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Ethical Issues In Physical Therapy

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Physician owned physical therapy services (POPTS) are organizations in which a physician can financially gain from referring physical therapy services to an institution in which they have ownership or some sort of financial stake in the company of referral. This is commonly known as referral for profit.1 An example of POPTS is an orthopedic surgeon owning his/her practice that employs physical therapists to which he/she only refers their patients. This type of referral not only gives unfair advantage to the physician owner; it more importantly takes away from the patient’s choice of provider. This issue has been a source of controversy for some time. The American Physical Therapy Association (APTA) has been in opposition to POPTS since the late 1970s. This opposition did not gain traction until the Stark legislation in the 1990s; which…show more content…
The APTA outlines a number of reasons for their opposition such as: conflict of interest, lack of patient choice, economic harm, ethical dilemmas, and legal problems. According to the APTA, this creates unfair financial advantage to the physician, creates less business in other physical therapy services, increases unnecessary utilization of care, and contributes to the increased expense of healthcare under POPTS.1 The APTA cites sources against POTPS such as Swedlow and colleagues who found that physical therapy services were utilized up to 2.3 times more when physicians referred to their own physical therapy services compared to non-POPTS.3 This not only suggests that some physicians may be abusing their referral power to increase their profit margins, but POPTS may also be contributing to healthcare waste and increased cost of care. Furthermore, small physical therapy businesses may see fewer patients forcing them to increase costs of therapy which will further lead to the rise in healthcare
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