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  • New APTA Resources Focus on Physician Self-Referral

    Activity on physician self-referral, in particular efforts regarding the exceptions to the
    in-office ancillary services (IOAS) exception to the Stark self-referral laws, has ramped up this year, and APTA has new online resources to help members understand federal self-referral efforts and get involved.

    New on APTA's Self-Referral webpage:

    • "Take AIM" video alert features APTA President Paul Rockar Jr, PT, DPT, MS.
    • Prezi presentation visually walks you through the issue.
    • "Self-Referral 101" takes a more textual approach to explaining the issue.

    You’ll also find APTA's position paper on self-referral, news items, and links to the Government Accountability Office reports that implicate financial incentive in physical self-referrals to prostate cancer radiation therapy, advanced imaging, and anatomic pathology services. (A fourth report, on self-referral in physical therapy, is due this fall and will be posted here as well.)


    • when are we as an organization going to stop spending so much time and money on physician self referral?! Hospitals and large health systems self refer (as do many PT clinics/corporations) and we are not railing against them! We have been having this push since I was in PT school over 25 years ago and it is getting old--that we spend what we spend on THIS and yet our public still doesn't understand what a PT does, why they might need one and what on earth a "Doctor" of PT does or is!!!!!!!! I recently went to APTA website for resources and was appalled at how little was there and how utterly uninformative it was. Many of the "public" brochures and links contain only text and are seriously lacking in useful content! Our dues are terribly expensive and it is clear that too much is going to administrative and political expenses and not enough where it can help the PTs in the trenches. So much rhetoric, so little action in the direction of truly promoting our profession in the eyes of those who need to understand it--our patients, our public.

      Posted by Beth on 9/15/2013 9:34 PM

    • I could not agree more, Beth. There are more pressing issues within the profession and the APTA is not assisting where needed. I feel the physician self referral issue is the focus of the APTA internally and not of the PT professionals themselves. Please focus on areas of concern that affect the overall survival of the profession and the quality of care issued to our patients.

      Posted by Laura on 9/16/2013 11:40 AM

    • There is a long history behind why physician self-referral is an issue that strikes at the very heart of our survival as a profession...in Texas, a patient must still have a referral to see a PT, and the physician may own their own PT...I'm flabbergasted that anyone in our profession can't understand the conflict of interest and the implications of this situation...it limits our profession's ability to attract our customers (patients) and the patient's ability to get to a provider of choice...it affects insurance reimbursement, and negatively impacts the overall cost of healthcare...without writing a book, the insurance industry and other non-PT entities have outlined this even since the 1980's...there is ample evidence of what I have stated...these were not my original thoughts! If we have no control over our own profession, and are simply employees of another profession, it doesn't bode well for our ability to survive and grow...many other professions already know this...why are we so slow to come to the understanding? Our dues, as a percentage of income, are a fraction of most other professions...and while it does "pinch" to pay up...I am adamantly in favor of my dues going towards the issues that I believe are key...direct access (patient choice) and self-referral...many of our other issues (including reimbursement) are affected by these two. I do agree with you, however, that we are not doing a good enough job with promoting our profession to the public...also very important.

      Posted by Patti L. Schwartz, PT on 9/17/2013 1:46 PM

    • Physician self referral really hurts private practice physical therapists. Yes, hospital systems also self refer and this, too, hurts private practice physical therapists. I applaud the APTA for their efforts to try and limit self referral while also agreeing that more time and attention should be spent on teaching the public about physical therapy and working with insurance companies to make copay's and deductibles more affordable so that patient's will actually be able to use the physical therapy benefits that insurance companies say they have.

      Posted by Suzanne Foxx on 9/17/2013 4:16 PM

    • I really can't see how a Prezi or a video is going to do anything to slow or stop POPTs. Isn't this all tied back to Medicare "physician status" that the APTA chose to give up on?

      Posted by Joshua on 9/17/2013 5:27 PM

    • In office ancillary services exception (IOAS) is very important move by APTA. I support it fully. This the reason why Physician wants physical therapy under their control- no direct access. It is golden goose for them. why they should leave alone. How long you work does not matter. What matters is result. This profession must be independent.As regard knowing physical therapy to people. This another subject. It is APTA's responsibility to educate people.

      Posted by Deepak sardey on 9/18/2013 8:31 AM

    • I think as clinicians we can do enough on our own locally to promote ourselves by the care we can deliver. One problem with self referral is that Medicare - who we all depend on, is going broke!! I don't think you would find many PT's in private practice that don't think POPT's is a big deal. The thing is you have to strike when you can. And there is a bill out there to close the loophole - hence the need for attention.

      Posted by dano napoli on 9/18/2013 11:01 AM

    • I know that self referral can be overutilized by clinicians but a law like this will hurt the people who are doing it right. The physician I work with respects our profession and my input on my treatment of our vestibular patients and when they are ready to discharge. He hires only staff who are qualified to treat the vestibular patients he sees. Having the whole treatment team here in the office is beneficial because I can get a lot more information from him about a patient than if we have to exchange emails and phone calls. Moreover, our patients love the convenience of coming to one site for the whole treatment. It's also much cheaper than receiving the same treatment in a hospital setting because we don't have the overhead they do. And, as was stated above, hospitals self refer all the time. There needs to be a greater focus on people charging for PT in offices who are not licensed therapist.

      Posted by Stephanie Ford on 9/19/2013 2:03 PM

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