Guest guest Posted May 13, 2011 Report Share Posted May 13, 2011 Off hand how about the patients right to chose his clinician. The usual Dr. response is something about how good their communication with the PT provider is enhanced, that is a straw dog. Fee splitting not permitted by us and yes, ethics is part of who we are and does not need to be an apology. I do not know where you are practicing but check your state statues for possible violations. Federal laws are not looking at these relations with favor. Talk to your local PT's and see what they have to say about it, what they have experienced. We will not reach our desired goals and independence in practice if we sleep with the devil. A. Towne, PT In a message dated 5/13/2011 8:13:08 P.M. Eastern Daylight Time, pt@... writes: I am a physical therapist with a small private practice. Recently I've been approached by a physician group wanting me to partner with them in a POPT venture. They are currently referring patients to me and so I want to take a careful approach to my discussion with them. There has been conversation in this group (PT Manager) about all the reasons why POPT's are bad for our profession but I am hoping for some response from the group that will help me present some reasons that this venture would be a bad idea for them, (the physician group). I'm sure I need to refer to more than just the ethical considerations in my conversation with them. Can anyone in the group provide me with conversation points that will possibly help me convince them that they should reconsider their plans for this business venture? [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2011 Report Share Posted May 14, 2011 Elise, I would consider a partnership where the profits from both enterprises are shared equally. Everyone walks away as a winner. If the medical practice does well we both benefit. Likewise, if the physical therapy practice thrives we all celebrate.  I would emphasize that I expect to be an equal partner in both the medical and physical therapy practice.  I would want to benefit from their hardwork, just as they expect to benefit from my sweat. Otherwise, it is nothing more than a servant-master relationship. The only person who deserves to be served is your patient, and if they are satisfied with your service you will continue to thrive regardless of whether this physician group exists. Sumesh Hamilton Physical Therapy      ________________________________ To: PTManager Sent: Fri, May 13, 2011 12:06:46 PM Subject: POPT  I am a physical therapist with a small private practice. Recently I've been approached by a physician group wanting me to partner with them in a POPT venture. They are currently referring patients to me and so I want to take a careful approach to my discussion with them. There has been conversation in this group (PT Manager) about all the reasons why POPT's are bad for our profession but I am hoping for some response from the group that will help me present some reasons that this venture would be a bad idea for them, (the physician group). I'm sure I need to refer to more than just the ethical considerations in my conversation with them. Can anyone in the group provide me with conversation points that will possibly help me convince them that they should reconsider their plans for this business venture? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2011 Report Share Posted May 15, 2011 Again on Sunday afternoon thinking...why can't we PTs hire an MD in our group rather the opposite? It is still POPT but with a twist. Just a thought. Hiten Dave' PT > > > I've often wondered how folks would feel if a medical group took a Doctor > of > Physical Therapy into their group with a relationship exactly the same as > when they bring in a new M.D. Did you ever wonder that? An equal partner. > > In many areas, state law would forbid that. So, uh, how about the inverse? > If THEIR law doesn't allow a PT to be part of their practice, then perhaps > ALL law should be that way. > > Just sorta wondering on a Saturday evening. > > Dr. Dick Hillyer > > Dr. Hillyer, PT,DPT,MBA,MSM > Hillyer Consulting > > POPT > > I am a physical therapist with a small private practice. Recently I've been > approached by a physician group wanting me to partner with them in a POPT > venture. They are currently referring patients to me and so I want to take > a > careful approach to my discussion with them. There has been conversation in > this group (PT Manager) about all the reasons why POPT's are bad for our > profession but I am hoping for some response from the group that will help > me present some reasons that this venture would be a bad idea for them, > (the > physician group). I'm sure I need to refer to more than just the ethical > considerations in my conversation with them. Can anyone in the group > provide > me with conversation points that will possibly help me convince them that > they should reconsider their plans for this business venture? > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2011 Report Share Posted May 16, 2011 I'm very impressed with this response. Instead of attacking at a moral issue, you have taking a dollars and sense issue which is nice complement. I was approached by a MD group once and told them I was concerned about the ethical stance of a POPTS. They told me " No Problem, we are a great group of physicians and WHEN YOU WORK FOR US, WE WILL NOT LET YOU be unethical. " Somehow I think they missed the point. Missing the point is easy to do when you are looking at things and feeling you are automatically on the high ground. Therapists can do the same thing. While I love your approach, I suspect its less than 100% effective. Physician groups come in with a pre-conceived idea; and the salespeople are so good at selling the idea of owning a PT practice. I am keeping your email on file. Great reply. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager [mailto:PTManager ] On Behalf Of Diane Sent: Sunday, May 15, 2011 5:16 PM To: PTManager Subject: Re: POPT I was approached with a similar offer to work in a POPT (Medicare participant who billed PT services as incident to physician's.) Here are a few reasons this was a bad idea for me: 1. I would have had to limit my referrals from other referral sources, since PTs in a POPT setting are required to receive >90% of their referrals from the physician(s) in the practice. Depending on the type of physician group, this could quickly homogenize your patient population. 2. Because I would have to bill under the physician's billing code, I could only practice when the physician was physically there. This would restrict my ability to perform off-site treatments, to set up gym programs, to perform home or ergonomic evaluations, to provide pool therapy at a leased community pool, etc. 3. Because my PTA bills under my NPI, and I would be billing under the physician's (not my) billing ID, my PTA could not work in the POPT with me. The benefits would have been access to their full clinical support system (scheduling, billing, insurance contracting...), benefits package similar to the physicians in the practice, and ability to specialize in a very narrow scope of PT practice. I am sure their interest in me was not financially-motivated, because they owned the MRIs, anesthesiology suites, etc. Any profit I could have produced would have been a drop in the bucket. Now, why would it be bad for them? 1. Start up costs and overhead for ongoing operations that they would not incur if they just kept referring to your practice. If they only hire you (and they accept Medicare) they will need to generate enough referrals to keep you productive, and should expect to have a modest profit. You may have to explain the differences between physician billing codes (which charge for " typical " times and PT codes which charge for " actual " time) They would really need to be able to support 2-3 therapists to make such a venture worthwhile. This may be a good opportunity for you to educate them that you as an individual practitioner have already assumed this risk in your practice and would welcome the opportunity to continue to do so. They may incur added costs if their EMR and billing software do not support rehab services. 2. Increased compliance/regulatory oversight. Medicare is looking more closely at these relationships in terms of the Impossible Day (more codes billed than hours in the workday.) and they are on the radar of private insurers, too. The physicians may not be aware that in response to published stories of fraudulent billing practices (primarily by chiropractors and physicians billing incident-to PT services) CMS published a final rule upgrading PT services to Moderate threat for fraud/abuse (Federal Register Feb 2, 2011) and are closely scrutinizing new PT start-ups and POPTS. The physicians would be response for fines and penalties for inaccurate PT services billed under their billing ID. They would need someone to assume the responsibilities of making sure they have a compliance program and of staying up-to-date on the changes to ensure continued compliance, or pay someone (maybe you) to be the rehabilitation director and perform those responsibilities (that you as an individual practitioner are already familiar with.) The real question is what do they expect to gain from the arrangement that can't be achieved in your current relationship? Commonly cited (not necessarily in this order:) 1. New revenue stream, 2. Tighter control over delivery of PT services (specifically, decrease over-utilization through closer communication with the therapist,) and 3. Improved customer satisfaction for those who can make one trip on the day that they have PT and MD visit the same day. If the main concerns are reasons 2 or 3, I'm positive you can address them in your current model. If the answer is 1, try not to look surprised when they say it out loud. One more suggestion. Go with the attitude that *you* are interviewing* them * and gather information about their customer base, practice needs, future growth potential, policies and procedures, etc. that will help you better meet their needs and/or you plan for future growth at your practice. This a fantastic (and free!!!) marketing opportunity for you; you have their undivided attention for the entirety of the interview, and can use it to sell them on the value of your services in the current model. Try to walk away on an " even though I don't think this fantastic opportunity is for me, I'd love to be able to continue to work together " note (and give suggestions of how you can still help meet their patients' needs.) On Fri, May 13, 2011 at 12:06 PM, Elise Lundeen <pt@... <mailto:pt%40valleyrehabltd.com> >wrote: > > > > > I am a physical therapist with a small private practice. Recently I've been > > approached by a physician group wanting me to partner with them in a POPT > venture. They are currently referring patients to me and so I want to take > a careful approach to my discussion with them. There has been conversation > in this group (PT Manager) about all the reasons why POPT's are bad for our > profession but I am hoping for some response from the group that will help > me present some reasons that this venture would be a bad idea for them, > (the > physician group). I'm sure I need to refer to more than just the ethical > considerations in my conversation with them. Can anyone in the group > provide > me with conversation points that will possibly help me convince them that > they should reconsider their plans for this business venture? > > Quote Link to comment Share on other sites More sharing options...
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