PTs Unite

Railroaded by the B&P

2009-05-08T12:50:00.000-07:00

Here is a link provided by Dr. Cheryl Resnik, PT and CPTA President regarding our hearing for AB 721. Seems that consumer welfare doesn't matter and the politicians maintaining their positions do.

Move the slider from the left to 3:55 to see the hearing.

http://www.calchannel.com/channel/viewVideo/311

What a shame that the self interests of the physicians are above the interest of their patients. We all would be better served if we worked together to address the reimbursement problems that face all medical providers.

Furthermore, if patients with movement disorder came directly to PTs, it might even decrease doctors' malpractice insurance given that all other docs (save orthopods) are worse than we are at diagnosing movement disorders (Resnik and Childs research draws these conclusions).

DS

Can't believe how time has past - Big Day Tomorrow

2009-04-27T15:02:00.001-07:00

Tomorrow the direct access bill AB 721 hits the floor.

Update - I have been working hard with the CPTA and they helped me set it up so the deposits go right into their account. Thanks to Stacy and Jennifer for their support.

Regardless if it passes or not, I am very pleased with the fact that a number of big names in our industry have stepped up and donated.

The outlook is good and I am confident it is time for a change in CA. Even if it doesn't happen this year, it's coming soon.

Thanks again to everyone,

David Straight

Well - here begins the legislation

2009-03-12T11:17:00.000-07:00

So the news is coming out. It's just a matter of time before the CMA starts flooding the media with their ignorant, misinformed arguments. Here is a link to a story:

http://www.californiachronicle.com/articles/view/93448 that talks about the bill that we are putting up for consumer direct access.

I predict that we will see more of these types of stories like this one here:
http://www.ama-assn.org/amednews/2009/03/09/prl20309.htm

It's beyond me. I just don't get it. How can an Association make these statements? Physicians have no training in PT, yet they "order it" and tell us what to do? Harvard study says that only 7% of MDs in 3rd year get a passing grade on musculoskeletal assessment and 24% of the 4th year student get a passing grade. As NPA Think Tank PT, Eric Robertson, puts it, [when answering the question if direct access is safe], "I hope that I have at least provided enough evidence to support my enthusiastic Yes!" that it is indeed safe. You can review his well articulated comments at http://www.npathinktank.com/2008/07/direct-access-i.html so I won't rehash it.

CPTA board members know this too well - the facts about the safety of direct access don't seem to matter. It's about relationships and that's exactly what PTsUnite.com is all about - generating the resources that are necessary to help facilitate relationship building so our asteemed Assemblymembers will know our perspective.

DS

Finally the Delays are Over

2009-03-07T23:29:00.001-08:00

Ptsunite.com is going live tonight. It's a soft launch. I will share the word with some of my friends, my colleagues that I am honored to know.

I am extremely optimistic that we can all do this together and start something big, something that will make a difference, something that will get our profession noticed for all the good deeds we do with millions of appointments every day!

I think about the fact that accessing a PT first could save our country billions of dollars. How? Think about the fact that chronic low back pain accounts for a majority of the expense of all of the resources that are dedicated to the care of low back pain patients. If they get to a PT sooner, there is the appropriate matched treatment, then I am certain we can keep a large number of patients from becoming "chronic".

Added the Quotes Tonight

2009-02-18T22:34:00.000-08:00

I added the quotes to the right-hand column and will put them here as well. It is shocking at the amount of evidence that is in favor of direct access. The cites I put up merely scratch the surface.

patients seen in military health care facilities are at minimal risk for gross negligent care when evaluated and managed by PTs, with or without physician referral.

Orthop Sports Phys Ther 2005; 35: 674-678.

Regarding physician referrals: One third (32%) of analyzed diagnoses were anatomically oriented and reported specific pathology. Non specific referral diagnoses are frequently provided to physical therapists by physicians.

J Orthop Sports Phys Ther 2005; 35: 572-579.

…the risk from either diagnosis or intervention from a physical therapists extraordinarily low, with the possibility of substantial benefit. This optimal combination of substantial benefit, with little or no risk, is relatively rare in the health care field and therefore represents an attractive health care investment.

J Orthop Sports Phys Ther Volume 36 Number 9 September 2006

Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions.

BMC Musculoskeletal Disorders 2005, 6:32

I would like to pose a question for you: Do you feel that you have the skills to recognize red flags and make a referral? That's all that you need to do. You don't have to make a differential diagnosis! Here is another quote from JOSPT:

Donna Wolf, Marth Ellen Katz, David E. Krebs

Boissonnault and Bass (1-3) contribute an excellent and stimulating description of several "red flag" conditions that should alert physical therapists (PTs) to the presence of nonmechanical sources of pain. They provide an important reminder that pain has many etiologies, and that despite physician referral, patients may have visceral pathologies whose symptoms cannot be remediated by PTs. Their sobering anecdotes motivate us to take more careful histories and to make more precise patient observations.

We believe, however, that when such "red flag" conditions appear to exist, the scope of physical therapy practice includes referral to other practitioners - be they MDs, PTs, RNs, or DPMs. We do not believe that scope of practice norms permit PTs "...to determine whether the symptoms are a result of...visceral pathology or other diseases".

J Orthop Sports Phys Ther 1991;13(5):218-219.
What do you think?

If you don't want direct access, you don't have to have it. If you don't, think of it as a great marketing opportunity. A reverse referral if you will. Call the doctor up and say, "I have a patient that came directly do me but I think you should see her first." I can think of no better way to generate referrals than to have patients first come to you and you refer them on to a physician!

Site goes out for PT Preview

2009-02-16T20:39:00.000-08:00

PTsUnite.com is now in its final testing.

I have sent out messages to some of my closest friends for final beta review.

The target date for release to the public is March 1, 2009. Before then, we will be beta testing and starting to gather donations from a small group to see how things go.

If you have any questions or comments, let me know.

David Straight, PT

The Power of Many

2009-02-13T01:34:00.000-08:00

It seems obvious and probably is, but the concept behind PTsUnite.com is simple - the power of many. For years, CA PTs have been trying to gain direct access. They keep going to a core group of donating members and ask them to write the big checks.

In early 2008, it was especially frustrating when we raised a large sum of money (I'm talking 10's of thousands), contributed to an Assemblymember and the bill wasn't even heard by the Business and Professions committee.

I thought we should do something different - tap a great number of people for a few bucks. The CMA isn't going to role over. In fact, it could go on for years more. The beauty of this strategy, similar to www.one.org and a strategy that allowed President Obama to raise 10 million dollars in less than a week, is that we as a PT profession can sustain this...and we have to. It's good for PTs sure but it's more important for CA consumers.

Please join me and those that have contributed already. This is not just a private practice issue, it is a PT issue. It may not impact you directly, but your support for your professional colleagues should go without saying. Like you, CA PTs help thousands every day. Give them a chance to save consumers money, needless suffering, and avoid the side effects of more aggressive treatments. It's the Best Choice and should be allowed to be the First Choice!

David

Power Up the Social Technology for PTsUnite.com

2009-02-13T01:28:00.000-08:00

Today, I just finished the install of a cool web app that will let viewers import their contacts safely from their address book and email an invitation out to all of their friends encouraging them to visit and contribute to PTsUnite.com .

You may recognize a similar application like this in FaceBook. Hopefully, it will be well received and utilized.

IMPORTANT NOTE: IF YOU USE THIS, AND PLEASE DO, I WILL NOT BE SPAMMING YOU OR USING THE EMAIL ADDRESSES IN ANY WAY. PLEASE READ THE PRIVACY POLICY ON THE RECOMMEND THIS SITE PAGE.

If you can let me know of any other creative ways that you think we can get the nation of PTs involved, please let me know.

David

PTsUnite.com is going live soon!

2009-02-12T00:13:00.000-08:00

I am excited and a bit nervous but after our California Private Practice Special Interest Group (CPPSIG for short) meeting, I was more motivated than ever to help CA PTs gain direct access.

I do hope that people will see this for what it really is. This is not an effort just for private practice. It is an effort for all the profession and what I hope will be an example for others to follow that can accomplish much more than I can.

It's for the students with their 210K loans, the outpatient hospital PT that has dedicated herself to being a great clinician and works with the Medicare patient on a fixed income (i.e. can't afford and should not have to spend money on a needless copay), and the outpatient private practice owner who knows he/she can save hundreds of thousands of dollars for patients when they can come directly through their door.

I am not sure how to articulate this. I hear that the inpatient PT doesn't care much about direct access. I get that! But, these same therapists should be supporting their colleaguesthat can really make a change in the medical system.

All that said, it's really about the CA consumers. I spoke with my father-in-law today. He has OA. Two weeks to get to his GP, another couple to get to a specialist and then another week to get an injection (they only do them 1x/month). Think of the weeks of discomfort, the needless copays ($30), and the risks of side effects with pain pills and video fluroscopic cortisone injection.

He should have had the chance to access PT first - no side effects, no waiting, and maybe no procedures.

Let's work together.
Let's establish a precedent.
Let's make a change.
Let's all do our part and make a small donation.

Come on this journey with me in gaining consumer direct access.

David