In October 2017, the Trump administration announced the “Patients over Paperwork” initiative — a plan that aimed, in its own words, to “reduce regulatory burdens on health care providers to allow them to spend more time on clinical tasks.”
Who could disagree with that?
Most Americans and certainly almost every medical professional — including physical therapists like myself — would wholeheartedly agree with this catchy slogan. Study after study show physicians and other care providers are spending exorbitant amounts of time filling out paperwork, a trend that has only increased over the past decade. While much of the paperwork we complete is important and necessary for the coordination and subsequent reimbursement of care, some of it is burdensome, superfluous and can even obstruct the delivery of treatment to patients.
As a physical therapist dedicated to improving the quality of life for patients suffering from chronic or acute pain in North Texas, I’m all too aware of this fact. Helping individuals cope with debilitating injuries or conditions that limit mobility has been the most rewarding part of my career, yet all too often I find myself buried in paperwork and administrative tasks instead of providing relief to those who need it most.
This sticky web of red tape is most epitomized by current Medicare mandates that require physical therapists to unnecessarily obtain two separate stamps of approval from a patient’s referring physician — even after they’ve already started physical therapy.
This frustrating process usually plays out as follows: When a primary care provider writes a referral for a Medicare patient to physical therapy, I meet with the patient and design an individualized plan of care that is unique to their specific treatment needs. Over time, I then implement this treatment plan and help the patient manage their pain, regain movement and begin on a path to recovery.
Unfortunately, this seemingly straightforward process is obstructed by Medicare regulations that require physical therapists to return to each patient’s primary care provider and have them reapprove each treatment plan again so that the services can be reimbursed by Medicare.
The amount of time that is required to vault over this onerous hurdle is immense. For physicians, it requires them to approve physical therapy for their patient after already providing the first referral — a process that undermines their initial clinical judgment, while forcing them to fill out yet another round of paperwork.
For physical therapists like me, it requires us to spend untold hours trying to contact every single patient’s doctor to obtain their stamp of approval. If we fail to get the patient’s physician to sign off on their individualized treatment plan within 30 days of the initial delivery of care, we don’t get reimbursed for the medically necessary treatment services already rendered.
To physical therapists and physicians alike, this process is as unnecessary as it is unfair.
If this burdensome and beleaguered process isn’t the antithesis of “Patients over Paperwork,” then I don’t know what is. Chasing down physician signatures is a time-intensive process that burdens doctors and physical therapists, all the while taking much-needed time away from the delivery of care to patients. In other words, it’s a lose-lose-lose scenario.
That’s why I urge our state’s representatives, including U.S. Rep. Michael Burgess, R-Pilot Point, and his colleagues in the powerful Energy & Commerce Committee, to join ongoing efforts from the administration, lawmakers and regulatory agencies to better discern reasonable reporting requirement from gratuitous red tape.
I look forward to working with Texas’ lawmakers to support and expand these efforts and am optimistic that we can begin to truly prioritize the delivery of quality care over needlessly excessive procedural hurdles.