The Dark Side of Paris
Monday January 23, 2012
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Recently, a physical therapist who had just returned from a vacation in Europe invited me to dinner. He gave me a "travelogue" of the cities he visited, complete with Facebook photos. He recounted his experiences in London, Paris, Rome and Vatican City. He spent the most time describing Paris, from its avant garde fashion to its "melt-in-your-mouth" croissants; from its gilded architecture and picture-perfect gardens to the quirky sanisettes (public self-cleaning restrooms).
Although he said he would love to return to Paris, he pointed out his disappointment with the city's underground Metro system. This wasn't because the system was inefficient. It was because it so contrasted with the city above — it was dirty and gum-encrusted. Paris may seem glossy and elegant, but its decay was apparent below, he said.
Is physical therapy the same as Paris — glossy and apparently offering a promising future on top but decaying underneath? For several years, we've been hearing about the steadily increasing demand for our services stemming from the aging of the active baby boomer generation and the return of injured war veterans. The Bureau of Labor Statistics projected a 30% growth in employment in the field between 2008 and 2018.
However, many therapists I speak with express concern about continual reimbursement cuts, which include services in the home health sector, an area of practice that had been immune to cuts for years. Even Medicaid health benefits are under scrutiny and projected to decline further. Several private practices in my locale have closed their doors or plan to close in 2012.
Are these signs of what lies beneath current and projected trends in the field? What is behind this dichotomy in my observations? Is it poor advocacy and lobbying on our part? Is it our own complacency? Why does the law of supply and demand seem not to apply to physical therapy reimbursements?
I don't have the answers to these questions. But there is one thing I do know: I still want to see Paris in person someday, and not just in Facebook photos, travel magazines in physicians' offices or on the Travel Channel. When I do, I will take the time to meet Parisian PTs and find out how they deliver services to their patients, and whether they must deal with the same constraints we do. I will also compare their overall healthcare system with ours. Most importantly, I will try to determine whether the physical therapy field there is similar to their city — gilded and picturesque on top but decaying underneath. •
Although he said he would love to return to Paris, he pointed out his disappointment with the city's underground Metro system. This wasn't because the system was inefficient. It was because it so contrasted with the city above — it was dirty and gum-encrusted. Paris may seem glossy and elegant, but its decay was apparent below, he said.
Is physical therapy the same as Paris — glossy and apparently offering a promising future on top but decaying underneath? For several years, we've been hearing about the steadily increasing demand for our services stemming from the aging of the active baby boomer generation and the return of injured war veterans. The Bureau of Labor Statistics projected a 30% growth in employment in the field between 2008 and 2018.
However, many therapists I speak with express concern about continual reimbursement cuts, which include services in the home health sector, an area of practice that had been immune to cuts for years. Even Medicaid health benefits are under scrutiny and projected to decline further. Several private practices in my locale have closed their doors or plan to close in 2012.
Are these signs of what lies beneath current and projected trends in the field? What is behind this dichotomy in my observations? Is it poor advocacy and lobbying on our part? Is it our own complacency? Why does the law of supply and demand seem not to apply to physical therapy reimbursements?
I don't have the answers to these questions. But there is one thing I do know: I still want to see Paris in person someday, and not just in Facebook photos, travel magazines in physicians' offices or on the Travel Channel. When I do, I will take the time to meet Parisian PTs and find out how they deliver services to their patients, and whether they must deal with the same constraints we do. I will also compare their overall healthcare system with ours. Most importantly, I will try to determine whether the physical therapy field there is similar to their city — gilded and picturesque on top but decaying underneath. •
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Monday January 23, 2012