Guest guest Posted December 28, 2009 Report Share Posted December 28, 2009 Dave, I totally agree with you. And thanks for the enlightening video. It was particularly interesting at the part about Congressman Bart Stupak being on the House Subcommittee for Investigations and Oversight (which investigates pharmaceutical companies and insurances companies among others) while at the same time receiving $110,000 per year (every year) from the pharmaceutical industry. Another little tidbit not mentioned on the video (and that I mentioned on the board before) is that his number one political contributor is Blue Cross Blue Shield of Michigan. Is it little wonder why we fail to get any substantive changes in these areas? Also, as you stated and I've stated previously on this board, there are very few, if any, free financial and commercial markets left. The existence of free markets is largely an illusion. , PT, OCS Marquette, MI RE: Universal Healthcare Alan To quote the old Saturday Night Live character Roseann Roseannadana, " Mr. Petrazzi, you sure ask a lot of questions. " They are important issues however. First point, what is being proposed is not Universal Healthcare. It brings us closer providing coverage for most people but does not cover everyone. There is a lot of biased interpretation being offered that makes understanding difficult. An excellent non-partisan resource is the Kaiser Family Foundation. Go to their website at www.kff.org. They summarize each of the proposed plans as well as line them up side by side and item by item to compare each. Remember there are two versions of bills. One from Congress and one from the Senate that have differences that need to be reconciled before they can become law. To answer your questions: There is nothing in it that addresses automony of therapists (what I assume you are asking?) Waiting times should not be a concern since it only addresses payment of services not practice The funds will go to pay for private insurance so Plans of care, frequency and duration will be defined by the private insurance companies. Reimbursement from Medicare is likely to be impacted. One of the provisions proposed is to take from Medicare to fund coverage to the currrently uninsured. The likely result is drop in either rates or coverage of procedures. Reimbursement from non-governmental insurance will largely be decided by these companies. They will not be able to deny services for pre-existing conditions or other underwriting practices of the past. This may effect their profitability, so it is unknown how they will react. The fear is that insurance premiums will go up for others to cover the formerly uninsurable. Salaries is an unknown. There may be a greater need for therapist in an already tight market, since more people will have insurance coverage and thus access to healthcare. The current shortage of therapists may create an employee advantage that makes therapist a valuable position that increases salaries. Or if insurance companies reduce amount of services they will authorize we could see the opposite. Small practices will face the same challenges they do today. If insurance companies partner with larger practices it could hurt the small ones. Insurance companies and physician groups could pit practices against each other to undercut prices. A small practice with low overhead could win. Or prices could be so low as to make the cost of delivering services more that the reimbursement. The % of Self-pay patients could drop as more people are covered by health insurance. If insurance companies cut back services, people who want additional services may have to pay out of pocket. Pursuit of patients seeking PT to delay surgery is unknown. That will likely depend on the insurance company, physician (group) and patient. Pursuit of patients seeking alternative health providers. It is important to note that the two bills being proposed are requiring those who can afford to buy health insurance to buy it and those who cannot buy it will get government assistance. This insurance will be from the same companies that now give us coverage. We are not facing any change in the delivery of services but a change in who has funding coverage and what the insurance providers can and cannot do. Your question about the APTA is something you will have to answer for yourself. I think in the big picture of all that has been proposed as possible changes leading to healthcare reform, they have protected and advocated our interests well. I hope this clarifies some of your concerns. Truth is that until a final bill is signed and enacted we will not know all of the answers or ramifications. One last comment. Most of the provisions of both bills will not go into effect until 2013. There will be a long lead time to figure out our best strategy. There is likely to be a reaction by the healthcare industry prior to then that we will have to deal with sooner. Ron Wall Axiom Healthcare Group Ontario, CA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2009 Report Share Posted December 28, 2009 Dave, I totally agree with you. And thanks for the enlightening video. It was particularly interesting at the part about Congressman Bart Stupak being on the House Subcommittee for Investigations and Oversight (which investigates pharmaceutical companies and insurances companies among others) while at the same time receiving $110,000 per year (every year) from the pharmaceutical industry. Another little tidbit not mentioned on the video (and that I mentioned on the board before) is that his number one political contributor is Blue Cross Blue Shield of Michigan. Is it little wonder why we fail to get any substantive changes in these areas? Also, as you stated and I've stated previously on this board, there are very few, if any, free financial and commercial markets left. The existence of free markets is largely an illusion. , PT, OCS Marquette, MI RE: Universal Healthcare Alan To quote the old Saturday Night Live character Roseann Roseannadana, " Mr. Petrazzi, you sure ask a lot of questions. " They are important issues however. First point, what is being proposed is not Universal Healthcare. It brings us closer providing coverage for most people but does not cover everyone. There is a lot of biased interpretation being offered that makes understanding difficult. An excellent non-partisan resource is the Kaiser Family Foundation. Go to their website at www.kff.org. They summarize each of the proposed plans as well as line them up side by side and item by item to compare each. Remember there are two versions of bills. One from Congress and one from the Senate that have differences that need to be reconciled before they can become law. To answer your questions: There is nothing in it that addresses automony of therapists (what I assume you are asking?) Waiting times should not be a concern since it only addresses payment of services not practice The funds will go to pay for private insurance so Plans of care, frequency and duration will be defined by the private insurance companies. Reimbursement from Medicare is likely to be impacted. One of the provisions proposed is to take from Medicare to fund coverage to the currrently uninsured. The likely result is drop in either rates or coverage of procedures. Reimbursement from non-governmental insurance will largely be decided by these companies. They will not be able to deny services for pre-existing conditions or other underwriting practices of the past. This may effect their profitability, so it is unknown how they will react. The fear is that insurance premiums will go up for others to cover the formerly uninsurable. Salaries is an unknown. There may be a greater need for therapist in an already tight market, since more people will have insurance coverage and thus access to healthcare. The current shortage of therapists may create an employee advantage that makes therapist a valuable position that increases salaries. Or if insurance companies reduce amount of services they will authorize we could see the opposite. Small practices will face the same challenges they do today. If insurance companies partner with larger practices it could hurt the small ones. Insurance companies and physician groups could pit practices against each other to undercut prices. A small practice with low overhead could win. Or prices could be so low as to make the cost of delivering services more that the reimbursement. The % of Self-pay patients could drop as more people are covered by health insurance. If insurance companies cut back services, people who want additional services may have to pay out of pocket. Pursuit of patients seeking PT to delay surgery is unknown. That will likely depend on the insurance company, physician (group) and patient. Pursuit of patients seeking alternative health providers. It is important to note that the two bills being proposed are requiring those who can afford to buy health insurance to buy it and those who cannot buy it will get government assistance. This insurance will be from the same companies that now give us coverage. We are not facing any change in the delivery of services but a change in who has funding coverage and what the insurance providers can and cannot do. Your question about the APTA is something you will have to answer for yourself. I think in the big picture of all that has been proposed as possible changes leading to healthcare reform, they have protected and advocated our interests well. I hope this clarifies some of your concerns. Truth is that until a final bill is signed and enacted we will not know all of the answers or ramifications. One last comment. Most of the provisions of both bills will not go into effect until 2013. There will be a long lead time to figure out our best strategy. There is likely to be a reaction by the healthcare industry prior to then that we will have to deal with sooner. Ron Wall Axiom Healthcare Group Ontario, CA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2009 Report Share Posted December 28, 2009 Dave, I totally agree with you. And thanks for the enlightening video. It was particularly interesting at the part about Congressman Bart Stupak being on the House Subcommittee for Investigations and Oversight (which investigates pharmaceutical companies and insurances companies among others) while at the same time receiving $110,000 per year (every year) from the pharmaceutical industry. Another little tidbit not mentioned on the video (and that I mentioned on the board before) is that his number one political contributor is Blue Cross Blue Shield of Michigan. Is it little wonder why we fail to get any substantive changes in these areas? Also, as you stated and I've stated previously on this board, there are very few, if any, free financial and commercial markets left. The existence of free markets is largely an illusion. , PT, OCS Marquette, MI RE: Universal Healthcare Alan To quote the old Saturday Night Live character Roseann Roseannadana, " Mr. Petrazzi, you sure ask a lot of questions. " They are important issues however. First point, what is being proposed is not Universal Healthcare. It brings us closer providing coverage for most people but does not cover everyone. There is a lot of biased interpretation being offered that makes understanding difficult. An excellent non-partisan resource is the Kaiser Family Foundation. Go to their website at www.kff.org. They summarize each of the proposed plans as well as line them up side by side and item by item to compare each. Remember there are two versions of bills. One from Congress and one from the Senate that have differences that need to be reconciled before they can become law. To answer your questions: There is nothing in it that addresses automony of therapists (what I assume you are asking?) Waiting times should not be a concern since it only addresses payment of services not practice The funds will go to pay for private insurance so Plans of care, frequency and duration will be defined by the private insurance companies. Reimbursement from Medicare is likely to be impacted. One of the provisions proposed is to take from Medicare to fund coverage to the currrently uninsured. The likely result is drop in either rates or coverage of procedures. Reimbursement from non-governmental insurance will largely be decided by these companies. They will not be able to deny services for pre-existing conditions or other underwriting practices of the past. This may effect their profitability, so it is unknown how they will react. The fear is that insurance premiums will go up for others to cover the formerly uninsurable. Salaries is an unknown. There may be a greater need for therapist in an already tight market, since more people will have insurance coverage and thus access to healthcare. The current shortage of therapists may create an employee advantage that makes therapist a valuable position that increases salaries. Or if insurance companies reduce amount of services they will authorize we could see the opposite. Small practices will face the same challenges they do today. If insurance companies partner with larger practices it could hurt the small ones. Insurance companies and physician groups could pit practices against each other to undercut prices. A small practice with low overhead could win. Or prices could be so low as to make the cost of delivering services more that the reimbursement. The % of Self-pay patients could drop as more people are covered by health insurance. If insurance companies cut back services, people who want additional services may have to pay out of pocket. Pursuit of patients seeking PT to delay surgery is unknown. That will likely depend on the insurance company, physician (group) and patient. Pursuit of patients seeking alternative health providers. It is important to note that the two bills being proposed are requiring those who can afford to buy health insurance to buy it and those who cannot buy it will get government assistance. This insurance will be from the same companies that now give us coverage. We are not facing any change in the delivery of services but a change in who has funding coverage and what the insurance providers can and cannot do. Your question about the APTA is something you will have to answer for yourself. I think in the big picture of all that has been proposed as possible changes leading to healthcare reform, they have protected and advocated our interests well. I hope this clarifies some of your concerns. Truth is that until a final bill is signed and enacted we will not know all of the answers or ramifications. One last comment. Most of the provisions of both bills will not go into effect until 2013. There will be a long lead time to figure out our best strategy. There is likely to be a reaction by the healthcare industry prior to then that we will have to deal with sooner. Ron Wall Axiom Healthcare Group Ontario, CA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2009 Report Share Posted December 28, 2009 , What advice would you give to a physical therapist facing health system change? Hopefully, not to load up on gold. You seem to have found a clever answer to a question no one is asking (at least not on this list-serve). What would be truly helpful would be for you to give strategies for coping with unexpected or unintended system-wide changes associated with more people accessing health care services paying fewer dollars per service. For instance: How should I manage bundled episodes of care (eg: 10 visits for chronic LBP for $750?) How do I handle outliers? What skills do I need to get my next PT job in a 'reformed' market? What skills do I need to manage my PT clinic for the next 10 years? Do I really 'need' the DPT or can I learn these things with an MBA? MPH? or MPT? Am I ready to be the first Point of Service under Medicare Direct Access? Is PT Private Practice still a viable business model in America? Is cash pay really an option anywhere other than andria, Va or Boca Raton, Fla? How about Sioux City, SD? These questions are what I think about most of the time - not whether a currency collapse will cause my 401K to resemble my son's piggy bank. Here's some unsolicited advice for you: be careful with gold. Over the last three successive 19-year periods (2001-1982, 1981-1966 & 1965-1946) gold has beaten stocks only once (1966-1981) and that was during a period of global turmoil and economic unrest. If history is any guide you have about 10 years to dump your gold holdings before your Mom's nest egg goes South and you don't get invited to Christmas dinner. Tim Tim ,PT timrichpt@... www.PhysicalTherapyDiagnosis.com > > > > > > > As the saying goes: " Government run healthcare: all the efficiency of the > > United States Postal Service coupled with all the compassion of the IRS. " > > > > The entities that will benefit the most from this program, in its present > > incarnation, are the two entities that have the most powerful lobbying > > influence in Washington: (1) the pharmaceutical companies and (2) the > > insurance companies. Patients will get some benefit. Providers ... well, > > better have flexible hamstrings.;-) > > > > Read Schiff's Economic Commentary for Dec. 23, " Dropping The Bomb on > > Healthcare " , to learn just one of the essential flaws of this program: > > http://www.europac.net/ > > > > Just remember, the last major legislation that was supposedly done for your > > benefit that was slipped in Christmas Eve was the Federal Reserve Act of > > 1913. That legislation was the ultimate source of the financial crisis that > > we are experiencing today. You think it's over? You think your 401K is > > coming back? Look again at its value in real dollar terms rather than > > nominal terms. It's actually losing money when you look at inflation > > adjusted Dow/gold ratios (and that's with a DJIA that's heavily > > manipulated). The middle class in America is being decimated by actions such > > as this and there's barely an outrage from the sheeple. > > > > Merry Christmas. > > > > , PT, OCS > > Marquette, MI > > > > Universal Healthcare > > > > It looks like this universal healthcare is going to happen. > > > > Regardless of your political or philosophic views, I have two questions: > > > > Q1: What impact do you foresee (degrees of increase, decrease, no change) > > universal healthcare having on: > > > > -Professional autonomy > > -Waiting Times > > -Plans of care, including frequency and duration > > -Reimbursement from Medicare > > -Reimbursement from non-governmental insurance companies > > -Salaries > > -Small PT practices > > -% of Self-pay patients > > -Pursuit of patients seeking PT to delay surgery > > -Pursuit of patients seeking alternative health providers > > > > Q 2: > > Has the APTA served our interests well during this legislative process? > > > > Very respectfully intended, > > > > Alan > > > > Alan Petrazzi MPT, MPM > > Rehab Manager > > Pittsburgh, PA > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2009 Report Share Posted December 28, 2009 , What advice would you give to a physical therapist facing health system change? Hopefully, not to load up on gold. You seem to have found a clever answer to a question no one is asking (at least not on this list-serve). What would be truly helpful would be for you to give strategies for coping with unexpected or unintended system-wide changes associated with more people accessing health care services paying fewer dollars per service. For instance: How should I manage bundled episodes of care (eg: 10 visits for chronic LBP for $750?) How do I handle outliers? What skills do I need to get my next PT job in a 'reformed' market? What skills do I need to manage my PT clinic for the next 10 years? Do I really 'need' the DPT or can I learn these things with an MBA? MPH? or MPT? Am I ready to be the first Point of Service under Medicare Direct Access? Is PT Private Practice still a viable business model in America? Is cash pay really an option anywhere other than andria, Va or Boca Raton, Fla? How about Sioux City, SD? These questions are what I think about most of the time - not whether a currency collapse will cause my 401K to resemble my son's piggy bank. Here's some unsolicited advice for you: be careful with gold. Over the last three successive 19-year periods (2001-1982, 1981-1966 & 1965-1946) gold has beaten stocks only once (1966-1981) and that was during a period of global turmoil and economic unrest. If history is any guide you have about 10 years to dump your gold holdings before your Mom's nest egg goes South and you don't get invited to Christmas dinner. Tim Tim ,PT timrichpt@... www.PhysicalTherapyDiagnosis.com > > > > > > > As the saying goes: " Government run healthcare: all the efficiency of the > > United States Postal Service coupled with all the compassion of the IRS. " > > > > The entities that will benefit the most from this program, in its present > > incarnation, are the two entities that have the most powerful lobbying > > influence in Washington: (1) the pharmaceutical companies and (2) the > > insurance companies. Patients will get some benefit. Providers ... well, > > better have flexible hamstrings.;-) > > > > Read Schiff's Economic Commentary for Dec. 23, " Dropping The Bomb on > > Healthcare " , to learn just one of the essential flaws of this program: > > http://www.europac.net/ > > > > Just remember, the last major legislation that was supposedly done for your > > benefit that was slipped in Christmas Eve was the Federal Reserve Act of > > 1913. That legislation was the ultimate source of the financial crisis that > > we are experiencing today. You think it's over? You think your 401K is > > coming back? Look again at its value in real dollar terms rather than > > nominal terms. It's actually losing money when you look at inflation > > adjusted Dow/gold ratios (and that's with a DJIA that's heavily > > manipulated). The middle class in America is being decimated by actions such > > as this and there's barely an outrage from the sheeple. > > > > Merry Christmas. > > > > , PT, OCS > > Marquette, MI > > > > Universal Healthcare > > > > It looks like this universal healthcare is going to happen. > > > > Regardless of your political or philosophic views, I have two questions: > > > > Q1: What impact do you foresee (degrees of increase, decrease, no change) > > universal healthcare having on: > > > > -Professional autonomy > > -Waiting Times > > -Plans of care, including frequency and duration > > -Reimbursement from Medicare > > -Reimbursement from non-governmental insurance companies > > -Salaries > > -Small PT practices > > -% of Self-pay patients > > -Pursuit of patients seeking PT to delay surgery > > -Pursuit of patients seeking alternative health providers > > > > Q 2: > > Has the APTA served our interests well during this legislative process? > > > > Very respectfully intended, > > > > Alan > > > > Alan Petrazzi MPT, MPM > > Rehab Manager > > Pittsburgh, PA > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2009 Report Share Posted December 28, 2009 , What advice would you give to a physical therapist facing health system change? Hopefully, not to load up on gold. You seem to have found a clever answer to a question no one is asking (at least not on this list-serve). What would be truly helpful would be for you to give strategies for coping with unexpected or unintended system-wide changes associated with more people accessing health care services paying fewer dollars per service. For instance: How should I manage bundled episodes of care (eg: 10 visits for chronic LBP for $750?) How do I handle outliers? What skills do I need to get my next PT job in a 'reformed' market? What skills do I need to manage my PT clinic for the next 10 years? Do I really 'need' the DPT or can I learn these things with an MBA? MPH? or MPT? Am I ready to be the first Point of Service under Medicare Direct Access? Is PT Private Practice still a viable business model in America? Is cash pay really an option anywhere other than andria, Va or Boca Raton, Fla? How about Sioux City, SD? These questions are what I think about most of the time - not whether a currency collapse will cause my 401K to resemble my son's piggy bank. Here's some unsolicited advice for you: be careful with gold. Over the last three successive 19-year periods (2001-1982, 1981-1966 & 1965-1946) gold has beaten stocks only once (1966-1981) and that was during a period of global turmoil and economic unrest. If history is any guide you have about 10 years to dump your gold holdings before your Mom's nest egg goes South and you don't get invited to Christmas dinner. Tim Tim ,PT timrichpt@... www.PhysicalTherapyDiagnosis.com > > > > > > > As the saying goes: " Government run healthcare: all the efficiency of the > > United States Postal Service coupled with all the compassion of the IRS. " > > > > The entities that will benefit the most from this program, in its present > > incarnation, are the two entities that have the most powerful lobbying > > influence in Washington: (1) the pharmaceutical companies and (2) the > > insurance companies. Patients will get some benefit. Providers ... well, > > better have flexible hamstrings.;-) > > > > Read Schiff's Economic Commentary for Dec. 23, " Dropping The Bomb on > > Healthcare " , to learn just one of the essential flaws of this program: > > http://www.europac.net/ > > > > Just remember, the last major legislation that was supposedly done for your > > benefit that was slipped in Christmas Eve was the Federal Reserve Act of > > 1913. That legislation was the ultimate source of the financial crisis that > > we are experiencing today. You think it's over? You think your 401K is > > coming back? Look again at its value in real dollar terms rather than > > nominal terms. It's actually losing money when you look at inflation > > adjusted Dow/gold ratios (and that's with a DJIA that's heavily > > manipulated). The middle class in America is being decimated by actions such > > as this and there's barely an outrage from the sheeple. > > > > Merry Christmas. > > > > , PT, OCS > > Marquette, MI > > > > Universal Healthcare > > > > It looks like this universal healthcare is going to happen. > > > > Regardless of your political or philosophic views, I have two questions: > > > > Q1: What impact do you foresee (degrees of increase, decrease, no change) > > universal healthcare having on: > > > > -Professional autonomy > > -Waiting Times > > -Plans of care, including frequency and duration > > -Reimbursement from Medicare > > -Reimbursement from non-governmental insurance companies > > -Salaries > > -Small PT practices > > -% of Self-pay patients > > -Pursuit of patients seeking PT to delay surgery > > -Pursuit of patients seeking alternative health providers > > > > Q 2: > > Has the APTA served our interests well during this legislative process? > > > > Very respectfully intended, > > > > Alan > > > > Alan Petrazzi MPT, MPM > > Rehab Manager > > Pittsburgh, PA > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2009 Report Share Posted December 29, 2009 One of the problems with publicly funded healthcare can be realized through Medicare part D prescription benefit and many state run Medicaid programs. The latter should be prick the ears of every PT listening. Medicaid programs dish out money to a variety of insurance plans who manage the health insurance needs of the poor. Many (with emphasis) do not cover Physical Therapy. How often have I wanted to prescribe PT to a low income person on Medicaid and could not? - often! The coverage is not there. So when you expand insurance coverage with public money, it does not always provide PT services. So supportors of federal healthcare reform beware especially of the money promised to help fund state Medicaid programs. (Incidentally, bribery money does not go very far - note the Nebraska senator). Though people will gain health insurance they may not gain access to your PT clinics. Second point, how many insurance companies came out of the woodwork to provide prescription coverage for Medicare part D plan - a baazillion! Talk about chaos. There is more to the point but I have to go workout and eat some lunch - fruit and veggies and protein shake. Ya know - healthcare. Tom Plamondon PA-C, PT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 2, 2010 Report Share Posted January 2, 2010 Barrett, I think " death " of our profession is a bit over the top. There have been many changes like anything in life, things change. The one thing we can count on is that our profession will continue to change. I do have to agree with you on one point, the hairdressers comment. I was involved in a MVA earlier this year and went to see a PT with excellent clinical skills. I liked the way he practiced which is pretty much how I practice. I am not highly clinical in my conversations with my patients I try to make them comfortable and they seem more relaxed. This was my second experience as a patient. The first PT I saw several years ago was technically competent but was not very friendly. He put me through some protocol exercises and I had the feeling his mind was already on the next patient waiting for him before he was done working with me. I felt part of an assembly line, even the atmosphere in the clinic seemed cold. Now to return to my most recent experience, well my PT went on vacation for a week. I was then seen by another therapist who had me in the gym doing some exercises on a mat table lying beside another patient. Then she started chatting with the other therapist on the other side of the mat table. They were talking about some party they had been to, were having some general gossip and chit chat as if I and the other patient did not exist. She was not observing my technique for the exercise and relying on me to keep count. I had to break up the conversation when I was finished though. I had not seen this kind of behavior in therapists before, is this a trend in larger clinics? Also can you clarify the point on " having failed to provide any financial incentive for the referral sources that fed my solo practice ... " Are clinics giving kickbacks to their referral sources? Wade , PT Eugene, OR Barrett Dorko wrote: > I have witnessed the death of our profession since entering the PT school > nearly 40 years ago. Now having failed to provide any financial incentive > for the referral sources that fed my solo practice for 28 years (it > consequently failed), and then not promising our colleagues my workshop > would solve all their clinical challenges in six hours without further > study, I find myself working in a large department that resembles a > hairdressing salon in style and atmosphere, except for the fact that the > hairdressers know a lot more about what they're actually doing and keep up > with the literature. > > I know I'm not alone with this opinion of what PT has become, but I can see > no way out. > > Barrett L. Dorko P.T. > Barrettdoko.com > Somasimple.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2010 Report Share Posted January 3, 2010 Stanley, I appreciate and value your optimistic tone but personally admit to being more of a realist than an optimist. I found this article valuable in explaining where we've been in physical therapy (or in our society as a whole for that matter) and where we're going. http://theautomaticearth.blogspot.com/2010/01/january-1-2010-fractal-adaptive-cy\ cles.html The question bears asking, where do we think we are on the Figure 2 Adaptive Cycle in Three Dimensions. And what is the evidence for our thinking or is our position conjectural and anecdotal I could be mistaken but my sense is you feel we're farther down on the y-axis than I do and ready for an upward turn ( referebce " Well I just don't think things can be any worse than they are now and that things will soon get better. " ). I hope you're right. , PT, OCS RE: Re: Universal Healthcare I have witnessed the death of our profession since entering the PT school nearly 40 years ago. Now having failed to provide any financial incentive for the referral sources that fed my solo practice for 28 years (it consequently failed), and then not promising our colleagues my workshop would solve all their clinical challenges in six hours without further study, I find myself working in a large department that resembles a hairdressing salon in style and atmosphere, except for the fact that the hairdressers know a lot more about what they're actually doing and keep up with the literature. I know I'm not alone with this opinion of what PT has become, but I can see no way out. Barrett L. Dorko P.T. Barrettdoko.com Somasimple.com Quote Link to comment Share on other sites More sharing options...
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