PHYS THER
Vol. 88, No. 9, September 2008, pp. 1009-1011
DOI: 10.2522/ptj.20070110.ar
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Linda Resnik and Dennis L Hart


Because this article has no abstract, we have provided an extract of the full text and any section headings.

We thank Freburger, Mielenz, and Fritz for their insightful commentaries on our article.1 Both commentaries2,3 help to situate this research within the larger context of efforts stimulated by the Institute of Medicine (IOM) to make health care providers more accountable for clinical quality.4,5 The IOM has recommended development of incentives that encourage quality improvement by rewarding providers’ performance, which would realign financial incentives in health care delivery.5 Although some administrators in today's reimbursement system realize that they can deliver care at lower cost by using an extender of care, such as a physical therapist assistant instead of a physical therapist, our findings suggest that greater use of physical therapist assistants negatively affects the quality of health care delivery. We believe that research such as ours as well as initiatives such as pay-for-performance5,6 or value-based purchasing7 strategies will encourage administrators to support clinicians in developing models of care designed to produce . . . [Full Text of this Article]


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