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.

NASA Should be Just Giddy with Pride Over Recent Successes

With the unmitigated and unprecedented success of the Mars Rover (Spirit and Opportunity) Program, the recent success of the Mars Phoenix probe and its discovery and confirmation of the presence of water on the Red Planet and now the successful completion of the Cassini Primary Mission, NASA should be absolutely giddy with delight over their successes.  My hat is off to you NASA!

Leveling the Playing Field

On June 23, 2008 the New Jersey General Assembly took the first step in restoring some sense and reason to the practice environment for Physical Therapists and healthcare consumers in the State of New Jersey by overwhelmingly passing Assembly Bill 2123 (A-2123).  This landmark piece of legislation seeks to establish standards of coverage and reimbursement that are commensurate with the standards of practice by which Physical Therapists in New Jersey are bound to abide.

A-2123 assures consumers that the coverage that they and their employers pay so handsome a price for will indeed provide services without arbitrary caps on payment for services rendered or visits for medically necessary services.  As we are all painfully aware, third party payment for Physical Therapy services has been in a downward death spiral.  A-2123 establishes a floor of reimbursement based on an already existing PIP fee schedule established by the State of New Jersey below which the insurers' liabilities may not fall.  It also provides for the elimination of capricious and arbitrary visit authorizations less than those proposed by the treating Physical Therapist's Plan of Care should authorization be sought.  This legislation also makes Direct Access an affordable option for consumers by eliminating all referral requirements for third party payment for Physical Therapy.  There are a host of other benefits of this legislation which are covered here.

When all else has failed there are other avenues that are available to combat the deterioration of the practice environment and the legislative arena is the one most apropos when all other avenues have failed to produce satisfactory outcomes. 

The Senate companion bill of A-2123 was introduced last week as well in the form of S-2072.  I for one am looking forward to the passage of this bill as well and the eventual enactment of this legislation by the stroke of the Governor's pen.

Might we see a doctors’ strike?

This article from ZDNet is interestingly insightful in that it recognizes the stress currently afflicting nearly all the various medical professions.  If the current trends continue or even accelerate (which I believe entirely feasible) we will all be in for a rude awakening when there is nobody left to treat us or at the very least participate in our insurance plans.  Unless a reasonable methodology for compensation for medical professionals is developed Universal Health Care will be like throwing a party where nobody shows up.