ation wherein a patient may be denied access to a specific treatment therapy. A serious implication of this situation is the potential denial of access to necessary health care services for a large segment of the population.
The access dilemma is, in the late-1980s, developing into a major health issue in the United States (US). Problems associated with access to health care services, generally, will likely worsen significantly, before beginning to improve.
One significant area which is being affected by the factors of economics and access is the delivery of physical therapy services. Physical therapy is being affected by economic factors, in that marketing and ownership relationships are developing, between some physical therapists and other healthcare professionals. Specifically, there are physician-owned physical therapy services (POPTS), joint venture operations involving physicians and physical therapists, and contractual arrangements between physicians and physical therapists, through which physicians are paid referral fees by physical therapists.
Opponents of profit-oriented arrangements between physicians and physical therapists contend that they create conflict of interest situations for physicians (patients may be referred for services which they may not require), and that they tend to increase the cost of physical therapy services. By contrast, opponents of any governmental regulation to preclude such arrangements contend that such regulation would tend to increase costs by restricting competition, and that many individuals would seek physical therapy services in the absence of competent medical advice.
Several important factors are involved in the question of whether or not formal economic relationships should be permitted between physicians and physical therapists. Of primary significance among these factors is patient welfare. Patient welfare in this context involves the quality of care and access to...