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Re: Will PT salaries increase?
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Re: Will PT salaries increase? - August 29, 2006 2:33:00 PM
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proud
Posts: 871
Joined: March 22, 2006
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ONstudentpt555,
could not resist. Add understand and apply evidence based practice...please. I have no doubt you will.
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Re: Will PT salaries increase? - August 30, 2006 6:03:00 PM
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physioo
Posts: 184
Joined: June 26, 2006
From: Canada
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hi all,
Can any of you guys give me some info on wages in the states as compared to Canada? specifically Michigan state if anyone knows
Im a canadian PT and am tempted to move to states, as cont education in Canada SUX! Takes long, they want money, and not offered on a contnous basis.
Thoughts? i like the dsc being offered in states, looks cool.
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Re: Will PT salaries increase? - August 31, 2006 4:16:00 AM
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srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
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physioo,
You can check salary.com for averages, although the numbers are a little inflated in my opinion. (Median is $69,000 for Detroit metro). Usually the base salary depends on how many years of experience you have, and whether you are a staff therapist, senior therapist, or director.
Which DSc are you looking into?
Sarah
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Re: Will PT salaries increase? - September 1, 2006 9:07:00 PM
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physioo
Posts: 184
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From: Canada
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andrews university
thoughts?
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Re: Will PT salaries increase? - September 2, 2006 10:13:00 AM
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jbird007
Posts: 297
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From: USA
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Will PT's salaries increase?
It depends on the insurance companies. It seems year after year insurance companies pay out less to providers and put on more restrictions so that they cover less. More and more Americans are without any type of insurance. Add in the factor of many PT's who want more freedoms and this could possibly lower a PT's overall collections. I encourage all health pros to start(if they aready haven't) thinking about setting yourself up for cash practices and looking deeper into ethical business and marketing skills. I have noticed quite a few MD's and many hospitals giving HUGE discounts for cash paying patients.
Jbird
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Re: Will PT salaries increase? - September 2, 2006 3:12:00 PM
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proud
Posts: 871
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Jbird007,
They pay less out to providers because they pay for too many useless treatments. Eventually, having millions of uninsured and demanding cash for treatment will just not work. What a horrible and biased system. Forcing people to choose between paying 75$ for groceries or to rehab a back problem is no solution. Talk about adding to the epidemic. Having insurance encourages people to be PROACTIVE in their health. ..which in turn, lowers overall healthcare costs.
Unfortunately, up until now, people have been going to the wrong "clinicians" for MSK problems. Being sold on weekly chiro visits, IFC, US, CST, rub A5/35. You name it. The era of EBM will be the required tonic for all the charlatans. MSK issues are treatable and, if done correctly, is a cost efective means of management.
No...people need coverage. Insurance companies will look to cover only what services adhere to the EBM model. i.e...university affiliation/and treatments that can be supported in the literature. Not a perfect solution because EBM has it's flaws as we all know, but it is the best alternative.
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Re: Will PT salaries increase? - September 2, 2006 5:39:00 PM
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Jon Newman
Posts: 1691
Joined: April 24, 2004
From: Amherst, WI
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Hi Proud,
When you mention "useless treatments", in what manner are they useless? I think you're onto something but I'm hoping you'll put a finer point on it.
Also, if I'm not mistaken, most seekers of alt. med. tend to use it 'in addition to' rather than 'instead of' traditional medicine (read EBM).
Thoughts?
_____________________________
[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? - September 2, 2006 7:00:00 PM
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srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
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physioo,
It looks interesting....orthopedic courses are based on NAIOMT system. You could also look into Oakland University (my alma mater) which offers Kaltenborn/Evjenth system and emphasizes evidence-based practice and research. OU also requires fewer credits (39 vs. 64 minimum at Andrews)..not sure why. [URL=http://www.oakland.edu.]www.oakland.edu.[/URL]
Sarah
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Re: Will PT salaries increase? - September 3, 2006 1:02:00 AM
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Randy Dixon
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Proud,
What I see is not so much a turn towards EBM by the insurance companies but a turn towards trying to satisfy their customers while keeping costs down. This means that many treatments that can't be justified are turned down, as you suggest, but there is also an increase in the number of "alternative" care that is reimbursable. If customer demand is high enough, insurances will provide it. They are businesses, not healthcare gatekeepers.
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Re: Will PT salaries increase? - September 3, 2006 7:44:00 AM
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proud
Posts: 871
Joined: March 22, 2006
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Randy,
From a business perspective, I think your line of thinking is wrong( sorry). If I am providing a service based on what the customer wants, that is fine. However, if I come to find out that my customers keep coming back with more and more claims, costing me huge amounts to keep everyone "happy"...that business plan will fail...like it is now for insurance companies.
Think of it this way: You own a auto repair center. People bring their cars into you and all demand that the "thumping sound" is the brake pads and demand to have those fixed. You say " oh yes sir, I will replace them right away"...customer happy. They leave and no thump...6 weeks later...the thump returns...and so on and so on. Low and behold, the car had faulty roters resulting in excessive wear and tear on the brakes...Not a very good way to run a business.
And as mechanics are experts( we hope) at diagnostics and repairing what is required, insurance companies will look to locate who is the expert in conservative MSK management? They will sort all this out through the literature.
Jon,
I see "useless"=unfounded. Maintenance manipulation for example is unfounded. "special" manipulation techniques are becoming unfounded. CST...is unfounded, even if used in conjunction with other treatments. It just feeds into "illness behavior" patterns and should be eliminated.
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Re: Will PT salaries increase? - September 3, 2006 7:48:00 AM
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proud
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I might add that some people fear that this will result in further restriction on what we can bill and make it even harder to make a living. And you are correct. No arguments here.
But if you have 10-20 years left in this career, the long term outcome should be just fine. PT will emerg as the "experts" and all those patients who were seeing the carlatans will be going to WHO instead? That is correct, the EBP practitioner, which equals more business.
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Re: Will PT salaries increase? - September 3, 2006 12:07:00 PM
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Jon Newman
Posts: 1691
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From: Amherst, WI
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Hi Proud,
Because of its theory CST is unfounded. This won't change no matter what else is used in conjunction with it. To my mind this is less interesting than why people seek out this sort of treatment in addition to the treatment that is purportedly well founded.
On a side note, I'm hoping PTs can start comparing themselves to something other than a mechanic. People, unlike cars, can do quite a bit to help themselves. I think when we see ourselves as mechanics, we fail most of what it is we do for a living.
_____________________________
[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? - September 3, 2006 1:54:00 PM
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proud
Posts: 871
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Jon,
Did I compare PT to a mechanic? No, compared the business of insurance to running an auto shop. How on earth did you read that as PT equal to mechanic?
Anyhow, I agree that it is interesting that people seek out these types of treatments. I have a theory: it is generally human nature to look for someone to fix our problems. This is why medication is over-prescribed and chiro has been successful. Neither of them work, yet people are happy to have the impression that something worked so long as they do not have to work too hard. Problem is that this system has historically failed and resulted in an epidemic of MSK problems.
I figure if the public is informed that EBP PT's are the experts, and all other charlatans are removed, the outcomes will improve. It prevents the public from being confused by pseudo-clinicians telling people that they have visceral intaglements that we can somehow magically mobilize through layers of tissue...right. Or that they have a "out of place" segement that needs to be adjusted regularly...again...right.
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Re: Will PT salaries increase? - September 3, 2006 3:22:00 PM
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Jon Newman
Posts: 1691
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From: Amherst, WI
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Hi Proud,
I suppose I saw insurance not wanting to pay the mechanic to keep fixing a car the same as insurance not wanting to pay PT to keep fixing a person. Mechanic and PT occupied the same positions in the analogy. You know, 'mechanic is to car' AS '(fill in the blank) is to people'. Perhaps it is an implicit relationship rather than an explicit one.
Sorry for the misread. Can you tell I'm a bit hypersensitive about this analogy--one that does get used with some frequency. I'll stick with my plea that PTs stop using the mechanic analogy as apt for our profession even if it is on a side note and not specific to your example.
_____________________________
[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? - September 3, 2006 4:12:00 PM
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proud
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I agree. I never liked the PT/mechanic analogy. I meant to use it in a purely business context. The human body is not a machine of course.
But I do think we are getting better at diagnosing pain behaviors/patterns. And I do think the public is owed a treatment that can be supported.
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Re: Will PT salaries increase? - September 3, 2006 5:41:00 PM
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Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
Status: offline
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Once again Proud you loose your credibility to me when you call me and "many" other PT's charlatans that practice methods that by your own personal definitions don't meet your criteria and place it under a total umbrella of evidenced based that you never define what that is for you. Research counters itself many times across many disciplines, therefore, depending on what study you choose to believe holds more validity, one will practice accordingly. But just as this study promotes one way, another total disputes it, and on and on the research tide changes. If you want to educate me and convince me differently about how I practice, attacking me and other colleaque won't give you a forum with us.
Jon, people seek out CST and other varied treatment because it works and they don't continue to have to seek care for their problem. My average visits is 7 for a condition. Many of them have been treated numerous times by EBP model therapists for years, and still aren't better. Not all of them can be lumped into a category of non-compliance either.
People seek out care that works period; people don't have the time or money for anything else. Many are already paying for their own healthcare, high deductible, co-insurances, and complete lack of insurance.
The United States ranks 17th in healthcare in the world despite our so called "high level of evidenced based methodology."
One of the biggest areas that I don't even see mentioned anywhere in this forum is nutrition. Our treatment wouldn't even be needed if proper nutrition would be followed by many people, but alas, research has screwed that up to...let's see today coffee is okay, tommorrow it is not, maybe the next day it kinda will be okay.
As a profession we are intelligent and expierenced and we use our hands and our brains and sometimes we are ahead with a treatment that we have yet to accurately be able to fully measure or the theory of it becomes more known later but it ends of being a different means then what we thought origianlly...that's the history of research and medicine.
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Re: Will PT salaries increase? - September 4, 2006 4:59:00 AM
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SJBird55
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From: Michigan
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Karie, an average number of visits of 7 with a standard deviation of what? How did the outcomes of pain and function change? And specifically, what patient population do you have the outcomes you state? How long did the results last? The argument that "it works" is not a strong enough argument in evidence based practice. I have seen more literature against craniosacral therapy than I have supporting the approach.
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Re: Will PT salaries increase? - September 4, 2006 6:44:00 AM
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Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
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SJBird
I am preparing a group of items for the CST thread to answer that aspect more specifically than this thread. Results last is the point...after years of various conditions, the people I see finally get relief and it is long lasting. I get numerous follow-up calls and word of mouth referrals from these people because their condition has remained improved significantly or was eliminated. Prior to seeing me, others of my profession and other professions had given up on them. What are those conditions, think of all the multi-level problem people you see that generally you can't improve much and that's my population, babies to geriatrics. Why do I keep doing these varied additional treatment approaches? Because of the gratitude I see in the eyes of these people who are getting their life back. If what I am doing is being a charlatan, helping people regain control of their lives and moving forward, then I guess that is what I am in Proud's eyes and maybe yours. But, I will not stop treating people with techniques that profoundly have changed the outcomes for my patients during my 25 years. I respect how you decide your treatment approach and we can respectfully disagree on what we decide as our rationale for treating a particular way, but to call someone a charlatan is below the belt and totally non-professional. I will not respond further to that type of dialouge, it doesn't dignify a futher response if one is a professional. (I am not referencing you SJBird, but rather Proud when I make that last comment.) Please see my response under CST for my final remarks. I am not going to continue with this forum because it is purely political and I have found through some good people on this site a better one where I can actually learn more about different rationales and maybe gain a different perspective of why what I do works. There people are willing to dialouge in a "learning" mode rather than I am a "evidence base practioner" and I can tell you whether or not your ethical which is all I see here.
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Re: Will PT salaries increase? - September 4, 2006 6:59:00 AM
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proud
Posts: 871
Joined: March 22, 2006
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Karie,
You think "I" lose credability? Just because I call a spade a spade does not result in lose of credability. I only apologize when I directly point an individual out. I make no apologies for what I percieve as accounatble clinical behavior.
Besides karie, I am not the one who needs to "define" anything. EBM is defined. I am sure you can research the topic and discover that CST, visceral intaglements do not meet the criteria.
Here is a thought: Perhaps these techniques are on to something...that is great, I say go ahead and do them. But bill the patient under that heading, and not PT until your claims can endure the rigors of research. If what you say is true, then you should have no worries about the research process now should you?
No one is telling you to discontinue CST etc. Just bill the patient for that technique. But I suppose insurance would not pay for it. I wonder why?
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Re: Will PT salaries increase? - September 4, 2006 9:26:00 AM
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Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
Status: offline
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Proud,
You can not call a spade a spade unless you have learned all there is to know about it and have looked at it from every angle. I will take a big leap and guess you have never attented one course on Lymphatic Drainage, Visceral Manipulation, Myofasical release, or Craniosacral Therapy. I also further will guess that you have never delved into the numerous literature sitations of research that are sited in the back of the textbooks. Until then, you cannot tell me that you come from a place an "expert" place of anything to call what I do and thousands of PT's in this country and around the world as unethical and unsubstantiated. I am open minded to new concepts that may explain better what it is that I am doing and from those individuals I happily dialouge.
As far as insurance goes Proud, many do and it's growing because it works. As mentioned in another thread, Blue Cross Blue Shield of Michigan the second largest insurer next to Medicare in this country has it listed as a treatment regime right under their PT manual therapy code 97140. I have combination of payers, insurance and private pay. I have letters from insurance companies giving me authorization to use the techniques. So insurance is not the issue here. As I said earlier, I am pulling together information to put on the CST thread before I leave this forum and what you all do with it is yours to decide. Rearch comes down to what you decide is a credible journal, solid research methodology, and your own personal bias. I believe over the years having seen research prove one thing and then disprove in the next, that it's not an exact science and that we don't always have the tools in place for measuring yet. Before the electron micrscope existed there were many things we couldn't understand that it has allowed us to investigate. Because we didn't have it before does it mean what it tells us didn't exist? Proper nutrition is a big research topic that I have been investigating for 5 years...lots of conflicting research, but one thing holds true is that many of the conditions we treat would be best resolved with proper nutrition...where does that leave many of our skills, evidence based in your eyes or not...many things to ponder.
To thine own self be true....good luck to you and your future!
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