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Re: Will PT salaries increase?
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Re: Will PT salaries increase? - August 23, 2006 6:42:00 AM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
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Jeep,
Answer me one thing are you a PT and if so how long have you been practising as one?
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Re: Will PT salaries increase? - August 23, 2006 7:28:00 AM
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proud
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Sabastian,
I thought your arguments were probably right on. But, if I may. It seems you are of the mind to let the public choose who they see? Those that provide the best care( be it PT's, Chiro's or whomever), will have the patients knocking at their door. Is this your thoughts?
My only concern with that is the public has historically been very susceptible to charismatic salesmen. I think a quick look at the explosion of expensive orthotics is a good example. Alot of cash spent on something with very little truth or support( check out a review of the literature by alice Aiken I think).
Also( here we go), chiropractors have been very good at selling their particular product to treat LBP. Yet here we are, an ever growing epidemic of LBP, and the literature continues to grow indicating that this highly specific skill of manipulation, is not really all that specific.
I have a buddy that owns a private practice and he says exactly what you say, in the end the public will choose where they go. I am just not convinced that is a very good patient-focused, cost effective way to go in the long run. And history is on my side with that one.
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Re: Will PT salaries increase? - August 23, 2006 11:30:00 AM
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Lehmkuhler
Posts: 69
Joined: December 14, 2005
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[QUOTE]
After reading through some of these threads in these forums regarding salaries it seems like some have negative attitudes toward PTs incomes but from what I have seen searching through job postings in newspapers/internet/PT school bulletin boards it seems like the private sector salaries are pretty good. [/QUOTE]That's the difference between 'best case scenario' and reality. If realistic numbers were published, it wouldn't be nearly as attractive...
And I'd be very cautious about "demanding" anything, rather focus on "earning" respect/$/etc.
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Re: Will PT salaries increase? - August 23, 2006 7:37:00 PM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
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Jeep,
From your profile I can see you are a DC in which case I think even as a Student I have a better understanding of the PT profession. IMO--I think it would serve YOU the best to try to leave your advice for the DC students. Since this is a PT forum I was gearing my comments and questions toward the PTs not you.
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Re: Will PT salaries increase? - August 24, 2006 2:02:00 AM
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Sebastian Asselbergs
Posts: 1117
Joined: September 29, 1999
From: Barrie, Canada
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well, Proud, I think we might disagree on this one. I can say with some certainty that most of my patients get referred by a) other patients who have friends/family who are of the same mind (involved in their own health), and b) doctors who don't like the assembly line clinics, and c) the yellow pages where my ad says "towards independent health".
You see, I am in a direct access province and don't need referrals to eval and treat, so there is much more choice for the patient.
And yes, chiros have always been good at marketing, while we just sucked at it. PT needs to improve there - but I didn't wait for my association to do it for me. Simple, clear ads, lots of (free) community presentations (schools), (free) help with small sports events and lots of communication with anyone who could be a referral source - because, although patients don't need them - I LIKE getting more of them...
Patients ARE getting more savvy - questioning their doc regarding NSAIDS, antibiotics, need for surgery, diagnoses of "age" "DDD" etc etc. It is a slow process, but in the 20 years I have been in this city, I have seen a significant change in numbers of patients with the "fix-me" attitude, to the "what can I do" attitude.
My experiences are tainted by a self-selecting process of course: over so many years, my reputation tends to attract those who are interested in learning what THEY can do for themselves. And this is also stimulated by some patients' limited PT coverage. In other words, they are looking for the most economical outcome situation.
Anyway, thanks for the interesting thread!
_____________________________
Mundi vult decipi
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Re: Will PT salaries increase? - August 24, 2006 2:31:00 AM
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Jon Newman
Posts: 1697
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From: Amherst, WI
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Hi Proud,
[QUOTE]I have a buddy that owns a private practice and he says exactly what you say, in the end the public will choose where they go. I am just not convinced that is a very good patient-focused, cost effective way to go in the long run. [/QUOTE]I'm confused by what you mean by "patient focused" when you think a patient's ability to choose where they go should be limited. And I guess you didn't actually state that but it seems that's what you're suggesting. Can you clarify that?
Thanks.
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Will PT salaries increase? - August 24, 2006 12:56:00 PM
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Lehmkuhler
Posts: 69
Joined: December 14, 2005
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ON...
I'm sure that as a student you pretty much know more than everybody here about everything... We once knew it all too.
Best of luck with that chip on your shoulder...
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Re: Will PT salaries increase? - August 24, 2006 1:43:00 PM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
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Lehk,
I dont know everything there is to know about PT and I wouldnt pretend to. Most PTs on this forum I am sure know much more.
But it just doenst seem to make sense to ask DCs advice about the PT profession just like it wouldnt make much sense for a DC student to ask advice from a PT over a DC. Nothing personal but if I wanted DCs advice I would go to a DC forum like chiroweb.
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Re: Will PT salaries increase? - August 24, 2006 2:24:00 PM
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proud
Posts: 879
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Jon,
Sure. I think my orthotics example sums it up for me. Health is a complex topic which requires a great deal of knowledge. This explosion of custom orthotic usage is an example of poor healthcare spending and how letting the generally uninformed public choose( sounds bad, but generally true).
Sounds like sebastain has carved out a great little niche, but I don't think that is the norm. Sounds to me sebastian, that you practice in a relatively educated community? That is great, and works in that environment.
Patient focused depends I guess on your perception. I think patient focused is ensuring that patients are provided with appropriate care in line with what the literature is saying.
patient focused: let me pose this question. If you had a bladder infection and went to your MD and he/she told you that you could have it resolved with proven medical treatments, or something a little off the wall but a few MD say it works...what would you choose? Obviously this is a simpified example of why sound medical direction and advice is important. LBP or MSK issues are much more complicated but we are really getting much better at understanding it. I just think PT's, backed by our leaders in research, can evolve to the point where we can claim to be that clinically sound with our advice.
If the public knew that those 400$ orthotics are mostly placebo and statistically, in the long run...what do you know...you still have LBP and PFS etc...they may not be too happy. But then again, most do not pay out of pocket now do they???? And there is the rub.
I think that any third party payer has the right and should have the authority to limit unsubstantiated claims( maintenance chiro in many cases, custom orthotics in many cases, CST in all cases etc). If the public would like to choose to spend their own money on this, then they should have the right to waste their own money...just don't waste my hard earned tax dollars to pay for it...
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Re: Will PT salaries increase? - August 24, 2006 2:43:00 PM
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ONstudentPT555
Posts: 224
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Proud,
I would have to totally agree with you. Even as a student that makes total sense to me.
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Re: Will PT salaries increase? - August 24, 2006 3:10:00 PM
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Jon Newman
Posts: 1697
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From: Amherst, WI
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Hi Proud,
Thanks for the clarification. Insurance companies do an outstanding job of denying payment for things that ought not get paid for. In fact they do it for a few things that should bet paid for too from what I've heard. But all that is moot since Sebastian's model is a private pay model and the insurance has no say in it.
You are correct that the public gets confused by what's on offer and that PTs are in a good position to offer what makes sense. But when you ask a question like "It seems you are of the mind to let the public choose who they see?", I come down on the "YES" side of that question.
An interesting podcast I found recently addresses this topic a bit.
Here's the link. [URL=http://www.npr.org/templates/story/story.php?storyId=5671238]My Cancer--No one's business but my own[/URL]
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Will PT salaries increase? - August 24, 2006 3:36:00 PM
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proud
Posts: 879
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well, I suppose two opposite lines of thought on this.
I think traditional medicine has a pretty good track record. Look at the life expectancy with each passing decade. I think back in the 1920's it was around 55? Traditional medicine is not perfect, but it is the best soultion, millions of uninsured is not( which would happen as healthcare costs skyrocket with an aging population seeking "alternative" treatments that often, our tax dollars foolishly fund)
I am of the opinion that PT is NOT "alternative" medicine. It should never be associated with it. I think we are, and should continue to strive for the traditional/evidence based model.
And ONstudentpt555, to answer your original question, I think you would see a change in pay scale the further we move away from unsubstantiated alternative treatments.
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Re: Will PT salaries increase? - August 24, 2006 3:51:00 PM
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Jon Newman
Posts: 1697
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From: Amherst, WI
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Although the topic of alt. med. and traditional medicine was mentioned in my link, I don't think it was the point of podcast--at least that's not what I got from it. And again, Sebastian's model is a private pay model and thus those seeking his care are not a burden on an insurer. And just because they are private pay doesn't mean they are seeking alt. med. Sebastian provides traditional healthcare from what I can tell.
I'm not sure why you feel you need to contend that PT is not alternative. Who's suggesting it is or should be?
I'm just saying that patients should be able to see whoever they want (notice I didn't say "and have someone else pay for it") and those in private practice serving private payers get to decide what treatment they want to deliver.
I actually don't think we're on opposite lines of thought but maybe we are. I still don't know.
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Will PT salaries increase? - August 24, 2006 4:32:00 PM
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proud
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Jon,
A little clarification on the Canadian system. All provinces have direct access. In Canada, most Physiotherapy private practice clients have insurance( blue cross, sun life etc). The policies generally cap the amount per year for Physiotherapy service. Therefore most private practice clients DO NOT pay out of pocket.
In any case , your notion that in Canada private practice means private pay... Not true. Most employers carry a healhcare plan but at a cost. And if you do not have an employer healhcare plan, the cost is pretty high to purchase your own individual plan( not high compared to the US of course).
Which means insurance companies must up their cost per member if they attend 20-40 "maintenance chiro" per year...EVERY YEAR!
In turn, my cost too remain insured grows and grows.
Also, is CST, visceral manipulation etc alternative? I say yes, by definition they are. No construct validity, no reliability and no research to suggest anything other than placebo...that is alternative. And the tone of many posts here seem to defend these approaches...and they are PT's.
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Re: Will PT salaries increase? - August 24, 2006 4:37:00 PM
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ONstudentPT555
Posts: 224
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Proud,
I think so too. I think it would be benificial for the progression of PT to steer clear from the stigma "alternative" medicine is sometimes associated with. It would give the profession more respect and credibility.
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Re: Will PT salaries increase? - August 24, 2006 4:47:00 PM
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Jon Newman
Posts: 1697
Joined: April 24, 2004
From: Amherst, WI
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Hi Proud,
My notion isn't that private practice=private pay. It just seemed that Sebastian's original posts suggested that going the private pay route might be a good idea for those concerned about salary. Perhaps I misunderstood that post.
I'm sure he'll clarify when he reads these posts.
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Will PT salaries increase? - August 24, 2006 5:04:00 PM
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proud
Posts: 879
Joined: March 22, 2006
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Jon,
I see. I guess my confusion is around what Sebastian is saying. In Canada, private practice patients usually( I'm going to say over 90%) have insurance that pays. We have universal healthcare also which provides PT in the hospitals.
Sebastian says he owns a private practice in Ontario, which to me, suggests that most of his clients are insured.
I think sebastian's original post was a theoretical answer to how you increase your salary. Charge what you wish and if you are good enough, they will come. Maybe, but I doubt it. Most people do not pay large sums out of pocket unless death is at their door.
And insurance actually keeps people healthy by promoting that people seek medical advice. In one province in canada, a few years ago they attempted to charge a co-pay( 15 bucks I think) for emergency room visits. The result was people actually stayed away resulting in more costly progression of illness!
Ulimately, I think that we cannot go to a complete "pay your own way" system. Insurance coverage is needed and should cover what is appropriate. Most credable PT's provide "appropriate" care so that should be included in any insurance policy.
But, if someone wants 400$ orthotics, then they can go right ahead and pay out of pocket. A few recognized foot abnormalities may be covered, but for the most part, an off the shelf, 30$ semi-ridgid should be fine.I betcha most do not go grab those 400$ rip offs that have been cleverly marketed, if they had to pay out of pocket...
In canada, many insurance plans cover massage therapy. That makes no sense now does it? It has no therapuetic benifit as a singular treatment. So why am I paying for someone to go...get rubbed?
I guess what i am saying is that I am all for third party payers getting down to it. What has research and what does not. I think if you are a PT who practices with a firm knowledge of the research, you will have few problems( a few road bumps I am sure), but PT will prevail as the provider of choice if we follow this model.
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Re: Will PT salaries increase? - August 24, 2006 5:47:00 PM
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savela
Posts: 63
Joined: October 7, 2004
From: toronto
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ONstudent,
I think it may be a good idea for you to review our College guidelines. I do not deal with insurance companies, some of my patients have plans, some do not and pay out of their own pocket. Our College sets a fee guide, and we are required to follow it.
If you set your fee too high, the public may make a compliant. We also have a detailed random assessment process that makes sure we are working within the College guidelines.
If you feel the guideline fee's are too low, when you graduate, join the CPA and get involved to change things or run for a placement on the College board of directors.
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Re: Will PT salaries increase? - August 24, 2006 5:58:00 PM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
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Savela,
Is this correct?:
"The Ontario Physiotherapy Association (OPA) recommends that private clinics charge $37.50 for 15 minutes of treatment,..."
http://individual.utoronto.ca/amandahu/page10.doc
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Re: Will PT salaries increase? - August 24, 2006 6:54:00 PM
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savela
Posts: 63
Joined: October 7, 2004
From: toronto
Status: offline
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ON,
I am sorry, my reference binder is at my office but I think it is about $130/hrs. I was assessed last year and was told I was on the high end of the scale. Your school will give you a binder of codes.
When I was a student I thought all I had to learn was the typical "ethics" questions for my PNE. I soon found out that the Ontario College has a 4 hour random eval and an online jurisprudence exam.
Ontario has high standards, I feel PT's are regulated stictly compared to Chiro's. Some may think this is a good thing.......... I think it hold's us back.
My point is that, we as a profession must work together to make a change. An example.....Chiro's can charge more for ART. I have taken the course yet I can not increase my fee's.
If you wish to work in Ontario, and do not feel PT's are compensated enough, email, vote and have your say.
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