Anti-POPTS Arguments

Anti-POPTS Arguments

Q: What lobbying arguments are being made by critics against physician-owned physical therapy services?

A: 1) Anti-Trust/Monopoly. Since insurance companies only require a physician referral for payment, then doctors self-referring will present an unfair advantage to the local physical therapist in private practice across the street (APTA has made presentations to the Federal Trade Commission on this issue…see FTC link).

2) Like Professional Ownership. Several professions (attorneys, CPAs, etc.) have legally limited ownership of their profession to “only” members of that particular profession. Precedence has been established and like professional ownership is a viable argument.

3) Conflict of Interest/Overutilization. Critics reference a couple of articles published in 1991 and 1992 as evidence for overutilization. JAMA vol. 258 Oct. 21, 1992 Physician Ownership of Physical Therapy Services and vol. II, September 1991 State of Florida Health Care Cost Containment Board (link to articles).

4) Quality of Care. Critics argue that the quality of non-physical therapy owned practices is at a below par standard when compared to that of physical therapy- owned practices. The strong implication is that physician based physical therapists have compromised both their ethical standards as well as their clinical knowledge base and commitment to excellence. “No real therapist would ever work for a doctor.” Those therapists are putting money before their profession.”

5) Ethical Dilemma. Since the physical therapists are paid by the doctors, then if the doctor wants more visits for a patient than the physical therapist deems necessary, the treating therapist will compromise their legal obligations of patient discharge, leading to unethical over-utilization due to fear of unemployment.