Doctors' employment of physical therapists at risk

Physicians say in-house physical therapy is better for patient care.

By Myrle Croasdale, AMNews staff. May 2, 2005.

Organized medicine leaders are alarmed over recent legal decisions that prevent physicians from employing physical therapists and threaten to undermine their ability to employ other health care-related professions.

Federal law allows doctors to refer patients to employees within their practice. But Delaware, Missouri and most recently South Carolina have made self-referrals to physician-employed physical therapists illegal or nearly impossible for physicians because of licensing penalties imposed on physical therapists who receive a paycheck from physicians.

In February, a South Carolina court upheld restrictions that went into effect in March 2004, leading E. Neal Powell Jr., MD, an orthopedic surgeon with Carolina Orthopaedic Surgery Associates in Rock Hill, S.C., to worry that his patients might take a longer time to recover from surgery. When patients come into his office for physical therapy, he said, he is able to monitor their progress and fine-tune their treatment more effectively than he can by sending patients off-site.

Robert H. Haralson III, MD, executive director of medical affairs for the American Academy of Orthopaedic Surgeons, said he fears that other licensing boards could use the physical therapy situation as an example of why they should be able to keep ancillary health professionals out of physicians' offices.

South Carolina Medical Assn. President John Evans, MD, agreed.

"This has the potential to affect any of the other professionals employed by physicians, such as radiology technicians, nurse practitioners, audiologists, perhaps even physician assistants," he said.