A subject that is, again, seeing some light in PT world is Physician Owned PT clinics or POPTS as they are often referred to (acronyms are cool). This subject is also being discussed over at Evidence In Motion and Rehabedge (a rehabilitation forum).
Why are these a problem or concern to those outside the PT profession? This is an excellent question, because this situation does affect the general public as well as my profession.
I'll forgoing making any claims of the ethical nature of a physician owned clinic or those PT's that work for them. Suffice to say, it IS bad policy. While the mantra of these setups is that it is an attempt to provide convenient care with better oversight, in the end it is more about improving the revenue stream than patient care. An MD wanting to make money is not a bad thing. But, POPTS do present specific problems:
- Inherent conflict of interest. The MD stands to profit from referring a patient to the clinic THEY OWN.
- Doing so restricts a patient's CHOICE in regards to PT consultation.
- When a patient can be used as an additional revenue source, the trust between that patient and the doctor is seriously compromised.
- POPTS directly impact the autonomy of an individually licensed, regulated, and recognized profession. Doing so can affect the quality of care a patient seeking consultation with a physical therapist receives.
Additionally, a well known study done by Jean M. Mitchell, PhD, published in the Journal of the American Medical Association (JAMA) found the folowing in regards to POPTS:
- “Visits per patient were 39% to 45% higher in joint venture facilities.
- “Both gross and net revenue per patient were 30% to 40% higher in facilities owned by referring physicians.
- “Percent operating income and percent markup were significantly higher in joint venture physical therapy and rehabilitation facilities.
- “Licensed physical therapists and licensed therapist assistants employed in non-joint venture facilities spend about 60% more time per visit treating physical therapy patients than licensed therapists and licensed therapist assistants working in joint venture facilities.
- “Joint ventures also generate more of their revenues from patients with well-paying insurance.”
For those being referred to a physical therapist, ask you MD if they have financial interest in where they are sending you (seems as though they should tell you upfront, doesn't it?). If you are not comfortable with this situation, request that they refer you to a more convienient or non-physician owned PT clinic. You can also go HERE to do a search for local physical therapists and how to contact them directly.
Jason L. Harris
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