Campus Physical Therapy Center

Physician Owned PT Services

"Physical therapy referral for profit describes a financial relationship in which a physician, podiatrist, or dentist refers a patient for physical therapy treatment and gains financially from the referral. A physician can achieve financial gains from referral by (a) having total or partial ownership of a physical therapy practice, (b) directly employing physical therapists, or (c) contracting with physical therapists. The most common form of referral for profit relationship in physical therapy is the physician-owned physical therapy service, known by the acronym “POPTS.” The problem of physician ownership of physical therapy services was first identified by the physical therapy profession in the journal Physical Therapy in 1976. While POPTS relationships were still limited in number in 1982, Charles Magistro, former APTA President, characterized POPTS as, “a cancer eating away at the ethical, moral and financial fiber of our profession.”

For many years, the American Physical Therapy Association (APTA) has opposed referral for profit and physician ownership of physical therapy services, taking the position that such arrangements pose an inherent conflict of interest impeding both the autonomous practice of the physical therapist and the fiduciary relationship between the therapist and patient. What became known as “the POPTS issue” was addressed by APTA’s House of Delegates in 1983, 1985, and 1999, with APTA specifically opposing referral for profit arrangements between physicians and physical therapists. The 2003 APTA House of Delegates once more resolved to develop state and federal legislative initiatives to achieve legal prohibition of POPTS.6 However, in recent years, facing pressures of decreasing revenues and increased costs of malpractice insurance premiums, and aided by weakening of federal antitrust legislation, physicians have accelerated the addition of POPTS to their practice. APTA’s push to achieve autonomous practice and direct access are in conflict with the medical profession’s renewed push to subsume physical therapy as an ancillary service for financial gain.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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San Mateo Physical Therapy Center

At the center of the clash between these two opposing forces are two questions: First, should one profession be able to claim financial control over another? Second, what are the real and potential consequences of referral-for-profit relationships and, more specifically, POPTS? Physical therapists must be unified in their vision of physical therapy as a profession, accepting the rights and responsibilities that come with such a designation. Only when members of the profession view themselves as autonomous professionals will they present themselves to consumers and the medical community as such and curtail their own participation in referral-for-profit relationships, including POPTS. Within physical therapy practice and the broader medical community, there must be renewed examination of the ethical and legal consequences of referral-for-profit relationships, and a push to strengthen legislative and regulatory prohibitions of such relationships ".

Physician Owned Physical Therapy Services