Why I Have a Cash-Based Practice

The Times, they are a Changin'!   Having practiced Physical Therapy for 29 years I have experienced a rapidly changing climate in healthcare.  With attorneys trying to direct my practice and insurance companies dictating what is and isn't appropriate for my patients, I was getting just a little fed up with the system.  Although I have been paid an hourly rate over the years when I worked for someone else, their reimbursements for my services, for which I have studied extensively over the years, have been declining.

If you haven't been paying attention, insurance companies are essentially taking over the practice of medicine.  They are telling P.T.'s, Doctors and Surgeons what procedures they can do, what they can or can't bill for,  and who they can treat.  I don't know about you but I don't want a insurance company representative deciding my healthcare needs.  Actually, I have been paying out of pocket for my health and dental care for years!  Why?  Because I want the best care I can get to stay healthy, prevent illness or hospitalizations.

I have always wanted to have my own practice.  I feel I am good at what I do, am conscientious to do it in a timely and efficient manner.    I feel this  is best for my patients.  However, if I opened a private practice in the traditional sense, connected to insurance companies,  I would need a large staff just to navigate all of the paperwork.  This would result in a huge overhead that I feel is unnecessary.

In my small cash based practice I average less than 5 visits for patients with low back, neck, or extremity pain.  I pride myself on teaching my patients how to take care of themselves and don't expect them to come back visit after visit for gradually changing programs.  I don't generally see patients who require physical therapy after surgeries and leave this up to practices that accept insurance because that can mean 30 or more visits to physical therapy in some cases.

In this business model, I am able to spend as much time as I need to with a patient to provide proper care and instruction in self-treatment.  It feels really good to practice this way, too!  Really good!

Essentially, I really wanted to spend more time with my patients, doing what I felt best for them and less time on paperwork and needless documentation.  After all, documentation and billing isn't about patient care...One on one time spent with your therapist is!

I Gave Up!

 (the Paperwork that is...)