Last year, hospitals hired half of all new doctors according to the Medical Group Management Association, a professional organization for physician practices. A 2009 report by the American Medical Association related that 1 in 6 doctors works for a hospital, and the number is rapidly growing. There are numerous reasons a doctor will accept a position as an employee, but that's not the topic for discussion in this particular article.
Hospitals love having physicians as employees because they assume that all of the physicians patients now belong to the hospital and/or Conglomerate and will often send patients to respective medical and/or rehabilitative services without even notifying the patient that they have a choice as to where to go. Hospitals and/or Big Conglomerates try to sell the idea that providing all services helps the quality of medicine, however, it mostly helps a hospital's bottom line by providing a steady stream of patient referrals. Let’s face it, the hospitals and big conglomerates may actually have good intentions, but in the end, it always turns out to be about numbers! Get as many in and out as you can.
In an article in The Press Of Atlantic City entitled, "Doctor's pioneer day rehab' to aid faster healing.' Day rehab is sold as a three hour session of intensive movement therapy for those who have undergone total knee replacements and total hip replacements — over five days for new knee replacement, seven for hips — under the guidance of physical therapists. They indicate the reduction in healthcare costs by using 'Day Rehab' as opposed to inpatient therapy. The article points that that the average cost for this great new service, 'Day Rehab' after knee replacement is $1860, compared to $4914 for rehab in an inpatient nursing facility. Also is noted that hospital inpatient rehab costs almost $13,000 in a 2006 study. The reduction is impressive, but what they don't compare is how much the cost differential can be were the patient to simply attend physical therapy at a private physical therapy office owned by an actual physical therapist who doesn't have to worry about meeting quotas or numbers or the sort.
Interestingly, and to the best of my knowledge, private physical therapy offices get reimbursed less than Hospital based rehab facilities, so imagine the savings if people just came to private physical therapy offices instead. Those providing programs like, 'Day Rehab' are probably able to obtain reimbursement equivalent to the 3 hours of provided care they claim to provide, whereas I, as a private physical therapy practice owner, could never negotiate such a deal with the insurance companies. Therefore, I not only provide the same or more time in physical therapy care, I get reimbursed far less; to me, this equates with savings!
Additionally, we don't just treat the affected area, we also examine and treat other movement pattern dysfunctions which when treated can provide a much better outcome for those who would like to function at their optimum level. Those of you who've had physical therapy for their total knee or hip replacement, I would venture to say that your knee or hip was the center of focus the entire time up until discharge.
Even more interesting is that I've apparently been providing my own 'Day Rehab' since I opened my N. Cape May facility in June of 2008. Apparently, doing the right thing wasn't enough; I just didn't apply a label to what I was doing. I have built a reputation since the opening of my facility as a genuinely caring physical therapist who offers unlimited time sessions for patients during rehab. They could come everyday or 3 days per week for as many hours as needed; however, to the best of my knowledge, I'm being paid far less than the quoted figures above. I suppose I neglected sell it to the public with a catchy name, 'Day Rehab.' Even with the indicated savings above, don't be surprised to see an increase in numbers of patient's treating in an endeavor to earn as much as possible with this system and don't be surprised if actual care begins to decline along with the desire to meet bean counter financial expectations. In the end, there's an awful lot of accounting that has to go on and it's got to be worth the time and effort!
What the hospitals try to sell is that this way of providing medical care rewards creation of more efficient, integrated models of care. Hiring doctors and forming the "accountable care organizations" envisioned under the law could actually give hospitals much more negotiating clout with health insurers— and drive up insurance prices paid by employers and consumers. If they are able to close down facilities like mine by monopolizing patients throughout the region, they further increases their negotiating power with the insurance company's.
As an independent physical therapist, I set my own policy’s. By focusing on quality care, I’m already going to benefit financially because of word of mouth advertising which is exactly what built my N. Cape May office. However, many people are given the impression they HAVE NO CHOICE but to go where they are sent by the employed physicians! THIS SIMPLY IS NOT TRUE! You have a LEGAL RIGHT to go where you choose for your physical therapy!
It is a Daunting task trying to educate the public to the fact that they indeed have a CHOICE where to go for physical rehab. Most of the time when the mom and pop shops have tried to compete with the big boys, they lose; so us physical therapist owned private practices are in for the battle of our lives; a battle from a vantage point of great disadvantage. Patient's see their physician, have their surgery and go where they are told to go and the public at large simply doesn't realize that they have a choice to go elsewhere. Even were they given a choice, private physical therapist owned practices do not have the initial vantage point of encouraging patient's to compare their services. An easy sales pitch from a Hospital physician employee may be all that is needed to steer patient's where the Hospital wants them to go.
I'm hopeful that people will Support the private physical therapy owned practice and choose physical therapist owned facilities instead of the big rehab conglomerates. Private owners take a personal pride in the services they rendered and employees WILL NEVER have that same commitment, no matter how well meaning! There isn't a physical rehab facility in the area that provides better service than we do! I direct you to the page entitled, "What Makes Us Different." These aren't just words; this is the Truth!
To all our Loyal Patient's We Thank You and we will repay you by continuing to provide The Best Possible Physical Therapy Care Available, but we cannot do it if the public allows the Big Conglomerates and Hospitals to dictate where they go for their care; they do this because they benefit financially! It's hard to find a Pharmacist owned Pharmacy any more! Let's keep Private Physical Therapy Practices in Business! Thank You!
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