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​Giving Staffing a Good Name

Testifying in Austin on HB 1039
 
This past Wednesday I got up at 4 am and hit the road at 5 am so that I could be in Austin to testify before our legislators regarding HB 1039, otherwise known as Direct Access. In essence, HB 1039 allows patients to see a physical therapist without a doctor’s referral. Currently, patients don’t need a doctor’s referral to see a massage therapist or “rolfer” but, by law, they cannot be treated by a PT unless they go see a doctor and get a prescription first.
 
So how did it go? I thought it went well for those in favor of 1039. By far (4 to 1?), those testifying in favor of 1039 outnumbered those against. Also, I was very impressed with the committee members because they all seemed to be listening, and those who asked questions asked very good ones.
 
So what did those against 1039 have to say? For me, the following arguments were the most interesting. First off, I only remember three people being against it. Here they are, and here is a brief summary of what I think they said.

        Accupuncture Representative: PTs should not get direct access because there are reports of them using dry needles as a form of PT, and that is not PT - that is acupuncture.
        Orthopedic Oncologist: I am against HB 1039 because PTs need to be part of a medical team and every team needs a captain; the doctor must be the Captain. Also, I sometimes prescribe drugs like statins that can cause body soreness. If those people went to a PT, they would be wasting their money because all they would have to do would be come see me, and I would tell them their pain was a side effect of the statins. Additionally, some forms of cancer may seem like a PT problem initially, and since a PT cannot diagnose cancer or order the test that detect cancer, valuable time could be lost and the person could die.
        PT Working For a Physician Owned Practice: I have the unenviable task of being against HB 1039 because I am a PT. I am still against it because PTs cannot give medical diagnosis, and patients need the medical diagnosis first.

 
I was fortunate enough to go on after the man from the Acupuncture Society, and I testified that, in 23 years of staffing PTs, I have never seen a PT put acupuncture on their list of things they do on their application, nor have I ever heard of a customer requesting a PT who uses needles. Even before I got up there, though, the committee members were pummeling him with questions that made him appear silly.
 
Also, the PT against 1039 had to sit next to Gary Gray, PT (President of the PT Board), who went on to testify that PTs screen all the body's systems and are well trained and eager to refer patients to doctors when something looks wrong.
 
By the time I left, there only seemed to be one argument against 1039 that did not get countered, and that was the one about statins causing soreness, which might lead to someone wasting his/her time and money going to a PT. I wanted to go back up and say that my doctors and pharmacists are always very quick to inform me when they give me a prescription with side effects. However, talking to the President of the TPTA, I was asked not to go back up since he could tell the legislators were starting to get weary. There were also about 3 more PTs already in line to re-testify.
 
So that is what happened at the hearing, folks. And, in case you’re wondering, this does not seem to be a partisan issue.
 
Obamacare Meeting and Information
 
Yesterday, I attended a meeting aimed at educating small business owners on Obamacare. I figure it is OK to say “Obamacare” since those who hate it and those who like it (including but not limited to President Obama) both seem to be OK with that term.
 
Looking at my notes, here is what I came away with.

            Rehabilitation is covered
            Most small businesses can get a tax credit for providing health care insurance (Not Stambush, though - you handsome and pretty people are too highly paid)
            We can, if we choose, start shopping in the Exchanges this October
            The Exchanges are supposed to be up and running January 1 of 2014
            The Exchange provides a large marketplace for small businesses to pool their buying power
            The Exchange can negotiate of behalf of the small business owner
            Members of Congress MUST use the Exchange (I did not know this)
            Businesses with less than 50 employees DO NOT have to get health care for their employees
            We do not have to get our health care insurance through the Exchange

The speaker at the meeting also advocated Texas opting into the Medicaid expansion. The reasoning boiled down to it saving lives and saving money. In the case of Texas, we have (according to the speaker at the meeting) 1.5 to 2 million Texans who could gain health care coverage. Also, according to the speaker, they are pushing for Medicaid to pay its providers more money for their services.
 
Also, if Texas takes the Medicaid expansion deal, it will be free to Texas for the first three years. After that, for every dollar spent on Medicaid, 10 cents will be paid by Texas and 90 cents by the federal government. If we do not take the expansion deal, we will be a “donor state” because our Federal Tax dollars will be not be coming back to help with Medicaid. We will just be helping other states.
 
If you would like to call Gov. Perry, his number is (800) 252-9600.
 
Finally, while this does seem to be a partisan issue, quite a few states with republican governors are accepting the Medicaid expansion for their citizens. From what I see at this website, 25 states and DC are accepting Medicaid expansion, two are leaning toward it, three are leaning against it, 14 are against it, and 6 states are undecided.
 
I hope this information has been helpful.