The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
Jump in the discussion.
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Notes -
Check your state laws - doctor cartels have made it illegal to access PTs indefinitely without a doctor's stamp of approval in many states.
As per your link the restrictions include things like:
"A therapist who has more than one year of experience supervises any therapists licensed for less than one year."
And:
"The therapist thinks the care is within his or her scope. If a therapist thinks the care is outside of his or her scope, he or she must refer the patient to an appropriate healthcare provider."
How are these unreasonable?
Insurance is more likely to prove a barrier.
I knew I'd summon you with this comment. You've quite simply cherry picked some reasonable sounding lines and neglected to mention the other conditions.
For example:
Wow, very reasonable, thank you AMA. That's Minnesota. What other restrictions do they have?
So I stand by what I said - in many states it is illegal to see a PT indefinitely without seeing a doctor.
That's extremely different from what you said before - seeing a PT for initial evaluation and treatment is not the same as seeing a PT indefinitely without further evaluation (such as things like imaging).
One of the purposes of that sort of restriction is to prevent scams where a PT just bills insurance without doing anything.
One of the reasons I can be reliably summoned this way is because the complaint is essentially baseless slander that does not acknowledge the possibility of other sensible explanations or the reality that the situation has changed in healthcare has changed. I am therefore (reasonably I think?) frustrated.
Conspiratorial posts about the AMA have low predictive value and create uncertainty for legitimately information seeking third parties like OP.
Really? Let's double check.
Are these the same claim? Have I changed my position? Let's get this straight before I respond to your other points.
Weird, could have sworn I double checked and didn't see anything about the timelessness in your original post. shrug
That doesn't address the substance of my complaint, however.
Interesting indeed.
What an isolated demand for rigor. What do we do about doctors billing insurance without doing anything? Or car mechanics?
Why does the law need to be involved at all? This is just between me and my insurer, right? If I want to see a physio on my own dime, that's none of their business, but I can't do that indefinitely.
Baseless slander, really? Then why did medical associations oppose the direct access campaign? What's your reason for calling something that happened a slander?
Please do explain why it's anybody's business if I see a PT for more than 90 days without a referral.
Changed how? Since when?
The AMA, like other professional organizations, is literally a conspiracy that seeks to extract benefits for itself first and foremost. I don't see how this can be disputed.
The predictive value here is quite clear - AMA opposition means you may need to jump through some number of hoops to access a PT. So OP should check his local laws. That's it.
Your citation is from 1991 - even with an atypical forum such as this one....most of our posters didn't exist at that time.
This is one of the central problems of complaints like yours, the lobbying activity of the AMA that people get frustrated about was something that occurred in their parents time, or their parent's parents.
That system is dead. Private practice is dead in most specialties. Physicians don't bill, the people who own the work of the physicians bill and make decisions.
You are misattributing blame.
Speaking of which, from your own citation -
"Opposing forces varied from state to state and included hospital and medical associations, physicians, chiropractors, and physical therapists."
If the AMA is the villain can you explain why doctors, physical therapists, and even fucking chiropractors were on the same side of the lobbying?
Of course, because that's when PTs were agitating for direct access laws that went against what the AMA wanted. By 1989 almost half of the states had a direct access law on the books.
Saying the AMA did a bad thing doesn't become a "slander" just because they didn't do it yesterday.
It's amazing how despite the fact that the AMA did this it's still misattributing blame to blame the AMA, I guess in this case because they didn't do it recently enough. I need to reaction one of those "women avoiding accountability" memes for doctors.
Are you asking me why chiropractors would be opposed to easier access to their competitors? Surely that is obvious?
As for why some PTs opposed it, it's probably because PT training went from certificate programs in the early 20th century to mandated master's degrees in 1979 (and now DPT programs). Lots of physios in in the 80s would have had only a bachelor's degree (or even just a certificate, bachelor's degrees didn't become required until 1960) so it could have been a matter of credentialed physios not wanting physios with less qualifications to have the same patient access, or genuine concerns about the incompetence of the physios with lower qualifications.
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