Referrals work both ways, PT tells Aspen hospital officials

Rick Carroll
The Aspen Times

A physical therapist cautioned Aspen Valley Hospital officials earlier this week that their orthopedics business risks losing a significant chunk of referrals under a new arrangement at the hospital.

Tim Reed claimed the hospital would surrender as much as $15 million in business from orthopedic patients under a scenario in which 10 physical therapists separately refer $1.5 million in patient care outside of the Aspen Valley Hospital District.

“I personally had patients leave Aspen to do orthopedic procedures that could have been done here,” read Reed’s statement to the hospital’s board of directors, who held their monthly meeting Monday. “$1.5 million worth. And that was with my positive, cooperative approach with AVH. Now that I cannot be assured of receiving any reciprocal respect for my business, I will be more cautious with referrals.”

Reed’s comments came after the hospital opened OrthoAspen in January and immediately banned physical therapists who aren’t hospital employees from providing services there. OrthoAspen comprises four former doctors from the now-defunct Aspen Orthopaedics Associates, who are now employees of the hospital, along with four orthopedic surgeons and three other doctors who will join later this year. Previously, Aspen Orthopaedics operated in the new hospital wing but its doctors were not on the hospital’s payroll.

Now that they are, the hospital no longer allows outside physical therapists to make clinical rounds at OrthoAspen, an arrangement that had been in place for decades with Aspen Orthopaedics when it was at the hospital and its previous location on Main Street.

Hospital officials have maintained that non-hospital employees cannot provide services under its roof because of liability concerns and other legal issues.

The clinical rounds were performed on a pro bono basis by the physical therapists, who aided the physicians by providing their patients with brace fitting and rehabilitative services, among other offerings. OrthoAspen now uses physical therapists employed by the hospital to provide the same services, prompting the shunned therapists to theorize that they will no longer get referrals from the hospitals’ orthopedic physicians.

Interim hospital CEO Terry Collins said the hospital is open to future discussions with physical therapists and it has no designs to cut them out of referrals.

“First, it is our intention to cooperate and collaborate with all of the physical therapists in our community,” Collins said.

He added: “We do not restrict our physicians from referring to any physical therapists. We also would not prohibit a physical therapist from coming in with one of their established patients, although they can’t deliver care to them while they’re here.”

Physical therapist Stan Cheo, however, who runs Aspen Sports Medicine, said an OrthoAspen employee told his presence was no longer allowed when he went there a few weeks ago.

“I was told face to face to leave and to not come back,” he told Collins and the hospital’s board of directors.

“I refer more out than I get back, and I’m fine with that,” Reed said, noting that “we have to come together if we’re going to accomplish your goals.”

Reed also said that 30 percent of outpatient orthopedic patients do business outside of Aspen’s hospital district — a figure that has emerged in previous public discussions. He argued that the hospital district’s mill levy, a voter-approved property tax that generates $3.9 million a year, would be unnecessary if more orthopedic patients used the Aspen hospital.

Responding to Collins’ statement that he’s willing to discuss the issue further with physical therapists, Reed said he wants a meeting of the minds to give the hospital a greater community feel that seemingly has eroded with OrthoAspen.

“There was a day, not all that long ago, when the sense of community prevailed at AVH,” he said. “PTs and other allied health care professionals worked with the doctors and even some hospital PTs to ensure the best care for the patients.”

More important, Reed said Thursday, is the patients benefited from the previous arrangement.

“I’m trying to take the side of what’s best for everybody,” he said. “The hospital will be best served by including everybody. … We need to make sure everybody has a choice. The hospital needs to do what the hospital needs to do; I understand all of that. But there’s a big exodus of patients going to Vail (Steadman Clinic) and elsewhere, and if the hospital is serious, we’ve got to do something about it.”