A few notes to file before I start this glorious of weekends.
-File under “Yes, Gina there is a Santa Clause”-and it is a physical therapist. Our good friend Gina Kolata of New York Times, has written an article called Sports Injuries: When to Tough it Out. Gina who describes herself as a “therapeutic nihilist” (side note: what the hell is that?) wants to know when to seek out medical care on a sports injury as opposed to “toughing it out”. Struck me as kind of sad that she never mentioned any consideration for directly accessing a physical therapist. On the others hand, she does mention the review by Orthopedic Section of APTA on taping for plantar fascitis as “weak” even though a podiatrist recommended it and Dr. Thomas “swears” by it (I can’t make this kind of stuff up). There are more mentions of doctor’s than a 1960’s soap opera but no doctors of physical therapy-although, you got to love the data she cited on MRI’s and minimal hip pain-70% abnormalities and more than half labral tears on essentially normal athletes.
-File under “The Great Debaters”. No, not the Denzil Washington movie. On one of the listserve’s there is a debate about debates on the issue of direct access. Paraphrasing here but one camp claims that even debating the issue shows how weak we are as a profession-we don’t even believe in it ourselves and the fact is that 45 states have it and it is already part of our profession. The other camp, namely academics, site that debates are “very effective, pedagogically” (that’s why I knew it was an academic before I read the byline). I, of course side with the academics on this one. The fact is that we have states that don’t have direct access including Indiana a.k.a. the land that time forgot. I wish the debate would occur in Congress as part of healthcare reform for the benefit of medicare instead of some “innovation center” demonstration project. In fact, I would like to debate that direct access is not an innovation at all-it has stood the test of time-the Ipad is an innovation. If things are going to change, it will be the future DPT’s that are current students as our strategies in medicare have failed and something tells me that these future debaters will not settle for a shallow victory in a demonstration project in a government innovation center.
-File under “Have you hugged your orthopedist today”. For their altruism of course. Appears that AAOS, ASOSM, and the American Academy of Pediatrics (just couldn’t get myself to look up the last acronym) are tired of the “epidemic proportions” of sports injuries in youth and they have combined to do a campaign called STOP Sports Injuries thru a series of public service announcements. The intent is to create awareness of head injuries and several hi profile cases of injured athletes of injured young athletes. They even have recruited some athletes (side note: what are the odds that Dr. Andrews has done surgery on them?). They of course are seeking funding for 5–10 million so that their message can be heard while starting the initiative self-funded (since the impact of healthcare reform won’t possibly hit them till 2013). I have to admit that I love Dr. Andrew’s quote that “….orthopedic surgeons are partially to blame for overuse injuries, having focused largely on developing new surgical techniques but not on promoting prevention”. I am quite sure that his ATC’s and PT’s who almost intentionally are never mentioned will likewise acknowledge the obvious.
-File under “Internist and healthcare reform”. I believe this internist’s view of healthcare reform is right on and in fact is a good bellwether for us in private practice physical therapy. We will have to opt out of network since a strategy to prevent too hi a rise in premiums will be to further reduce provider payments. how to see even more patients in a less paid but more regulated environment? That’s the subject of a forthcoming post-sort of.
-File under “Best April Fool’s joke that wasn’t a joke”. I also considered filing it under “deficit reduction strategy” is the report from CMS that effective April 1 is the 20+% reduction in payments and that claims will be held for 10 days with the thinking that the “doc fix” will occur. So, pay us less and hold back the less payment might work in loan sharking but to think that either one doesn’t impact medical professionals is absurd-but then again, this is the same concept that has us being taxed for 10 years but benefits for 6 as our healthcare reform package currently exists.
Have a super weekend.
