Patients have a choice for where they attend Physical Therapy even if directed to a single PT practice by their physician. Unfortunately, physician owned physical therapy practices are on the rise around the country and referrals are being driven to these practices due to financial incentives. These practices often utilize less qualified personnel (aides, technicians) to deliver PT services at a higher cost than independently owned practices. In addition, research shows these practices utilize a higher percentage of passive modalities (ultrasound) inconsistent with current medical research guidelines.
A recent article highlights the importance of choice when patients select a Physical Therapist after knee surgery. Mitchell and colleagues researched Medicare data on 3,771 total knee replacements performed between 2007 and 2009 (Health Services Research. 2016). Researchers divided these patients into three groups based on where they attended Physical Therapy and the financial relationship between the Physical Therapy clinic and the physician.
1. 709 patients received PT a a clinic where there was a financial connection with the physician
2. 2215 patients received PT at a clinic where there was no financial relationship
3. 847 patients received PT at a clinic with an independent provider, but referring physician had a financial interest
The researchers found patients who received Physical Therapy at a physician owned clinic were seen for twice as many visits and received less individualized care. Authors also noted a decrease in intensity at the physician owned clinics likely responsible for the longer plan of care. Intensity was described as the amount of individualized interventions designed to improve range of motion, strength, and endurance. These results are consistent with prior research demonstrating the key financial and quality differences between physician owned and non physician owned Physical Therapy practices.
Patients are advised to research into the ownership of their Physical Therapy clinic and choose a Physical Therapist who can deliver the most effective and efficient interventions possible.