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Re: PT salaries
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Re: PT salaries - March 8, 2005 4:29:00 AM
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JLS_PT_OCS
Posts: 1684
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From: USA
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I think when the 3rd party payment system collapses and people are back to being in charge of where to spend their money based on evidence of outcomes and market forces, then enough will be enough.
I think PTs are positioned to do EXTREMELY well in that type of environment.
I can't wait, but I'm not holding my breath, either.
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: PT salaries - March 9, 2005 7:03:00 PM
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Randy Dixon
Posts: 744
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Jason,
What besides your own expectations prevents that from being the environment now?
That's not a challenge, it's a question I've been asking myself and in various ways on this forum since I got here.
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Re: PT salaries - March 10, 2005 1:31:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
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Randy,
I'm not sure I understand your question.
If you are asking why the medical and entitlement systems in our country are the way they are, I can't tell you that. :)
I can say our friends and colleagues in Canada have had a government health system for a long time, and it is naturally collapsing with the weight of inefficiency that all government programs suffer from. It is my understanding from reading some of their posts that the best way to practice up there is to be private and not see patients on the health system, but rather in a fee for service type deal. They have been ahead of us in many ways for some time. (go canucks!)
If the entitlement/socialization system we have now bothers anyone, there are some of us out there trying to change it.
Here's a good first step: [URL=http://www.lp.org]www.lp.org[/URL]
Randy, I'm not sure if I answered what you asked... :)
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: PT salaries - March 10, 2005 3:33:00 PM
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Ray
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From: Oreland, Pennsylvania
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I agree and disagree with some of the points regarding salary. For most of us we have been steeped in a tradition of passive recipient of referrals from doctors including physiatrists with little to no knowledge of the intricacies of rehabilitation. The skill set required of a master clinician is grossly underestimated. Why should a physiatrist with a few years of residency in rehab and typically a frac tion of the working knowledge commnad what they do.
PT's are not breed to be business oriented, but I believe that in the broader scope of advancing large scale national public health initiatives for instance with the NIH and the like that PT's are uniquely suited to lead these initiatives as DPT's especially. There is no difference in a DPT, DO or MD each is an EXPERT in their respective field. WE STILL ARE GROSSLY UNDERPAID!
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Re: PT salaries - March 11, 2005 3:02:00 AM
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JLS_PT_OCS
Posts: 1684
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From: USA
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Well said Ray.
I think that may be part of why the Physiatry lobby is strong and anti-PT.
Me and a good family medicine physician can handle just about anything under the sun.
What's the purpose of a physician who specializes in rehab but doesn't do surgery? I thought that was the purpose of having a PT instead of a physician...
I think that may also underlie some of Physiatry's involvement in the CAM movement with acupuncture, MFR, dry needling, etc.
I heard someone refer once to alternative medicine as "So-Called Alternative Medicine", which makes the appropraite acronym "SCAM".
:)
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: PT salaries - March 11, 2005 3:20:00 AM
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SJBird55
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From: Michigan
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The physiatrist that I worked with was pretty good and did not offer the same services that physical therapy offered. He handled the toughest types of patients who both were and were not surgical candidates. The surgeons who performed spinal surgeries would often times look to him to perform facet injections and those procedures were at times used diagnostically to determine the level that the surgical procedure could potentially be performed based on the patient's response or sometimes those injections were actually treatment interventions. He used radiographic imaging while he did the procedures and could print out the image to indicate the exact location of the procedure - I think they called their thing in that room the C-arm? He also did EMG's. He didn't perform any CAM stuff - muscle energy and manipulation yes. He also did those HA injections - I can't remember if he used synvisc or that other one (the surgeons also did those injections). So, basically, he either helped diagnostically to specify the level involved or he was an option for patients who weren't/couldn't have surgery but had pain.
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Re: PT salaries - March 11, 2005 7:10:00 AM
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JLS_PT_OCS
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From: USA
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That sounds like a great practice scope. I too have worked with Physiatrists who do that stuff.
In that context, makes you wonder why his professional organization would care if we have direct access or not, since clearly we aren't going to be injecting people, etc.
Fluoroscopic imaging is commonly referred to as "the C arm" because it is a big "C" shaped device that the joint or area is placed into for visualization.
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: PT salaries - March 12, 2005 3:55:00 AM
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Dr.Wagner
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From: Indianapolis
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Physiatry is a REALLY popular profession right now, I remember talking to many medical students who were headed straight in that direction.
The residency is unusually long (4 years after medical school), but extremely thorough regarding medical differential (generally a 1 year internship prior to formal residency).
Personally, that was the direction I was headed until I changed my mind with EM.
But I guess that is a whole different topic.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: PT salaries - March 18, 2005 4:39:00 PM
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BRuchin
Posts: 43
Joined: December 9, 2004
From: Atlanta, Georgia
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Wow, this is getting heated.
As a student about to graduate and interviewing for jobs and salaries and positions, I look at a lot of things.
My opinion of salaries is that yes we should get paid more. Why do so many PTs write off so much each year.....because Ins. companies only pay so much and we refuse to get more from the patient.
People in this country spend millions each year on plastic surgery, they have TV shows about it, but those same patients bitch about paying a 20% copay, or meeting their deductible.
Why don't PTs as a whole charge more, and make the patients responsible. charge them. let them call congress and urge congress to pay more, why do we have to do it.
We will never make what physicans make, but chiros make more than us. why, they make people pay.
yes, we have to work for what we want, there is no 9-5. my job, I will be 7-7, sometimes no lunch break. big deal. I will make a good salary. yes I want more.
I agree with Rick, work for what you want. bring in more money and get more money. direct access will be great, no excuse not to pay. if they do not, take them to court if needed. physicans do.
I want to make 100k, will it happen, it is up to me. I agree with those previous posts of saying join APTA, and state organizations, get involved. the more money we have going for it, the better. why do you think the AMA is so strong. we have to beat them for DA.
this is just an opinion. salaries are up, bonuses are up, reimbursement goes it. we ALL have to work for it. those who want to progress their career and those who do not.
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Re: PT salaries - March 18, 2005 5:09:00 PM
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Jon Newman
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From: Amherst, WI
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Jason,
It isn't just the physiatrist lobby that cares if we get direct access or not, it is the policy of the AMA to oppose direct access.
Let's see if this link works, but I doubt it.
[URL=http://www.ama-assn.org/apps/pf_new/pf_online?f_n=resultLink&doc=policyfiles/HnE/H-35.982.HTM&s_t=physical+therapy&catg=AMA/HnE&catg=AMA/BnGnC&catg=AMA/DIR&&nth=1&&st_p=0&nth=1&]AMA policy on PT direct access[/URL]
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: PT salaries - March 18, 2005 7:21:00 PM
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tc
Posts: 137
Joined: January 7, 2004
From: Los Angeles area
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The american board of orthotists (not sure of the exact title) is also opposing direct access, because they believe we will then be able to prescribe orthotics and then also provide them, cutting them out of the picture.
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Re: PT salaries - March 19, 2005 7:05:00 AM
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coloradojulie
Posts: 413
Joined: November 10, 2002
From: colorado usa
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There was a study recently either in JOSPT or Physical Therapy, that looked at the difference between orthopedic docs, family docs and PTs in ordering tests (MRI and Xrays), I believe. It compared the diagnositic abilities of all of the groups. They found that the PT and ortho docs had little difference in their appropriateness whereas the non orthopedic docs were significantly less apt to appropriately order/diagnos. Interesting when most often our gate keepers and referral sources seem to possess less orthopedic knowledge than we do.
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PRC
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Re: PT salaries - March 19, 2005 12:31:00 PM
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ptdan23
Posts: 224
Joined: November 6, 2003
From: Orlando, FL
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coloradojulie...do you know what issue that was?
Dan, PT.
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Re: PT salaries - March 19, 2005 2:26:00 PM
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FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
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the opportunity to make 6 figures it totally out there as a PT, if the salary is what you desire though you may be in the wrong field, but if you need to hear it from someone making over 100K as a PT, well the consider this your testimonial...
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Re: PT salaries - March 19, 2005 2:38:00 PM
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jma
Posts: 2322
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From: NY
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The study was, "Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapist, Orthopaedic Surgeons, and Nonorthopaedic Providers, JOSPT, February 2005; Volume 35(2), pgs 67-71."
Interesing article.
JMA
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Re: PT salaries - March 19, 2005 5:56:00 PM
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Dr.Wagner
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From: Indianapolis
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That simply begs the question...who decided "appropriateness??" Sounds rather like an "opinion".
This is REALLY a comparison of "standards of care" which cannot be compared group to group and actually possess any meaning other than "group A standards for ordering radiography was similar to group B"
There is NO UNIVERSAL STANDARD.
Example...one can use Nexxus criteria till the cows come home, but if you are sued...you are not judged by your peers, but rather by lay people who are influenced by lawyers. I order NUMEROUS films that technically I KNOW will be negative, but I do so as a defensive mechanism. This would NOT follow under the Orthopod's standard of care, but QA would say it is prudent.
Also, ordering a CT of the Cspine in trauma is NOT the standard of care in radiology...but with Trauma Surgeons (community to community) it IS the standard of care...so who is right?
So how do you VALIDATE this study...well, it depends on who you ask.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: PT salaries - March 20, 2005 7:51:00 AM
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BRuchin
Posts: 43
Joined: December 9, 2004
From: Atlanta, Georgia
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To comment on the JOSPT article mentioned before, there was another article about the effectiveness of a PT, OCS; PT; and something else. also a good article.
this also rises the question. what is a clinical certification worth???
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Re: PT salaries - March 20, 2005 8:24:00 AM
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SJBird55
Posts: 2312
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From: Michigan
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Well, obviously about $1,500! :D Paid out of pocket with generally no monetary return.
Mentally we assume clinical certification logically means being a topnotch therapist - and we all know what happens when we assume. Resnik did an article on effective therapists and she an Jensen did a follow up qualitative article on the characteristics of an effective therapist. It was quite interesting to read how an effective therapist differed from an "average" therapist.
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Re: PT salaries - March 20, 2005 8:43:00 AM
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SJBird55
Posts: 2312
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From: Michigan
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Wags... the family docs do the same thing. I know and they know that half the time the crap they order isn't because they truly feel it is necessary, but patients can be demanding and the way our legal system is creates the atmosphere that physicians need to have documentation in place to defend themselves.
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Re: PT salaries - March 20, 2005 10:44:00 PM
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Randy Dixon
Posts: 744
Joined: August 6, 2004
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Jason,
I'm a fellow Libertarian. Or is that Libertine? I always get confused.
My question was regarding the statement: I think when the 3rd party payment system collapses and people are back to being in charge of where to spend their money based on evidence of outcomes and market forces, then enough will be enough.
I think PTs are positioned to do EXTREMELY well in that type of environment.
I can't wait, but I'm not holding my breath, either.-Jason
Isn't the reason you aren't in that type of environment really one of choice? There are PT's on this forum who practice on a patient pay system.
There is a lot of talk about Direct Access giving PT's autonomy and the golden life, but the fact is if you work for someone else, you work for them, if you make your money from insurance, then you work for the insurance companies. The only way you gain true autonomy is by getting paid by the patient.
As far as insurance companies paying PT's more: there is a lot of concern about proving the effectivity of PT. I don't think that is the major issue to be concerned with. Insurance companies aren't really overly concerned with this, if they were they would be funding all the studies. They are a business, they wish to reduce costs and attract customers. The only way PT becomes a factor to them is when it becomes a deciding factor for their customers. I can write a lot about this, I have written a lot about this, but the bottom line is that PT as a profession needs to be more CUSTOMER-oriented, not just PATIENT-oriented.
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