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johnny appleseed -> About To...Leave...? (March 6, 2001 2:24:00 PM)

hello all,

i've been following this forum for about 2 years now...seen the worst that ppl were talking about a year ago and the general perception that things have gotten better lately. However, I am at a big junction right now. I am trying to balance what i know about the field, the future as it is perceieved by the community here as well as what i need to do to survive and help my family. As mcap has always said..."what you do now will impact you for the rest of your life"....so true.
Anyway, my current dilema is whether or not to drop out of PT school (in my second year - of three...don't worry it's a cheap public program [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] ) and switch to another masters program. It would be very easy to do and the one i have in mind would only take 2 semesters and a summer to complete....about what it would take to finish my PT program. I could even work during the day. Argggggh!!! Its frustrating b/k i know that i am not at the top of my class and never will be. I'll admit it. I have always been one of those individuals that really,really,really studies alot, busts my chops but never gets the grade i'm shooting for (in PT classes anyway). Put candidly, I don't know if i can ever practice with distinction to be truely awesome (ie to avoid the pink slip) nor be the "Super-PT" my patients deserve. It also seems like there would be more stablity (non-H/C provider) in ANY other field.
What also really bothers my is the immobility of pay (ie just for inflation). Knowing that what i start at will be pretty much what i will end at (all things being equal) kinda...like....SUCKS! I have read how Dana D is working three jobs and i know many of you are working multiple locations but is it worth it now? (Hey, isn't Bobcat doing some C++ programming right now?)

I know that i seem to be babbling and perhaps i am being a bit of a wuss for not "keeping my chin up" but i am sad about this whole endeavor of mine...something i've been trying to do for the past couple years....potentially all for nothing. But to pursue? It could be even worse for me in the future.....
Bottom line: Is it reasonable to say the long-term job outlook for PT's is pretty much the same as it was in March 2000 "WHY?" thread? Am i still looking at a future where job cuts, PPS limits, financial uncertainty moreover the existance of the PT profession will be at the top of my "to plan for" list? Are the newly graduated PT's reading this second guessing themselves again. Is the author of "WHY?" still asking W H Y?

thanks for your input...


[This message has been edited by johnny appleseed (edited March 06, 2001).]



edilling -> Re: About To...Leave...? (March 6, 2001 3:46:00 PM)

What was the long-term outlook for PT 10yrs ago? (it was green and roses as far as the eyes could see) Maybe we are not that good at long term outlooking? except to know that things change.

By the way, if you do not cont. PT what profession do you propose getting into that has total job security, no risk of declines in compensation level, and no expectation that you perform to the best of your abilities for the next 30-40yrs?(even union jobs get cut)

If you like PT stick with it. If you do not like it change to something you will like.
Good Luck
Erik



johnny appleseed -> Re: About To...Leave...? (March 6, 2001 4:39:00 PM)

thanks for your reply Erik.... [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]

i think you misunderstand me......I'm not talking about a world were we all kick back and have a beer and get paid to do that. I am use to kicking my rear in whatever i do.

I am not talking total job security nor pay declines nor about "getting away with" not performing to the best of my ability. I know that this is definately not a perfect world nor do i portend to be one of those people who wanted to go into PT for the money. What i am talking about is the "very existance" of Physical Therapy as a job-category (as opposed to ATC's doing PT) and the ability to be compenstated above inflation-type adjustments (ie mcap's 3% comments). thanks again and keep that input rolling!

[This message has been edited by johnny appleseed (edited March 06, 2001).]



johnny appleseed -> Re: About To...Leave...? (March 6, 2001 4:49:00 PM)

I understand how many of you might be thinking to yourself's "ahhh, this person shouldn't be a PT anyway"....that's fine....

I'm talking real life now. I would hazard to guess that i represent the segment of PT
's and PT students who AREN'T on this board; my ego is OK with not being the top 1/3 of my class and to actually admit it. At the same time I know I did something right to make it into a public program in california. But, i guess to add to my questions above...what did or what are the other 2/3's of your graduating class doing right now? Practicing with distinction? Happy in what they do? Or do you see these ppl as the first to be cut? Hard questions...possibly offending questions but real-life questions nonetheless...

thanks....


[This message has been edited by johnny appleseed (edited March 06, 2001).]



mcap -> Re: About To...Leave...? (March 6, 2001 6:52:00 PM)

Johnny:

Your issues are serious ones and ones that I think we all consider from time to time. First, here are a few thoughts:

1. Do not ever confuse grades in PT school with how good of a clinician you will be. Many of the top students in my graduating class have not bothered to pick up a journal since they graduated and, in my opinion, add very little to the profession.
If you are concientious and you take the trouble to read and think then you will do better than many of your peers. PTs seem to want to consume large amounts of information and commit a lot of it to memory. There are many, many bright people out there but I think, in general, that they don't think independantly enough. They seem to continue their habits after they graduate latching onto what their more experienced coworkers are doing or learning from the latest guru. This field needs people who are skeptical and who are ready to think for themselves.
Case in point.....how many of your brilliant classmates are actually skeptical about at least some of the information they are learning in school. They should be.
I didn't beleive a lot of what I learned in PT school and waited until after I graduated to sort things out for myself. Now, when I go back there to lecture, I inform my students that I would be a lot happier if they were skeptical about what I teach as opposed to just beleiving everything I say.
2. Your conerns about the field "going away" are understandably difficult to voice. Most PTs would counter by saying "you are ridiculous, there will always be PT." But you aren't. It IS a valid concern - one that I have had myself on many occaisions. All I can say is that I don't know what will happen. It seems unlikely that PT will just dissapear but certainly not impossible.
3. There is little to no job security in any profession these days. So don't let that be your reason. The only advantage you may have elsewhere is that with a broader background you may be able to shift areas in ways that will be impossible with a PT background.
4. The money.....no matter what anyone says......is an issue and a concern for many of us. True.....none of us went into this profession for the money. But ten years ago, the salary differential between a PT and someone who did something less redeaming or rewarding was a certain amount. Now that amount is much greater and it will continue to increase. You will have to strike your own balance. For me, I could never imagine having a job that didn't add something to society. On the other hand, I have to ask Sallie Mae's permission before going out to dinner [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]

good luck!
mcap



johnny appleseed -> Re: About To...Leave...? (March 6, 2001 7:35:00 PM)

thanks for your input mcap...

Keep em comin'!!



johnny appleseed -> Re: About To...Leave...? (March 7, 2001 8:18:00 AM)

thanks for your input SJ.

(Is it possible to have a false-positive for the "bumbling idiot" test? [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] )



Rose -> Re: About To...Leave...? (March 8, 2001 4:38:00 PM)

Hello,Johnny....

I ponder this question almost daily. ALmost weekly I have some kid in high school IM'ing me to "ask a few questions to help with a high school assignment". We go through the same questions.....time after time.....the high schools are STILL saying P.T. is a "hot occupation"..."one of the top 10"...and I think somewhere someone is publishing this as a national study finding. I answer with a lot of trepidation.

To tell you that if this field is what you really want to do..go for it ... is also said with trepidation on my part. You can "go" for whatever you desire but if the SUnday papers go week after week without a listing for anything but "prn" therapy positions , I , personally, would seriously reconsider what I wanted to go for. Being at the top or the bottom of the class makes no difference if the jobs aren't there. I still stand by my position that the recent debilitating reimbursement cuts have debilitated our profession's need. Those who say "the pendulum will swing back" need to tell me when it swung this way before....and when did we have an instance of the government taking something away and then saying "oooops...made a mistake... here it is back again". The government and insurance companies have forced us to do less for less to make their bottom line healthier.....do we all really think they will change back to any significent degree ? Maybe if some congressman's mom is hurt by it all we will stand a chance.

Now I'll step down carefully off my soapbox and try not to trip and break my hip in doing so.......but if I do I'll have an edge in knowing what to do for myself when I am denied therapy coverage.



johnny appleseed -> Re: About To...Leave...? (March 8, 2001 8:25:00 PM)

thanks for your reply Rose... [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]

[This message has been edited by johnny appleseed (edited March 09, 2001).]



johnny appleseed -> Re: About To...Leave...? (March 15, 2001 7:05:00 PM)

thanks for your frankness Bobcat. Your comments are always amusingly apreciated.



Ron -> Re: About To...Leave...? (March 16, 2001 7:19:00 AM)

Wow, you folks are into this one
I can tell you this, if you don't like what you do - get out, life is too short
if you like what you do - consider yourself blessed.

I found this quote in an article some years ago, I have it posted on my wall
Johnny , it may help you answer your question, although it does take some mind melting (I'm an old trekie), hope your up to it. [IMG]http://www.rehabedge.com/forums/biggrin.gif[/IMG]
"A master in the art of living draws no sharp distinctions between his work and his play, his labor and his leisure, his mind and his body. He hardly knows which is which. He simply pursues his vision of excellence through whatever he is doing, and leaves others to determine whether he is working or playing"
See ya I have to get back to palying.....



johnny appleseed -> Re: About To...Leave...? (March 16, 2001 1:49:00 PM)

Hmmmmmm.....Fascinating.... [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]

thanks for your input Ron...



mcap -> Re: About To...Leave...? (March 16, 2001 7:51:00 PM)

JA:

Although my approach may be slightly more benign than the "cats!" I must say that I agree with some of the points

The lack of respect for science and evidence based practice in PT is absolutely infuriating!!!!!

Another thing......many of the "Gurus" and experts are not paying attention to the evidence and are not open to debate.

I remember Sahrman talking about how the Transversis Abdominis produces no trunk movement and therefore you need to train your obliques for stabilization. I went up after the lecture and pointed out the Australian group had looked at BOTH the TA and the multifidi. The multifidi certainly produce movement of the spine and are believed to control motion segmentally. She looked at me like "who are you to question me" and dismissed me immediately.

Oh well.......................

mcap



johnny appleseed -> Re: About To...Leave...? (March 17, 2001 9:12:00 AM)

i guess that's one good thing about the program i'm in; there is an extreme emphasis on EBP. Particularly from my research, ortho and electromyography profs. Its cool b/k from day one, they have always stressed and linked EBP, the Australians and the good things that they're doing, doing Medline searches, etc. etc.. Actually, my research and electro profs are downright amazing. I believe my electro prof usually wins huge federal study grants to do real research...

Hmmmmm, at least i know i would have my foundations set....

(a question based on ignorance and begging to be asked) I assume that other programs are not like this??

JA



mcap -> Re: About To...Leave...? (March 18, 2001 8:13:00 AM)

JA:

In my program I was exposed to a lot of research and I would agree that many PT programs are doing really great research. However, many programs do not have the facilities or the money to do top quality research. Also.....don't forget.....in other disciplines they are able to hire RESEARCH faculty. They have minimal teaching responsibilities and are there mostly for resarch. In PT programs there are very few of these positions. If a faculty member is responsible for 3 classes per term, many with labs and additional responsibilities; how much research do you expect them to do?

But the biggest problem by FAR is not with the programs. It is with the rank and file of our profession. Everyone can talk research while they are in PT school but what happens after they graduate?? Do they think independently? Do they innovate? Do they even bother to consult Medline or pick up a journal? As far as I'm concerned, the answer for many PTs is NO!!!!!!!!

And even worse, they support gurus and fill the coffers of "institutes" that offer therapies that are conceptually vague and have no research support.

Think of all of those manual therapy courses for spine pain. There is virtually no evidence that manual therapy has a long term effect of back or neck pain!!!

Does this mean that it doesn't work. No. But therapists should start by saying to themselves that "hey this may not work but I am doing it for the following reasons."
Instead, PTs think "I know this works....I need to learn more and practice more.....and I hope I can be as good as the "expert" who taught me." Where is the skepticism that is the foundation of science.

mcap



Sebastian Asselbergs -> Re: About To...Leave...? (March 26, 2001 7:15:00 PM)

Johnny Appleseed: A late post for this thread; I took 8 years to get through high school - you know the 60's happened - wow, man those dutch clouds man.....
I graduated at 31 at the top of my class (waaayyyy back in '83) - was very comfortable with people, lousy at scientific PT. Spent 2 years in psych hospital as a sole-charge PT, covering a population of 500 in- and 3000 outpatients; all this in a government hospital here in Ontario Canada. Paperwork. Triplicate. 60% paperwork, 40% patients: from individual rehab to group work.... Not glamorous - not at all: the first sweet little lady on Wing "A" (geriatrics) stood still while I adjusted her slipper lace around her ankle, and peed very gentle over my fingers, still humming her "Oh Susannah". NOt glamorous and underpaid.
Long intro to say: I took the job because I needed a job to get into Canada. 17 years later, I have been in private practice for 15 years finally doing what I really like - science based problem solving with people.
The status of PT is ONLY what each of us individually makes it - expecting society or legislation or universities to make it happen is a pipe dream - they help, but ultimately, the people we treat and mistreat will remember us.
You aren't an academic wizard - big deal, neither am I. And I am good at what I do - still learning though. But good. With being good comes being willing to "not knowing everything" - seems you didn't need 17 years to realize that. You're already ahead of me. And remember: I'm good! (my mom says so....)

This opus magnum is only to say: I think you have the potential to make a good PT - simply because you seem to have the curious, assertive thinking necessary for the profession.
try to finish - it really isn't a waste. Take any job - I haven't had a job i could not walk away from - make your own - it'll take time.
Sebastian



johnny appleseed -> Re: About To...Leave...? (March 28, 2001 9:24:00 PM)

thank you all for your posts. i appreciate everyone's efforts to make this time a little clearer...

JA



johnny appleseed -> Re: About To...Leave...? (May 9, 2001 4:58:00 PM)

I've pretty much made up my mind....adios compadres...thanks for the memories...good luck to everyone else...thanks for the support!

JA



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