In episode 210 we're joined by Dr. Michael Schneider for the conclusion of our discussion and more on the idea of a physical therapist and chiropractor functioning as a primary spine practitioner. We discuss the need for such a certification, associated challenges and his views on PTs and Chiros joining together. This week on MCF!
Addressing Imaging Findings
Mike agrees that relying on radiological findings feeds into the negativity for the patient. He is of the opinion that clinicians can loose credibility with patients if they are unable to at least look at the reports of imaging. As first line of care clinicians, physical therapists and chiropractors can decode the medical jargon of radiology reports for the patients and put their minds at ease.
Basic understanding of common medications used for low back pain, their indications and contraindications, dosages are required if we even want to foray into the possibility of prescribing medications as physical therapists or chiropractors. Mike feels that even if we do not get to prescribe medications, an understanding always helps us improve our skills of understanding and educating the patients.
Value Based Healthcare
Finances need to align with services, there would be value based healthcare but currently we have a system of fee for services. Low tech but better quality clinicians are at a disadvantage because currently value is defined based on the number of billable services a clinician orders.The irony of the current system is that if you provide good services and patients improve sooner with your treatment, your reimbursement in less compared to those who keep their patients for a longer time in the clinic and the eventual outcomes can be less than optimum.
Advice to Outcome Based Mindset Clinicians
New payment models are being seen in the USA healthcare model including bundled payments, case fees. The other thing being seen is waiving of co-pays by heath plans if there is value based services. Employers also are contracting directly with value based providers and by-passing health-care insurers.
Hence the advice is to stay the course and have faith because, big changes are coming and when they eventually happen, value based practitioners will be ready.
One option to survive in today’s scenario is cased based practice. With huge co-pays, it would not be hard for those seeking care to consider paying out of pocket for value based services.
Chiropractors and physical therapists need to stop being territorial and come together and work on a passive public education campaign.
Mike and his colleagues are looking to expand the PSP program with a second venue in Los Angeles and the main goal is to improve awareness for the value of care provided.
To find out more about the University of Pittsburgh
To read more about Dr. Michael Schneider
Click the link below to access a list of papers authored by Dr. Schneider