Deja Vu All Over Again – Where Have all the …Gone?

As I was reading this article from the NY Times today and put it on Twitter earlier today I had a strange sense of Déjà Vu.  Probably because it reminded me of this earlier post on my blog.

I have an sense of impending crisis in healthcare that will be reminiscent of the recent bailout of the financial institutions and the possible bailout of the automotive industry.  The only question will be who will bailout medical providers?  Sadly this is a crisis that if not solved soon will require a much more lengthy period of recovery as the education and training of medical providers takes years so the recovery curve is likely to be extraordinarily lengthy.

Saying “Thanks!” a Little Differently this Holiday Season

My Partners and I have decided that instead of doing the typical holiday routine of delivering fruit baskets and treats to express our gratitude to our many referral sources, this year we will be making a cash donation to the local food bank or Toys for Tots in their name.  The choice of charity will be theirs. 

To our many referrers, thank you for the opportunity and privilege of serving our mutual patients in 2008.

Insurers Propose Universal, Centralized Healthcare

According to this story from the LA Times America’s Health Insurance Plans, a trade group representing the insurance industry has made a significant proposal regarding Universal Insurance.  As this debate ensues everybody is going to have to make sure that what inevitably arises doesn’t provide Universal Insurance accompanied by Universal Non-Coverage. 

Consumers should be assured that their benefits provide reasonable payment to providers so that providers will participate in the plans, that coverage determination will be based on necessary and appropriate provision of services without arbitrary and capricious caps or limitations based solely on the profit motivations of the private insurance carriers.

While there is tremendous even dire need for reform in Healthcare it needs to be accomplished by thoughtful, deliberate and circumspect means.  A rush to a final proposal will only complicate the already complicated and failing system currently in place.

Half of <Insert Your Medical Profession Here> Would Leave <Insert Your Medical Profession Here>???

This article from CNN reports on a recent survey revealing that half of all primary care physicians surveyed would leave their profession if they had an alternative.  While this statistic may be shocking to those outside of the medical community it probably comes as much less a surprise to those within the community.  As we continue to witness the death spiral of declining third party reimbursement from insurers while all costs of practice are rising it has become increasingly difficult for medical providers to maintain a sustainable practice.

At what degree of Crisis will we recognize that the current model of third party payment is failing and that it has to be corrected soon or we will once again reap the punishment of failing to recognize impending failure of a national system?

CMS Testing Multiple PHR’s

An interesting post on zdnet discusses some of the goings on with regard to CMS and online PHR systems.  You can read the post here at Medicare Tests Multiple PHRs including Google.

Understanding and Ownership

Those that know me well and follow my various blog postings know that I am an adamant advocate that ownership of Physical Therapy services should solely be held by Physical Therapist licensees.  When one considers the myriad of problems and recent scandals impacting our profession including aberrant billing patterns and some that are outright fraudulent and the depth of ignorance regarding almost all practice related compliance it should be a shocking experience. 

I think the explanation of this situation and perhaps the single best defense of my position is summed up best when over one hundred years ago Upton Sinclair wrote "It is difficult to get a man to understand something when his salary depends upon his not understanding it."  Those who operate services as non-licensees are outside the reach of licensing boards and are thusly unable to be held accountable, it creates an environment whereby those licensees who work for them are at greater risk of exploitation.

Our development as a profession is fully contingent on attaining sole ownership.  Abdicating ownership means abdicating control and without control we will never be fully recognized as a fully developed profession.  Other professions such as physicians and lawyers have recognized this long ago and until we have embraced this concept we will continue to yearn for a recognition we don't yet deserve.

Physical Therapy and Direct Access

Dr. Eric Robertson of the NPA Think Tank Blog  has been writing a series of articles on Direct Access and he invited me to provide a guest commentary on the legislative efforts currently underway in New Jersey to restore some sense and reason to third party reimbursement and coverage for Physical Therapy services including direct access by consumers.  You can view the series including my contribution here.