not pay

for PT. We have had patients tell us that their physician will not write them

an order for PT unless the have the PT in the physician's office.

Zarosinski, PT, MS

Providence Health System

Portland, OR

Re: FW: physician ownership

Russ it comes to values. I would urge you to read more on the topic thru

your professional association and fully understand the negative impact POPTS

have on the image of the profession, the lack of support it gives to your

colleagues work in trying to gain a clear, unquestioned position in the health

care

service community, and frankly, that many of these types and for profit

types of practice environments are the antithesis of where this profession is

heading.

Naive, I can assure you I am not. Take long look at what you have wrote and

ask yourself where your decisions have benefitted the goals of your

profession

Jim Dunleavy Pt, MS

[Guest guest]

,

I agree with you that physicians sending patients exclusively to their own

provider is wrong. I think you misunderstood my point. I undertand your

position as I have been there. My question is where are the hospitals in this

conflict of interest? I don't see the difference with a hospital owned

insurance company exclusively sending their clients to their own hospitals,

especially when they refuse contracts with competing clinics like mine. The

patients can come to my clinic, but only when they pay " out of network fees " .

It is for financial gain, on the part of the healthcare system. I know that the

physicians do not gain from this, unless they are employed by the hospital, but

the hospital organization sure gains from this. If we are looking at fairness,

let's look at the physicians who unethically refer as well as all others like

hospitals. This obviously touches a nerve with me, as this is going on in this

community. I compete against a POPTS, and a hospital in this situation.

Fairness is choice that the patient has to make up their own mind where they

want to go. Many POPTS, hospitals, clinics have exclusive agreements which is

unfair. My point is that this issue is bigger than just the POPTS, and to go

after and eliminate one entity is going the wrong direction.

________________________________

From: PTManager on behalf of Zarosinski,

Sent: Wed 5/25/2005 12:44 PM

To: PTManager

Subject: RE: FW: physician ownership

Matt, I work for an integrated health care system. We do have physician groups

as a part of the system and the system does have an insurance company. The

physicians may refer patients wherever they want and of course, we would prefer

that they refer to our clinics. The difference between this and a physician

owned practice is that there is no financial incentive/reward for the physicians

if they refer to our clinics and no punitive action against them if they refer

outside of the system. I see this as a huge difference. Physicians owning PT

clinics is an avoidable conflict of interest. I find it interesting that the

only patients sent to us by physicians who own PT clinics are patients that have

insurance that do not allow them to go to that physician's office, patients who

have no insurance or patients who have Medicaid and the Medicaid does not pay

for PT. We have had patients tell us that their physician will not write them

an order for PT unless the have the PT in the physician's office.

Zarosinski, PT, MS

Providence Health System

Portland, OR

Re: FW: physician ownership

Russ it comes to values. I would urge you to read more on the topic thru

your professional association and fully understand the negative impact POPTS

have on the image of the profession, the lack of support it gives to your

colleagues work in trying to gain a clear, unquestioned position in the health

care

service community, and frankly, that many of these types and for profit

types of practice environments are the antithesis of where this profession is

heading.

Naive, I can assure you I am not. Take long look at what you have wrote and

ask yourself where your decisions have benefitted the goals of your

profession

Jim Dunleavy Pt, MS

[Guest guest]

Do the physicians get paid by the health system? If so, then I believe

there is a conflict. What would happen if a physician referred 100% of his

patients out of the system? I don't think they would be part of the system

for long. Why else would the system employ them? If the system pays the

physicians, they are looking for a return on that investment. I'm sure the

administration tracks the income generated from employing the physicians.

The incentive here is financial in that if the physician wants to continue

to be employed that had better improve their referral profiles. I see no

difference in this scenario then the one Matt describes. I see this issue

as a violation of antitrust laws. The APTA should be fighting to close the

loop-holes in the Stark legislation. Do they have the clout and power is

the main question!

Re: FW: physician ownership

>

>

>

> Russ it comes to values. I would urge you to read more on the topic thru

> your professional association and fully understand the negative impact

POPTS

> have on the image of the profession, the lack of support it gives to your

> colleagues work in trying to gain a clear, unquestioned position in the

health care

> service community, and frankly, that many of these types and for profit

> types of practice environments are the antithesis of where this profession

is

> heading.

>

> Naive, I can assure you I am not. Take long look at what you have wrote

and

> ask yourself where your decisions have benefitted the goals of your

> profession

> Jim Dunleavy Pt, MS

>

>

>

>

[Guest guest]

Do the physicians get paid by the health system? If so, then I believe

there is a conflict. What would happen if a physician referred 100% of his

patients out of the system? I don't think they would be part of the system

for long. Why else would the system employ them? If the system pays the

physicians, they are looking for a return on that investment. I'm sure the

administration tracks the income generated from employing the physicians.

The incentive here is financial in that if the physician wants to continue

to be employed that had better improve their referral profiles. I see no

difference in this scenario then the one Matt describes. I see this issue

as a violation of antitrust laws. The APTA should be fighting to close the

loop-holes in the Stark legislation. Do they have the clout and power is

the main question!

Re: FW: physician ownership

>

>

>

> Russ it comes to values. I would urge you to read more on the topic thru

> your professional association and fully understand the negative impact

POPTS

> have on the image of the profession, the lack of support it gives to your

> colleagues work in trying to gain a clear, unquestioned position in the

health care

> service community, and frankly, that many of these types and for profit

> types of practice environments are the antithesis of where this profession

is

> heading.

>

> Naive, I can assure you I am not. Take long look at what you have wrote

and

> ask yourself where your decisions have benefitted the goals of your

> profession

> Jim Dunleavy Pt, MS

>

>

>

>

[Guest guest]

Do the physicians get paid by the health system? If so, then I believe

there is a conflict. What would happen if a physician referred 100% of his

patients out of the system? I don't think they would be part of the system

for long. Why else would the system employ them? If the system pays the

physicians, they are looking for a return on that investment. I'm sure the

administration tracks the income generated from employing the physicians.

The incentive here is financial in that if the physician wants to continue

to be employed that had better improve their referral profiles. I see no

difference in this scenario then the one Matt describes. I see this issue

as a violation of antitrust laws. The APTA should be fighting to close the

loop-holes in the Stark legislation. Do they have the clout and power is

the main question!

Re: FW: physician ownership

>

>

>

> Russ it comes to values. I would urge you to read more on the topic thru

> your professional association and fully understand the negative impact

POPTS

> have on the image of the profession, the lack of support it gives to your

> colleagues work in trying to gain a clear, unquestioned position in the

health care

> service community, and frankly, that many of these types and for profit

> types of practice environments are the antithesis of where this profession

is

> heading.

>

> Naive, I can assure you I am not. Take long look at what you have wrote

and

> ask yourself where your decisions have benefitted the goals of your

> profession

> Jim Dunleavy Pt, MS

>

>

>

>