Since as far back as the ‘70s, APTA has had a strong stance against physician-owned physical therapy services. POPTS has become synonymous with “referral for profit” (RFP). RFP describe situations in which a referring doctor refers a patient for PT and stands to receive a financial gain from the referral. If you are like many students you may be wondering, what’s the big deal?
Some concerns about RFP/POPTS:
· RFP can lead to physicians having undue influence on the clinical judgment of a PT and can make our profession appear to be an ancillary service (along the lines of x-ray services, massage, etc.). This negates all the work our profession has done to become more autonomous.
· The financial incentives may lead to a conflict of interest, because the doctor employs the PT or receives financial incentives that may lead to an avoidable conflict of interest since the doctor receives money for each referral. Because the doctor contracts or employs the PT, he would directly profit from every patient he self-refers. This can then lead to excessive or unnecessary procedures and treatment durations. RFP can also lead to “cherry-picking” patients with well-paying insurances.
How do you identify a RFP or POPTS clinic? If you can answer, “yes” to any of the following:
· Does the PT work directly for a Physician practice?
· Does a physician own a part of the practice?
· Does a physician rent the PT practice space for an above-market rate? Or based on the volume of treatments provided?
· If you’re not sure, ASK! Ask the clinic who the owner is and where they get referrals.
What are the obligations if you discover such a practice?
“The APTA Code of Ethics states that it is the obligation of the PT to inform his or her patients when the patient’s referral is from a physician who has a financial interest in the physical therapy service.”
That is, your obligation is to provide the best care to your patients, including notifying them of their right to be informed and choose their healthcare provider. Your responsibility is also to your profession, and you should inform your state PT association if you suspect a clinic of participating in RFP.
On the flipside, don’t attack clinics or call them out for being unethical - APTA has noted a distinction regarding ethics and has defined POPTS/RFP as bad policy, but not necessarily unethical. Contact the PTWA RFP Committee to get involved and stay informed as this issue is still evolving with local litigation in progress and the nationwide fight. More information is available through APTA RFP/POPTS resource center: http://www.apta.org/AM/Template.cfm?Section=State_Gov_t_Affairs&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=311&ContentID=37286
Post contributed by Senayet Woldemariam, SPT
President, UW DPT 2011
Vice President, SSIG
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