Competition in American Medicine & Physical Therapy Leads to Quality Care

The celebration of Memorial Day makes every person a little more proud of being an American and ever proud of each individual/family member who has served. This pride inspires us to do what we can to make America a better place. With the changing economy, people start thinking more about how they can help America and the cities they live in, for example, by supporting local businesses, which ultimately supports respective communities. Speaking of helping America, we must consider the competition that is raging between the big conglomerate medical/healthcare corporations, hospitals and that of private doctors’ offices and the private offices of rehabilitation specialists. It’s no secret that many physicians have been bought out and hired by big conglomerates and/or hospitals. Additionally, many privately owned physical therapy practices have gone out of business all because of the direction this country has taken in allowing a monopoly-like environment to prevail. Privately owned medical and rehabilitation centers can save us money and, more importantly, improve quality care.
As Gottlieb notes, throughout the country, big conglomerates and hospitals are acting to consolidate local physicians to secure monopoly-like positions that give them bargaining power and allowing them to increase their medical and rehabilitation reimbursements. According to Gottlieb’s report on Forbes.com, studies show that this sort of market concentration leads to higher healthcare costs. In 2006, the Synthesis Project published a research synthesis on the impact of hospital consolidation of medical services on prices, costs and quality of care. Since that time, the literature has greatly expanded. The evidence and expanded evidence on competition and quality shows that competition leads to higher quality. Review of the research shows that decreasing competition via consolidating medical services will not lead to cost reductions or clinical improvement, and may lead to enhanced market power for providers. Unfortunately we are headed more toward a monopoly-like system rather than a system which fosters competition.
ObamaCare increases the costs that a physician faces by continuing to run his/her own independent medical practice in many ways, and it also creates a reimbursement scheme that favors the hospitals still further, by allowing outpatient procedures to be better compensated when they are performed inside a hospital owned practice versus an independent office. All of these elements have had the predictable effect of driving consolidation of medical practices around the hospitals. According to Forbes.com, this is going to raise healthcare costs, and lower productivity across the medical marketplace. As the Synthesis Project of the Robert Wood Johnson Foundation concluded, ultimately, increases in health care costs are passed on to health care consumers in the form of higher premiums, lower benefits and lower wages.
What can the medical and rehab consumer do about it?
The medical and rehab consumer ‘can’ make a difference, but how much of a difference will be based upon each person’s individual efforts. However, all too often many simply do what they are suggested to do by their respective physician and often don’t realize that they actually have a choice where they go for their medical and/or rehab services. This is not the day and age to ‘just go’ where you are told for medical and/or rehab services; especially by a hospital or corporate paid physician employee, even though they may be very well meaning physicians. We as the consumers of medical and rehabilitative services have to understand the situation and make our own decisions. We have some great physicians in Cape May County, however, the freedom physicians have to refer to facilities other than those owned by their employers is undeniably being squeezed. With all the recently opened medical and rehab offices, it’s rather obvious that employers expect their employee physicians to make use of said offices.
If you are seeing a physician who is part of a hospital or large conglomerate you have to consider the allegiance the physician may have with the entity who employs them. The Hippocratic Oath is an oath historically taken by physicians and other healthcare professionals swearing to practice medicine honestly. One can only hope that where a physician sends you for outpatient services, whether physical therapy, cardiology, radiology or other, he/she would recommend a facility which they know offers “as good” or what he/she deems “better care” at lower costs. One can only hope that the medical and/or rehab consumer will do their due diligence by personally investigating their options rather than just doing as they are told. Question: Is it a violation of the Hippocratic Oath for a physician to send a patient to a medical or rehab facility owned by their employers when they have the option to send the patient to a facility who offers the same care, or possibly even better care and with more time availed to their respective patients at a lower cost? I’ll let the medical and rehab consumer decide for him/herself.
We at Pro PT & Rehab Physical Therapy (Cape May) have been fortunate to have physicians recommend our center for physical therapy because they know we put forth extraordinary efforts for our patients. They know that we avail ‘No Session Time Limits’, that we allow return visits the same day with no extra session charges; they truly care about the rehab potential of their patients and they do so regardless of whether they are employed by an entity or are independent. They also know of the quality care their patients receive at a host of independently owned medical practices, so despite being an employee of a large corporation and/or hospital, they will still recommend external facilities for their patients.
There are a lot of great physical therapist doctors out there, however, the time they avail you, the environment they avail you and the equipment they avail you is not necessarily up to them as they are employees who may be in a setting requiring them to follow set corporate rules. I’m certain many physical therapist doctors are quite satisfied with the quality of care they deliver as they should be; however, what if they had that extra bit of freedom that a private practice offers? Your choices as a medical/rehab consumer can have an impact as to where this healthcare and medical system are going in this country. If you believe medical / rehab practitioner independence is important, than you have every reason to consider the importance of receiving your care at the office of independent practitioners.
There is no magic bullet to correct what is and has been happening to the medical/healthcare system in this country. Currently physician groups throughout the country are taking measures to align and find ways to combat the current direction we are going in and maintain their independence. This is something doctors of physical therapy also strive for. Certainly becoming politically involved would be helpful, but realistically, how many people are able to take the time to learn the issues and to take action? While it would be great for people to become more politically active, there are some very simple actions which could be quite helpful.
When you are prescribed a medical and/or physical therapy procedure, visit available facilities yourself, don’t assume the one closest to your home or office or is the best choice to make. Convenience can also cost you quality. This applies to any medical and/or rehab service. If you know the facility is privately owned and isn’t part of a multi-location conglomerate/corporation, you will already know the practitioners will likely have greater freedom of practice, a less sterile environment and the costs to the system will be less. Simply by choosing a privately owned entity, you allow such entities to survive and hopefully thrive. If you are satisfied with the care you received at a hospital and/or conglomerate location despite aforementioned variables, then at least that is your decision to make. In the end, you decide what is most important for you, but don’t let anyone else make your decisions for you. If you would like to help promote competition which has always improved quality, if you would like to help foster the existence of privately owned medical and healthcare entities, if you would like to help to reduce medical and healthcare costs which also helps keep premiums down, then take personal initiative and don’t just follow the powers that be. You have the right to choose where to go for your medical and healthcare services. Regardless of your ultimate choice as to where to go, understand that private practitioners are being squeezed, many of them out of existence and when they are gone, where is true competition which has traditionally served us as the main driver of improving quality care?
If you need treatment for musculoskeletal pain and/or dysfunction, you can legally see your doctor of physical therapy without a medical doctor’s prescription. This is why we at Pro PT & Rehab invite people with musculoskeletal pain to visit us for a free consultation.
See Testimonials and actual video of patient treatments on the Testimonials page at www. CapeMayPhysicalTherapy.Com. See testimonials from Jack Facciolo, D.O. of Rio Grande, Suketu Nanavati, MD, Cardiologist of Cape May Court House (treated as a patient), and Dr. David Rayfield of Northfield, who traveled over an hour for physical therapy care based upon word of mouth and a host of others who have learned that, “It Truly Matters Where You Go For Your Physical Therapy & You Have The Right To Choose The Best.” Located at 650 Town Bank Rd, North Cape May, Ste 203; 609 884-9800; CapeMayPhysicalTherapy.Com – It’s worth driving the extra mile!