Monday, June 30, 2008

totally bummed about work

Ok, today was the last day before the new Medicare provisions go into effect. In their infinite wisdom, our elected officials have, through their inaction, been unable to pass a bill extending continued physical therapy benefits beyind 18 visits annaully, to Medicare patients,.. oh as well as giving us a 10.6 % pay cut.. with another 5.6 % cut to come in January. Jolly. So tomorrow, my patients will either cancel, decide not to go food shopping, or just cross their fingers and pull out the credit card. I am totally bummed looking through the schedule, seeing a full half of todays list of patients are Medicare recipents, the majority of whom are juggling with the cost of driving to PT, never mind having to pay out of pocket for it..
As the 4th of July comes up, and there is a faint hope that the bill will be reeviewed upon the return of the Senate and House after the holiday, I wrote a happy holidays letter to our local rag: and just in case thy don't publish it, I am printing it here, in cyberspace, with maybe a few passers-by to glance through it. If you are the child of a loved parent, or if you are afraid of growing old in this country, pass it on. I moved to this country 12+ years ago, invested my heart and soul in it, and here I am, a few days before we all go out to wave flags, go sailing, eat macaroni from a paper plate, fill our eyes with tears thinking patriotic thoughts, while our older, injured parents and neighbors are worrying about the cost of their next physical therapy visit and how much medication / gas / food / heating oil (insert your own ________ ) can cut out in order to make it. I am totally bummed, not only because these people have welcomed me as their own child in this community, this country, but because this is a sure sign of the things to come, an ecology in peculiar imbalance where our elders are as we speak, being nudged out onto the creaking icefloes. A strange time, as I plan to take the stage in our local church, as an invited member of our broad tribe in Sag Harbor, as a still dripping wet citizen of this country, to read the Declaration of Independence and the Bill of Rights (how ironic) with a flag in one sweaty hand and a desperate sinking feeling in my belly.

(to the editor @ the easthampton star)

Dear David,
I am writing to your paper, and to address my adopted community for assistance, both for my profession, but primarily for themselves. As many of your readers have passed through the doors of my business, and literally through my hands, I have had the pleasure of being able to assist many in this town to resume their physical capabilities and return to a full, functional life.

Despite the increasing stresses of annually diminishing reimbursements from the insurance industry, combined with the rising cost of doing business for everyone, my partners and I at Manual + Sports Physical Therapy (MSPT) have been able to continue to provide quality care to many locals and visitors alike. However, with this weeks decision in congress to cut payments to doctors by 10.6% beginning July 1st, and for a future cut in January 2009 of a further 5.6%, our business, and our ability to provide continuing care for our Medicare patients, is in jeopardy.
Our schedule of payments (as PT’s in out-patient non-hospital based clinics) from Medicare is directly liked to the physician pay scale, and thus our physical therapy reimbursements will also be severely cut, beginning this week. Patients receiving Medicare-covered physical therapy will be limited to a maximum of $1810 per annum, which works out to about 18 to 20 visits, per annum. Worse still, linked with this bill HR6331, is the cut to an exemptions process for the more impaired patients, who prior to this bill passing, had been able to qualify for an exemption; for example, someone who might have a knee replacement, and also suffers from a rotator cuff tear, or someone who has had balance difficulties and co-existing knee and back arthritis, an elder who has chronic back pain and also has hand arthritis... To anyone who has had ever seen their parents age, none of these conditions are surprising, but anyone can figure out that few of these complex conditions are manageable with a 6 week coverage of physical therapy. All patients will now be subject to the cap of $1810, regardless of the complexity of their condition. Following this 18 visit maximum, which many of my Medicare patients have already met, these elderly will have to self-pay, or be discharged. Some will be able to manage in a home setting or a local gym with an exercise program, most will not. The majority of our Medicare patients continue to need the skilled delivery of physical therapy care beyond the arbitrary cap, and would continue to benefit from that continued care.
I therefore urge your readers, this week, to call their members of congress and senators, and urge their support for the passage of HR6331. They will resume work following the July 4th recess, on July 7th. There is a chance that pressure from the public, in an election year, will force the reinstatement of the exemptions process, and continue to facilitate the care that I and my staff have been able to offer across the east end, from our Southampton, Sag Harbor, East Hampton (East End Physical Therapy) and Montauk offices.
As an aside, I will be participating in the reading of the Declaration of Independence at the Whaler’s Church in Sag Harbor on July 4th.. This follows an invitation from the Deacon’s committee, who each year, gather a group of citizens to represent the diversity of the area in celebration of the past with an eye on the future. As a twelve year resident and a six year-citizen, I am honored and delighted to participate in this special event. As someone who cares deeply for this community’s older, injured physical therapy patients, as well as its weekend warriors and athletes, I will be privileged to take to the stage in this event. I hope your readers will attend, and be moved to look, not just back at the dappled, colorful past, but ahead towards a country that values the health and well being of its older citizens. Please make a call to your political representatives right after the glorious fourth.
Yours Sincerely,
Sinéad A. FitzGibbon, P.T., M.S.P.T.

No comments: