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Teacher parallels?
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Teacher parallels? - August 8, 2001 10:58:00 AM
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mcap
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Joined: February 8, 2000
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Group:
The education debate seems to be front and center these days. There is a lot of talk about how to improve schools and how teachers should do more. Meanwhile, there is a significant shortage on the horizon and no one seems to be ready to remedy it the only way possible - more money!
One of the complaints leveled against teachers is that many of them do not peform to their potentiall. But where are the incentives to be the best? They are mostly paid the same based on experience and qualifications.
I see some of this in P.T. Hospitals and clinics often pay clinicians on a scale. And in many situations, no matter how much you read, how many courses you take, how much better you are than other staff members, your raise will be the same and your compensation will be the same as everyone else's. I know where I am, (a good place), advanced degrees, certications, courses and skills count for nothing at year's end.
I beleive that we have an ethical obligation to read the research and to keep current and to think more about what we are doing. And I also beleive that many PTs fall very short in this area. But.....we should not be ignorant of human nature and motivation. In other words...........given absolutely no incentive to improve their clinical skills and to be a better clinician, how many PTs do you expect to change?
Respectfully,
Mcap
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Re: Teacher parallels? - August 8, 2001 12:55:00 PM
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Andrew M. Ball, MS, PT
Posts: 500
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From: Chapel Hill, NC, USA
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Mcap,
I recently went to a venture capital seminar for business students wanting to go into biotechnology in the Research Triangle Park area. I've always thought that my expert clinical skills, evidence-based approach/skills, publications, and MBA should count for something, and that I should command a larger salary than I get. The speaker made a good point, 99.9% of people aren't underpaid . . . they are paid exactly what they are worth. If you believe that you're undervalued, you're not. You're only worth as much as anyone is currently paying for your services. If I was worth more money, I'd be commanding it elsewhere.
Using myself as an example, many people think that I'm undervalued because I could go and work for one of the big six consulting firms and with degrees in both PT and business, I could perhaps command a salary well over 6 figures. Does that mean that's what I'm worth?
No.
Such a job would require more than 3 times as much work, countless more hours, lots of travel. It's not the same as what I do, and until I'm willing to put in the extra effort to make that kind of career jump . . . I'm not worth that, I'm worth my meager state employee salary. The trade off is time to do schoolwork and superior job security. I'm only worth as much as the new graduate who could (with 3 months of my training) take over my job and do it almost as competently as I. That's the salary that I'm currently worth, and by those standards, I'm GROSSLY overpaid.
As I approach the end of my PhD, that may change. I may eventually be worth that 6 figure income. The point is, it's up to ME to establish what I'm worth and put forth the effort to change my situation to make that come about. If I stay in my current position, I may FEEL undervalued, but if that's all I'm motivated to command, then that's what I deserve.
The same is true of any physical therapist.
Drew
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Re: Teacher parallels? - August 9, 2001 6:53:00 AM
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mcap
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Drew:
I understand your points and I can see what you are saying but I would be careful before listening to all of those MBA types. I would ask you to take a step back for a second because it's not that simple.
First of all, let's look at management consulting. These people make big money and traditionally, an MBA from a top business school was required to get in with one of the big firms. Recently however, a couple of the firms have been taking people in other fields, giving them a 21 day crash course in management and then sending them out. Preliminary results show that they are fairing as well or better than their MBA counterparts. This begs the question.....were any of them worth that much in the first place?
Come take a stroll to NYC. There are thousands of brokers and institutional sales people who are paid well into the six figure range. However, many of them could be replaced by more recent grads at far cheaper and yet they retain their huge bonuses. In fact, look at all of the fund managers out there who could never beat the average over five years, and yet the huge salaries continue.
One of my patients taught and entry level class for one of the big all street firms out here. This course was designed to instruct on the basics of finance....aka.... "this is a bond.....this is a stock, etc." His rate........$5,000 per two hour class. His summation.....am I worth it....absolutely not.....but compensation has nothing to do with reality down there.
All of the larger law firms have moved entry compensation to 120,000 plus bonus. This was in a response to a dot com threat that never materialized and now they are strapped for cash.
So you see......people are paid less and more than they are worth.....all of the time.
Compensation has a lot to with tradition.
The issue in P.T. as in teaching is a bit different - it is merit pay. There is very little pay based on merit like there is in corporations. No one is saying PTs should get an accross the board raise. Only that it would be interesting if some got paid more and some less based on certain things (difficult to do, I know). And my point is, in light of this......how much work do we expect certain PTs to put in?
Since as you put it, PTs are being paid what someone will pay them, there is not much incentive for them to improve or to do the things that we on this board sometime admonish them to do.
mcap
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Re: Teacher parallels? - August 11, 2001 12:28:00 PM
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holly garwell
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From: England
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hmmmm - If reading research papers/attending courses could command greater salaries, then perhaps objective measures such as number of patients through the door, treatment outcomes, clinical effectiveness could be used. That would really separate the weak from the great!!
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Re: Teacher parallels? - August 12, 2001 5:54:00 AM
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Andrew M. Ball, MS, PT
Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
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Holly,
Courses in unproven techniques should not be worth anything at all in salary increases. Execpt perhaps to justify why smaller and smaller salaries should be offered to many of the "experienced" PT's when they try to change jobs if they've not kept up with any kind of reading. Reading articles, and practicing from an evidence-based perspective is entirely different than digesting and reapeating what someone on the lecture circut has spoon-fed the clinician. Only about half the time is the information accurate in the first place.
READING about CST or SCS is one thing, and therapists should be commended for doing so, but paying several hundred dollars to learn a technique that's clearly sham . . . that says something about the professionalism, ethics, and problem solving skills of the therapist. Something very negative, and as such, I'd offer less and less of a salary to someone with increasing years spent "perfecting" skill in a bogus technique such as SCS or CST.
If I gave the impression that I advocate that salary should be related to skill however, let me clarify. When an industry is regulated, and prices set by something other than supply and demand (as is the case in healthcare), there is an inherent danger. That danger is a professional delusion of grandeour.
Physical therapists like to talk about what they are worth on the basis of outcomes because most don't understand basic economics or managerial finance. We are worth what someone is willing to pay. The third party system distorts that and inflates our perceived value of our own services . . . we are worth not what the pseudoregulated market supports, we are worth what the market would support in a direct professional to client payment scheme, which is to say not much.
Andrew M. Ball, MS, MBA, PT
[This message has been edited by David Adamczyk (edited August 12, 2001).]
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Re: Teacher parallels? - August 12, 2001 8:35:00 AM
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mcap
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Ms. Bird!!
How are you? I must disagree with some of what you said.
Look at some of the measures you discuss. Productivity and patient satisfaction. Productivity usually has nothing to do with the individual therapist. The marketing (or lack thereof is usually the manger's or facilities responsibility). The average staff PT has very little to do with their schedule being full.
Second......I have been observing this phenomenon for quite sometime. Patient satisfaction often has little to do with the skil of the clinician. I have seen PTs that act like each patient's best friend. They do lot's of massage, lot's of talking and caring and they are never in a rush to get rid of patients. This results in higher satisfaction but the patients stay on program too long and often return with any minor ache.
For me, I use very few modalities or other crowd pleasers. I try to treat every patient in as few treatments as possible and I don't let anyone get the idea that PT is the answer to all of their problems. Now....look at my patient satisfaction. Probably not as high as joe therapist previously mentioned, yet I have little doubt that I am doing a better and more ethical job!!
Drew:
I can certainly see what you are saying. The third party payor system has pumped us up. However, we are not alone. Many people would choose to forgo many serives (doctor's visits, imaging, treatments, etc.) if they had to pay for it themselves.
As for the argument that people are only worth what someone is willing to pay them. Sorry, but I feel that is just not true. As a matter of fact.....it's morally indefensible. Extend the argument to the extreme.....
Look at Slavery. People didn't think they were worthy of a salary, or basic human rights for that matter. But according to your logic, that was what the market could bear at the time.
Look throughout history as workers were exploited by companies often at the risk of their lives. The fact that they were worth more, deserved more, led to the unrest, organization and reforms that are now in place to protect us. But there is a long way to go. Any look at certain industries would tell you that many, many workers are worth more than they are paid. Many are worth less. But to simply say you are worth what someone is willing to pay you is a dangerous idea.
Respectfully,
Mcap
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Re: Teacher parallels? - August 12, 2001 7:03:00 PM
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Andrew M. Ball, MS, PT
Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
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Mcap,
Your point is a good one, but requires a response that may give some people the impression that I'm equating human worth with financial worth, or that I'm somehow biased against either African-Americans or Organized Labor. I am neither. I am a member or a minority group myself, and deplore bigotry in all forms.
I ask anyone who's offended by this post to read it several times before responding to it. Odds are, that if you're offended, you've taken a line or two out of context. The point here is that human worth, financial worth, and political worth are NOT the same thing. I don't think that anyone would argue that at times througout history, many minority groups have had human worth, but nothing else. I am IN NO WAY implying that ANY minoity group was void of HUMAN WORTH at any point in their history.
I'm not exactly saying that PT's are worth what the market will bear. I am saying that people are FINANCIALLY worth what the market will bear AT THAT TIME. But I'm also saying that this worth is a dynamic process that is in the complete control of the individual, and whining to the enviroment in lieu of organization and action, accomplishes little. Organized action is required to change one's enviroment, and by extension, POLITICAL OR FINANCIAL worth. The significant strides in civil rights, women's rights, and gay's rights stand in memorial to that fact. People changed the envirnoment that dictated their POLICIAL worth . . . not the other way around. No one gave women the right to vote . . . though they had HUMAN worth, they had no POLITICAL worth until pioneers like Susan B. Anthony transformed human worth into political worth first. Just because they believed that they had inheret political worth did not make it so.
I like your analogy though. There is not a direct correlation obviously because slave-owners did in fact buy, sell, and trade slaves. Furthermore, as I understand American history, the cost of owning a slave was (thankfully) prohibitive for all but the affluent few. The point is, that slave owners did in fact see a value in slave ownership, and paid handsomely for it . . . the slave however, was not paid for his or her services until the Civil War (and slave revolts before it) began to demand otherwise.
This is by no means to say that anyone, anywhere, ever deserved to be enslaved and exploited. Your analogy fits so well with my original point, and not because I'm arguing that slaves didn't have HUMAN WORTH but because they DID. At the time, that's ALL they had. They had little FINANCIAL and little POLITICAL worth . . . that is why they were unexcusably explotied.
Most slaves and exploited workers (like PT's) had an internal (and accurate) sense of HUMAN worth that surpassed the environment that they lived. This was clearly justified, but by no means translated into FINANICAL or POLITICAL worth, of which they were in general robbed of. At the time however, not slaves nor workers were motivated in an organized fashion to change their situation. It was not until the PERCEIVED FINANICAL AND POLITICAL worth of any of these groups began to change that organization and envionmental change began to take place. Only then did their ACTUAL FINANCIAL AND POLITICAL worth improve.
My point is that PT's tend to want to skip that step of effecting environmental change and simply demand respect without first changing the enviroment around them. History teaches us that life just doesn't work that way. Never has a minority group been freely given increased rights without first asking for them, and subsequently working to make that happen.
Physical therapy is no different. We must stop wasting time trying to effect FINANCIAL AND POLITICAL change in ways that neither the public nor other healthcare professionals understand nor appreciate. In my opinion, history teaches us that this approach is futile and isn't going to work. Outcomes research is nice, and we need it, but it doesn't replace an all-out marketing campaign to change the enviroment.
My point is actually exactly the one that you made:
A person's professional situation is what he or she makes it. FINANCIAL worth is not determined by external factors, it is determined by the individual . . . so if you don't like the enviroment that you're in, change it.
Drew
[This message has been edited by Andrew M. Ball, MS, PT (edited August 13, 2001).]
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Re: Teacher parallels? - September 3, 2001 2:46:00 AM
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Hirsch
Posts: 43
Joined: October 16, 2000
From: Germany
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I thought you PT's were't in it for the money! [IMG]http://www.rehabedge.com/forums/eek.gif[/IMG]
You should come to Germany were PT's make squat! I'm serious...the salaries here are horrible compared to what a PT can potential earn in the US. And no matter how much more education or experience one has as a PT, in Germany, you still make squat! I don't know how the situation is in England...but it's horrible here...Mark Hirsch
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