Dr. Jake Berman here again!
Physical therapy has gotten a bad rap over the past 20+ years and it’s time to shed some light on why. From what I hear (I wasn’t practicing back then), the 80’s and early 90’s was the heyday of physical therapy. You could see one patient per hour, bill the insurance your rate, and be fully reimbursed for your services.
Then the HMOs came out-that’s “Health Maintenance Organization,” and it’s the type of insurance plan that only pays for you to see doctors who are “in network”-and Medicare changed its policy to only reimburse a percentage of what was billed for PT services. All the other insurance companies followed suit and did the same.
This was the beginning of the end for quality of service in the medical field. Because of the decrease in reimbursement rates, physical therapists have to see multiple patients per hour so they can bill multiple insurances and get reimbursed enough to keep their doors open.
When you have to see more patients per hour, it becomes more and more difficult to provide quality hands-on manual therapy. So who gets the short end of the stick? THE PATIENT! The therapist is running around to 3-4 people per hour, and the patient gets handed off to a tech or aid and then shuffled off to a corner to perform stretches and exercises alone. The patient takes longer to get better, and the PT is EXHAUSTED and can’t provide quality service!
This downward spiral led me to open Berman Physical Therapy. I was tired of insurance companies dictating what treatment my patients received. I was tired of trying to find different ways to justify my services as “are medically necessary” just so the patient could receive care from me. I was tired of seeing the frustration on my patient’s faces every time I had to tell them that they had used up all their visits and needed to be discharged long before they were ready.
By staying out of network and refusing to play by the insurance company’s rules, I’m able to do exactly what is appropriate for my patients-no more and no less than exactly what they want and need!