Jerry Henderson, PT writes: I am aware of a basic tenet in writing, speech making, or casual conversation: The one sure fire way to bore your audience is to talk too much about yourself. Even though I’m aware of the danger of self absorbed writing, I would like to discuss a bit about my own professional journey. Not because my favorite subject is Me, but because I think my experiences closely parallel what has happened to our profession over the past twenty years.

As a teenager, I suffered a comminuted femur fracture in a tobogganing accident.   After being in skeletal traction for 6 weeks and a hip spica cast for another 8 weeks (bad fracture), I was seen in the hospital PT dept. for a few days prior to discharge. I decided at that point that I wanted to be a physical therapist. 

After four years of uneven undergraduate college performance; I was accepted as a second alternate to an out of state physical therapy program.  Thankfully, there were others accepted to the program that were also accepted elsewhere and took those opportunities, so I made it as the last person accepted to my class.  It was at physical therapy school that I discovered that there were physical therapists that didn’t work in hospitals or nursing homes, but actually worked for themselves as private practitioners.

After graduation and passing board tests, I accepted a position as a staff therapist at a large closed panel HMO hospital system. Clinically, it was great experience that I found both challenging and enjoyable. Professionally, it was extremely frustrating dealing with the bureaucracy and inefficiencies of a large healthcare system. In retrospect, I think I was given a preview of how healthcare would operate if it were totally managed by the government.

Totally frustrated at the HMO four years later, I naively decided to go into private practice. At that point in my life, I couldn’t tell you the difference between accounts payable and accounts receivable, but the need to know what I was doing didn’t seem to matter.  Although I didn’t realize it at the time, the recipe for succeeding as a physical therapist in private practice was the easiest business proposition you can imagine:

·         Treat your patients;

·         Submit a bill to the insurance company in any old format you wanted;

·         Get paid in full in a couple of weeks, generally with no questions asked;

·         Repeat as necessary to pay the bills and yourself.

Life was good for a while. But, it turned out that the above formula was only sustainable as long as healthcare was affordable for everyone. After it became more expensive, the insurance companies started asking some uncomfortable questions, like “Was this treatment really necessary?” and “Can you start submitting your bills on this new form called the HCFA 1500?” Those payers really had the nerve.

By the early 90’s, my private practice colleagues and I were very indignant about these aggressive payer tactics, but life was still overall pretty good. But soon after the beginning of the first term of the Clinton Administration, the changes in our industry accelerated rapidly: we first started hearing the term “Managed Care”, large publicly held companies were purchasing physical therapy practices as fast they could and paying way too much money for them in the process, some payers were making completely onerous demands and (gasp!) were asking for copies of our clinical records before paying claims. In short, our business was becoming a lot more complicated, and we were beginning to understand that we didn’t have the information infrastructure necessary to operate in this new complicated environment successfully.

During the mid 90’s some of my Washington State colleagues and I came to feel that our interests in this rapidly changing environment were not being well represented by our state chapter of the APTA.   A group of us created an independent association of physical therapists to lobby our legislators and work with our payers proactively on our behalf. The association was very successful in its short existence, but was disbanded over what turned out to be unfounded threats that we were engaging in price fixing and collusion.

All of this piqued my interest in looking at a computerized documentation system for physical therapists. I looked at some of the offerings for clinical documentation systems available at the time and didn’t care for any of them. Although I barely knew how to turn on a PC at the time, I decided to start a software company with one of my colleagues. (I like to call this my “Fire, Ready, Aim” method of business planning.) Our nascent company developed a little software platform for physical therapy documentation. It was OK for it’s time. Even though it was not a commercial success, it was a valuable object lesson. Among the lessons learned:

·         A system has to be very configurable to meet the needs or our industry across a variety of settings;

·         There is more to our business than my PT centric view of it: scheduling, billing, and business management are at least as important as clinical documentation;

·         Watch payer behavior closely, especially Medicare, for they will rule the world; and, most importantly;

·         Get some help from people who know what they are doing.

With those lessons learned, I founded Clinicient in 1998. We have delivered a totally integrated system specifically designed for rehabilitation. More importantly, we now have a team of experts in business management, rehabilitation billing, and software development.

I believe that Clinicient is now has the necessary pieces in place that will help our customers get the financial reward they deserve for providing great care to their patients. 

“Rewarding Great Care” is more than a slogan for our company; it is the central core principle by which we operate.