The Monday Memo
August 20, 2012 PITT DPT STUDENTS
Let’s start at the beginning. Imagine a simplified scenario where you seek the professional advice of your MD due to some medical problems (of course, this is reasonable). During the course of the evaluation and treatment, the MD orders some advanced imaging, maybe prescription drugs and a bout of physical therapy (again, not a total stretch). You pay for your scheduled MD appointment and follow their advice since it was their professional recommendation for your problem. However, would you second guess the opinion of the MD if you discovered they profited each time you or one of their patients used another service they owned, such as imaging, medications or physical therapy? Um… YES! OF COURSE! You’d wonder if you actually needed these things or if the MD recommended them simply so they could stuff their pockets with your healthcare plan reimbursement!
Physician Owned Physical Therapy Services, also known as POPTS, are run by MDs who engage in this exact behavior mentioned above. Owning additional services, ones that directly affect the bottom line, severely compromises the MDs judgment when recommending appropriate care for their patients. This 2006 report revealed physicians mark up and profit up to 1700% for prescription drugs dispensed to worker’s compensation patients. A recent New York Times article also acknowledges how lucrative this system can be and cites California as a state that has “clamped down on the process.” Not only is this unethical, costing Californians billions of dollars and is a total conflict of interest, but it’s now illegal! So, MDs have turned to ‘Referral for Profit’ schemes through POPTS and physician owned medical spas. Fortunately, in California, Governor Jerry Brown signed a ‘medi-spa’ bill into law, increasing the penalties for owning and operating a medical spa. The group at STOPPOPTS.org has been vigorously trying to accomplish the same for POPTS.
Naturally, when one group advocates for a particular side (physical therapy) there must be opposition supporting the other (physicians, chiros, etc.). In some ways that’s the turf battle and is somewhat expected. However, when a particular side engages in back room, under the table deals and compromises the legal political efforts of parties carrying competing opinions, things turn sour! In fact, in California, it’s become absurd! An assemblymember, one with close political ties to organizations and associations in opposition to physical therapy direct access laws, actually used $200,000 in taxpayer funds to frivolously audit the California Physical Therapy Board, which resulted in revealing absolutely no dirt or wrong doing by the CPTB. According to StopPOPTS.org, this same assemblymember also allegedly hired a PI for $5,000 to investigate and stop those responsible for the StopPOPTS.org blog! A physical therapist in California, @RobertSnowDPT, quoted Benjamin Franklin to describe this situation noting “Democracy is two wolves and a lamb voting on what to have for lunch.”
CA & Physical Therapy
Physical therapists and the CPTA (California Physical Therapy Association) have been engaged in a dog fight for physical therapy direct access in the state of California for years. Three years ago, a bill on direct access was stopped but there’s a new hope in the latest bill, SB 924. Unfortunately, due to some very questionable politicking and possible back room deals that haven’t allowed for transparency and public disclosure, the direct access bill looks like a shadow of its former self. Many questions still remain. Changes in the language through a series of amendments announced by the Assembly Appropriations Committee have seemingly undermined the ability for a physical therapist to treat autonomously. If that’s not bad enough, the amendments actually legalize POPTS, something this bill was not even intended to address initially!
As explained in the language of SB 924, “Existing law regulating professional corporations provides that certain healing arts practitioners may be shareholders, officers, directors, or professional employees of a medical corporation or a podiatric medical corporation, subject to certain limitations.
“This bill would add licensed physical therapists and licensed
occupational therapists to the list of healing arts practitioners who may be shareholders,
officers, directors, or professional employees of those corporations.”
The Money Trail
You can come to your own conclusions, but I’d suspect that more money means they have a larger influence! Source: http://ca.opengovernment.org/money_trail/
“Liberty is a well-armed lamb contesting the vote.” Benjamin Franklin
Compromised legislative transparency, limiting patient choice, increasing MD profit, practicing unethical medicine and straining our heath care system further is not okay! Therefore, we need all who agree to take action! So, what can you do?
- At the VERY LEAST, you can become members of the APTA and your state chapter. These membership fees help support our PT Political Action Committee as it fights for legislation that enhances utilization of physical therapy services.
- Sign the petition to stop Physician Owned Physical Therapy Services!
- Call these Assemblymembers directly and let them know you’re against back room deals!
- John A Perez Speaker of the California State Assembly
- P: (916) 319-2046 F: (916) 319-2146 @SpeakerPerez
- Charles Calderon Floor Leader
- P: (916) 319-2058 F: (916) 319-2158
- Connie Conway Minority Floor Leader
- P: (916) 319-2034 F: (916) 319-2134 @AssemblyConway
- Jerry Hill Caucus Chair
- P: (916) 319-2019 F: (916) 319-2119
- Toni Atkins Majority Whip
- P: (916) 319-2076 F: (916) 319-2176 @toniatkins
- Robert Hernandez Assistant Majority Whip
- P: (916) 319-2057 F: (916) 319-2157 @Roger_Hernandez
- Mike Allen Assistant Assembly Floor Leader
- P: (916) 319-2007 F: (916) 319-2107
- Fiona Ma Speaker pro Tempore
- P: (916) 319-2012 F: (916) 319-2112 @fionama
- Darrell Steinberg President pro Tempore
- Money Trail
- P: (916) 651-4006 F: (916) 323-2263
- Felipe Fuentes Assemblyman
- P: (916) 319-2039 F: (916) 319-2139
- Mike Gatto Assemblyman
- P: (916) 319-2043 F: (916) 319-2143 @mikegatto
Social Media Army
Follow the #SB924 hastag and other interested physical therapists on twitter:@ChrisReed1 @Jerry_DurhamPT and @RobertSnowDPT. California based physical therapy program University of the Pacific (moderated by Todd Davenport) @PacificDPTweet and @PittPT Pittsburgh Physical Therapy student @MattDeBole. Tweet at @APTAadvocacy and The California Physical Therapy Association @CPTAtweets. Keep up the pressure! #SolvePT