The Lymphedema Bill in Congress

Becky, excellent question, the bill was simplified to just cover treatment and garments and eliminate the training requirements.

Whenever we question this, we're told we can petition the local licensure board for PT"s--well, I queried why Linda T Miller, queen of the weekend wonder courses, graduate of no qualified LE training school, gets away with calling herself "Doctor" when she holds a bachelors degree, and the PT board of Pennsylvania would not divulge any information about her, beyond what I could find on their web site. So that avenue is worthless, especially when we're facing a powerful national lobby.

I personally think we should somehow make insurance credential PT's. Since they argue that LE treatment is covered in their general training (I have an article to show that it is not.) 

It's actually pretty appalling: let's say a general internist decides that her training suddenly qualified her to perform brain surgery--well, her state licensure board would/should suspend her license, for practicing outside the scope of her training.

How do the PT"s get away with it. Add the OT"s to it. And, since their training is so varied, the national LMT people won't touch the subject.

Maybe we ask NALEA--the four major training schools what to do about it. But, they signed on to the bill as major "stakeholders"--the sad reality is that with the training stipulation gone, they got the APTA and the American Cancer Society, and a far better chance of getting some where with the bill.

Nicole Stout was on the board of the NLN until she resigned to devote herself to APTA.

And remember, she is the expert who declared that lymphedema is never painful....No further training necessary....

Someone figures out what we can do, let me know.

Kira 

Nancy, I saw quite a number of PT's--and through out and still I have my highly trained LMT who is LANA and Klose and Vodder certified, but insurance will not pay for her as she's not a PT/OT--and I found that since I don't have 2 cm of swelling--because I wrap every night and wear compression--I was told I didn't meet criteria for treatment. And the patients I send to the best LE clinic I can find nearby get treated until the volume goes down and then discharged with no follow up.

I posted the advice from the LE PT, and she said the relationship should be long term, but since the PT insurance model is assess, treat and discharge--it's nearly impossible, and way too much time is wasted documenting medical necessity. LE needs a different insurance criteria.

I saw a patient at high, high risk for LE, with an achy arm, and her surgeon had her see the LE clinic at her hospital twice, but didn't code as LE, and the patient is stuck with a $800 bill.Now that her arm is painful and feels swollen to me--yet doesn't measure 2 cm ( a completely made up criteria--created by 2 PT's for one study, never validated, yet accepted as the gold standard), I sent her back to another clinic and coded it as LE. I figure she's stage zero at least.. I wished I had a bioimpedance to document increased fluid.

Getting back to Nicole Stout: why don't PT's accept their limitations: medical students can't get a license when they graduate with their MD's--they have to do their residency. Why should PT's be assumed to be competent in all areas of rehab--without additional specialty training--, when good studies show they're not?

Kira 

Kate, you nailed it. When the bill first came through, my younger daughter was a legislative aid for a congresswoman, and she told me it was considered dead in the water from the start. I guess the CBO--Congressional Budget Office has to sign off on it, and declare savings, and you need at least 100 co-sponsors.

I agree, concessions were made to try and get a bill that would pass, but as you so wisely wrote--they're not fooling us.

Kira