If you ever have to have your hip or knee replaced, wouldn't you assume that your surgeon would pick the artificial parts based on what you needed? On what would be best for you? Well, sadly, that's not the case. The New York Times reported that the four major manufacturers of artificial joints agreed to pay $310 million dollars in penalties for violating anti-trust laws.
Basically, companies like Stryker and Zimmer were paying orthopedic surgeons to use their implants with patients.
Medicine and business are tough to blend. Decisions to improve the bottom line often come at the expense of the consumer without the consumer ever completely understanding what has happened. It's the proverbial rug being pulled out from under you without ever knowing you were on a rug to begin with.
An orthopedic surgeon stopped by our office one day, a guy I have known for 25 years, a top referral source of our practice. I was surprised. He had never done that before. He said he was in the area and wanted to just say hi. Hmmm.....
Well, after a few minutes of chit-chat, he says, "Well, now for the bad news. We hired a therapist. Yep. We're going to do physical therapy in our office instead of sending it out." I just looked at him. He looked down, shifted his weight, cleared his throat. "It's someone you trained so she'll be ok for most stuff. You know, it's just an economics thing. Reimbursements are dropping, Medicare is squeezing us. We needed to get some more revenue and PT can make us some money. But, I wanted you to hear it from me first. I'm not really in favor of it. I just want to be a doctor but the other guys, they all were for it. Why can't I just be a surgeon?"
I wanted to say, "Well, say three Hail Mary's and you'll be fine," but instead I said, "You can still send us the folks your therapist can't help. I'm sure they'll be a few. We'll be happy to help you out." It was the best blend of truth and kindness I could manage. Will his patients get better at his place? Maybe. Maybe not. But, that's not the point. The point is that he already knows our abilities, our track record. If you asked him where he would send his mother, I seriously doubt it would be to his own in-house rehab. And he knows it - he couldn't look me in the eye, shuffling his feet, genuinely upset.
When medical decisions are subservient to dollars, they are always bad decisions. A physician is the agent for the patient; acting in his or her best interest. When medical decisions are subservient to dollars, the physician is a double agent; treason of the worst kind.
And now, it looks like the State of California agrees.
A new ruling by the State of California Legislative Counsel found that physician-owned physical therapy clinics (POPTs) are illegal in California. This means that doctors in California will not be able to employ physical therapists and refer to them to profit from the referral.
How does this help you - the potential client? Competition almost always improves something in business. In physical therapy, there's very little competition when the person who writes the referral, which is a requirement, then determines where you go for rehab. Doctors who own their own rehab have no incentive to refer elsewhere and patients assume that the doctor would of course make the best choice for them and offer no objections. The demise of doctor-owned rehab will create a sorely needed competitive environment and the patient is the benefactor.
Of course, what starts in California moves East at the pace of an inch worm. But, there's no end worse than the end of hope. So, here's to hoping that the anti-doctor owned rehab movement gains some steam.
If you ever have to have your hip or knee replaced, wouldn't you assume that your surgeon would pick the artificial parts based on what you needed? On what would be best for you? Well, sadly, that's not the case. The New York Times reported that the four major manufacturers of artificial joints agreed to pay $310 million dollars in penalties for violating anti-trust laws.
Basically, companies like Stryker and Zimmer were paying orthopedic surgeons to use their implants with patients.
Medicine and business are tough to blend. Decisions to improve the bottom line often come at the expense of the consumer without the consumer ever completely understanding what has happened. It's the proverbial rug being pulled out from under you without ever knowing you were on a rug to begin with.
An orthopedic surgeon stopped by our office one day, a guy I have known for 25 years, a top referral source of our practice. I was surprised. He had never done that before. He said he was in the area and wanted to just say hi. Hmmm.....
Well, after a few minutes of chit-chat, he says, "Well, now for the bad news. We hired a therapist. Yep. We're going to do physical therapy in our office instead of sending it out." I just looked at him. He looked down, shifted his weight, cleared his throat. "It's someone you trained so she'll be ok for most stuff. You know, it's just an economics thing. Reimbursements are dropping, Medicare is squeezing us. We needed to get some more revenue and PT can make us some money. But, I wanted you to hear it from me first. I'm not really in favor of it. I just want to be a doctor but the other guys, they all were for it. Why can't I just be a surgeon?"
I wanted to say, "Well, say three Hail Mary's and you'll be fine," but instead I said, "You can still send us the folks your therapist can't help. I'm sure they'll be a few. We'll be happy to help you out." It was the best blend of truth and kindness I could manage. Will his patients get better at his place? Maybe. Maybe not. But, that's not the point. The point is that he already knows our abilities, our track record. If you asked him where he would send his mother, I seriously doubt it would be to his own in-house rehab. And he knows it - he couldn't look me in the eye, shuffling his feet, genuinely upset.
When medical decisions are subservient to dollars, they are always bad decisions. A physician is the agent for the patient; acting in his or her best interest. When medical decisions are subservient to dollars, the physician is a double agent; treason of the worst kind.
And now, it looks like the State of California agrees.
A new ruling by the State of California Legislative Counsel found that physician-owned physical therapy clinics (POPTs) are illegal in California. This means that doctors in California will not be able to employ physical therapists and refer to them to profit from the referral.
How does this help you - the potential client? Competition almost always improves something in business. In physical therapy, there's very little competition when the person who writes the referral, which is a requirement, then determines where you go for rehab. Doctors who own their own rehab have no incentive to refer elsewhere and patients assume that the doctor would of course make the best choice for them and offer no objections. The demise of doctor-owned rehab will create a sorely needed competitive environment and the patient is the benefactor.
Of course, what starts in California moves East at the pace of an inch worm. But, there's no end worse than the end of hope. So, here's to hoping that the anti-doctor owned rehab movement gains some steam.