APTA's effort to get member opinions on potentially unnecessary physical therapy tests and procedures is off to a strong start, but the association is looking for as much input as possible as it considers joining a national campaign to educate consumers on making informed health care choices. Physical therapists (PTs) have until April 4 to forward suggestions via an online form.
As part of its Integrity in Practice initiative, APTA is exploring the possibility of participating in the "Choosing Wisely" program, a national American Board of Internal Medicine (ABIM) Foundation-sponsored project that provides the public with lists of health care tests and procedures that may be unnecessary under certain circumstances. Consumer Reports is partnering with ABIM to promote the campaign and helped to create a video describing the effort, which was also featured in the March 2014 edition of the American Association of Retired Persons (AARP) newsletter.
The association is on the lookout for any PT-controlled procedure that tends to be done frequently or carry a significant cost, yet whose usefulness is called into question by evidence. APTA will convene an expert panel to review and rate all member submissions and create a list of approximately 10 potential items that will be narrowed down to 5 by way of an all-member survey. The top 5 questioned procedures will then go to the APTA Board of Directors for final approval. Nearly 60 suggestions have been received so far.
If approved for use by the ABIM Foundation, APTA's "5 Things Physical Therapists and Patients Should Question" would join similar lists (.pdf) provided by organizations including the American Geriatrics Society, the North American Spine Society, the American Academy of Family Physicians, and the American College of Occupational and Environmental Medicine. Procedures called into question by these and other organizations include routine imaging of certain patients with inflammatory arthritis, recommending more than 48 hours of bed rest for patients with low back pain, and screening of adolescents for scoliosis.
APTA’s version of "5 Things" would become a component in the association's large-scale initiative to highlight physical therapy's role in eliminating fraud and abuse in health care. The effort is the subject of a feature article (members-only access) in the February issue of PT in Motion.
A March 20 and 21 meeting of the Federal Trade Commission (FTC) examined activities and trends related to cost, quality, access, and care coordination that may affect competition in the US health care industry. APTA representatives attended the event and provided pre-workshop comments (.pdf) that pressed for greater patient access to physical therapists (PTs), the elimination of physician self-referral, and expanded health care networks under the Affordable Care Act (ACA), among other issues.
The meeting, "Examining Health Care Competition (.pdf)," was attended by APTA staff and included panel discussions and presentations on the professional regulation of health care providers, measuring the quality of health care, and the interplay between quality and price transparency, among other topics.
In the pre-workshop comments submitted to the FTC, APTA President Paul A. Rockar Jr, PT, DPT, MS, wrote that even though some form of direct access to PTs is allowed in 48 states, certain state restrictions enacted for political reasons are an obstacle to effective treatment. These restrictions, which include visit caps, time limits, or rules about the number of days a PT can treat before referring a patient to a physician, "are not based on evidence, clinical need, patient safety, or the best interest of the patient," Rockar wrote.
Rockar also described to the FTC how physician-owned physical therapy services restrict trade and limit “the consumer's right to choose his/her physical therapist," a limitation that the consumer might not even perceive, "as no other option is offered." Other portions of the letter urged the FTC to work toward expansion of health care provider networks to include nonphysician providers, and to carefully review new models of service delivery such as accountable care organizations (ACOs) to ensure that the new systems do not disenfranchise patients by limiting choice.
The association will also submit follow-up comments after the workshop.
FTC's meeting follows the release of a policy paper (.pdf) that questions regulatory frameworks that it feels limit consumers' ability to seek treatment from Advance Practice Registered Nurses, particularly by way of restrictions on independent practice. In that paper, agency analysts propose that limited practice scopes and burdensome requirements for physician supervision or approval effectively dampen competition and leave consumers with fewer choices, a situation that "can have serious health and safety consequences."
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APTA's national awards program has announced the full list of recipients (.pdf) of recognition for their outstanding contributions to the physical therapy profession.
The honorees include newly named Catherine Worthingham Fellows as well as recipients of the Mary McMillan Lecture Award, John H.P. Maley Lecture Award, and Lucy Blair Service Award. APTA also announced award recipients for excellence in education, practice, service, publications, research, and academia.
Recipients will be recognized at the Honors and Awards Ceremony on Thursday, June 12, 5:30 pm–6:30 pm, during the 2014 NEXT Conference and Exposition in Charlotte, North Carolina, with a reception to follow. Family, friends, colleagues, and conference attendees are encouraged to attend this important event to support and honor these members’ achievements and contributions to the profession.
Nominations for the 2015 Honors and Awards Program will open September 2014.
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