Is Transparency A Game Changer In Consumer Direct Access To Physical Therapy?

Transparency. It has a way of breeding trust amongst groups and individuals. But there is so little of it anymore – with hidden agendas at every turn – that I think most consumers think it doesn’t even exist anymore.

Those hidden agendas exist throughout health care. But what about the evidence? For example, the data to support consumer direct access to physical therapy has existed for years. All of the “issues” presented by our counterparts simply don’t exist, nor have they in any other country in the world.

So why is it that the legislative powers-that-be aren’t listening?

We actually have that answer. It can be found in the back room finagling and lobbying that consumers and physical therapists alike don’t see and just won’t discuss publicly. Until now.

Let’s have some transparency on the issues that affect the discussion. Or, in other words, let’s take a moment to reflect on the 800 pound gorilla(s) in the room.

Legislators in countless states have been throwing bones to physical therapists for years now. Take California’s SB924 as but one example. Give with one hand, take with the other – and who loses? The consumer. What is oftentimes deemed as a “success” is, quite frankly, a calculated decision by the powers-that-be to appease the masses. That’s not “working together” for the consumer whatsoever. Transparency.

As it stands, there are just 17 states with full direct access to care. It is inexcusable for the APTA to say otherwise. It has been like this for two decades. I am sure that the “48 states having direct access” statement makes the APTA look like it has a far higher level of efficacy than it really does. Transparency.

The traditional method in the legislative process would be to be nice to our counterparts, raise money, pay a lobbyist, and provide campaign contributions to certain legislators that are supportive of our cause.

Guess what? That doesn’t work. Why? In Texas, look at the list of top political donors in the 2010 election cycle. At number 13, you find the Texas Medical Association. They are putting $1.6 million dollars into the legislative coffers. Not all of that is with the intent of stopping direct access, but it is always with the hidden agenda of “if we need you, we know we can count on your support”. Transparency.

Reality check: the Texas Physical Therapy Association, as a group, will never raise an equivalent number of dollars. So why the battle cry of “raise more PAC money”? Why go there time and time again? Why play the game with the other team’s rules?

We should expect nothing to change until we deal with these harsh realities, and until we change the game.

Consumer direct access to physical therapy is at a crossroads right now. We need to approach this in a disruptive fashion. Here’s a novel idea: let’s involve the one group that can change all of it - the consumer. Be transparent and accountable to the consumer. A little truth-telling never hurt. Let them know how their rights are negatively affected by the current legislative environment and special interests, and let them use their voting power in their constituency to change the result.

When consumers realize they don’t have the freedom or right to choose their provider, they will respond. That isn’t a limit placed by the insurance company. The gatekeeper model removes those rights from the patient. When losing that right and freedom costs the consumer money as well and doesn’t give them a better outcome in the process, ask the consumer who wins. I am sure they will know the answer. In the state of Texas, a state that has the worst health care in the nation and 25% of the population uninsured, who’s best interests are legislators looking out for?

It has been a little over a year since that fateful night of April 22, 2011 when Texas had it’s first hearing of a consumer direct access to physical therapy bill. We are a short 5 months from the next legislative session, and where does the consumer stand on this now?

In the same place that they stood on April 22, 2011. Or 1991. Harsh transparency.

If consumers want to increase their access to care and pay less for their care in the process, then it is time to step up. If consumers want the right to choose their provider freely in an open health care market, then it is time to step up.

A little transparency in the process wouldn’t hurt.

Photo credits: nicolasnova