Today's Quick Links are from Physio Blogger, EIM via Selena Horner, and Allan Besselink
Physio Blogger goes over how he uses Type I and II (osteopathic terms) Motion for lumbar spine treatments. He begins his post saying we all have our assessments and treatments for treating the lumbar spine. He goes on to post some examples on how he drives the above motions functionally, according to his influences.
Allan Besselink recently posted something I would expect an MDT Diplomat to write. Most MDT trained PTs believe that hands on care equals dependency, and for sure, it does make the patient dependent on passive models of care IF and that's a big IF the appropriate home exercise and educational framework are not instructed. Taking the best of MDT (making the patient responsible for their own condition) and adding hands on techniques that will make the HEP more comfortable and thus the patient is more compliant only makes sense. Hands on care at least guarantees that some 1:1 time will be spent with the patient and actual active interaction occurs. I have seen MDT trained clinicians have 3-4 patients at a time doing pressups while they go off and do their paperwork so it absolutely works both ways.
Selena Horner wrote a post over the weekend for EIM's blog on The Future Payment Model and Quality of Care. I do think the model needs to change from quantity to quality. I actually worked for a company that was an outsourced Peer Review for several HMOs. We tried to change the way things are done, based on outcomes, number of visits. The providers who had a higher tier (lower visits, better outcomes, active treatments like HEP, manual therapy, and ther ex) were supposed to get reimbursed more than lower tier providers (higher visit average, passive modalities, no HEP). It was also supposed to be mandatory that all episodes of acute uncomplicated cervical and lumbar pain were supposed to be referred out for musculoskeletal care with NO meds, radiology, etc... ordered as long as simple criteria for the PCP were met. Several HMOs were apparently on board, knowing it would provide a HUGE cost savings, and in the end, ortho specialists started flipping out, and to my knowledge, the plan was never took off. Sad... and people think HMOs don't get it... Thoughts?
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