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Re: Referral for Profit on PTManager

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Posted
Posted

You do a great service for us all . BTW - I am very familiar with POPTS

but it only involves about 5% of my efforts. I ALWAYS try and help the private

practice PT. Sometimes their choice is to go out of business or find a way to

partially capture POPTS business through contracting within their existing

facilities. Just wanted to clear the air on that - 5% - MAYBE. Thanks again

and take care. Doug

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

In ALL messages to PTManager you must identify yourself, your discipline and

your location or else your message will not be approved to send to the full

group.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Visit the NEW and IMPROVED www.InHomeRehab.com<http://www.inhomerehab.com/>.

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Posted
Posted

I would be willing to start this discussion and would like to begin

with a question. How is physcian ownership of physical therapy

hurting the profession? I understand that it hurts the PT practice

owner but to many that feels like market based competition and people

are trying to limit that competition. I would be very interested to

hear this from non-PT practice oweners.

My opinion is that a PT should be able to choose their work

environment. I have worked in both PT and MD owned clinics where the

quality of care and the focus on reimburesment were the same. I have

seen both settings where the focus was not on quality of care. I

don't think you can generalize the quality of care or the busniess

acumen based solely on ownership.

The largest and most public therapy based fraud has been perpetrated

by large corporations, read HealthSouth, Physiotherapy Associates.

Cetainly there are many other reasons why folks want to limit

physician ownership but none of them appear to rise to the level of

truely " hurting the profession " . It strikes me the opposite could be

true and this question is an example. What hurts the profession more

than lack of communication. If we separate ourselves based on

something like who owns the business we work for that strikes me as

hurting the profession becasue now we have a fractured organization

where people are " locked out " of communcaiting with their peers.

If the goal of this listserve is to assist physcial therapists then

why limit it based on practice setting or ownership of that practice?

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

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Posted
Posted

I am all for the idea, however I am not sure how you enforce this and?what is to

keep others from reading the answers anyway? It sounds great, but may be tough

to monitor effectively.

Oh and by the way, I am a private practice owner with 3 POPTS in our town (2 of

which opened up 3 months after we opened our doors 3 years ago.) Anything we can

do to help,? I am all for.

J. Boyle PT, DPT, CSCS

President

Gaston Rehab Associates, Inc.

1361-B East Garrison Blvd

Gastonia, NC 28054

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

In ALL messages to PTManager you must identify yourself, your discipline and

your location or else your message will not be approved to send to the full

group.

PTManager encourages participation in your professional association. Join APTA,

AOTA or ASHA and participate now!

Visit the NEW and IMPROVED www.InHomeRehab.com.

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Posted
Posted

Since this is a fully moderated list, all messages must be approved

before they go out to the membership. We've been reviewing all

messages (and rejecting about 60% or the messages)for many years.

Messages that do not meet the protocol requirements are rejected with

explanation to the author. Offensive messages are deleted. Repeat

offending authors sometimes are simply banned from the list (rarely)

Sorry about the censorship but the membership does not want to

receive 50-100 " me too " messages per day

Hope that clarifies

Kovacek

>

>

> I am all for the idea, however I am not sure how you enforce this

and?what is to keep others from reading the answers anyway? It sounds

great, but may be tough to monitor effectively.

>

>

> Oh and by the way, I am a private practice owner with 3 POPTS in

our town (2 of which opened up 3 months after we opened our doors 3

years ago.) Anything we can do to help,? I am all for.

>

>

>

> J. Boyle PT, DPT, CSCS

>

> President

>

> Gaston Rehab Associates, Inc.

>

> 1361-B East Garrison Blvd

>

> Gastonia, NC 28054

>

>

>

> Referral for Profit on PTManager

>

>

>

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

>

>

> In ALL messages to PTManager you must identify yourself, your

discipline and

> your location or else your message will not be approved to send to

the full

> group.

>

> PTManager encourages participation in your professional

association. Join APTA,

> AOTA or ASHA and participate now!

>

> Visit the NEW and IMPROVED www.InHomeRehab.com.

>

>

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Posted
Posted

I agree with this --

I have worked for PT owned agencies and the big " hospital " conglomerates who

were both only out for a huge profit. I currently work for a physician owned

clinic who has more CE funds for the therapists than any of my prior employers.

Plus, we are more ethical in our business practices and do not ever encourage

overbilling like my previous employers often did. Oh, and we get referrals from

outside our physician group because of our quality staff, extended ours and

exemplary customer care.

The sad news is that we're in negotiations with a hospital system.

Laurie Heer, MS,PT

Proud to be Supervisor of rehabilitation services

Medical Associates Health Care Centers

Re: Referral for Profit on PTManager

I would be willing to start this discussion and would like to begin

with a question. How is physcian ownership of physical therapy

hurting the profession? I understand that it hurts the PT practice

owner but to many that feels like market based competition and people

are trying to limit that competition. I would be very interested to

hear this from non-PT practice oweners.

My opinion is that a PT should be able to choose their work

environment. I have worked in both PT and MD owned clinics where the

quality of care and the focus on reimburesment were the same. I have

seen both settings where the focus was not on quality of care. I

don't think you can generalize the quality of care or the busniess

acumen based solely on ownership.

The largest and most public therapy based fraud has been perpetrated

by large corporations, read HealthSouth, Physiotherapy Associates.

Cetainly there are many other reasons why folks want to limit

physician ownership but none of them appear to rise to the level of

truely " hurting the profession " . It strikes me the opposite could be

true and this question is an example. What hurts the profession more

than lack of communication. If we separate ourselves based on

something like who owns the business we work for that strikes me as

hurting the profession becasue now we have a fractured organization

where people are " locked out " of communcaiting with their peers.

If the goal of this listserve is to assist physcial therapists then

why limit it based on practice setting or ownership of that practice?

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

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Posted
Posted

As the Kentucky delegate at the recent annual Federation of State

Boards of Physical Therapy meeting , a majority of the delegates

(states) voted to move forward to have the Federation put forth a

request for study to researchers that would be willing to compile data

and provide an assessment of the impact of RFP/POPTS on the physical

therapy profession. The study will be funded up to $250,000.

I would encourage all of those with " data " and or experiences to make

you voices known. Feel free to contact me directly or submit your

information through your respective state boards.

Ron Barbato PT

Administrative Director, Rehabilitation Services

Ephraim McDowell Health

Voice:

Fax:

rbarbato@...

PRIVILEGED AND CONFIDENTIAL: This transmission may contain information

that is privileged subject to attorney-client privilege or attorney work

product, confidential and/or exempt from disclosure under applicable

law. If you are not the intended recipient, then please do not read it

and be aware that any disclosure, copying, distribution, or use of the

information contained herein (including any reliance thereon) is

STRICTLY PROHIBITED. If you received this transmission in error, please

immediately advise me, by reply e-mail, and delete this message and any

attachments without retaining a copy in any form. Thank you.

Referral for Profit on PTManager

>

>

>

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

>

>

> In ALL messages to PTManager you must identify yourself, your

discipline and

> your location or else your message will not be approved to send to

the full

> group.

>

> PTManager encourages participation in your professional

association. Join APTA,

> AOTA or ASHA and participate now!

>

> Visit the NEW and IMPROVED www.InHomeRehab.com.

>

>

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Posted
Posted

Laurie and others,

I respect your thoughts and I am in full agreement that it should not be where

you practice, but how you practice (in an?ideal world). Unfortunately no one

wants to admit they work in a " bad " environment and most PT's have, what a

colleague of mine?refers to as, " peace corp genes. " Even more feelings are

involved when there are no laws prohibiting such work and the pay is good and

the population working with is desirable.

I have seen hospitals strong-arm physicians to refer within. I worked for a PT

in private practice that went to jail for Medicare fraud because he was upcoding

and falsifying records behind our backs. I have known of?physicians accepting

compensation in return for referrals to private practices. And I too have had

the misfortune of sending a client to a physician for a second opinion only to

have the client call to cancel further appointments because the physician was

referred to the physicians own clinic. So there is no one way to generalize this

situation and it covers all practice settings. However I am also aware of the

reality of the situation and that there are no ideal circumstances. Healthcare

is now a business whether we like it or not. Those of us that own a private

practice?are more aware of the business than those that work for someone else.

Trust me, when we opened our doors I thought a cash box, a phone, a scheduling

book and equipment would a business make (not literally, but figuratively).?I

am?proud to say I am?still learning as our business evolves.

While not against the law in the majority of states, I believe that for the same

reasons Medicare is looking at the rulings on physician owned diagnostic centers

(because it sets up too much temptation for use), the topic of POPT's needs to

be addressed. Your experience in a physician owned setting I am sure is not

unique and there are many well run offices. Unfortunately much like a monopoly

in any business (and funny how no one in a monopoly ever complains about a

problem with monopolies), physicians that self refer do so at the cost of fair

competition. I know hospitals also do this, but for sake of argument lets take

the large hospital system out of this.

If there are two physical therapy offices in town, one owned by the physician

and the other a private practice, the private practice?by far has?less chance of

survival if it relies on physician referrals (especially in those states without

direct access). All the physician has to do is plant the seed that they

recommend their own office (because why would the doctor not have the best PT in

town, if they think they themselves are the best in town at what they do) and

the client goes there. Especially if they know nothing about either one of the

clinics. I ran into this while interviewing right out of school about ten years

ago in land. I went to a small town where a physician did not like the PT's

at the only clinic in town.?Because of this?he decided he wanted to open his own

clinic to drive them out of business. I don't know how it turned out, but I

would imagine since he was the only orthopedic surgeon in town he was probably

successful at doing so. Even worse is when two competing physician groups, each

open up a PT clinic and not only look for ways to save their revenue, but also

to increase their numbers.

Now if all the physical therapy practices are privately owned and the physicians

have no interest in any of them, things like customer service, knowledge and

training of staff, location, insurances in network with, and so on will come

into play and the best clinic will usually win or at least if any clinics went

under it would be because they just could not compete with the others on a fair

playing field. All issues of upcoding, falsifying records and adding treatment

charges would take care of themselves with insurance audits and the state

physical therapy association would be able to deal with the therapist as needed.

With " incident to " billing for therapy services allowed, how can the state

physical therapy board punish someone who is not a PT, but still practices like

one??I may be getting off track, but POPT's are allowed to employ such folks and

still bill under CPT codes. We have to think what is best for society, not just

ourselves.

Our organization?is very fortunate to have built relationships with the many

physicians in town that do not own physical therapy services and the majority of

these offices send to?the clinics based on who?they feel the most comfortable

with, who provides the best service, which clinic is closest to the client's

home, and which clinic takes the client's insurance. All things based on best

interests of the client and no potential for gain other than a thank you for the

referral from the client on a return visit and a thank you from us for the

referral.

As for a little background on this issue: When we opened our doors three years

ago?there were?no POPT's in our?city and 9 PT clinics in operation. Since then

three POPT's opened and 4?of the other?PT clinics closed. We have seen our

numbers drop because two of the three POPT's are owned by orthopedic surgeon

groups accounting for 12 total surgeons and about 4 PA's who are?in heavy

competition with each other. Tracking our numbers we were at an all time high of

client visits three months after opening our doors. What happened?four months

after we opened? The two Ortho POPT's opened up. We still see some?referrals,

but only those that need late evening hours and those they are not in network

with.

I weighed in on the issue last night and will weigh in again. I am much more

cautious with how I respond in this group, than with other groups where I know

it is only private practice owners,? because I know there are folks out there

that read responses without ever commenting that work in " referral for profit "

environments. I am in full support of disclosing your status and maybe even

terminating membership for those that work in environments that are not in

support of advancing the PT profession at all levels. When it comes down to

making a living it is tough to tell someone they can't, but?support from peers

and what is right for the greater good is sometimes what is missing when people

make decisions. Also for the record, in South Carolina where POPT's are now

against the law, I know many PT's that had to change jobs, but have yet to hear

of one not being able to find a job somewhere else.

By the way, still not in a " referral for profit " situation and able to make a

living.

J. Boyle PT, DPT, CSCS

President

Gaston Rehab Associates, Inc.

1361-B East Garrison Blvd

Gastonia, NC 28054

Re: Re: Referral for Profit on PTManager

I agree with this --

I have worked for PT owned agencies and the big " hospital " conglomerates who

were both only out for a huge profit. I currently work for a physician owned

clinic who has more CE funds for the therapists than any of my prior employers.

Plus, we are more ethical in our business practices and do not ever encourage

overbilling like my previous employers often did. Oh, and we get referrals from

outside our physician group because of our quality staff, extended ours and

exemplary customer care.

The sad news is that we're in negotiations with a hospital system.

Laurie Heer, MS,PT

Proud to be Supervisor of rehabilitation services

Medical Associates Health Care Centers

Re: Referral for Profit on PTManager

I would be willing to start this discussion and would like to begin

with a question. How is physcian ownership of physical therapy

hurting the profession? I understand that it hurts the PT practice

owner but to many that feels like market based competition and people

are trying to limit that competition. I would be very interested to

hear this from non-PT practice oweners.

My opinion is that a PT should be able to choose their work

environment. I have worked in both PT and MD owned clinics where the

quality of care and the focus on reimburesment were the same. I have

seen both settings where the focus was not on quality of care. I

don't think you can generalize the quality of care or the busniess

acumen based solely on ownership.

The largest and most public therapy based fraud has been perpetrated

by large corporations, read HealthSouth, Physiotherapy Associates.

Cetainly there are many other reasons why folks want to limit

physician ownership but none of them appear to rise to the level of

truely " hurting the profession " . It strikes me the opposite could be

true and this question is an example. What hurts the profession more

than lack of communication. If we separate ourselves based on

something like who owns the business we work for that strikes me as

hurting the profession becasue now we have a fractured organization

where people are " locked out " of communcaiting with their peers.

If the goal of this listserve is to assist physcial therapists then

why limit it based on practice setting or ownership of that practice?

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

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Posted
Posted

Hi ,

In my opinion, it is the open discussion of the problems that POPTS create

for the profession that would do more good than the elimination of it (by

leaving those in POPTS off the list). It is abundantly clear that many PT’s

still do not see why POPTS are hurting the profession. Through continued

discussion, we can possibly change the hearts and minds of this group.

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

Howell Physical Therapy (a therapist-owned private practice)

Eagle, ID

howellpt@...

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Kovacek

Sent: Thursday, September 20, 2007 6:34 PM

To: PTManager

Subject: Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

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Posted
Posted

I tend to agree with about the effect of POPTs, but can also see the other

side. Perhaps by adding the level of care/practice setting we will provide

additional information to help target answers to many of the questions. It would

also allow those with strong feelings one way or the other options when

responding or asking questions.

Irene Bartlett, PT Rehab Director

Mercy Hospital-Des Moines

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Kovacek

Sent: Thursday, September 20, 2007 7:34 PM

To: PTManager

Subject: Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

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Posted
Posted

Tom

Just to clarify

There is absolutely NO consideration being given to restricting

access to this List (PTManager) The issue is to require disclosure

of working in a referral for profit situation when someone posts to

the list.

Hope that clarifies it

Kovacek

>

> Hi ,

>

>

>

> In my opinion, it is the open discussion of the problems that POPTS

create

> for the profession that would do more good than the elimination of

it (by

> leaving those in POPTS off the list). It is abundantly clear that

many PT's

> still do not see why POPTS are hurting the profession. Through

continued

> discussion, we can possibly change the hearts and minds of this

group.

>

>

>

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

>

> Howell Physical Therapy (a therapist-owned private practice)

>

> Eagle, ID

>

> howellpt@...

>

>

>

> _____

>

> From: PTManager [mailto:PTManager ]

On Behalf

> Of Kovacek

> Sent: Thursday, September 20, 2007 6:34 PM

> To: PTManager

> Subject: Referral for Profit on PTManager

>

>

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

>

>

>

>

>

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Posted
Posted

Hi ,

Thanks for the clarification about the POPTS issue.

I understand your clarification and I guess I was jumping a step ahead. My

understanding is that members of the list serve are having trouble feeling

free to respond on the list because they know others, including those that

work for POPTS, are reading and getting information from the list. If that

is a correct description, then the only way to fully address their concern

is to de-list these therapists and limit the list to non-POPTS therapists.

Have respondees list their practice setting doesn’t prevent them from

accessing the information/discussions about POPTS and does nothing but

create a way to discriminate against them

The clarification does not change my opinion. I don’t agree with listing

practice setting for POPTS therapists or de-listing POPTS therapists. I

think this list would be better served by having an open and balanced

discussion about it and use the discussion to change opinions.

One additional point and another suggestion: . Maybe the list needs regular

reminders, not only about netiquette, but also of the care in what is

discussed (ie be careful with responses because the list is open to a large

diverse group)

Respectfully,

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

Howell Physical Therapy

Eagle, ID

howellpt@...

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Kovacek

Sent: Friday, September 21, 2007 11:19 AM

To: PTManager

Subject: Re: Referral for Profit on PTManager

Tom

Just to clarify

There is absolutely NO consideration being given to restricting

access to this List (PTManager) The issue is to require disclosure

of working in a referral for profit situation when someone posts to

the list.

Hope that clarifies it

Kovacek

>

> Hi ,

>

>

>

> In my opinion, it is the open discussion of the problems that POPTS

create

> for the profession that would do more good than the elimination of

it (by

> leaving those in POPTS off the list). It is abundantly clear that

many PT's

> still do not see why POPTS are hurting the profession. Through

continued

> discussion, we can possibly change the hearts and minds of this

group.

>

>

>

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

>

> Howell Physical Therapy (a therapist-owned private practice)

>

> Eagle, ID

>

> howellpt@...

>

>

>

> _____

>

> From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

[mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com]

On Behalf

> Of Kovacek

> Sent: Thursday, September 20, 2007 6:34 PM

> To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

> Subject: Referral for Profit on PTManager

>

>

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

>

>

>

>

>

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Posted
Posted

-

I think this is a great idea - it will be like wearing a " Scarlet 'P' " . . .

Here are some other ideas of how people should identify themselves for full

transparency:

* Everyone should divulge their utilization rate (visits per new patient)

- " 8.5 "

* Stipulated orders against professional license - " L "

* People that sign low reimbursement contracts that drive reimbursement

down for everyone - " C "

* Excluded from by CMS from Medicare / Medicaid - " E "

* APTA member - " M " , " M+ " if you belong to multiple sections, or " M* " if

you hold a leadership position

* Political affiliation - standard " D " , " R " or " I "

* Generation - " X " , " Y " , " Greatest " , " Boomer "

* College mascot - " Duck " , " Horned Frog "

Sorry for the sarcasm. I think this change to the listserv is unnecessary.

Personally, if I want to find out about the background of a person posting on

PTManager I simply do a Google search on their organization. I think name,

discipline and organization is enough. Adding a website for their organization

would be a plus.

I belong to several other listservs, some where the majority of the questions

are anonymous postings through the moderator. The beauty of PTManager is the

openness of questions, the ability to debate topics, the chance to hear

differing views, etc. The subscribers need to be able to weed through the good

and bad, but that is a learning process in itself. I think having too many

requirements will simply hinder open discussion and may make PTManager more of a

pep rally of people will the same views.

In PT nirvana, POPTs would not exist. However, at this point, while some people

may think POPTs are unethical, they are legal and a viable business option for

some providers. These settings pose a competitive threat to PTs in private

practice but so do hospital-based PT clinics, chiropractors, ATCs, LMTs, etc.

As in any profession or practice setting, there are good, ethical groups and

providers, and there are those that are unprofessional and abuse the system. If

POPTs are going to be eliminated it will be because of situations where the

system has been abused. At this point CMS seems to have a heightened awareness

of some problems in POPTs settings.

Thank you for the forum PTManager provides for our profession and asking for our

input.

Todd Gifford, PT

TherapeuticAssociates

www.therapeuticassociates.com

www.careconnections.com

/

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

In ALL messages to PTManager you must identify yourself, your discipline and

your location or else your message will not be approved to send to the full

group.

PTManager encourages participation in your professional association. Join APTA,

AOTA or ASHA and participate now!

Visit the NEW and IMPROVED www.InHomeRehab.com.

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Posted
Posted

This has been an open forum with exchange of ideas from many types of

practices. I have heard from people in therapist owned practices, corporate

owned practices, hospitals, SNF, non-treating managers, non-therapists with

expertise (J Hall), etc. I value the multiple opinions and cannot see

limiting that free flow of expert advice. We are all dealing with different

versions of the similar issues. We also have different expertise and views

that add value to conversations.

I would hate to be excluded in the next line of limitations. In my personal

case, I rarely see patients anymore; but, feel I have provided expertise and

gained information in exchanges. I see no problem and would encourage

providing some baseline info that is relevant to the conversation. I have

always restrained on this since I don’t want to sound like I am advertising.

Steve Passmore PT

CEO Healthy Recruiting Tools

HYPERLINK " mailto:spass@... " spass@...

HYPERLINK " http://www.healthyrecruiting.com/ " www.HealthyRecruiting.com

" What we did for you yesterday is history.... What can we do for you today "

From: PTManager [mailto:PTManager ] On Behalf

Of Kovacek

Sent: Thursday, September 20, 2007 7:34 PM

To: PTManager

Subject: Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

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12:07 PM

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Posted
Posted

I have for most of my professional life have been opposed to physician owned

services, whether there was a referral for profit mindset or not. Perhaps we

need to focus on the setting rather than the behavior since, in an e-mail, i am

not sure how we can judge the behavior

I would suggest:

Physician owned

PT owned

Corporate for profit

Corporate Not for profit

Having proposed this I would again remind those in physician owned services that

although you might be providing good clinical care, you as a professional have a

responsibility to your profession and your colleagues as we all benefit from all

our professional behavior. While legal, it is demeaning to the profession that

these situations exist. I would urge all in these situations to reconsider your

definition of professionalism and where your colleagues fit into it and how the

public perceives the profession when you share your license, and your revenue,

with another licensee/referral source....is the orthopedist or physiatrist that

you work for splitting his/her office or surgical fees with you?

Jim Dunleavy PT, MS

Director, Rehabilitation Services

Trinitas Hospital

, NJ 07207

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.487 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.5.488 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

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Posted
Posted

Interesting...

The following passage may assist in informing our deliberations:

PHYSICAL THERAPIST OWNERSHIP AND OPERATION OF PHYSICAL THERAPY SERVICES HOD

P06-02-24-48 (Program 32) [initial HOD 06-01-25-24] [Position]

Consistent with the American Physical Therapy Association Vision Statement

for Physical Therapy 2020, the American Physical Therapy Association

supports exclusive physical therapist ownership and operation of physical

therapy services.

(Program 32 - Practice, ext 3176)

(APTA Bylaws, Positions, Standards, Guidelines, Policies, and Procedures.

Available at:

http://www.apta.org/AM/Template.cfm?Section=Policies_and_Bylaws1

<http://www.apta.org/AM/Template.cfm?Section=Policies_and_Bylaws1 & TEMPLATE=/

CM/ContentDisplay.cfm & CONTENTID=25675>

& TEMPLATE=/CM/ContentDisplay.cfm & CONTENTID=25675. Accessed September 21,

2007)

......

So, as I read that HOD Policy, perhaps our discussion should include far

more than POPTS. It would appear that the APTA officially does not support

ownership and operation of physical therapy services by *any* of the

following:

Department of Defense...

Veterans Administration...

US Public Health Service...

Indian Health Services...

Any State Department of Health...

State Division of Mental Retardation facilities...

University Medical Centers...

Acute care hospitals...

Inpatient rehab facilities...

Home health agencies...

Nursing homes...

Not for profits...

For profits...

Corporate...

Investor owned...

Most schools of physical therapy are not therapist owned or operated. And

of course, Cleveland Clinic, Mayo Clinic, Leahey Clinic are all physician

owned practices.

Warmest tornado regards,

Dick Hillyer, PT

W. Hillyer,DPT,MBA,MSM

Hillyer Consulting

Cape Coral, Florida

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Steve Passmore

Sent: Friday, September 21, 2007 6:19 PM

To: PTManager

Subject: RE: Referral for Profit on PTManager

This has been an open forum with exchange of ideas from many types of

practices. I have heard from people in therapist owned practices, corporate

owned practices, hospitals, SNF, non-treating managers, non-therapists with

expertise (J Hall), etc. I value the multiple opinions and cannot see

limiting that free flow of expert advice. We are all dealing with different

versions of the similar issues. We also have different expertise and views

that add value to conversations.

I would hate to be excluded in the next line of limitations. In my personal

case, I rarely see patients anymore; but, feel I have provided expertise and

gained information in exchanges. I see no problem and would encourage

providing some baseline info that is relevant to the conversation. I have

always restrained on this since I don't want to sound like I am advertising.

Steve Passmore PT

CEO Healthy Recruiting Tools

HYPERLINK " mailto:spass@HealthyRecrui <mailto:spass%40HealthyRecruiting.com>

ting.com " spass@HealthyRecrui <mailto:spass%40HealthyRecruiting.com> ting.com

HYPERLINK " http://www.healthyr <http://www.healthyrecruiting.com/>

ecruiting.com/ " www.HealthyRecruiting.com

" What we did for you yesterday is history.... What can we do for you today "

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

[mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com] On

Behalf

Of Kovacek

Sent: Thursday, September 20, 2007 7:34 PM

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.487 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.5.488 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

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Posted
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Jim writes: “…is the orthopedist or physiatrist that you work for splitting

his/her office or surgical fees with you?â€. I am asking this of those

employed in a PT owned practice, does every PT owner have his PT staff share in

the profits? Of course some will, maybe even many. This may indeed be far less

frequent in a POPTS. If we all were to open our own private practice, would

that serve our profession any better? Yet for some who fervently argue against

POPTS, that would be the only reasonable alternative…they often will refer to

it as “survival of the fittestâ€. Fact is though that not all people have

that fire in the belly, that is necessary to run a private practice. Not

everyone is prepared to work under that pressure or to accept the risks that go

with running your own business. Fact is some of us will thrive as owners of a

private practice, for others it is more comfortable to be employed.

Economically each of us makes decisions that work for us and our families.

I am completely in favor of rallying against blatant abuse or exploitation of

our profession wherever it exists, but that applies not just to POPTS, but also

to any PT and non-PT financed care setting. Forums such as PT Manager serve an

important purpose: Educate anyone who wishes to be a member on what is ethical

and professional conduct, behavior and/or practice. It can educate how to

recognize abuse and how to stand up to it. It can, should, will and has

highlighted the good, the bad and the ugly. It should not be a pulpit or the

soapbox of just one perspective. It should continue to be an open forum.

Many in history have had to openly identify themselves, only to quickly become

outcasts, if they were or had not already been labeled as such. Even by those

who only recently had been their neighbors, friends even. Who wants to be

associated with an outcast? Self preservation is a powerful force. In history

many that were outcast had no or only little control over their fate or the

cause of it. Many that were outcast had always been respected members of their

communities and always contributed much to it. Those who accepted the fact that

others were “less†than they, have often become to regret it. Those who

were responsible for others being cast out, quite often were out to preserve

only their personal interests or that of a select few. (Please do not draw any

unintended parallels or inferences, my intent is only to question the principle

of asking/demanding others to label themselves or for them to be labeled.)

Some have posted that unscrupulous or unethical practice knows no boundaries.

It is in fact a reality of today’s business world and is prevalent in

virtually every aspect of life. It seems to have become a part of the American

way of life and is mostly justified as “freedom of enterpriseâ€. In my

opinion we do not fight this by labeling well meaning, often very ethical

professionals who for respectable, even understandable, reasons are employed in

the settings of their choice. We fight it through open and honest discussion.

By exposing, questioning and reporting unethical, even illegal, behavior and

practice, and by urging/educating others to, through their professional conduct,

challenge unethical or illegal behavior/practice at their place of employment.

Allow this forum to educate each who wishes to be a member, encourage the

exchange of information, allow this forum to continue to serve as coach and

mentor to any who cares to read the hundreds, even thousands of emails. Over

time many will recognize that ethical and professional conduct is what will grow

our profession, not fanatic opposition to an undesired element.

I do believe it is wise though from time to time to remind this list, that this

forum is open to anyone…to anyone. Not just well intended professionals, but

also to those who audit us, pay us, wish to profit from us, those who are

looking for ammunition against us…ANYONE!!! That, to me, is far more a

significant problem given the amount and kind of sharing that occurs, then

asking those who work in a POPTS to identify themselves as such.

Respectfully,

van Well, PT

Redford, MI

Happily (?) employed.

From: PTManager [mailto:PTManager ] On Behalf Of

JIMDPT@...

Sent: Friday, September 21, 2007 7:32 PM

To: PTManager

Subject: Re: Referral for Profit on PTManager

I have for most of my professional life have been opposed to physician owned

services, whether there was a referral for profit mindset or not. Perhaps we

need to focus on the setting rather than the behavior since, in an e-mail, i am

not sure how we can judge the behavior

I would suggest:

Physician owned

PT owned

Corporate for profit

Corporate Not for profit

Having proposed this I would again remind those in physician owned services that

although you might be providing good clinical care, you as a professional have a

responsibility to your profession and your colleagues as we all benefit from all

our professional behavior. While legal, it is demeaning to the profession that

these situations exist. I would urge all in these situations to reconsider your

definition of professionalism and where your colleagues fit into it and how the

public perceives the profession when you share your license, and your revenue,

with another licensee/referral source....is the orthopedist or physiatrist that

you work for splitting his/her office or surgical fees with you?

Jim Dunleavy PT, MS

Director, Rehabilitation Services

Trinitas Hospital

, NJ 07207

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

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Posted
Posted

IMHO, I have no issue with complete identification including name, credentials,

location, and even practice setting. For some, they may have legitimate reasons

for not fully identifying the facility name and this is not necessarily

problematic. However, self-disclosure of " referral for profit " or " physician

owned PT service " begins to mark individuals with a stereotyped bias which is

often more an emotional issue than proven detriment to quality care. True, any

referral for profit situation is abusive to patients and is ethically, morally,

and legally wrong. Just as physicians steering their patients to a single

facility, whether owned by them or not, is potentially abusive unless it is

based on quality measures. Yet when you identify POPTS arrangements, are they

all inherently evil and potentially abusive to the patient? Are they all really

a " referral for profit " situation? Probably not. We don't have the data to

demonstrate that POPTS are always bad situations where

patients are financially compromised. While opposed to POPTS arrangements on

principle, I have to admit that I know of POPTS clinics where the patients are

better served (quality, efficiency, outcomes) than in other PT owned clinics.

Before we brand our colleagues with a Scarlet P on their forehead we need to

look in the mirror and honestly ask what purpose having this disclosure will

achieve. Not to mention how honestly individuals will self-identify. Or will we

be forced into a " witch-hunt " to " out " our colleagues.

So let's continue the data driven and emotionally-based discussions of the

pitfalls of referral for profit and physician owned, but let's not add more

initials after our names such as RFP or POPTS. If we drive those folks away from

this listserve, we will lose our opportunity to convert them with commentary and

wisdom. Or they us to the other side.

Disclosure: I have never worked in a POPTS arrangement, nor do I plan to in

the future.

W. , PT, MS

Chair, PTA Program

Baker College of Park, MI

Therapeutics

Grosse Pointe Woods, MI

Committed to Quality

Kovacek wrote:

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

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Posted
Posted

In adding fuel to the fire, consider this....ABC (PT owned) therapy competes

with XYZ (PT owned) therapy...and with the hospital and inhome part B rehab, and

POPTs and massge therapy and chiropractors and personal trainers and Pilates

instructors,, etc...I could go on and on.?

My point is everyone in business competes with everyone else in that field.? No

matter who owns the building or corporation.? A SNF is not PT owned, neither is

a hospital, school?or some wellness centers with PT.? Consider the

many?corporations that provide rehab that are not owned by PT's.? Should we

outlaw hospital outpt PT?? If you are pure to the non PT owned ideal, then the

answer must be yes.??The hospital is the only place a pt can go when thier cap

runs out,?how is that even close to fair for us? That is worse than the POPTs,

at least the POPTs have a cap too.?

I'm not agruing for POPTs, but am saying the suggestion of all PT owned therapy

is flawed and not feasible at his time in history.? Don't get me wrong, I'd love

to be the therapy provider for the local hospital...so would all the other

PTPP's in town...see...we all compete..thus we must find a niche and be better

at what we do than the next guy in order to stand above the rest.?

Picking on the docs will not end referral for profit.? Our local hospital system

gives incentives for doctors and social workers to refer within the

system....just like a POPT, but we don't fight them, we allow them to be exempt

from the caps!!? Additionally, not all PT " s want to be owners.?

Medicare and insurance co's do not yet recognize us as primary providers...one

day they may, but it doesn't seem to be soon.?They are so bogged down, that WE

are thier last concern (as shown by the caps).?

We need to be careful.? If we make PT practice exclusive to PT, trainers and

others will be hired to preform " fitness or wellness " care...the docs and

hospitals will lobby with thier big money and muscle to get insurance to pay for

preventative care, and rehab will totally change.? Don't underestimate the power

of the big dogs...better to make friends with them, or they will bite us.?

Example:? Hospitals are exempt from the cap...big money, big voices, big power

with the government and the insurance.?

I do not think we should eliminate PT's who work for POPTs, they are many of

them and they will form their own organization if we exclude them.? Besides

aren't PT's all about helping others regardless of thier position?...all others

not just patients.? I have never seen a profession with so much infighting.?

Nurses don't do this based on thier practice setting, neither do respiratory

therapists or OT's.? " You're not in a private practice, so I can't be friends

with you and will exclude you. " ? How old are we?? It's ridiculous and immature.?

We are all trying to get along and it's America, free enterprise.

If you can't make it, changing the laws or excluding others from hiring your

peers is bullying.? If the POPTs go away( we must also outlaw ALL non PT owned

practices (schools, nursing homes, home health etc), will you hire all the PTs

out of work??

I contend that if that happens, docs will not refer to PT because they will feel

like we bullied them and they will give home ex. and move on.? I already know of

several docs who tell pts never to go to PT because they are pretentious and

" holier than thou. " ? It's very sad.? Can't we all just get along?? Be good at

what you do and you'll be in demand and will succeed.

How 'bout that can of worms.... I'll get off my soapbox. Thanks for letting me

be devils advocate...I like a good discussion.

Amy

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.487 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

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Checked by AVG Free Edition.

Version: 7.5.488 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

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Posted
Posted

I agree, but I would also ask, does the hospital or snf or home health agency

share it's profits with the therapists?

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.487 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

No virus found in this outgoing message.

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12:07 PM

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Posted
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Amy correctly points out that " ...everyone in business competes with everyone

else in that field. " But it's dangerous to speak of medical care " competition "

outside the context of our current regulatory and third-party systems. Perhaps

the most important of medical care's realities today is that there is virtually

zero level-field competition! Access to services (and to payment for services)

is obsessively controlled-and NOT by consumers. It is the rules, not

consumer-driven supply and demand, that determine who gets what.

<?xml:namespace prefix = o ns = " urn:schemas-microsoft-com:office:office " />

Government and other third-party rules define what care is, its value, and the

circumstances under which it may be given. Government exercises indirect control

over wages, supplies, business procedures, and even malpractice insurance (which

can be cheaper or more expensive depending on whether a care system meets

certain federal qualifications).

POPTS are a part of the mess. The rule system makes physicians primary

gate-keepers, thereby giving them the ability to exercise monopoly control-by

artificially pumping up utilization or by tethering patients to their business,

or both. That's just plain bad. And if we're going to control one side, we ought

to, really must, control the other. (Merely writing a law giving patients a

choice just doesn't cut it, since physician " recommendations " are powerful-few

patients buck them.)

Or, and this is just a pleasant dream of mine, we could quit entirely all this

obsessive controlling and let true market forces flourish in healthcare.

Dave Milano, PT, Director of Rehab Services

Laurel Health System

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.487 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

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Posted
Posted

Ahhh, a level playing field, consumer ability to choose where they

want to go without influence by an insurance company or a doctor or

other source that makes money off of that influence, may the best PT

win, if only.

E. s, PT, DPT, OCS, FAAOMPT

www.douglasspt.com

>

> Amy correctly points out that " ...everyone in business competes

with everyone else in that field. " But it's dangerous to speak of

medical care " competition " outside the context of our current

regulatory and third-party systems. Perhaps the most important of

medical care's realities today is that there is virtually zero level-

field competition! Access to services (and to payment for services)

is obsessively controlled-and NOT by consumers. It is the rules, not

consumer-driven supply and demand, that determine who gets what.

>

> <?xml:namespace prefix = o ns = " urn:schemas-microsoft-

com:office:office " />

>

> Government and other third-party rules define what care is, its

value, and the circumstances under which it may be given. Government

exercises indirect control over wages, supplies, business

procedures, and even malpractice insurance (which can be cheaper or

more expensive depending on whether a care system meets certain

federal qualifications).

>

>

>

> POPTS are a part of the mess. The rule system makes physicians

primary gate-keepers, thereby giving them the ability to exercise

monopoly control-by artificially pumping up utilization or by

tethering patients to their business, or both. That's just plain

bad. And if we're going to control one side, we ought to, really

must, control the other. (Merely writing a law giving patients a

choice just doesn't cut it, since physician " recommendations " are

powerful-few patients buck them.)

>

>

>

> Or, and this is just a pleasant dream of mine, we could quit

entirely all this obsessive controlling and let true market forces

flourish in healthcare.

>

>

> Dave Milano, PT, Director of Rehab Services

> Laurel Health System

>

>

> Referral for Profit on PTManager

>

> It is time for a decision on protocol for this list serve -

PTManager

>

> I have received quite a few calls and emails from many members of

> PTManager regarding the level of support that is provided on this

> list to all members. I am very proud of that - we've accomplished

> much over the almost 10 years that we've done PTManager. I believe

> the peer to peer support here is unparalleled in our profession.

> Thanks.

>

> Now I have a question for the group. For quite some time we have

> required all messages to PTManager to include a name, a discipline

> and a location. Several have also requested that we require a

> practice setting. Sometimes (but not always) this is needed to

> provide a good answer to a query as some issues are different

> depending on the type of setting.

>

> Quite a few members have also asked that we require all members to

> disclose if they are in a " referral for profit " practice such as a

> physician owned therapy practice. The rationale is that - although

> PTManager is devoted to peers helping peers - many of our members

are

> hesitant to provide assistance to a practice that is hurting the

> profession - which I personally believe is the case with POPTS.

>

> I would like to hear any and all discussion on this subject and

will

> not require such a disclosure during this discussion. After at

least

> a week period, we will make a decision on whether or not to require

> that all messages to PTManager indicate that they are or are NOT

from

> a referral for profit setting.

>

> I look forward to the discussion. Please post all messages to the

> list and not to me personally.

>

> Kovacek, MSA, PT

> Owner/Moderator

> PTManager listserve

> PTManager.com

>

> No virus found in this incoming message.

> Checked by AVG Free Edition.

> Version: 7.5.487 / Virus Database: 269.13.27/1020 - Release Date:

09/20/2007

> 12:07 PM

>

> No virus found in this outgoing message.

> Checked by AVG Free Edition.

> Version: 7.5.488 / Virus Database: 269.13.27/1020 - Release Date:

09/20/2007

> 12:07 PM

>

>

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Posted
Posted

Dave,

You said it much better than I could.? It is the rules of the payors that

dictate what happens.? Thanks for you insite.

Amy McBree-Babb, DPT

HSPT

Ft Myers, FL

Referral for Profit on PTManager

It is time for a decision on protocol for this list serve - PTManager

I have received quite a few calls and emails from many members of

PTManager regarding the level of support that is provided on this

list to all members. I am very proud of that - we've accomplished

much over the almost 10 years that we've done PTManager. I believe

the peer to peer support here is unparalleled in our profession.

Thanks.

Now I have a question for the group. For quite some time we have

required all messages to PTManager to include a name, a discipline

and a location. Several have also requested that we require a

practice setting. Sometimes (but not always) this is needed to

provide a good answer to a query as some issues are different

depending on the type of setting.

Quite a few members have also asked that we require all members to

disclose if they are in a " referral for profit " practice such as a

physician owned therapy practice. The rationale is that - although

PTManager is devoted to peers helping peers - many of our members are

hesitant to provide assistance to a practice that is hurting the

profession - which I personally believe is the case with POPTS.

I would like to hear any and all discussion on this subject and will

not require such a disclosure during this discussion. After at least

a week period, we will make a decision on whether or not to require

that all messages to PTManager indicate that they are or are NOT from

a referral for profit setting.

I look forward to the discussion. Please post all messages to the

list and not to me personally.

Kovacek, MSA, PT

Owner/Moderator

PTManager listserve

PTManager.com

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.487 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.5.488 / Virus Database: 269.13.27/1020 - Release Date: 09/20/2007

12:07 PM

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