Want to know the AAOS view about Recruiting Physical and Occupational Therapists?

I was recently scouring facebook, when I came across an article shared by Harrison Vaughan, of In Touch Physical Therapy.  This article highlights some key factors for Orthopaedic Surgeons, when recruiting Physical Therapists for employment.  This article inadvertently demonstrates why a Physical Therapist should not accept employment by an Orthopaedic Surgeon.    While I am a strong advocate for open lines of communication amongst practitioners and multidisciplinary care, this article evokes an heir of hierarchy that we should not accept.   To read the article in full context go here.
Here are a couple of gem’s about their guidelines of hiring us.

Clarify the candidate’s position on working within a physician group. The American Physical Therapy Association has a long-standing policy against physician-owned PT and many therapists are under the mistaken impression that orthopaedic groups offer PT/OT solely to profit from referrals. Pass on candidates who express any objection or voice even a minor concern.
Don’t overpay therapists. You should not need to pay more than the prevailing compensation rate for therapists in your area, and those figures should be readily available.
Don’t (ordinarily) hire the owner of a local PT/OT practice. If these candidates had good clinical and managerial skills, they would have developed a successful private practice and would not be looking to work for someone else.
Update: Here are some additional articles on the AAOS regarding Physical Therapists:
Taking Direct Action on Direct Access 
The Truth Behind APTA’s Campaign Against POPTs
Adding Physical Therapy to Your Practice  (Cant ignore this quote: “Naturally, one of the primary benefits is financial. Profit in excess of $100,000 per therapist per year is not unreasonable, and in many areas of the country the potential upside is even greater. Current MGMA data (2010 Report; 2009 Data) indicate mean collections are $235,000 for PT and $199,000 for OT, with an average profit of nearly $160,000. Although potential diminishing returns limit how many therapists a clinic may hire, these additional revenues cannot be ignored in an era of declining physician reimbursement. Next to ambulatory surgical centers, therapy is often the most profitable ancillary tool orthopaedic surgeons wield.”)

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  • Hey Joe, hope you are well. I enjoy following you on Facebook. I very much support the idea of being steps ahead of the average and find your posts to be refreshing. This one caught my eye in particular because I work for a POPT (yeah, I said it). While I can look from the other side of the glass and understand why these practices are frowned upon by the APTA, I ask you to consider not grouping us all together with such a negative label. I work for a great group and with some of the best PTs I’ve ever met. Sure, we don’t have to work very hard for referrals. But every single patient referred to us by one of our docs is given the option (several, actually) to go elsewhere. We also get referrals from outside docs and by word of mouth. And we have less pressure to bill fraudulently because of the ortho cushion around us. I guess what I’m saying is: we aren’t all bad. Just wanted to give my two cents. Thanks for reading, take care!

    Samantha (Grimes) Brown May 18, 2014 5:43 pm Reply
    • I respect and have enjoyed reading the comments made on this story. Dialogue like this is very healthy for our profession and is needed. I have become somewhat of a journeyman in my career and have worked solely in outpatient orthopedics, but for several employers and business models (I have worked for POPTS as well). I agree with JW Matheson that physical therapists will not be able to progress and be seen as the primary care providers for musculoskeletal care in some of our current working environments, but I cannot single out POPTS when large corporations, hospital chains, and others are engaging in similar referral patterns and business practices. I have lost several referral sources because the hospital they were owned by forced them to send all patients “in-house”. The only difference between this sort of arrangement and a POPTS, in my opinion, is that the physicians work for the same entity that the physical therapists. I have also seen more questionable billing practices in large corporate settings than the POPTs that I have come in contact with.
      I would like to ask JW Matheson (sorry that I do not know your official title) what his thoughts on the position that physical therapists have in the US Army? They have powers and abilities that civilian PTs do not but are classified as physician extenders and are seen as serving a vital role in the health of the US solider.
      Having said that, I am very glad that this article was posted and believe that physical therapists need to know what they are worth both clinically and financially. I have seen too many therapists in my career who have been told how insignificant they are so many times that they believe it. I also have met many physical therapists who have no idea what they are billing and what type of reimbursement they receive either because that information is not made accessible to them or they choose not to know. Physical therapists also need to know what is going on in the world around them. Physical therapists in the United Kingdom were granted the ability to write some prescriptions with proper training. PTs in the army have also written prescriptions for some time. We as physical therapist must search for the answers both individually and collectively if we are to grow our profession.

      Matt Condo May 21, 2014 2:28 pm
  • Thanks for reading Samantha and hope all is well! I apologize if the post sounded like it negatively reflected the Physical Therapists whom are employed by POPTs. The post was more directed at the ridiculous recommendations made on the AAOS website about hiring Physical Therapists. The language used by the AAOS may represent views that differ from your individual situation but should be made light of, as our two groups often have a close-working relationship.

    josephbrence May 18, 2014 5:52 pm Reply
    • I’ve actually worked with Cary Edgar but must admit this article was worded pretty harshly. I can see your point, for sure.

      Samantha Brown May 18, 2014 6:03 pm
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  • Joe,
    Thanks for the post. My frustration is that if you took the AAOS webpage and replaced “therapists” with “orthopaedic surgeons” and APTA with “AAOS” it illustrates the hierarchical undertone that bothered you. If posted that way, orthopedists would scoff and say, “I would never work for a PT.” That is exactly what we are saying.
    Regardless of who is being recruited, the undertone is one of arrogance, exclusivity, and dominance. The only “fix” I see is one where academic programs avoid sending students to POPTS, education programs spend time debating the POPTS issue versus ignoring it, state/federal legislation overturns POPTS, and most importantly, PTs view themselves as a distinct professional provider on the multidisciplinary team. If you want to work for an orthopedist, become a PA-C or, as an ATC, become a physician extender. As a profession we need to decide if we are a commodity, a technician, a sidekick, or an independent entity.
    We have created part of this problem as we graduate PTs with an average debt of > 80K. When a 10-15K difference exists between what a POPTS pays and what a private practice can pay, the issue becomes even more difficult. The issues of “incident to” billing and reimbursement further complicate the discussion.
    If the PT profession agrees to accept POPTS, we are accepting the fact that we are not and will never be primary care providers of musculoskeletal care. For those of us that own private practices, this is unacceptable.

    JW Matheson May 20, 2014 8:43 am Reply
  • “POPTS are a cancer eating away at the moral and ethical fiber of our profession” Charles Magistro, APTA President 1973-1976
    It doesn’t matter how good the PT is and how the patient is given options in which PT they see. Bottom line is ownership=control and we cant advance our profession to the level reflective of our education if we give away ownership. Profits need to be retained by the PT profession for the profession to maximize its growth.

    Eric Chaconas May 20, 2014 12:37 pm Reply

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