Re: MD ownership

May 31, 2005

Un fortunately I believe is correct and I don't take offense if you

disagree. I liken it a little bit to when managed care first hit and when we

had a Medicare cap to deal with; as much as we hated and opposed the idea of

these monumental upheavals, we couldn't control the situation and learned to

adapt. I think I've sometimes been unfairly maligned as being part of the

problem by my study of physician contracts, but that came out of need as I kept

hearing disaster stories from my members about long time practices going down

because of POPTS. I don't believe a therapist should EVER be an employee and a

contract for services leaves you with autonomy. Please bear with me for a brief

moment.

I've found a growing glitch in the system recently as I have surveyed many

physicians who have in-house programs. Needless to say I was very surprised at

these findings. A large percentage are unhappy with their situations,

predominantly because of their " employees " . I've found they would rather

contract an established private practice therapist, for whom this could be a

satellite office (95% are already equipped), who has an owners mentality. I'm

always looking for ways to recapture market share that's gone and this is

becoming a huge opening.

For example, one member was seeing 24 patients a day with her current staff.

Unfortunately, due to a physician bringing therapy in-house, her daily visits

have dropped to an average of 15. The physician told the therapist months in

advance that he would like her to open a small space in his building or within

his office, and he would direct all of that business to her either independently

or through contract. She declined to do it because she didn't think she could

" afford it " . Judging by the result, she couldn't afford to NOT do it. The

physician contacted a therapist in his building and that's where his business

went. We've since regained that business through contract, but not after many

critical months.

How? When revisiting the possibility of contracting to perform therapy for a

physician or group (as an adjunct to her current practice), she insisted she

couldn't take a lesser dollar amount. What she neglected to see was that it

would cost her NOTHING to see up to nine more patients a day (15+9=24) as

expenses and staff were fixed for that volume-24. In the first quarter of my

very first physician contract, we took in nearly $29,000 in cash with an added

expense of only $300. These contracts are " Capacity Fillers " . Physician

contracts are no different than contracts with managed care. You take a reduced

fee in exchange for volume, and in this case, exclusivity. I know this goes

against the grain and I sincerely respect that. But they're not playing in a

way that we can win so we must find ethical and legal ways to participate or

die. Thanks for listening and understanding that I am not an opposing view.

I'm just tired of sitting at the same intersection watching wreck after wreck,

knowing that another one is coming, and doing nothing. Hope you all had a

wonderful and safe Memorial Day! Doug

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz<http://www.aptc.biz/>

doug@...

MD ownership

I don't know how many people are aware of the country that we live in, but big

business will ALWAYS rule at the end of the day. I don't profess to like it,

but I do understand it. There's too much money on the side of the big

corporations, doctors, etc...to think that there will be a change in the rules

that says that PT's can only own PT clinics. The APTA could lobby till the cows

come home, we could all join and give them 10% of our income and that still

isn't going to match the fight that the " other side " will bring. It's certainly

a noble idea to think that PT's are the most qualified to run PT clinics, but

it's a case of too little to late since the POPTS have such a strong foothold in

the game. I've got a few things that spring to mind when thinking of the fight

against corporate America (and that's what it is when you are against non-PT

ownership), Home Depot ate up all of the small hardware stores, Walgreen's/CVS

has taken over the pharmacy game, Blockbuster ate up the video stores, we could

keep going with this list...

So it's too bad that the trend is this way but reality is that government will

not rule in favor of the little guy (in any significant measure). The whole

idea that now MD's have to use " real " PT's to treat medicare is a joke that I

hope none of you see as a victory. It frustrates me to no end when a local doc

opens up PT in his office but I know that business is an evolution and that we

must continue to try to do things better, cheaper, etc...year after year if we

hope to succeed for the long term. Don't get caught with your pants down,

complaining about the way things are. Assume they are always going to be this

way and only get worse and then (and only then) can you have a chance to

succeed. When you attack the beast for what it is instead of complaining that

it's not a fair fight.

Non-PT clinic owner (boo, hiss, arghhh!)

May 31, 2005