When two Government officials and an ex-official publish an article in the Annals of Internal Medicine that essentially says “Docs, get with it and embrace change.  You all will and should be working as employees of hospitals or very large practices since they are the only groups that can improve outcomes, care productivity and patient experience-that’s what the Affordable Care Act and American Reinvestment Act is all about”.

And all this time I thought it was about providing more universal access and lowering the cost of healthcare for Americans?

We are already seeing some backlash by physicians who quickly warn the White House that small practices should not be written off.

Are we to assume that this same phenomenon is going to be expected in physical therapy as well?   Will everybody in private practice simply surrender and go to work for a hospital or “vertical organization”?

The most disturbing assumption is that large institutions are the only one’s capable of delivering productive care, improved outcomes, and the best in patient experience. One only has to look at CMS’ own data to see that for the last several years that outpatient physical therapy has moved from large institutions to private practices despite a supposed competitive advantage of not having to deal with a cap.  Add to it that freestanding private outpatient centers don’t get provider based reimbursed and you can quickly surmise that the mere existence of private practice-not to mention its growth gives appropriate support that cost effective delivery is hardly owned by “large vertical organization”.  Orthopedic Board certification and residency training?  Guess which setting has a higher percentage?

I can’t honestly think of one example in any industry where the best outcomes, best productivity, and best “experience” was delivered through the largest vertical organization.  Can you?

larry@physicaltherapist.com