Chiropractors in Your Practice

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Have any of you guys worked with (or currently work) with Chiro's in same group? same office?


If so what has been the experience?

Partner and I are toying with idea, as 1/2 of our pts currently see one anyway and we do have extra space in clinic 2 days a week

Why not hire a DO who does primarily OMT?

Originally Posted by DOctorJay

Why not hire a DO who does primarily OMT?

Chiro is cheaper.

we are considering because we want to control quality and workers comp especially pay for it. Contract maybe... They can't be partners....

Originally Posted by Louisville04

Chiro is cheaper.

Omt better reimbursed though usually

DOs who actually do OMT are few and far between

what is OMT

Around 2002-3 I did this for about 6 months. Was hard to get patients to accept it. Was hard to get insurance to pay for it. Ended up parting ways and hiring a PT nistead.

Originally Posted by DOctorJay

Why not hire a DO who does primarily OMT?

Why not hire a PT with extensive manual training?

therapists with post PT school residency/fellowship training to be certified as AAOPMT or NAIOMT fellows can do all the manual treatments the patient could need, while still staying within the real medicine/therapy world for the rest of the treatment plan.

Once I discovered this level of advanced PTs in PMR residency, I've never needed to send a patient to a chiro or DO since.

Also easier to bill for than OMT.

Originally Posted by bedrock

Why not hire a PT with extensive manual training?

therapists with post PT school residency/fellowship training to be certified as AAOPMT or NAIOMT fellows can do all the manual treatments the patient could need, while still staying within the real medicine/therapy world for the rest of the treatment plan.

Once I discovered this level of advanced PTs in PMR residency, I've never needed to send a patient to a chiro or DO since.

Also easier to bill for than OMT.

A website where you can find maually certified PTs:

http://www.naiomt.com/pages2/findcertpts.html

Originally Posted by jsaul

what is OMT

I think its: Oral Maxillofacial Therapy.

Originally Posted by SSdoc33

I think its: Oral Maxillofacial Therapy.

seriously man. I really didn't knwo what OMT therapy stood for.

Originally Posted by jsaul

seriously man. I really didn't knwo what OMT therapy stood for.

Overtly Masochistic Tendencies?

Or Maybe This;


Osteopathic Manipulative Treatment

Any Stark issues with referring to your own PT/chiropractor/manipulation master?

Originally Posted by painstop

Any Stark issues with referring to your own PT/chiropractor/manipulation master?

Unfortunately, no.

Originally Posted by bedrock

Why not hire a PT with extensive manual training?

.

That would be great but living in BUMF--- desert town, not easy to get a P.T. to come to live here


Chiro's are as thick as flies here though

Originally Posted by jesspt

Unfortunately, no.

why "unfortunately" so everyone else that is not an MD or DO can make any profit out there and not be held to the standard of an MD, that is "unfortunate" uggg...

Originally Posted by Jcm800

why "unfortunately" so everyone else that is not an MD or DO can make any profit out there and not be held to the standard of an MD, that is "unfortunate" uggg...

I think it is a conflict of interest, and I think that those shoulde be removed whenever possible.
Do you think otherwise?

Originally Posted by jesspt

I think it is a conflict of interest, and I think that those shoulde be removed whenever possible.
Do you think otherwise?

I think if you own PT and have it on site and refer to it, making it known you own it, there is no conflict of interest at all. So yes, I think otherwise.

Originally Posted by Jcm800

I think if you own PT and have it on site and refer to it, making it known you own it, there is no conflict of interest at all. So yes, I think otherwise.

I'd say that isn't how it tends to work. Also, the Office of The Inspector General did a little looking into POPTs practices. Looking at the data presented in the report, it's hard to say there isn't a tendency toward overutilization and abuse.

Originally Posted by jesspt

I'd say that isn't how it tends to work. Also, the Office of The Inspector General did a little looking into POPTs practices. Looking at the data presented in the report, it's hard to say there isn't a tendency toward overutilization and abuse.

Right, cuz PTOPT doesnt find any possible reason to keep a medicarebpatient until their 1800 bucks is used up. If I refer a patient to PT, if they aren't making progress I stop the PT, but if it's is a PTOPT practice, they keep on and always write "would benefit from additional PT"

OIG only cares because about the above because they can bully doctors, more than anyone else, sadly.

Originally Posted by Jcm800

Right, cuz PTOPT doesnt find any possible reason to keep a medicarebpatient until their 1800 bucks is used up. If I refer a patient to PT, if they aren't making progress I stop the PT, but if it's is a PTOPT practice, they keep on and always write "would benefit from additional PT"

OIG only cares because about the above because they can bully doctors, more than anyone else, sadly.

Sadly, there are jerks in every profession who will put finances ahead of the concerns of the patient, and that includes some PTs who own their own practices as well. But stating that you know of some PTOPTs that are abusing the system isn't really an argument against the inherent conflict of interest that exists in a referral for profit situation.

FWIW, you sound as though you run your practice ethically, and I wasn't trying to single anyone out in particular. But, when you look at the OIG report, the results of their inquiry were pretty staggering when you look at POPTs in total.

Jesspt,

Your response was respectful and backed up by information, so I appreciate your response. Obviously, all parties involved have their own inherent conflict of interest (whether it be a therapist or a physician). The OIG report revealing a few internal medicine docs billing 2 MILLION dollars one year and $ 300,000 the following year obviously implies to me there was something fishy going on the prior year that resulted in a nicely-worded letter for those guys to cease and desist. Like you said, there are always bad apples regardless of the letters after their name.

Originally Posted by jesspt

I think it is a conflict of interest, and I think that those shoulde be removed whenever possible.
Do you think otherwise?

A doctor wants to offer PT through his office. A PT wants to work for him, doesn't want to be self-employed. Patients want to go here. Yet many PTs want the laws changed to ban this practice since it would potentially benefit them.

One of the biggest problems in this country is everyone wants the laws changed in their favor. To hell with free trade, life has to be fair! And if it is not fair, change the laws!

Originally Posted by jesspt

Sadly, there are jerks in every profession who will put finances ahead of the concerns of the patient, and that includes some PTs who own their own practices as well. But stating that you know of some PTOPTs that are abusing the system isn't really an argument against the inherent conflict of interest that exists in a referral for profit situation.

FWIW, you sound as though you run your practice ethically, and I wasn't trying to single anyone out in particular. But, when you look at the OIG report, the results of their inquiry were pretty staggering when you look at POPTs in total.

I did not state that i know of SOME, i ONLY know of PTOPT that are abusing the system. especially trying to capture walk in patients

Originally Posted by PMR 4 MSK

A doctor wants to offer PT through his office. A PT wants to work for him, doesn't want to be self-employed. Patients want to go here. Yet many PTs want the laws changed to ban this practice since it would potentially benefit them.

One of the biggest problems in this country is everyone wants the laws changed in their favor. To hell with free trade, life has to be fair! And if it is not fair, change the laws!

I think that there are also PTs who would like the legislation changed to avoid a referral for profit situation.

Didn't mean to be a troll or hijack the thread.

Originally Posted by jesspt

I think that there are also PTs who would like the legislation changed to avoid a referral for profit situation.

Didn't mean to be a troll or hijack the thread.

what you mean is that PTs would like legislation changed to avoid a referral for profit situation that profits someone else. Then only PTs could own PT, and they can continue to do whatever they want, abusing the system as much as possible.

How does that eliminate referral for profit. It is still a referral to the PT, but then it is PT owner who then profits. I would consider this, if the PT could not take walk ins, and people be able to sell all the unnecessary nonsense to the patients on "discharge"
I almost never write for TENS units, very rare, I will, i have nothing against it, but every patient that goes to ANY PTOPT i always get a faxed request for a TENS unit, or an H-wave, or a home traction unit...

i will stop feeding the troll at this point.

Originally Posted by Jcm800

what you mean is that PTs would like legislation changed to avoid a referral for profit situation that profits someone else. Then only PTs could own PT, and they can continue to do whatever they want, abusing the system as much as possible.

How does that eliminate referral for profit. It is still a referral to the PT, but then it is PT owner who then profits. I would consider this, if the PT could not take walk ins, and people be able to sell all the unnecessary nonsense to the patients on "discharge"
I almost never write for TENS units, very rare, I will, i have nothing against it, but every patient that goes to ANY PTOPT i always get a faxed request for a TENS unit, or an H-wave, or a home traction unit...

i will stop feeding the troll at this point.

jesspt a troll?? Huh?