Saturday, November 1, 2014

What is wrong wrong with healthcare???

How far can health care dollars get divided?
So I'm still working this blog thing into my schedule. (Kids and life, huh?)

From my previous topic, it looks as if our of town patient is coming along. I'll see if I can get a better update.

Today's topic is about healthcare in general. Medicine (PT included) is about people, but it's also a business.

I received an email this morning that was just so disturbing that I feel like sharing. It's from a company that offers to create a "unique collaboration" between physicians and physical therapists. Essentially, the physicians invest in the company. My practice would get referrals from those physicians and the company would pay me for my work. (Standard Reimbusement - Whatever they take for their "management") The profit they render is divided with some going back to the Physician Investors.

Physicians would get paid for referring patients to PT.

It is definitely something that could make my business busier. So I emailed them back:


I'm not sure how you identified me as someone to contact using my email at SUNY Buffalo where I teach in the PT program there.

How do you rationalize or justify getting paid for NOT providing care? How exactly does this benefit patients in any way?

It is this constant cash grabbing mentality from outside interests that is ruining healthcare. I know you're rationalizing by thinking your are "connecting" people in some sort of way. Some way that couldn't be done in the absence of your group; but how exactly do you place a value on that? And how do you think you could keep it from being disproportionate?

It is this constant commercialization of healthcare that is ruining it! Physicians open their own PT practices under the guise of "controlling care". Controlling care to help provide better care. That is not even close to the truth. The truth is: the only thing they wanted to control was the potential revenue from the care they prescribed. There are business articles written in their professional trade magazines about it! Those articles had titles like, "You are letting $$$ leave your clinic with every PT script you write!"

The resulting model isn't one of caring, it is a model based on dollars. It results in massive volume clinics with a focus on the bottom line and NOT on patients. Physical Therapists graduate and take jobs at big practices while seeing 6 patients an hour. They just think it's the way it is. Patients just think that it's the way it is!

I had to open my own practice so I would NOT have to treat my patients like mere numbers. I actually had no other option to treat patients in a responsible manner. If I could, I would surely NOT go through all the pain and stress of being a small business owner. It's horrible! I busted my ass in PT school to help people, not to spend hours strapped to a desk! Hours spent, attempting to keep my small business alive.

But I am at my desk. I do the extra work that is required, because if I don't, the only options people will have are the big box, corporate like clinics, who just care about how many patients they can run through their clinic. I do this work, because I believe in a model that requires way more patient attention. I do this work, because I haven't given up yet. I somehow believe that if I can make it work, that others will follow; and gradually, over time, the level of care will improve and so will outcomes that are tied to that higher level of care.

The obstacles to this model really start with outside interests like your group who want to pull more out of an already miniscule revenue stream. You see an opportunity for enterprise. You see your own revenue stream for doing what? Soft tissue manipulation? Skilled therapeutic exercise intervention? A keen analytical eye focused on finding a patient's key movement dysfunction? Expert level joint manipulation delivered with hands that practiced this skill over countless hours to become effective?

I'm sorry Doug, but if you believe that what you're doing is going to make the world a better place... I just don't see how.

If you're in this to make some money... Hey man, it's America and America is a business. Go get yours bud!

I'm in this to help as many people as I can. Your offer does not fit into that goal at all.

Please, do NOT send me any more offers to join your group. I am clearly not interested in the BLANKETY-BLANK (replaced so I don't get sued!) group.



It's just something to think about. Many family insurance plans cost close to $20K annually. Those costs go up every year and reimbursement to the actual providers might go up every 5 to 15 years. Where does all the money go?

I'll have some ideas on where it goes in the coming weeks. Next week though we will post on some simple strategies to help reduce even chronic knee pain.

Please provide as much feedback as possible. And if the above topic doesn't sit well with you... Feel free to share this post with others. It's not opinion. It's truth!