Guest guest Posted September 22, 2006 Report Share Posted September 22, 2006 Anyone who thinks that PTs should not have exclusive ownership & control of PT services should watch this report about Wal-Mart and " price competition. If we persist in allowing PT to be treated like a commodity, such as the generic drugs sold by Wal-Mart, this is our future. Again, don't get me wrong; there is really nothing wrong with price competition for PT services. There IS something when the " competitors " do not have to play by the same rules because the " owner " of the service is unregulated, and more importantly; when control & pricing of the PT service is out of the PTs' hands. “Wall Street Journal Video: Hastings, senior analyst at Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like a $4 prescription price will have a profound effect on the competition and the economy in general.” http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISadEfgqT tbXrp0 Sincerely, Ken Mailly, PT Mailly & Inglett Consulting, LLC NJ Society of Independent Physical Therapists P.O. Box 375 Matawan, NJ, 07747 1- www.NJSIPT.com “He who is being carried does not realize how far the town is.” Nigerian Proverb Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2006 Report Share Posted September 22, 2006 Ken correctly points out the injustice of unlevel playing fields, but it's difficult for me to equate freedom with the notion of equal regulation for all. We must remember that these unlevel playing fields exist within another systemic problem: Third party payers and regulators have effectively elbowed their way into the realm of clinical decision making. " Owners " (PTs and otherwise) these days answer to everyone but the patient. The patient-provider relationship used to be sacred---patients were in charge, clinicians second in command. Things have changed; patients and providers are now together in the back seat. Unsurprisingly they (i.e. we) are are acting like back seat drivers---annoying, but tolerable as long as they can't reach the steering wheel. Give patients control of their own lives. Give clinicians control over clinical matters. Take control away from distant bureaucrats. Support Healthcare Savings Accounts. Dave Milano, PT, Director of Rehab Services Laurel Health System 32-36 Central Ave. Wellsboro, PA 16901 dmilano@... Ownership of PT Services Anyone who thinks that PTs should not have exclusive ownership & control of PT services should watch this report about Wal-Mart and " price competition. If we persist in allowing PT to be treated like a commodity, such as the generic drugs sold by Wal-Mart, this is our future. Again, don't get me wrong; there is really nothing wrong with price competition for PT services. There IS something when the " competitors " do not have to play by the same rules because the " owner " of the service is unregulated, and more importantly; when control & pricing of the PT service is out of the PTs' hands. " Wall Street Journal Video: Hastings, senior analyst at Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like a $4 prescription price will have a profound effect on the competition and the economy in general. " http://release. <http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISadEfgq T> theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISadEfgqT tbXrp0 Sincerely, Ken Mailly, PT Mailly & Inglett Consulting, LLC NJ Society of Independent Physical Therapists P.O. Box 375 Matawan, NJ, 07747 1- www.NJSIPT.com " He who is being carried does not realize how far the town is. " Nigerian Proverb Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2006 Report Share Posted September 22, 2006 I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) .... more than 1000% return in 10 years. http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt=Ref\ resh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & ComparisonsF\ orm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " do > not have to play by the same rules because the " owner " of the service is > unregulated, and more importantly; when control & pricing of the PT > service > is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at Bernand > Sands, tells CNBC that even Wal-Mart's incremental moves like a $4 > prescription price will have a profound effect on the competition and the > economy in general. " > > > http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISadEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2006 Report Share Posted September 23, 2006 Has any PT in private practice tried giving a guarantee for the PT services provided? E.g. have the patient pay $80 per visit for 10 visits ($800) and after 4-5 visits, if the patient is not seeing any reduction and/or improvement in their own definition of " disability " then the patient can ask for their money back. Here there is no ins. billing. Patient can ask for a super bill which he/she can submit to their respective ins comp. I think that unless we as PTs do not show this kind of confidence of money back guarantee, in the eyes of a lay person (patient) we are never going to rise above massage therapist, chiros etc. I have never seen any PT giving this kind of gaurantee, however, after being a PT for 21 years I am ready for this challenge as I am really fed up of POPTS and ins. companies draining every ounce of lifeforce out of our practice. I would like to go directly to the public and share risk and rewards. Hiten Dave' PT Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) .... more than 1000% return in 10 years. http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the > competition and the economy in general. " > > > http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2006 Report Share Posted September 23, 2006 Hiten, There are serious legal & ethical ramifications to this topic, as many states prohibit health professionals from offering such guarantees, and our professional standards address this as well. Ken Mailly, PT Mailly & Inglett Consulting, LLC www.njptaid.biz Bridging the Gap! ________________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Hiten Dave Sent: Saturday, September 23, 2006 4:08 AM To: PTManager Subject: RE: Ownership of PT Services Has any PT in private practice tried giving a guarantee for the PT services provided? E.g. have the patient pay $80 per visit for 10 visits ($800) and after 4-5 visits, if the patient is not seeing any reduction and/or improvement in their own definition of " disability " then the patient can ask for their money back. Here there is no ins. billing. Patient can ask for a super bill which he/she can submit to their respective ins comp. I think that unless we as PTs do not show this kind of confidence of money back guarantee, in the eyes of a lay person (patient) we are never going to rise above massage therapist, chiros etc. I have never seen any PT giving this kind of gaurantee, however, after being a PT for 21 years I am ready for this challenge as I am really fed up of POPTS and ins. companies draining every ounce of lifeforce out of our practice. I would like to go directly to the public and share risk and rewards. Hiten Dave' PT Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) .... more than 1000% return in 10 years. http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the > competition and the economy in general. " > > > http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2006 Report Share Posted September 23, 2006 This is a very slippery slope. If a provider gives the patient his/her money back, ultimately the provider has just provided free services. Free services can be viewed as an inducement which is bad. very, very bad. I'd be interested to hear others take on this. Tessa Tessa L. Chenaille, CHC, CHP President & CEO Chenaille Compliance Consulting, LLC 5 Ross Street, Medford, Massachusetts 02155 P: F: W: <http://www.chenailleconsulting.com> www.chenailleconsulting.com " The time to fix the roof is when the sun is still shining. " - F. Kennedy Confidentiality Notice: This email may contain protected health information or proprietary information that is strictly confidential. If you are not the intended recipient, you are hereby informed that using, disclosing, copying, distributing or taking action in reliance of the content of this email is strictly prohibited. Please notify the sender by replying to this message and then immediately delete this email and any attachments. Any information contained herein is not considered legal or financial advice and recipients should not rely on this as such. Recipients are advised to consult with a competent professional in the event legal or financial advice is required. The information contained herein is believed to be current and accurate, however, recipients are cautioned that changes in laws, regulations and statutes routinely occur. Thank you. _____ From: PTManager [mailto:PTManager ] On Behalf Of Hiten Dave Sent: Saturday, September 23, 2006 4:08 AM To: PTManager Subject: RE: Ownership of PT Services Has any PT in private practice tried giving a guarantee for the PT services provided? E.g. have the patient pay $80 per visit for 10 visits ($800) and after 4-5 visits, if the patient is not seeing any reduction and/or improvement in their own definition of " disability " then the patient can ask for their money back. Here there is no ins. billing. Patient can ask for a super bill which he/she can submit to their respective ins comp. I think that unless we as PTs do not show this kind of confidence of money back guarantee, in the eyes of a lay person (patient) we are never going to rise above massage therapist, chiros etc. I have never seen any PT giving this kind of gaurantee, however, after being a PT for 21 years I am ready for this challenge as I am really fed up of POPTS and ins. companies draining every ounce of lifeforce out of our practice. I would like to go directly to the public and share risk and rewards. Hiten Dave' PT Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) .... more than 1000% return in 10 years. http://moneycentral <http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtB t> .msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the > competition and the economy in general. " > > > http://release. <http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa> theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2006 Report Share Posted September 23, 2006 My view point is from the patient's side. Patient goes to Macy's store, buys a shirt and if not happy can return it with full refund. If PTs and chiros hoot their horns....that we have this remarkable ability and/or technique which can help with the patient's pain, then why can't we give them a guarantee? This question came to me because of the unethical competition going on my town where POPTS are mushrooming. Also when a patient(this is from a lay person's view) has back pain they think of going to a chiro and/or to a massage therapist and paying from $75 to $120 to a massage therapist is fairly routine. PTs may have lost or are in the process of loosing to chiros, acupuncturists and massage therapist as a new breed of Medical Massage Therapist is coming into town! When someone has back pain they are not looking at evidence based treatments, they will go to anyone who will get their pain better fast! When I opened my clinic in 1985, I got a business license and I have to run my clinic as a business, however, it is a service based business and now I have to worry about legality and ethics of my dealings with my patients. I called my Ca chapter of APTA and posed the above question. They were not helpful as their comment was if the patient complained that they did not get their money back then the consumer's affair division of the state gets into the picture and that can get ugly. I can see how the ins companies are viewing us.. If a patient is unhappy or did not get any relief from the PT, the PT still gets paid from the ins. Co. for providing the service. But if the patient got better in fewer visits compared to the normal protocol visits then the PT needs to be rewarded. Here the PT has no incentive in getting the patient better fast so the ins. Cos. Start enforcing utilization reviews and case managers etc...musculoskeletal disability treaters(PTs, chiros etc)need to give the patient and the ins. Cos. some kind of reassurances that we are going to do what we are promising to do...thereby financial guarantees. There are some MD clincis started in CA which charge $40 per visit, cash. In $40.00 a patient actually sees an MD and gets a diagnosis. Maybe PTs need to do the same and cut the middleman out ( the ins. Cos.)Think about the termendous cost savings from billing/staff/waste of time in authorization etc... Hiten Dave' PT Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) .... more than 1000% return in 10 years. http://moneycentral <http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtB t> .msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the > competition and the economy in general. " > > > http://release. <http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa> theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2006 Report Share Posted September 23, 2006 How about measuring and tracking your outcomes to prove that PT works. That is where this needs to go. As far as POPS goes, some of my biggest referral sources are POPS, as we do a better job than their therapist do..... Thanks, Barker F. II Clinical Director Lakeway Aquatic Therapy & Wellness Center P.O. Box 342348 1927 Lohmans Crossing, Suite 100 Austin, TX 78734 -Office Tel. - Office Fax - Mobile www.lakewayaquatics.com This email and any files transmitted with it may contain PRVILEGED 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 or contact the sender at the number listed. Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) ..... more than 1000% return in 10 years. http://moneycentral <http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtB t> .msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the > competition and the economy in general. " > > > http://release. <http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa> theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2006 Report Share Posted September 23, 2006 Barker--Good luck to you! Seems like the MDs in your town have a conscience. In CA they say it is dog eat dog..it is true! Yes, the MDs who own PT send their family members and close friends to us for PT as we do provide good care, however, the major bulk goes to their mediocre PT department. One of the hot shot MD from that group even came to me for his low back problem. He even praised me for our superior care---it definitely felt good. Soon I am finding out that the MD is in a slip and fall litigation and basically he just used me as an outside PT!!! But the law of Karma finally got him. He died of prostate cancer. Hietn Dave' PT Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) ..... more than 1000% return in 10 years. http://moneycentral <http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtB t> .msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the competition > and the economy in general. " > > > http://release. <http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa> theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2006 Report Share Posted September 24, 2006 How about just billing them in three easy payments of $19.99, Maybe throw in a set of Ginsu knives as well. Sorry, offering money back guarantees does nothing to advance the profession and in fact pushes us back to the place where the other fringe practitoners are, you know, sitting behind a kiosk in a mall offering " free spinal assesments " with some gadget that beeps as it passes over trigger points. I agree with the others who suggest measuring outcomes and then using that data to prove to insurers, patients and referral sources that you are the best choice. Don't waste too much time worrying about " medical " massage therapists, as we all know, massage is nice but let a patient pay a 80$ a visit without any lasting relief and they will soon find a way towards the evidence. We need to be out there, educating the public, showing them the way. E. s, PT,DPT, OCS www.douglasspt.com s Orthopedic & Spine Rehabilitation, Inc. > > Has any PT in private practice tried giving a guarantee for the PT services > provided? E.g. have the patient pay $80 per visit for 10 visits ($800) and > after 4-5 visits, if the patient is not seeing any reduction and/or > improvement in their own definition of " disability " then the patient can ask > for their money back. Here there is no ins. billing. Patient can ask for a > super bill which he/she can submit to their respective ins comp. I think > that unless we as PTs do not show this kind of confidence of money back > guarantee, in the eyes of a lay person (patient) we are never going to rise > above massage therapist, chiros etc. I have never seen any PT giving this > kind of gaurantee, however, after being a PT for 21 years I am ready for > this challenge as I am really fed up of POPTS and ins. companies draining > every ounce of lifeforce out of our practice. I would like to go directly to > the public and share risk and rewards. > Hiten Dave' PT > > Re: Ownership of PT Services > > > I agree with Ken's statements wholeheartedly. I'm not sure exactly what the > > intent of Jim's letter is, since the points being made to appear to be all > over the map but there are a few issues here that'd I'd like to address. > First of all, physical therapy, in its present state, is certainly not a > commodity (and I hope it never will be). Being a commodity requires a > certain degree of homogenity and/or sameness that is simply not present in > contemporary physical therapy. On the contrary, there is a wide range in > quality of services provided by physical therapists. Try being a patient at > > a variety of different clinics and you'll quickly make that discovery. Just > > this week, I had a new patient who had been a patient with us previously and > > had also experienced therapy at a local hospital and at a new private > practice in the area. She returned because (as she said it), " You seemed to > > have a better handle on this than any of the other places and everyone I > talked to said you were the best in the area and I discovered the same > thing " . Our backgrounds as physical therapists (education, experience, > training, personal attributes, etc.) are certainly not homogeneous and > neither is the service we generate. While many consumers aren't necessarily > > aware of this difference, at least initially, most of the discerning ones > are or become so quickly. I think it behooves us each to provide the best > possible services of which we are capable in a manner which is unique to us > as individuals. > > Furthermore, the article in Harvard Business Review was entitled " Redefining > > Competition in Health Care " , not " Redefining Completion in Health Care. " > This article is written from the same perspective as the entrepeneurs who > brought you HMOs, managed care, etc. These are business strategies designed > > to enrich MBA toting middlemen at health care practitioners' expense, not > benefit the patients or the entities paying for insurance. Look at the > obscene profits Wall Street parasites are making versus our falling > reimbursement rates and the skyrocketing cost of insurance to our patients > and their employers and you see where the money is going. The money trail > never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) > ... more than 1000% return in 10 years. > http://moneycentral.msn.com/investor/charts/chartdl.asp? Symbol=UNH & ShowChtBt > =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9 =2 & Comp > arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType =8 > Has the increase in your salary since 2000 come anywhere close to matching > the increase in their profits? I don't think so. These are the savviest of > > business people who will play us off one against the another as our incomes > plummet while they sit back, rubbing their hands in glee, watching their > coffers fill to overflowing. I know because I've watched these leeches at > work as I've made my investment decisions and have done much better by them > as a shareholder than as a physical therapist. My rationale was that if > they're draining money from me in one venue, I'll look for a return in > another. Unfortunately, the poor patient ultimately winds up suffering at > their hands almost as much as we do. > > I'm afraid you lose me when you get off into medications since comparing > medications to physical therapy is like comparing pineapples to Osage > oranges (they're not even close). Nevertheless, commenting on some of the > remarks you made, I think Medicaid costs will come under control when there > is some accountability and responsibility built into the system (and from my > > perspective, there appears to be next to none). Also, until we make radical > > changes in lifestyle, reward people for health behaviors rather than for > sickness behaviors, shift away from pharmaceuticals to nutriceuticals and > wholesome food, truly educate our young about physical fitness, mental well > being, and nutrition (and make physical true education education rather than > > a joke), reduce the political influence and power of pharmaceutical > companies, etc., medication costs will continue to be exorbitant, Canada or > no Canada, WalMart or no WalMart. > > My solution for the insurance/reimbursement dilemma ... radical. Cut out > the middleman. If consumers and employers dealt directly with providers and > > bypassed the middlemen, health care costs would drop dramatically. The > increase in employers' administrative costs would be far less than the > ongoing increases in health insurance. It'll probable never happen but I > like dreaming about it. > > , PT, OCS > Marquette, MI > > > Ownership of PT Services > > > > > > Anyone who thinks that PTs should not have exclusive ownership & > > control > > of > > PT services should watch this report about Wal-Mart and " price > > competition. > > If we persist in allowing PT to be treated like a commodity, such as the > > generic drugs sold by Wal-Mart, this is our future. > > > > Again, don't get me wrong; there is really nothing wrong with price > > competition for PT services. There IS something when the " competitors " > > do not have to play by the same rules because the " owner " of the > > service is unregulated, and more importantly; when control & pricing > > of the PT service is out of the PTs' hands. > > > > " Wall Street Journal Video: Hastings, senior analyst at > > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > > a $4 prescription price will have a profound effect on the > > competition and the economy in general. " > > > > > > http://release.theplatform.com/content.select? pid=qiQahnhnPM8fCVKKRISa > > dEfgqT > > tbXrp0 > > > > Sincerely, > > Ken Mailly, PT > > Mailly & Inglett Consulting, LLC > > NJ Society of Independent Physical Therapists > > P.O. Box 375 > > Matawan, NJ, 07747 > > 1- > > www.NJSIPT.com > > > > " He who is being carried does not realize how far the town is. " > > Nigerian Proverb > > > > > > > > > > ---------- > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2006 Report Share Posted September 24, 2006 I think it would be better to establish good communication at the first visit, and state that if the pt is not making significant progress after a given amount of time, we will reevaluate, discharge, and/or continue to advocate for them for whatever other services they may need. Most pt's will be very satisfied with their care if we initially sit down with them long enough to find out what their expectations are. If the expectations are unreasonable it's up to us to establish reasonable goals that both parties can agree on. I would leave the money back guarantee to Wal-Mart. Pierre H. Rougny, PT MTC Director of Rehab Sebasticook Valley Hospital 21 Leighton St. Pittsfield, ME 04967 (207)487-9293 Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) ... more than 1000% return in 10 years. http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowC htBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the > competition and the economy in general. " > > > http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2006 Report Share Posted September 24, 2006 I believe PT services and getting paid in the future it is going to be eventually be based on performance. How costly effective you are at getting pts better using clinically evidence based practice and how quickly they are getting better. That simple!! RON MASRI, MPT " Tessa L. Chenaille " wrote: This is a very slippery slope. If a provider gives the patient his/her money back, ultimately the provider has just provided free services. Free services can be viewed as an inducement which is bad. very, very bad. I'd be interested to hear others take on this. Tessa Tessa L. Chenaille, CHC, CHP President & CEO Chenaille Compliance Consulting, LLC 5 Ross Street, Medford, Massachusetts 02155 P: F: W: <http://www.chenailleconsulting.com> www.chenailleconsulting.com " The time to fix the roof is when the sun is still shining. " - F. 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Thank you. _____ From: PTManager [mailto:PTManager ] On Behalf Of Hiten Dave Sent: Saturday, September 23, 2006 4:08 AM To: PTManager Subject: RE: Ownership of PT Services Has any PT in private practice tried giving a guarantee for the PT services provided? E.g. have the patient pay $80 per visit for 10 visits ($800) and after 4-5 visits, if the patient is not seeing any reduction and/or improvement in their own definition of " disability " then the patient can ask for their money back. Here there is no ins. billing. Patient can ask for a super bill which he/she can submit to their respective ins comp. I think that unless we as PTs do not show this kind of confidence of money back guarantee, in the eyes of a lay person (patient) we are never going to rise above massage therapist, chiros etc. I have never seen any PT giving this kind of gaurantee, however, after being a PT for 21 years I am ready for this challenge as I am really fed up of POPTS and ins. companies draining every ounce of lifeforce out of our practice. I would like to go directly to the public and share risk and rewards. Hiten Dave' PT Re: Ownership of PT Services I agree with Ken's statements wholeheartedly. I'm not sure exactly what the intent of Jim's letter is, since the points being made to appear to be all over the map but there are a few issues here that'd I'd like to address. First of all, physical therapy, in its present state, is certainly not a commodity (and I hope it never will be). Being a commodity requires a certain degree of homogenity and/or sameness that is simply not present in contemporary physical therapy. On the contrary, there is a wide range in quality of services provided by physical therapists. Try being a patient at a variety of different clinics and you'll quickly make that discovery. Just this week, I had a new patient who had been a patient with us previously and had also experienced therapy at a local hospital and at a new private practice in the area. She returned because (as she said it), " You seemed to have a better handle on this than any of the other places and everyone I talked to said you were the best in the area and I discovered the same thing " . Our backgrounds as physical therapists (education, experience, training, personal attributes, etc.) are certainly not homogeneous and neither is the service we generate. While many consumers aren't necessarily aware of this difference, at least initially, most of the discerning ones are or become so quickly. I think it behooves us each to provide the best possible services of which we are capable in a manner which is unique to us as individuals. Furthermore, the article in Harvard Business Review was entitled " Redefining Competition in Health Care " , not " Redefining Completion in Health Care. " This article is written from the same perspective as the entrepeneurs who brought you HMOs, managed care, etc. These are business strategies designed to enrich MBA toting middlemen at health care practitioners' expense, not benefit the patients or the entities paying for insurance. Look at the obscene profits Wall Street parasites are making versus our falling reimbursement rates and the skyrocketing cost of insurance to our patients and their employers and you see where the money is going. The money trail never lies. Look at the 10 year returns for Unitedhealth Group Inc. (UNH) .... more than 1000% return in 10 years. http://moneycentral <http://moneycentral.msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtB t> .msn.com/investor/charts/chartdl.asp?Symbol=UNH & ShowChtBt =Refresh+Chart & DateRangeForm=1 & CP=0 & PT=8 & C5=9 & C6=2006 & C7=9 & C8=2006 & C9=2 & Comp arisonsForm=1 & CE=0 & DisplayForm=1 & D4=1 & D5=0 & D3=0 & ViewType=0 & PeriodType=8 Has the increase in your salary since 2000 come anywhere close to matching the increase in their profits? I don't think so. These are the savviest of business people who will play us off one against the another as our incomes plummet while they sit back, rubbing their hands in glee, watching their coffers fill to overflowing. I know because I've watched these leeches at work as I've made my investment decisions and have done much better by them as a shareholder than as a physical therapist. My rationale was that if they're draining money from me in one venue, I'll look for a return in another. Unfortunately, the poor patient ultimately winds up suffering at their hands almost as much as we do. I'm afraid you lose me when you get off into medications since comparing medications to physical therapy is like comparing pineapples to Osage oranges (they're not even close). Nevertheless, commenting on some of the remarks you made, I think Medicaid costs will come under control when there is some accountability and responsibility built into the system (and from my perspective, there appears to be next to none). Also, until we make radical changes in lifestyle, reward people for health behaviors rather than for sickness behaviors, shift away from pharmaceuticals to nutriceuticals and wholesome food, truly educate our young about physical fitness, mental well being, and nutrition (and make physical true education education rather than a joke), reduce the political influence and power of pharmaceutical companies, etc., medication costs will continue to be exorbitant, Canada or no Canada, WalMart or no WalMart. My solution for the insurance/reimbursement dilemma ... radical. Cut out the middleman. If consumers and employers dealt directly with providers and bypassed the middlemen, health care costs would drop dramatically. The increase in employers' administrative costs would be far less than the ongoing increases in health insurance. It'll probable never happen but I like dreaming about it. , PT, OCS Marquette, MI Ownership of PT Services > > > Anyone who thinks that PTs should not have exclusive ownership & > control > of > PT services should watch this report about Wal-Mart and " price > competition. > If we persist in allowing PT to be treated like a commodity, such as the > generic drugs sold by Wal-Mart, this is our future. > > Again, don't get me wrong; there is really nothing wrong with price > competition for PT services. There IS something when the " competitors " > do not have to play by the same rules because the " owner " of the > service is unregulated, and more importantly; when control & pricing > of the PT service is out of the PTs' hands. > > " Wall Street Journal Video: Hastings, senior analyst at > Bernand Sands, tells CNBC that even Wal-Mart's incremental moves like > a $4 prescription price will have a profound effect on the > competition and the economy in general. " > > > http://release. <http://release.theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa> theplatform.com/content.select?pid=qiQahnhnPM8fCVKKRISa > dEfgqT > tbXrp0 > > Sincerely, > Ken Mailly, PT > Mailly & Inglett Consulting, LLC > NJ Society of Independent Physical Therapists > P.O. Box 375 > Matawan, NJ, 07747 > 1- > www.NJSIPT.com > > " He who is being carried does not realize how far the town is. " > Nigerian Proverb > > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
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