A little Jeopardy game.
Professions for $100 Bob
-about 100,000 practicing in the US
-a well documented shortage in the marketplace
-a brand identity in the marketplace-patients have an idea what they do but don’t totally get it
-has serious autonomy issues
-low payments, increased cost of business, and substantial regulatory constraints are causing major problems to their business model making viability of private practice a serious concern
-graduates come out of school with a huge debt load
-spends more time with patients than most other medical professionals
-are trying to get medicare and private insurers to change the way they are paid from fee for service to a “bundled payment” system
Ok, now remember, you have to answer in the form of a question.
What is physical therapy?
buzz, buzz. That is incorrect. Next.
What is primary care?
Yes, Bingo, congratulations.
Perhaps you are surprised to hear that primary care is in fact the “twin sister of a different mother” for physical therapy these days. We have more in common with them then any other medical specialty and it is time to seriously explore a strategic alliance and attempt to carve out a meaningful role in health care delivery-one that incorporates medical outcome along with EBP, “personalized healthcare” coupled with customer service,and cost effectiveness.
Family practice was the first in the US to embrace EBP broadly and in their training and were the first to have a board certification and a re-certification process. Unfortunately, thru the combination of both shortage and patient “specialty” mindset (I can access a specialist directly why should I see a family physician?) they have been marginalized in recent years in the broad scope of health care deliver. This would include the broad deployment of retail clinics that utilize mid level practitioners and the significant use of mid level practitioners within specialty practices. Add proliferation of urgent care clinics, AMA’s work with CMS to disempower primary care via financial rewards for specialists, and the strong decline in US medical students entering this field and you have an out of control downward spiral that would rival Brittany Spears.
Some pundits are even comparing family practice to “a classic immigrant position: a low paid, unattractive job that American’s won’t fill” others are declaring that without fixing, universal health care is unattainable. On an interesting note, Medrants makes a great case that the “best and brightest” need to be in family practice (we feel the same way in PT for similar reasons).
Many sources are banding together to try and bring relief to this primary care via alternative payment methods that would enhance reimbursement to primary care physicians. Employers are also forming coalitions in response to this situation. Lots of eyes are paying attention and we can’t afford to be passive with the opportunity in front of us.
Now is the time for us to partner with the AAFP.
The strength of working together has significant upside. Imagine work clinics with a combination of PT musculoskeletal experts and family physicians that would be able to handle both comp and non-comp problems. Perhaps partnering in the medical home concept makes even greater sense. Family practice MD’s are accepting of other practitioners working with them and PT with its transition to DPT, direct access in most states, and our specialty in musculoskeletal medicine is in prime position to usurp nurse practitioners and PA’s and work in partnership to establish a significant role and a branded identity together in health care delivery. We need to try these models in the near term.
After all, we have too much in common to ignore.
Thoughts?
