Physical Therapist Bill Headed to Governor

by David Gorn

TOPIC ALERT:

The Senate and Assembly this week passed a bill that could change some of the rules regarding physicians, physical therapists and patients.

AB 1000 by Assembly member Bob Wieckowski (D-Fremont), designed to increase patients' direct access to physical therapists, is headed to the governor's desk.

"Patients will no longer need a diagnosis from a physician before beginning treatment from a physical therapist," Wieckowski said in a statement. "This is a great victory for health care consumers in California."

The bill was co-sponsored by the California Physical Therapy Association, and yet the main opposition to the bill also came from physical therapists.

Paul Gaspar, president of the Independent Physical Therapists of California, said the bill wasn't really about direct patient access to therapy as much as it was about changing the financial relationship between physicians and physical therapists.

"People who own [physical therapy] businesses are very concerned about this," Gaspar said. "We feel threatened that people are going to take advantage of us."

Physician groups now will be able to directly hire physical therapists, and Gaspar said that means they'll be able to make money on the work of other providers. That bucks a national trend, he said, that goes against referral-for-profit plans.  

Gaspar said his group will talk to the governor's office about the possibility of a veto, based in part on national legislation (HR 2914) by Rep. Jackie Speier (D-San Mateo) that may conflict with the state law.

Wieckowski said direct access to physical therapists can only be good for consumers.

"This bill helps streamline health care delivery in California and will help patients get the access they need," he said, "rather than losing valuable time with unnecessary and costly delays."

Robert Weiss
In my opinion as a lymphedema patient advocate, a California resident and author of a California bill for the treatment of lymphedema patients according to current treatment protocols, this bill is a disaster for the 200,000 lymphedema patients in California. The bill is counter to the current concept of "patient-centered medicine". Briefly I contend that: 1) The accepted protocol for treatment of lymphedema, "complex decongestive therapy" includes manual lymph drainage, compression bandaging, garment fitting, decongestive exercises and home self-treatment protocols are not part of a PT curriculum and are not tested for in the licensing process; 2) Any licensed PT or OT in California, trained & certified or not in the specialized lymphedema treatment protocols can legally treat a lymphedema patient; 3) Self-referred treatment of self-diagnosed lymphedema is dangerous absent a physician's determination that certain co-morbidities do not exist. AB1000 offers no LE patient protection.
Robert Weiss
In my opinion as a lymphedema patient advocate, a California resident and author of a California bill for the treatment of lymphedema patients according to current treatment protocols, this bill is a disaster for the 200,000 lymphedema patients in California. The bill is counter to the current concept of "patient-centered medicine". Briefly I contend that: 1) The accepted protocol for treatment of lymphedema, "complex decongestive therapy" includes manual lymph drainage, compression bandaging, garment fitting, decongestive exercises and home self-treatment protocols are not part of a PT curriculum and are not tested for in the licensing process; 2) Any licensed PT or OT in California, trained & certified or not in the specialized lymphedema treatment protocols can legally treat a lymphedema patient; 3) Self-referred treatment of self-diagnosed lymphedema is dangerous absent a physician's determination that certain co-morbidities do not exist. AB1000 offers no LE patient protection.

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