Dear TAC: I own an integrated medical center, or MD/DC practice. I don't think that the insurance companies really want to gel rid ol" us. I do feel that they want to curtail the abuse of greater insurance on the physical medicine side. Everyone always has something to say about how great it was in the 8()'s as a chiropractor. The insurance was great...we got paid very well...I miss the 80"s.... The problem is that there are a few MD/DC practice management groups that encourage DCs to have a pseudo MD on site to allow the DC to get their services covered as physical therapy. The MD needs to be an integral part of the patients" care, not just a rubber stamp. These types of MD/DC practices are going to ruin it for the rest of us. just like those chiropractors that made MILLIONS in the 8()"s ruined it for the rest of us. If the insurance companies see that any group is abusing its ability to render care and be reimbursed a FAIR price, they will flag claims, and put strict guidelines in place to protect their ASSets. In an MD/DC practice, the medical physician should be a physiatrist. What service does a medical doctor that isn't specialized in physical medicine and rehabilitation bring to an existing DC practice? If a clinic has a general practitioner as a part of its practice, and the chiropractor expects the MD to contribute anything other than medications, he/she is going to be surprised. What clinical experience does a medical doctor have in rehabilitation? Do people really think that the insurance companies are stupid? They know what each kind of physician should be billing for. I. personally, think that chiropractors should be careful about integrating. If you're going to do it. do it ethically. II you have a rehab facility, then get the appropriate kind ol MD. If our fellow chiros open billing mills with phantom MD's. we are all in for real trouble. Expect PT codes to be applied to rehab by physical therapists only. Those of us that have chosen to walk away from groups like ASHP and expect a fair remuneration for services will be in trouble. 11 the insurance companies take away our ability to bill for rehab, because of coding abuse, we will all be boxed into an adjustment code. It's bad enough that we have allowed physical therapists to "joint mobilize"... In a nutshell, our office has seen more patients that have had sour tastes in their mouths from chiropractic horror stories, and would never have seen a chiro. They come to us. because we have a physiatrist. After they get better, they have a much better feeling and understanding towards chiropractic, as a therapy and profession. MD/DC practices can be good for all of us. if they practice ethically. On the other side of the coin. MD/DC billing mills will cripple our profession's ability to provide rehabilitative services with fair reimbursement Steven Tvcrs. D.C.
