In coming back to this forum, I must start by firmly rejecting some of the assertions made by MrPhysio. For a start, my well known and publicly stated view in relation to fees is more accurately reflected by alophysio. If physio fees were close to that of Dentistry, I'd be very pleased.

I am aware of MrPhysio's views and acknowledge his right to air them (although I don't acknowledge his privately expressed opinion that the APA has an obligation to provide public forum for him to do so). As is often the case, I must correct a few factual inaccuracies.

1. ACCC legislation tends to be not negotiable as the AMA found out in a very very expensive exercise (for both the organisation and individuals) a couple of years ago. In the last 12 months, I've had one health fund threaten to drag us into the courts before they backed down and one that threatened to drag us before the ACCC because of our position on fees. I always find it strange that some physio's want the APA to break the law on their behalf. If you're committed to breaking the law - do it yourself.

For a laugh - look up how many solicitors work for insurers first. Then consider that health insurers spends over $160Mil a year on physio alone - the profession (worth over half a $Billion a year in Aust) provides the APA around $10Mil.

2. PBA has always publicly stated that preferred provider schemes are not in the interest of physiotherapists. We recommend that people don’t join however funds have a legal right to have such schemes (yes - the ACCC solicitors checked it for us) and physio's have the legal right to ignore our recommendation.

3. I completely disagree with MrPhysio's reporting of recent communications from the APA - It's inaccurate. The new APA strategic plan called for strong protection of the APA member brand, particularly in relation to continuing professional development, code of conduct and compliance with APA professional standards - The article is clear on this so I'd suggest people read it and form their own view on its contents.

4. We can argue about competitive strategy till the cows come home however the APA has had more success in the last 3 years in Victoria (a jurisdiction MrPhysio has an interest in) than it had in the previous 10 years and the APA alone (and I repeat for ASPP fans - the APA alone) has managed to get the last 2 increases in NSW workcover fees - market rates plus 12.5% (and we're working on NRMA / MAA insurers - Hot Tip - charge MAA patients full private fees and let them argue with insurers). The APA's stated position is market rates plus the additional cost of servicing compensable patients. Competitive strategy takes more that a baseball bat.

As for APA "deals" physiobob - No APA service comes with a requirement that any product is purchased through a third party (there's those pesky ACCC laws again) - and remember, the APA does return all revenue to members by way of service and advocacy - we're not for profit and owned by the members so lets not go there.

Alophysio - On a more positive note, we're looking at those journals but they're bloody expensive. The ones you refer to will only allow access on a per member fee basis (rather than the capped fee we have with the existing journals) which means the APA doesn’t add significant value through group purchasing (which means all we're doing is forcing all physio's to effectively buy MT or spine online). If we can’t add value through a service, we'd prefer to keep the fees lower and let people make their own decision on whether they should purchase products. We are looking at whether the relevant clinical groups may be able to offer them on subscription.

Finally, I'm not here to debate APA policy or to fend off misrepresentations about the APA - I'm here to offer some comment that physio's may find helpful (to the extent that I'm able without diminishing the value of PBA membership).

The guys offering cheapy services rarely survive in the long run. I'd say differentiate your services so that you're not competing directly with cheap services on price (and before you say it - they differentiate salt so don’t tell me you can’t differentiate physio). Focus on key target markets that don’t require referrals from network type GP's (yes, I'm as concerned about GP Networks in Western Sydney as you are) and try to get directly to the client. Work out what your break even point is for each employee (yes PBA has a tool to help), add the desired return on investment and pay employees a fair percentage up to that point. After the employee has covered their costs and a fair return on investment, increase the percentage as an incentive (but calculated on a moving average model over several weeks to prevent abuse). I strongly suspect that if every practice owner in Australia went through this exercise, consultation rates would jump because they'd realise how little they are making from their efforts.

Finally, if you want to do compensable work - focus on it and build a high volume, systemised, low cost of delivery practice (lots of graduates, lots of process and IT driven results, ruthless focus on return to work and endpoints). If you don’t have a high volume low cost practice - it will always be difficult to make money from compensable patients (an unfortunate but increasingly true fact that means that in future, compensable patients just wont get access to the best physio's as they will only do private work).

*Yes MrPhysio, I know - that doesn't work with semi rural practices because the doctors wont refer......... Rural practices are an entirely different challenge and not one that I have time for at 8:20pm on a Friday night. I'm going home because like most of my association colleagues, I've done enough for the physiotherapy profession this week.