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In response to ASHA's appeal, I am writing a letter to my legislators regarding the therapy cap. In doing so, however, it has become more apparent that the underlying problem is our lack of professional autonomy and recognition as a distinct and separate discipline from physical therapy-a distinction that has become no more apparent since 1997 and the first cap.
The "lumping" of speech-language pathology into rehabilitation services, has been one of the greatest detriments to our discipline and is reflected in many hospital brochures and Web sites as a sublisting to physical therapy, as if we are another modality.
Having been a program director for an outpatient clinic, I know that physical therapy does not cost the health care delivery system less money; in fact, many consumers of physical therapy are repeat clients with chronic problems, the need for adaptive equipment, or repeat procedures, all of which cost more money. The difference, apparently, is that PT has somehow obtained better recognition and reimbursement, despite less demand for outcomes and efficacy studies.
It saddens me to realize that if many consumers don't know what we really do, and if the hospitals that hire us don't know what we do, then surely we can't expect policymakers to know what we do and vote to retain our services.
In today's health care business climate, it's all about "showing them the money," and if we don't soon, we will continue to see our positions dwindle, job satisfaction decline, and our salaries deteriorate.
Mary Spremulli
Punta Gorda, FL
spre713@hotmail.com
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