Annotated Bibliography Physician Referal for profit
Magistro, Charles M. “Twenty-Second Mary McMillan Lecture. ” Physical Therapy Journal of the American Physical Therapy Association. 67 (1987): 1726-1732 CINAHL Full Text web 23 October 2012 The journal makes reference to a lecture given by Charles M. Magistro, Director of Physical Therapy, Pomona Valley Community Hospital, presented at the Sixty-Third Annual Conference of the American Physical Therapy Association, San Antonio, TX, June 28-July 2, 1987.
The paper initially deals with the growth of the profession over the years with Magistro emphasizing that “We physical therapists never must permit our profession to be jeopardized by failing to provide those services that justify our existence” (Magistro 1728). He explains that “The most urgent of these challenges is in the matter of education” (Magistro 1728), the issue is really affected by funding concerns proposing to readers to support the foundation’s fund-raising campaign to improve the quality of PT education.
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He was convinced that “the foundation had unlimited potential because its goals were tied so closely to the survival of our profession, specifically providing funding for research and scholarship activities” (Magistro 1731). The author is emphasizing the need to support the foundation to improve the profession in one way or another, a message that has made the article interesting and persuasive. This article sheds light on several issues in the physical therapy profession. Magistro makes his opinion very clear on the topic of physician referral for profit. I remain deeply concerned about anything and everything that has the potential to debase our profession, whether it be the improper use of supportive personnel by our own members or the reaping of profits by practitioners outside of our profession from their unethical referral arrangements. I stated in one of my talks on this subject that referral for profit arrangements involving physicians and physical therapists are like a cancer eating away at the ethical, moral and financial fibre of our profession” (Magistro 1731).
The article states Magistro’s opinion but it doesn’t go into detail about the effects physician referral for profit can have on the profession of physical therapy. There are several quotes from the author in between the paragraphs on some of the pages that gives the reader an idea about what the next section of the paper will be about. “Position on Physician-Owned Physical Therapy Services (POPTS). ” American Physical Therapy Association. (Jan. 005): 1-5 CINAHL Full Text web 23 October 2012 The paper discusses that POPTS was added by physicians to their practice due to their decreasing revenue and increasing costs of insurance premiums relating to malpractices despite APTA’s effort to legally prohibit the POPTS arrangement.
However, APTA’s acts “are in conflict with the medical profession’s renewed push to subsume physical therapy as an ancillary service for financial gain” (1). There are two opposing forces on the issue and the major concerns are financial control over another and the potential consequences of POPTS. First, should one profession be able to claim financial control over another? Second, what are the real and potential consequences of referral-for-profit relationships and, more specifically, POPTS? ” (1). The paper also states that “Physical therapists must be unified in their vision of physical therapy as a profession, accepting their rights and responsibilities that come with such a designation” (1). When these professional become united, reducing POPTS will be possible. A conflict of interest becomes more apparent when a physician employs a physical therapist.
The arrangement denies patients of their right of choice. As to economic and financial harm, POPTS arrangements “have significant adverse economic impacts on consumers, third-party payers, and physical therapists” (1). The paper gives a background of the evolution and development of physical therapy as an autonomous profession including the development of rigorous educational standards designed to enhance the profession on a continuing basis. There is information in this article that supports the harmful effects that physician owned physical therapy services have on patients.
The article is referenced from several different sources. The author expresses his observation about the state of POPTS but his observations are limited in scope which leads to the lack of direction at the end. “Reactions from Members and Patients on Physician-Owned Physical Therapy Services (POPTS). ” American Physical Therapy Association. (Jul. 2007): 1-5 CINAHL Full Text Web 23 October. 2012 The APTA defines “referral for profit” as “a financial relationship in which a physician refers patients for physical therapy treatment and derives a financial benefit from the referral.
In the most familiar arrangements involving referral-for profit, members of the medical community have an intriguing interest on ownership in physical therapy practices to which they refer, known as physician-owned physical therapy services, or POPTS” (2). A patient’s experience with the practice is discussed and shows a feeling of disappointment with the treatment provided. The patient (Kelly) is willing to come forward for a documentation of the case. “Kelley’s willingness to come forward appears to be quite rare (2). In a survey conducted in 2004 by APTA, more than half of the respondents indicated their patients had described problems at physician-owned practices, such as poor care and treatment by non-PTs” (3). But the debate on POPTS is far from over since a majority of “patients are reluctant to come forward” (5) and reports their case to APTA and the proper authorities. “Other PTs have provided stories of regular patients lost to physicians who previously had not been referral sources” (4).
The paper ended with a note that “For the sake of American patients, whose well-being is being compromised by the financial interest of health care providers, additional efforts are needed. ” (5). The paper is lacking illustration, only one sample is illustrated. Although it portrays the current state of POPTS in the United States by The American Physical Therapy Association (APTA) as having a “conflict of interest” for health care providers, more illustrations should have been provided to strengthen the author’s position on the matter. Sullivan, K. J. , Wallace, J. G. Jr. , O’Neil, M. E. , Musolino, G. M. , Mandich, M. , Studer, M. T. , Bottomley, J. M. , Cormack, J. C. , Nicholson, S. K. , Jensen, G. M. “A Vision for Society: Physical Therapy as Partners in the National Health Agenda. ” Physical Therapy. Journal of the American Physical Therapy Association. 91 (2011): 1664-1672 CINAHL Full Text web 23 October 2012
The article deals with the future prospects of Physical Therapy as a profession based on The American Physical Therapy Association’s (APTA’s) Vision 2020 statement which is “provided the stimulus our profession needed o develop a stronger self-awareness and broader public perception of physical therapy as a doctoring profession (1664). The statement refers to the stimulus required to even more professionalized PT amongst the current political events and demographic changes in the society. Also, “technological advances in medicine that continue to decrease mortality yet increase morbidity, and the critical need for more affordable health care will have an impact on the demand for physical therapy services” (1664). The challenges of the profession was given importance by referring to Dr.
Ruth Purtilo’s McMillan Lecture delivered in 2000 in which she said: “In short, societal critics call us to a partnership that accepts constraint and makes prudent use of resources in the name of the common good of the human community. It is up to us to take society’s concerns seriously under advisement. . . . The very core of being professional demands it and it is key to survival in the new millennium” (1671). Receiving a degree and gaining recognition after the board exam is not enough to make someone a professional.
He/she needs to undergo a series of steps on how to immerse with the society, interact with people and deal with co-professionals. “University leadership is needed for the advancement of research and specialty practice” (1671). Physical Therapy education should enhance society, “A society in which all people live long, healthy lives” (1671). The article provided some insights in improving the system of education leading to a Physical Therapy degree which is a good material to start with as far as education is concerned. The bottom line is that professionalism is usually shaped by the education the professional has received.
There are two graphs in this article that make the information easy to understand. There are also headings beginning each section so the reader has an idea of what each section will be about. “Tahan, Marva “POTS Benefit Patients. ” Magazine of Physical Therapy. 13 (May 2005): 8-8 Academic Search Complete web 5 November 2012 In this letter to the editor of the magazine of physical therapy a physical therapist expresses his opinion on the issue of POPTS. According to the writer he has worked in many different settings as a physical therapist and he states that “ I can personally attest that of all these settings the atient gains the most from a physician owned clinic” (Marvin Tahan 8). He backs up this opinion by saying , “Because physical therapist and physicians work side by side, the physical therapist has access to all the patients files (including x-rays, MRI’s, EMG’s, etc. ) and also is able to communicate with physician throughout the day regarding patient care” (Marvin Tahan 8). The writer brings up the issue that “physicians increase the number of patient visits to the physical therapist for financial gain” (Marvin Tahan 8) and he does not believe that this happens.
His belief is that “the only time the physician interferes with the physical therapist/client relationship is in order to better patient care” (Marvin Tahan 8). The letter is very clearly states his opinion on the subject of POPTS. The letter is short and doesn’t provide a lot of evidence to persuade the reader that POPTS is in the best interest of patient care. However, he did end with a statement that I think all physical therapist can agree on “I hope that in the future we as physical therapist can work together to continue to maintain the focus on patient care (Marvin Tahan 8). “The Debate in Hospice Care. Journal of Oncology Practice. 4 (May 2008): 153-157 CINAHL Full Text web 23 October 2012 Part of the article discusses the eligibility requirements for Medicare Hospice Benefit (MHB) and the Center for Medicare and Medicaid Services is tasked to provide the service which include “physical therapy, occupational and speech-language therapy, nursing care, social services, physicians’ services, short-term inpatient care, counselling, home health aide services, medical appliances and supplies (including drugs and biologic agents), respite care for family caregivers, and family bereavement” (153).
The article also calls for exercise of professional restraint of the Oncologists when it provided that “Oncologists must learn to recognize their own professional limitations and gain a clearer understanding of when the benefits of hospice care outweigh the benefits of active, curative treatment. More timely referrals not only provide patients with optimum hospice care but also help hospice programs remain financially stable by balancing costs over time and patients.
Lastly, oncologists in the community need to be aware of the practices relating to admission and the range of services provided by the hospices in their area so that they can help their patients find end-of-life care that best meets their needs” (156). The paper provides the reader with an outlook of hospice care and physical therapy in future referral-for-profit cases because “non-profit hospices cannot afford to provide expensive treatments, and for-profit hospices may decline admission to individuals who require or want treatments that are costly” (155).
Physical therapist may no longer be obligated to physicians since they are provided with a new way of practicing their profession independently. The article is short and easy to read. It is broken down into different sections under title headings so the reader has an idea what the topic is for the next section.