Surviving and Thriving


How to stay successful In the new world of health care.

By Rob Worth, PT, DPT, MS, OCS, MTC, ATC/L

“If you are prepared to accept the consequences of your dreams then you must still regard America today with the same naive enthusiasm as the generations that discovered the New World.” —Jean Baudrillard, French semiologist. “Utopia Achieved,” America (1986, trans. 1988)

Surviving and thriving in the new world of health care and integrated health care systems can certainly be a daunting thought. Depending on where in the country you practice, you may already be seeing many alliances forming around you and maybe you are not sure what, if anything, you should be doing about it. Fortunately, new world innovation still comes down to a few age-old attributes: value, relationships, and integrity.

Value. Though the uncertainty of new payment models (i.e., per diem based on patient severity and treatment complexity, bundled payment, etc.) is intimidating, there will always be a place for the highest quality physical therapy services that are provided at a reasonable price. Be that provider. The health care system is in dire need of a solution that provides cost-effective care for patients and prevention/wellness for populations. For example, through providing onsite industrial injury care and prevention for one of our client companies, our practice saved the company over $100,000 in their fourth quarter alone. This is real value that we as physical therapists can provide. It is an exciting time for physical therapists, especially those providing direct access care, because we are uniquely positioned to step up and become the cost-effective solution for managing conservative musculoskeletal care. Do you provide cutting-edge, cost-effective care to your patients? Do you track and measure your outcomes? Imagine the value to your patients if your treatment techniques provide the same quality outcomes but allow them to finish their treatment in three to four fewer treatment sessions. With today’s higher copay and/or higher deductible plans, you could be saving your patient hundreds of dollars in direct out-of-pocket expenses. Patients will very quickly see the value in your services and you will quickly become the provider of choice.

Relationships. Being a provider of high-value physical therapy services is the cornerstone of success. However, if you are not engaging in discussions with employers, insurance companies, physician groups, as well as involving yourself in the community, you are going to miss out on some opportunities and find your practice to be less a part of integrated systems of care in your community than you would like. Do you have a specialty service that no one else in your area offers? Is there some special training that you and your staff have that will allow your team to be essential to a network that is forming, or one that already exists but might have a lack of providers in your geographic area? This is a great “door opener” to help get you at the table and secure the continued success of your practice. You may find that your practice does not offer a service that your community needs. If you are always trying to stay current with the needs of your community and local referral sources, it will help you anticipate how to grow your practice for future survival. When it comes to key players in the integrated systems of care in your community, if you are not sitting at the table you may end up missing out. Collaboration is key—form a network with other like-minded private practices and align with other health care providers and groups. Although many of us gravitated toward private practice for the autonomy and independence, there is oftentimes strength in numbers. You do not have to join a group, but it is better to be asked than to miss the opportunity completely.

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Integrity. As everyone is jockeying for positions in this evolving health care world, maintaining integrity in your clinical practice and your business interactions will allow your practice to have a positive reputation that endures. In September of 2014, the American Physical Therapy Association (APTA) launched the Center for Integrity in Practice as part of its Integrity in Practice Campaign (www.apta.org/Integrity), designed specifically for physical therapists, physical therapist assistants, educators, students of physical therapy, and leaders to better understand fraud, abuse, and waste in health care. It is vital for us to understand the impact that fraud and abuse have on the profession of physical therapy, on individual physical therapists, and on their freedom to practice. The goals of this center are to help physical therapists and physical therapist assistants identify and understand the risks and possible pitfalls associated with fraud, abuse, and waste. The site provides some specific solutions and resources to help members reduce risks, improve care, and also to help navigate our complex regulatory and payment environment. If you have not taken the time to explore the content in this part of the APTA web page, add it to your to-do list. Business integrity is not a place to take shortcuts—instead it should be the cornerstone on which you build your practice. Having integrity in your practice will help to create opportunities for strategic alliances as integrated systems of care form.

It is a brave new world in health care and following the age-old attributes of creating value, developing relationships, and maintaining integrity will guide you in the right direction. Do not just live in the new world—be a part of creating it!

Rob Worth, PT, DPT, MS, OCS, MTC, ATC/L, is the president of Advanced Physical Therapy & Sports Medicine. He can be reached at rob@advancedptsm.com.