Health Care Reform and Physical Therapy

If you’ve been around a radio or television or an online news source in the past week you have no doubt heard a lot about “Health Care Reform.”  Naturally, there is significant focus on what shape the plan will take, how much it will cost and who will pay for it, and – the hottest topic of late - when we might expect to see some legislation make its way to the President’s desk. 

Of course, I have been curious about how the field of physical therapy might be affected by proposed reform.  Until more details are debated and drafted by Congress, we won’t really know the answer to that, but I was impressed when I discovered an entire section of the APTA’s website devoted to the “Health Care Reform” issue.  Here you can read the Association’s position on health care reform and find out about how APTA staff, affiliates, and members are advocating on behalf of the profession to legislators.  Their Government Affairs committee has maintained nearly weekly updates and podcasts on their activity and the situation in general – a good resource for comprehensive but relatively quick overviews.  And if you’re so inclined, they even have a virtual rally where you can participate in the advocacy online. 

I’ll keep you posted on details as this whole issue develops (since it sounds like the original August 1 goal date for legislation is no longer relative, we may be waiting for several months ) and invite you to share any information you discover.

The Value of Being a Clinical Instructor

I recently read an article on the APTA blog about how their Clinical Instructor Education and Credentialing Program (CIECP) reached a new milestone – more than 25,500 PTs and PTAs (and an additional 1,000 non-physical therapy health professionals) have now completed the course.  Amazing.  What a wonderful indication of passion for, and dedication to, advancing the profession.  Whether or not a Clinical Instructor (CI) completes this course, it is commendable that so many therapists devote time to mentoring the next generation of clinicians.  And after querying a few of our own CIs, it sounds like the learning aspects of this relationship go both ways.  

As with many medical professions, physical therapist students must do hands-on work in the field prior to graduation.  These clinical rotations not only help students identify which settings and specialty programs might be a good fit for them, but they give students exposure to a variety of diagnoses and situations and a chance to work with real patients, under the direct guidance of an experienced mentor.  

The vast majority of TAI’s clinics work with students at various stages in their schooling and, as a company, we value and encourage this practice.  We have dozens and dozens of CIs in the company (many of whom have completed the CIECP) and typically host more than 50 students in a given year (some who spend a few weeks in a clinic and others who spend 6 months or even a year in a clinic!).  David Deppeler, PT, OCS, FAAOMPT, Clinical Education Director, has said:  “The educational environment created by working with students helps keep us thoughtful and dynamic in our practice.” 

This sentiment was reiterated by every TAI clinician who I talked to about why he/she is a CI.  Matt Booth, DPT, OCS, Director of TAI-Boise Parkcenter stated:  

I regard the CI position as highly valuable for many reasons: 1.) Students bring new ideas into the clinic and keep me on my toes so I don’t get stuck in a treatment rut; 2.) Taking students for years has allowed me to have a “pipeline” of PT’s interested in working for my clinic, 3.) I am giving back to my profession by sharing my knowledge, and I promote this with my patients and referral sources; and 4.) When a good 3^rd year student is in their last affiliation, they can be a valuable asset in the clinic through their final projects, as well as helping with a caseload.   

Nicole Smyth, DPT, OCS, therapist at TAI-Fairwood PT said: 

I take interns for 2 reasons: 1.) I feel that being a “more recent” graduate I still remember the struggles of being an intern.  I can sympathize with their struggles but also have the experience and extra education to help them attain all their goals; 2.) I feel that if we want to continue to see advancements in our profession we need to support the schools that are producing the new physical therapists.  As a company Therapeutic Associates offers more highly skilled manual therapists, which is an area that all new grads seem to struggle with.  We have the education to help grads with these very important skills.   

Kudos to APTA for leading the way with important edification for experienced therapists who want to mentor students and BRAVO to all of the therapists out there who make time for supporting PT students as Clinical Instructors.

CareConnections: Looking At Another Side of PT

I love talking to people about so many aspects of this profession – discussing therapists and their skills, finding out about interesting specialty programs and ways in which clinics work their communities, hearing incredible stories from patients about how PT changed their lives.  One thing I tend not to think about much is the paperwork stuff – charting, billing, outcomes, scheduling, just to name a few.  Every therapist has to do it and even though it may be among a pracitioner’s least favorite things to do, it is an essential part of the job.  I started to look into how our therapists tackle all of this and found our CareConnections system to be really fascinating.

CareConnections is a Web-based suite of rehabilitation medical management services that TAI developed many years ago to assist providers and payers alike.  All of our 60+ clinics use the suite and hundreds of other PT companies around the country use it too.  Primary features include:

Outcomes System (formerly known as TAOS): A functionally based patient data collection system that compares clinical outcomes to similar groups of clinics and provider submitted episodes of care.  The database is significant - averages between 18,000 and 19,000 records per quarter and has been collecting data from providers across the country since 1996.  Through analysis of benchmarks in areas like functional improvement, perceived improvement, decreased pain, and return to work status, the Outcomes feature allows therapists and health plans to determine how and when therapy services are effective.

Patient Satisfaction Monitoring: A standardized survey for patients that allows them to provide valuable feedback about their overall experience (from the front office through the treatment itself).  This is a great tool for the people who you likely consider to be your biggest customers.

Treatment Guidelines: These are written by a therapist (now in their third edition), with researched parameters of care grouped by anatomical body region and cross referenced by ICD-9 code. Over 86 diagnosis-related treatment patterns give clinicians guidance on how to proceed with treatment and give payers assurance upon which medically-appropriate care can be measured.

Prior Authorization/Advice System (PAS): This tool provides real-time, web-based authorization of services to a clinician.  With efficiency as its driving force, PAS gives payers the ability to set into motion a provider’s referral and care plan without a phone call or fax – just a simple and quick mouse click! 

Currently, over 450 facilities (outpatient facilities and hospitals alike) in 30 states across the country use CareConnections.  It’s one of the more sophisticated systems on the market, but also quite user-friendly.  If you have questions about the suite itself or want to test some of its features, contact Josh Benson at joshb@taiweb.com.

Did You Know?

I am currently seeing one of our Physical Therapists after battling for a few weeks with consistent lightheadedness and neck pain.  Her combination of manual therapy treatment focused on my upper cervical spine, and an exercise plan to strengthen specific muscles in my neck and back seems to be working already (after the first two visits!) and I am hopeful that our work will eliminate my symptoms altogether. 

A few years ago, I would have never gone directly to a physical therapist for a condition like this (wouldn’t have known it was an option!), nor would I have even known that a PT could help me with these symptoms.  We tend to think of outpatient physical therapy as a good option for post-surgery rehab of a knee or hip, or maybe for back pain issues, or even for injury prevention with regard to specific athletic training.  Did you know that an outpatient PT can also treat:

• TMJ/TMD symptoms
• Women’s and Men’s health issues (incontinence, pelvic pain, pregnancy issues, urological dysfunction, sexual dysfunction)
• Orthotics fitting
• Tennis/Golfer’s elbow
• Carpal Tunnel Syndrome
• Headaches
• Office Ergonomics Assessment

This list represents just a tiny fraction of some of the more unique conditions that an outpatient PT can treat.  For many more, you can visit our website or the websites of other outpatient clinics.  And I realize that many of this blog’s readers are therapists.  Perhaps you have other interesting and unique conditions you treat or specialty programs you offer that you would like to share?  I look forward to engaging in a dialogue.

On a related note, I found this video that APTA produced to share more on what PT can do for you.  It focuses on some of the more general benefits (versus treatments of more unique conditions like I discussed above), but is interesting and well done nonetheless.  Enjoy!