There is something about this that is simply worth sharing.
It's not often that I find a passage that I share here verbatim. But every so often, something, somewhere, rings true - and I think this definitely qualifies.
Quincy Jones was the keynote speaker at SXSW in Austin this year. Although I was not in the hall to witness this live, it is most certainly something that bears repeating. At the end of his address, he shared the following words with the crowd as they stood and joined hands and repeated them together:
"On this day ...
I will mend a quarrel.
I will search out a forgotten friend.
I will dismiss a suspicion and replace it with a trust.
I will rather say, "I'm sorry I did" than "I wish I had" ...
Updated 4/2/2009: see below
Further discussion and information can be found in the forum here .
Here is a rather distressing piece of information that I read this morning:
1 of every 4 Texans is uninsured.
That's a rather humbling and disheartening statistic. With that in mind, our health care system needs to continue to seek out ways for patients to get the care they need, when they need it, in a cost-efective manner.
Direct access to physical therapy can help contribute to the solution. By removing one additional step in the process of attaining the necessary care, Texans can save a significant amount of money. Health care costs will drop, and this will help everyone - insured and uninsured.
Take a moment to ponder why anyone in the health care system would oppose this. It's an issue of access, and cost savings - which are both good things for all Texans. Direct access has not been found to increase liability claims in states that have it. In the end, it's a winning proposal for all. But in the same breath, you also need to consider the forces that would oppose such legislation and the lobbyists that support them.
This issue shouldn't be about the lobbyists, and it shouldn't be about the powers-that-be with the not-so-well-hidden agendas of money and power that continue to tell us that they have the patient's best interest from and center. This is about access to appropriate health care. This is about a system that is financially strapped - for the insured and the uninsured.
And it's about you, the patient.
If you care about your cost of care, and you care about your access to care, then I would suggest one thing: it's time to write to your legislator in support of HB 607 and SB 433. By speaking out, we can all benefit.
Update 4/2/2009: Texas Medical Association reports on their website that Texas ranks #43 of 50 states for a "shortage of physicians, both primary care physicians and specialists". There aren't enough physicians in the state, and they are not supporting direct access to physical therapy to provide improved access to care. Is this about the consumer? Again, you make the call.
It's 15 feet to the basket, 19 feet to the baseline. The distance never changes.The shot remains the same - over and over again.
Some call it a "free throw" ... a "foul shot" ... others call it a "charity shot". Over the course of a basketball lifetime, you will shoot thousands of them. You've been doing it since you were old enough (and strong enough) to do so. And the mechanics haven't changed since you started playing the game.
One ball, one smooth motion, one release, one arc, one swish. Just 15 feet ... over ... and over ... and over ... just you and the ball and the hoop ...
Surely, after a few thousand repetitions, with some coaching, you could learn to drain a minimum of 70 to 80% of them. That doesn't sound at all unreasonable. Purely examining the shot as a motor task alone, I could easily envision 80% being reasonable.
At least that's what you'd think.
We debate the issue of creationism and evolution ... then we debate the issue of whether either (or both) of these should be taught in school ...
We debate the issue of sex education in school ... and should we educate students regarding abstinence or safety (or both) ...
And now, we have another "debate" - between Pope Benedict XVI and the Cochrane Collaboration.
I guess I don't need to tell you who the Pope is - that goes without saying. As for the Cochrane Collaboration , let's just go to their website for who they are:
As I read the ongoing drama (and outrage) about AIG , it all makes me think of pro sports. Let's just insert "pro football" as an example.I know, it seems like a strange association - AIG and pro football - but perhaps they could take note of some of the business practices that seem to be "acceptable" in the world of pro sports. It might just help solve the problem.
If this was a pro football team:
- we would expect a win-loss record that puts us into the playoffs, and we would pay for the employees (namely, coach and players and support staff) to get it done. Of course, that would be within any salary cap that is applicable.
- many players and coaches presumably have a performance bonus in their contracts - for example, a bonus if the team makes the playoffs, or if the player attains certain performance criteria (number of catches, number of tackles, etc).
- the fans think nothing of demanding a winning record, and also think nothing of removing [insert here - coach/player/water boy] if they aren't "delivering the goods" (or the water).
- and when the aforementioned coach/player/water boy has his contract terminated abruptly, and he doesn't get his performance bonuses, we as fans really don't seem to care. It's accepted practice, isn't it?
- if we expand this to college sports, how many college coaches think nothing of "jumping ship" when a better offer comes around, thereby not fulfilling their contract requirements - and nobody seems to care then either.
So here's where the irony begins.
I will admit - the math geek in me found this interesting.
Today - March 14 - is Pi Day. And imagine this - it has been recognized by the U.S. Congress as such (our tax dollars hard at work, I am sure). I guess it's like a "Hallmark Day" for math enthusiasts.
So for those who need a reminder, the mathematical constant pi is the ratio of the circumference of a circle to it's diameter.
For true geeks, the number is 3.1415926535 ...
... and yes, to this day I still remember pi to all those decimal points - no Wikipedia reminder required. No, I have no idea why that is permanently etched into the deepest recesses of my cortex. I suspect it's because math (and science) were the classes that got me through high school. If you want a reminder of how to calculate it, you can always throw frozen hot dogs - among other options, of course.
Officially, there is a Pi Day and, wait, a Pi Second - 3/14 at 1:59:26 ... and yes, people do celebrate this!
But wait, there's more ...
Texas HB 607 and SB 433 are, simply put, consumer access bills. They don't change the scope of practice of physical therapists (i.e. what they can and cannot do as part of their clinical practice). These bills simply remove the current gatekeeper status of physicians. As it currently stands, physical therapists in the state of Texas are the only health care providers remaining that require a referral from a physician. With this having a direct impact on access to care and cost of care for consumers, it is important for everyone to write to their representatives in the House and Senate to support these bills. I sent the following letter to all members of the House Public Health Committee and the Senate Health and Human Services Committee this past week.
I am a physical therapist in Texas and am writing to you in support of HB 607/SB 433. This consumer access bill would allow Texans direct access to physical therapy services without a referral by another licensed healthcare provider.
There are three primary reasons to support this bill:
Cost: The current regulatory practice - allowing doctors to be gatekeepers to physical therapy in our State - adds enormous costs and waste to our health care system. The added costs are not just to Texans as individual consumers, but also to the State of Texas in Medicare costs. As but one example, a 1994 study by Mitchell and de Lissovoy noted that the total paid claims for "physician referral episodes of care" averaged $2,236, as compared to $1,004 for "direct access episodes". Data such as this has existed for the past 15 years. As costs have continued to skyrocket since then, there is a need to move forward with a regulatory practice that will provide more cost-effective care to all Texans.
Access: The current regulatory practice creates a barrier to health care for Texans. The reality of clinical practice is that when patients are faced with a choice to either 1) go to a gatekeeper (in order to then be referred to a physical therapist) or 2) simply not go at all, they tend to choose the latter option. This creates chronic situations out of acute ones. An acute problem that can be dealt with in a very short period of time can now become a chronic issue that yields years of health care expense.
Training: Physical therapists are internationally recognized as experts in therapeutic exercise prescription. The educational process is extensive and on-going. Under the current regulatory practice, a patient can be advised on therapeutic exercise prescription by virtually any healthcare provider and even personal trainers (none of which have any formal training in therapeutic exercise) - yet a patient requires a gatekeeper referral to exercise the option to see a physical therapist (a healthcare provider who's primary educational background is in therapeutic exercise prescription).
HB 607/SB 433 does not expand the physical therapy scope of practice, nor does it affect the current statutory duty to refer to a healthcare professional for conditions outside of the scope of practice of a physical therapist. The evidence from states that have updated their physical therapy practice act shows that allowing citizens to access a physical therapist without a referral has not negatively impacted liability claims.
I believe it is time for Texas to make a change that benefits all Texans. I would like to thank you in advance for your support of HB 607/SB 433.
If there is any way that I can be of assistance or provide further information regarding this issue, please contact me at 512-914-0871 (email This e-mail address is being protected from spambots. You need JavaScript enabled to view it ), or the Texas Physical Therapy Association at 512-477-1818 (email This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).
Sincerely,
Allan Besselink, PT, Dip.MDT
Director, Smart Sport International
As I bring this issue to the attention of the consumer, many are absolutely surprised and dismayed that the current regulations exist. For those who have been to physical therapy in the past, they have experienced delays in their care; for those that haven't, they are upset that they don't have the option to access a physical therapist directly - for both issues of access and cost.
For further information on these bills, please refer to my previous post. If you support these bills, please take action! Legislators need to hear a strong voice from their constituents to overcome the political inertia of medical lobbyists.
Allan Besselink, PT, DPT, Ph.D., Dip.MDT has a unique voice in the world of sports, education, and health care. Read more about Allan here.