How many patients do you see in a week? (Full Version)

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tgrim -> How many patients do you see in a week? (February 14, 2006 9:33:00 AM)

As a new grad I am working very hard. I see somewhere in the ballpark of 80 patients per week and up to 15 new evals in a week. I was just wondering how many patients on average you see in a week (visits and new evals).

Thanks,
tgrim




tnt -> Re: How many patients do you see in a week? (February 14, 2006 2:17:00 PM)

tgrim, you are working hard, especially the 15 new evals in a week. To determine wether your working TOO hard, a few other factors must be considered. For example: What type of pt population/diagnoses are you primarily treating, do you have ancillary help (aide, assistant), how many hours in a week are you seeing this number of pts, how long do you have 1-on-1 with each visit and each eval, what is your treaatment style, what type of setting do you work in, and, bottom line, do you feel you are able to provide quality care to each case?

Personally, after 13 yrs working in many different outpt ortho settings, I have determined that I need 30 min of 1-on-1 time with each visit and 45-60 min for each eval, to provide the quality evaluation and treatment services deserved. I feel I can straddle the line between maximum efficiency and maximum effectiveness at about 70-75 pts in a 40 hour week and about 5-7 new evals. This is with no ancillary help, and can be enhanced with the addition of an aide, and further with an assistant.

Please be cautious, especially early in your career, with working in facilities that push volume over quality, and do not allow a new grad to develop the manual skills that will continue to be increasingly important in our profession in the next few decades. Anyone can use US, HP and E-Stim to help pain, but the manual techniques, neuromuscular re-education and individually developed exercise regimens are what improve quality of care and drive our profession forward.




stan1980 -> Re: How many patients do you see in a week? (February 14, 2006 3:08:00 PM)

About 15 per day and 5-10 new evals each week. Of course i practice overseas, but it would be interesting to compare 'work loads' if i may say so




Sean Weatherston -> Re: How many patients do you see in a week? (February 14, 2006 3:21:00 PM)

I'm having visions of a recent thread about use of aides, ATC's, etc. and being double or triple booked while still billing out individual treatment codes instead of group therapy charges.

That being said, 80 patients and 15 evals can be done, but seems like that's more than 40 hours per week....don't let them get you on salary!

I treat around 40-50, but that's with 45-60 min per patient and working about 50 hours a week with patients and several more hours with other stuff that comes with hanging your own shingle.




OAK -> Re: How many patients do you see in a week? (February 14, 2006 3:31:00 PM)

I average 150 patients per week and have seen upward of 250. The numbers are not as important as what your comfort level is. It also depends on what type of injuries your patients primarily have.




SJBird55 -> Re: How many patients do you see in a week? (February 14, 2006 5:34:00 PM)

tgrim, the number that you treat per week isn't the key... how you bill for services is the key. The number of untimed units and timed units billed out in a day is what determines if you are practicing correctly combined with the level of supervision provided the patient. With the right mix - 80 patients a week averages to 16 patients a day which is definitely very doable.




FLAOrthoPT -> Re: How many patients do you see in a week? (February 14, 2006 9:06:00 PM)

In my day I saw about 20 a day, and I am soooooooo glad I now only see one at a time. I truly feel that patients should get one on one PT. But I know this is not always feasible with insurance structures..
Ben




tgrim -> Re: How many patients do you see in a week? (February 15, 2006 11:34:00 AM)

I see 80 patients and up to 15 evals per week with the assistance of an aide approximatly 20 hours per week and an ATC 16 hour per week. I also work 40 hour weeks. In addition to the patients that I see, the PTA at this facility see an additional 80 patients per week.
I am salary at 40 hour per week. I feel that my patients are getting excellent care, however, I too believe that one on one care is the best, however we are just too busy.
Long story short, as a new grad trying to pay off student loans I feel that I am working very very hard and not making the salary to cover my productivity. Any suggestions?
Just to add, I love the fast paced nature of this facility. I see a LOT of high school athletes and 99% orthopaedic patients. About half of them are post-op.

thanks,
tgrim




SJBird55 -> Re: How many patients do you see in a week? (February 15, 2006 11:56:00 AM)

Where you are currently employed may have some staffing issues. Technically, anything an aide does and anything an ATC does is not considered "physical therapy." If you were to practice according to the rules and regulations of Medicare, those services provided by an aide or an ATC are not billable. BCBSM, I believe, just came out with a statement in which they are also following Medicare and do not want ATCs providing services billed as physical therapy. In other words, by the definition of skilled services, if an aide or an ATC provide any part of the service, that part of the service is not viewed as skilled and technically cannot be billed.

So, now besides looking into HOW your services are being billed, you now need to do homework and learn the CPT codes and the definition of the level of supervision required and understand WHO is to be doing the supervision. I'm in Michigan and it is "legal" for aides/ATCs or anyone for that matter to be my supportive staff, but in the eyes of some third party payers it is fraud to actually bill out for their services because of the rules and regulations of those third party payers. Most organizations will tend to follow the policies and procedures of the strictest rules/regulations so that the quality of the service provided is equal all across the board AND to eliminate staff confusion as to who is allowed what (to reduce errors).

Besides that, with Medicare regulations... if you are working in a private practice and the PTA is functioning without a PT present in the suite, the appropriate level of supervision is not occurring. A PTA functioning in a private practice situation requires a higher level of supervision than a PTA functioning in either a hospital situation or a home health situation.




tf8560 -> Re: How many patients do you see in a week? (February 15, 2006 9:24:00 PM)

Hey Ben, Ive been out on my own now for about 5 months (Here in south fla..aventura to ft laud)doing the 1 on 1 home visits among other things. I have found the racing around and juggling schedules to be mentally tiring and often stressful. Psychologically, I have not yet made the mental transition to all cash yet and find the dwindling reimbursements, higher copays which nobody wants to pay mentally difficult. I know the answer lies in changing my mind set but I'll take any suggestions about making it work. In many ways, I miss the office setting. Please feel free (anyone) to chime in.

PS Im a slow typer..and get bored and lonely driving around all day from patient to patient so if anyone wants to call with any advice, my cell is 954-628-2215 it would sure beat ESPN radio.

Tom Fletcher, PT




tnpta2 -> Re: How many patients do you see in a week? (February 16, 2006 12:25:00 PM)

I WONDER HOW OAK CAN KEEP TRACK OF THE 3.75 TO 6.25 PATIENTS A HOUR (40 HOUR WEEK)THEY NOTE ABOVE.
I FEEL LIKE FLAORTHOPT ABOVE ABOUT ONE-ON-ONE.
I HAVE HAD PATIENTS TELL ME THEY WERE HANDED A COPY OF EXERCISES AND TOLD TO DO THEM ON THEIR OWN AS THE THERAPIST TENDED TO SEVERAL OTHER PT'S.
WHERES THE THERAPY AT?
PATIENTS WONDER WHY WE MEASURE ROM/STRENGTH AND
FILL OUT OUTCOMES MEASURES.




FLAOrthoPT -> Re: How many patients do you see in a week? (February 16, 2006 5:21:00 PM)

tom i'll call you this week-
work smarter not harder...
Ben




FLAOrthoPT -> Re: How many patients do you see in a week? (February 16, 2006 5:22:00 PM)

ps. the office comradery thing has no substitute. It is the freedom, flexible schedule, autonomy and good paythat is the pay off. But, ESPN radio rules, mike and mike then THE MAN Collin Cowherd, then DP, and evan cohen how can you beat it?
Ben




OAK -> Re: How many patients do you see in a week? (February 16, 2006 5:53:00 PM)

"I WONDER HOW OAK CAN KEEP TRACK OF THE 3.75 TO 6.25 PATIENTS A HOUR (40 HOUR WEEK)THEY NOTE ABOVE.
I FEEL LIKE FLAORTHOPT ABOVE ABOUT ONE-ON-ONE.
I HAVE HAD PATIENTS TELL ME THEY WERE HANDED A COPY OF EXERCISES AND TOLD TO DO THEM ON THEIR OWN AS THE THERAPIST TENDED TO SEVERAL OTHER PT'S.
WHERES THE THERAPY AT?
PATIENTS WONDER WHY WE MEASURE ROM/STRENGTH AND
FILL OUT OUTCOMES MEASURES."

You seemed to have missed the point of my post. You can't judge a Therapist's caseload simply by the numbers. I realize some conditions require alot of time to treat properly, but how much one on one is required for a tennis elbow?

P.S. WHY ARE YOU YELLING?




tf8560 -> Re: How many patients do you see in a week? (February 16, 2006 6:55:00 PM)

Yeah, I like Mike and Mike, Dan Patricks sister Ann was a friend in my univ of Dayton days. (a very cute cheerleader with a great personality to match)Dan keeps asking those tough questions I like when he tries to stir things a little

Gotta love Sirius satellite radio

Tom F




tnpta2 -> Re: How many patients do you see in a week? (February 16, 2006 8:37:00 PM)

Oak,
You know you would get a response from those numbers. Hopefully you are being honest or just fishing for a response. No "yelling" meant, just an old habit from my law enforcement days for the gov't.
Maybe you can share your billing numbers for the patients seen. It makes for interesting conversation for work and our states ethics meetings.




OAK -> Re: How many patients do you see in a week? (February 16, 2006 10:34:00 PM)

"Oak,
You know you would get a response from those numbers. Hopefully you are being honest or just fishing for a response. No "yelling" meant, just an old habit from my law enforcement days for the gov't.
Maybe you can share your billing numbers for the patients seen. It makes for interesting conversation for work and our states ethics meetings."

I was just joking about the yelling.

The numbers are legitimate. I wasn't looking for a response, I just wanted to make a point that quality of treatment should never be judged based on caseload size, but should be determined more correctly by overall results. (ie. return to work rate, success rate, compliance rate, patient satisfaction etc...)

I live in Canada, so unfortunately I don't have any billing numbers for you.




eam -> Re: How many patients do you see in a week? (February 17, 2006 9:46:00 PM)

Hi Tgrim,
I also work a 40 hr week. I see max 14 patients per day. 1-1 treatments-30 mins. 1 hour evals. We do not have PTA's or aides. If you feel that you are giving your best in care then that is all that matters. Every PT manages their time differently and you have to be in a facility that works right for you.
Erica




FLAOrthoPT -> Re: How many patients do you see in a week? (February 18, 2006 3:04:00 PM)

ok, let me be the devil advocate jerk:
Legally, if you see medicare patients you pretty much have to see them one on one only. Thus, if you see medicare patients and any other insurance, you need to treat them the same, so you should be treating everyone one on one and using group billing codes when you have non one on one situations. So, legally, this is moot unless you have non medicare and even then it isn't really legal. So, while we all know we can see more and give the correct attention, it is not legal. But, all being said, I feel 45 minutes apart for hour treatments are pretty good compromise.
Ben




katieptatc -> Re: How many patients do you see in a week? (February 18, 2006 4:53:00 PM)

I feel lucky compared to most of you who are seeming to be working hard with seeing in excess of 60 patient's a week. I used to do it too. Now I am fortunate enough to treat 10-12 patients a day (8 hours a day), deliver quality care, maximize bill appropriately, and still make a decent profit margin, if I mangage my cases well - IE) payer mix. Just remember it's about quality of care - and are your patients on the receiving end of it? Katie




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