Bucking the Trend: PT Job Market Is Good Unlike other job markets in the slowing economy, physical therapists are experiencing higher employment, though wages and hours have been reduced, according to Eli's Rehab Report and a survey by the American Physical Therapy Association (APTA). The survey found that the unemployment rate for physical therapists is 1.4%, down from 1.8% only 6 months ago. This is the lowest reported unemployment rate since APTA first started collecting data in 1998. The findings agree with what administrators are finding in their practices. "I am seeing the job market for therapists improve," says Andy Whitener, MS, PT, director of postacute services for the Northeast Georgia Healthcare System. "The demand is back up and the supply is not meeting current needs. The current needs also seem to be for the more experienced therapists-the ones who can ‘hit the road running,' understand the importance of efficient productive practice and customer relations. Unfortunately, this is all happening as reimbursement continues to drop and, at the same time, there is a severe nursing shortage. There will be more competition for the health care dollar allocated for human resources. During my career I have not seen the nursing shortage and therapist shortage occur to such degrees at the same time." Jack Carroll, PhD, MHA, CEO and president of Sheltering Arms Rehabilitation Centers, Mechanicsville, Va, agrees, noting that "demand has picked up considerably over the past year." Carroll attributes this increase to "the temporary moratorium on the $1,500 Medicare caps, and the normal, repetitive cycle of PT schools, which wax and wane in applications and graduations." Despite this reported demand for therapists, the APTA survey found that both pay and hours have been slashed. Of the respondents employed in skilled nursing facilities, 22% reported that they had reduced salaries-though, according to Rehab Report, this is half the rate from 1999. About 10% of respondents reported reduced work hours, but, again, this was about half of what it was in 1999. About 20% of physical therapy assistants reported that their hours had been reduced, though this number is down from 24.5% 6 months ago. PTAs in home care, however, fared worst: nearly 40% reported reduced hours. $79.6 Million Verdict Rejected by Court On September 19, a Florida state appellate court rejected a $79.6 million verdict against Humana Health Insurance Company for cutting off special care coverage to a girl with cerebral palsy, reported Knight Ridder Business News. The 4th District Court of Appeal ruled Circuit Judge James T. Carlisle made a series of "glaring errors" that resulted last year in a jury handing down one of the largest verdicts in Palm Beach County history. The case is now to be given to a new jury to determine how much the company should pay the family of Caitlyn Chipps. The jury that awarded the January 2000 verdict was responsible only for determining how much in compensatory and punitive damages the company should pay to the Chipps family. Carlisle had already entered a default judgment against the company after it repeatedly failed to turn over documents requested by the Chipps' legal team. Mark Chipps, a deputy with the Palm Beach County Sheriff's Office, filed suit against Humana in 1996 after the company took his daughter Caitlyn off a special case management plan and moved her to regular coverage, leaving the family to pay for the girl's speech, occupational, and physical therapy. Carlisle ruled that Humana falsely represented coverage to the Chipps family and intentionally cut off Caitlyn's special care coverage with disregard for her well-being. The default judgment has been upheld by the 4th District Court of Appeal and denied a hearing by the Florida Supreme Court. The Chipps' attorneys sought a $100 million judgment against Humana. The company's attorneys said they should be liable for only $14,000. Following 3 weeks of testimony, the jurors awarded the Chipps family $1.1 million in compensatory damages and $78.5 million in punitive damages. The appellate court ruled that Carlisle erred by giving jurors instructions that characterized Humana's conduct as "so gross and flagrant as to show a reckless disregard of human life or the safety of persons exposed to the effects of its conduct." The court also ruled that Carlisle failed to tell the jury it did not have to award punitive damages or could give a nominal amount. In addition, the 4th District Court of Appeal found that Carlisle improperly prevented Humana from refuting some testimony that the company's policy violated industry standards. Humana's attorneys said the company, which has 400,000 clients in Florida, made mistakes in cutting off special care coverage to Caitlyn and a handful of other children. Beware Shady Consultants A General Accounting Office (GAO) report released in June warns that some medical consultants are leading providers astray with unethical and illegal advice, according to Eli's Rehab Report. The report is the result of an undercover investigation in which a physician under contract with the GAO and a criminal investigator posing as a member of the physician's staff attended three seminars and workshops on how physician practices can enhance revenue and avoid being audited. According to the report, the GAO learned that the consultants were giving advice that, if followed, could land provider-attendees in trouble with law-enforcement authorities. Texas Patients Assigned to Fictional Case Workers About 12,000 sick and injured Texans recently found out that they had been assigned to nonexistent case workers, the Houston Chronicle reported. Because the Texas State Rehabilitation Commission is understaffed and has a huge backlog of patients, it set aside the 12,000 cases for staff to deal with when they worked overtime. The backlogged patients were assigned to one of 25 fictional case workers. All of the nonexistent workers were given the first initial W. One letter to a client was even signed "W. Jackson." Jackson does not exist. The use of the code names began in January, when the Social Security Administration approved overtime pay to reduce a backlog of 78,000 applications. According to a spokesman for the Commission, the use of code names did not prevent the applicants from eventually receiving help from a real person. Alternatives to Resistance Training Prove Effective Resistance training, which includes weight lifting, builds muscle and prevents bone loss, injury, and weight gain. The September issue of the Mayo Clinic Women's HealthSource reported that some people avoid resistance training because an injury or health condition makes weight lifting impossible. For these people, there are several effective alternatives, including isometric exercise, Pilates, water resistance and resistance bands. Isometric exercise uses one's own body for resistance. Pilates is a system of exercises that are derived from dance and ballet moves. They are performed on the floor or with special machines, and are designed to strengthen the muscles of the lower back, abdomen, and buttocks. Water resistance can be used by nearly anyone, including those with rheumatoid arthritis and osteoarthritis. Water supports body weight and reduces stress on joints and muscles. Resistance bands are latex bands that offer resistance by stretching. The more they are stretched, the more resistance the bands offer. However, if the bands are used incorrectly, they can irritate injuries. People who are allergic to latex can look for latex-free versions. Disabled Man Named Big Brother of the Year Virginia resident Chris Grandle, who suffers from spina bifida and walks with crutches and leg braces, has been recognized as the Big Brother of the Year. Adding to that award, Big Brothers Big Sisters of America (BBBSA) presented Grandle and his Central Blue Ridge, Va, chapter with the National Organization on Disability (NOD)/Aetna Award for Inclusion of People with Disabilities for showing that a person with a disability can serve as a model volunteer and mentor. Grandle began volunteering as a Big Brother in 1998. He was paired with a 9-year-old who lives in a single-parent home and is not disabled. Over the last 3 years, Grandle has done numerous activities with the boy, including building model trains, trips to museums, fishing, camping, and making brownies. Grandle also gives presentations on how to work as a Big Brother or Big Sister and promotes the work of BBBSA around Virginia. The NOD/Aetna award comes with a $1,000 grant, which will be given to the Central Blue Ridge BBBSA chapter for encouraging a person with a disability to be a volunteer and promoting him as an exemplary mentor. As Big Brother of the Year, Grandle will also receive the Valvoline Gold Caring Hands Award. As the recipient of this award, Grandle will serve as a national spokesman for BBBSA, which has as its goal to serve 1 million youths by 2010. Lott Questions AMA "Monopoly" Senate Minority Leader Trent Lott (R-Miss), in a letter to Department of Health and Human Services (HHS) Secretary Tommy Thompson, questioned the American Medical Association (AMA) practice of charging to supply new outpatient billing codes needed for filing claims, according to the August 24 issue of Eli's Rehab Report. Lott said that this arrangement is a federally approved "monopoly" that is harmful to patients because it drives costs up. Lott called the AMA's exclusive copyright protection of CPT codes "a financial windfall for the AMA," and told Thompson that it makes it difficult for patients to comparison shop among different providers. "The AMA has been able to impose on the entire nation the AMA's obviously self-interested policy against consumer comparison shopping for medical care based on price by suing Web sites and others to prohibit them from posting comparisons of doctors and other medical fees on the Internet using the CPT code," Lott wrote. He noted that such comparison shopping should be one of Americans' "most potent weapons" in driving down health care costs, which would reduce the ranks of the uninsured.
