I recently watched the first webisode of #sipwJerLarKar on youtube. During this webisode, FTPT contributor, Karen Litzy, sat down with Jerry Durham and Larry Benz (with many appearances by Barrett Dorko) to discuss if we are Winning or Losing. While the topic itself leaves much room for interpretation, I suspect the overall agreement with the participants (other than maybe Barrett), is that we are #Winning. While I am not sure I would use this term, due to the annoying meme created around Charlie Sheen , I get their point—we are gaining ground in an ever-so-changing and competitive healthcare marketplace. Let’s attempt to analyze where we are heading…
Obviously, most of the readers know the entry level education of a Physical Therapist in the United States is now a doctoral degree. While this may eventually help us gain ground on our competition, the additional years of education have not resulted in any substantial market gains in reimbursement. While this is quite disconcerting (#Losing), I suspect we need to consider the indirect revenue gains such as a large market pool of care-seekers (as stated in the discussion, more people will seek out physical therapy next month, than they did this month), and the potential impact we may have in influencing those individuals to individuals to seek us first (direct) next time. The simple term Doctor, may help impact this change. But is the cost of a doctoral degree, substantiated by the continue low numbers of reimbursement?
We are seeing a small shift in the education dynamics with Evidence in Motions partnership with South College. This partnership will graduate a DPT in 2 years, followed by a one-year paid residency (hence reducing the cost of the degree). I suspect many who hold stakes in the educational sector, such as myself, will be paying close attention to their process. Simply, the increased popularity of post-doctoral residency and fellowship appears to be part of a cultural shift in the perception of specialization within our education. It appears the current #DPTStudents are driving this, and I agree with Jerry that they appear to be asking great questions, and it appears they are aspiring to become great clinicians. The future of the profession appears to be quite strong.
Currently, 50 states and the District of Columbia (DC) allow physical therapists to evaluate patients without a prior physician’s referral and 48 states and DC improve accessibility further by allowing physical therapists to evaluate and treat, under certain conditions, patients without a referral from a physician. – www.APTA.org
With consumers carrying health plans requiring more cost sharing than ever before (high deductibles, etc), we have to promote the cost effectiveness of seeking our care first. I have interacted with some clinicians who see as high as 70-80% of their clientele via Direct Access (check out Sports Medicine of Atlanta and Revolution PT), but this is still not the norm. In the video, Larry mentions his sentiment for unrestricted Direct Access, and I fully agree. We need to continue to fight for these benefits, while educating the public that we are effective; we are safe; we are science-based; and we are cheaper— than other routes of care. There is a bit of uncertainty on how Direct Access will pan out, but for our profession to thrive, we need to promote and live this! We should all take the #DirectAccessChallenge and attempt to seek out 1 new patient next week, whom will access our services, without a referral.
While I only have experience in Outpatient and Home Health sectors, I do have to say I am very optimistic about our evolving practice patterns. Research is indicating that we are effective in medical screening (very important for the argument that we can be stand-alone) and we appear to be dropping useless modalities, and reverting to more interactive and active programs. We are educating in right terms, and we are utilizing more science-based, plausible interventions in the care of our patients.
I recently received a text message from Eric Lehman, a recent graduate of the University of Pittsburgh, who just began using the “Recognise” app for the treatment of a patient of his who has CRPS. Eric was ecstatic to see the effectiveness of this simple app,within a comprehensive graded motor imagery program. While I am a little concerned that new modalities, such as dry needling, may be replacing the ultrasound heads, I am optimistic that more clinicians appear to be thinking about why something may work vs. it works. This is evident as you make your way around social media and observe all the discussion and debate.
Overall, I suspect we are heading in the right direct and gaining ground as a profession. We need to continue to challenge ourselves and to continue to speak and write in right terms.
– Joe B