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Career Advice
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Career Advice - August 18, 2006 4:49:00 AM
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ysumpt2006
Posts: 113
Joined: March 31, 2005
From: Youngstown, Ohio
Status: offline
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Ok, here is the deal. I just got licensed in Ohio and am a new grad. I have a couple of offers on the table and they are at a variety of settings (all ortho outpatient). One is a hospital based sports med facility (the area I really want to be in), one is a nationally based facility (Benchmark Medical) and the last one is a facility closely linked with a physician's office (not sure if it is a POPT clinic).
Salaries are similar with a couple of them doing a sign-on bonus.
My dilemma is this:
The one I really want is 60 miles away and I'm not in the position to move right now. But it would give me the opportunity to see a lot more diagnoses, it is sports minded (2 universities and 4 high schools are affiliated with it), the staff is great, etc.
The national one is 5 minutes away from my house, but the benefits are over 400 per month and I need benefits for my wife and I.
The other one is 30 minutes away with great benefits (25 per month), the highest salary only by a couple of thousand), but a very limited patient base (diagnoses are mostly knee/hip replacements)
I think the hospital based one would give me the best exposure to stuff I want to see and start my career on the right track, but everyone in my family feels it is too long of a drive and the one with the cheap benefits should be the one to go to.
Any words of wisdom?
Thanks all.
_____________________________
Ken Shearer, PT
Certified Strength and Conditioning Specialist
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Re: Career Advice - August 18, 2006 5:24:00 AM
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yarringtonpt
Posts: 112
Joined: July 4, 2006
From: Waynesville, NC
Status: offline
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How did you feel about the staff / environment of the 30 minutes away facility?
Do you feel that an opportunity to work at the 60 miles away clinic will still be there when you are in a position to move?
What is most important to you for your first job?
_____________________________
Eric Yarrington, PT, MPT, OCS
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Re: Career Advice - August 18, 2006 5:39:00 AM
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SJBird55
Posts: 2286
Joined: May 10, 2004
From: Michigan
Status: offline
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1) What are productivity requirements? How is productivity defined?
2) What is the staff ratio? (PT/PTA/tech)
3) Who owns the facility?
4) Is there a compliance department/officer?
5) What kind of documentation system is used?
6) What is the turnover rate?
7) How many evaluations/day are required or expected?
8) Who determines patient scheduling? Who do patients see for return visits? How much time is scheduled for return visits?
9) Taking that staff ratio one step further... how does the facility view supervision of supportive staff?
10) Taking that staff ratio another direction... what is the relationship like wih supportive staff? (Do all supportive staff work with all therapists or does each therapist have a particular PTA that is teamed wtih that therapist?)
11) Is there a formalized mentor system? What are the qualifications of the physical therapists?
12) How does salary change with experience? Vacation time?
13) Any money/time allotted for continuing education?
Technically, there is such a shortage of physical therapists out there and companies are having difficulty with functioning at appropriate staffing levels, you actually may have other employment options that you don't even know about. You could go through the phone book and make a few calls.
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Re: Career Advice - August 18, 2006 5:59:00 AM
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ysumpt2006
Posts: 113
Joined: March 31, 2005
From: Youngstown, Ohio
Status: offline
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Yeah, I already did the call around thing and nothing is available in this area. It is a very "dead" blue-collar workforce here and the big businesses are moving out taking a lot of other jobs with it.
I'm just gonna focus on the furthest one and the middle one for the comparisons below:
1. Productivity--12 patients (Hosp) vs 12-15 (Private)with Hospital paying 2-300/mo extra for productivity of 85% or more
2. STaff ratio is 1:1 PT:PTA both places
3. Hospital vs Doc for ownership
4. compliance--hospital--yes, other--Don't know
5. Documentation--Dictation both places
6. Turnover rate--not bad either place
7. Evals--hospital--2-3 at the moment, other--dep. on surgeries
8. scheduling--hospital--keep own schedule, other--central scheduling--see PT when possible
9. Not sure other than state regs
10. All PTA's work with all PT's in hosp--team in other
11. Hospital--2 other PT's--9 years exp--same place; other--15 year experience, and unknown on other
12. Salary will increase each year and with special "clinical tracts" in the hospital (up to 11% per year plus productivity bonus--one PT has doubled his salary in 8 years); other increase of 2.5k after 90 days with periodic increases as they deem fit
13. Continuing Ed--Hospital--fully paid (travel expenses included) and encuraged; other--not sure as PA does not require Continuing ed. As a side note of this issue, I also have my CSCS and need continuing ed for that.
The Hospital salary is approaching 60k with a 5 or 7k sign-on; the other is 60k and then 62.5k after 90 days.
_____________________________
Ken Shearer, PT
Certified Strength and Conditioning Specialist
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Re: Career Advice - August 18, 2006 6:57:00 AM
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yarringtonpt
Posts: 112
Joined: July 4, 2006
From: Waynesville, NC
Status: offline
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I have worked in a hospitalbased OP/Sorts clinic and had a good experience. You've got to ask yourself if you feel that you could sustain 120 miles of driving per day. If it were closer, I'd say jump at the hopsital job without question. I think it has more to offer for a new grad. Best of luck.
_____________________________
Eric Yarrington, PT, MPT, OCS
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Re: Career Advice - August 18, 2006 7:06:00 AM
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SJBird55
Posts: 2286
Joined: May 10, 2004
From: Michigan
Status: offline
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How current are you with the Stark Laws? You need to know the physician owned company files claims.... would you be providing services "incident to?" In regard to #9, you not only need to know your state regs, but you also need to know the payer mix (with the payer's defintion of supervision) and the definition of CPT codes (and the level of supervision required for codes utilized).
Referral for profit situations are not always in a patient's best interest. Hospital settings can fall into that kind of a category; physician owned practices are obviously in that category. I, personally, have nothing against therapists working in referral for profit situations as long as rules and regulations are followed.
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Re: Career Advice - August 18, 2006 3:41:00 PM
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Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
Status: offline
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ysumpt2006
2 red flags for me that stand out in the two remaining places you are considering concerns the doctor owned clinic....you said scheduling is central and followup is ? PT if possible. When you are newly out in the field you need to be able to work with your patients with some continuity to use your skills, otherwise you just become an evaluation therapist and that doesn't help you to improve your skills and develop experience with different treatment approaches to see what works for yourself.
The other item is that it appears it is owned by maybe one doctor, or only a few, you didn't really say. A physician owned clinic, in my experience, has a greater chance of being in violation of the Stark Law than larger multi-groups, could be wrong on this. But, the smaller the group, the more micromanaging can be done by them.
When I was a new grad this was a brand new topic, POPTS, and my undergraduate studies never addressed this situation. While on my last internship, I took a job at a "large" clinic which had 10 therapists and no PTA's. It was a great environment, had access to all the records, docs were in an out of our department when needed or looking for advice from us on how to manage various patient situations. It was a very "adult" non-ego driven group. Patients were not required or coerced to seek Physical Therapy in the clinic from the physicians there. In fact many patients travelled long distances to see the physicians and we routinely were finding therapy locations closer to their home. Anyways, it was a unique situation, not all were or are like that. In spite of this, all the therapists, including me and another new grad had to testify before the WI State Legislature and explain our ethics for working in this situation. I became experienced fast concerning the POPT implications. So be careful of that situation as SJBird55 speaks to as well.
Your 60 mile drive sounds like the best career move. But you have to way all the variables, family is important, doesn't do any good to have a great job and not have your family happy.
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Re: Career Advice - August 19, 2006 2:50:00 AM
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jma
Posts: 2310
Joined: August 24, 2000
From: NY
Status: offline
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The doctor owned facility also catches me eye as well. Unless the gas prices are not affecting you as it does here in NY, and the drive is smooth, one could commute but the close facility sounds better. Agree with the post above.
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Re: Career Advice - September 11, 2006 5:17:00 PM
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ysumpt2006
Posts: 113
Joined: March 31, 2005
From: Youngstown, Ohio
Status: offline
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Well, after thinking it over for a while, I took the sports medicine position--will have a better opportunity to see a variety of diagnoses, practice area I have wanted since I started PT school, great atmosphere, hospital based facility, etc.
The drive is gonna be a long one, but gas is 2.06 right now. It will be worth it in the long run.
_____________________________
Ken Shearer, PT
Certified Strength and Conditioning Specialist
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