I have 8 years of experience in outpatient orthopedics, masters, and certified in Mckenzie. This is my first post and I am curious to see how others feel about our profession and I am asking for help. It appears to me that this profession is going no where. In my state we do not have direct access and we are at the mercy of the MD. You cannot just open a private practice and think you will survive. The ortho group in our area opened their own practice and essentially shut down some of the other practices. I have also never felt the warm fuzzy of a "medical team" that I was told about in school. In my world, the doctor is always right and if he wants stupid ultrasound on a chronic back, then you either do it or you fight. I am a fighter. I would like to know what we, as physical therapists can do to save this profession. How do we get real direct access? How do we stop physician owned practices? How can we compete with chiropractors, who we all love to bitch about, but they laugh at us? How do we get better reimbursement? Unless you think $17/ treatment is enough.
I didnt go to school for 7 yrs to max out at 65k. I couldn't possibly recommend this profession to anyone. Could you really say to someone you like, "hey go to school for 7 years, become a "doctor of physical therapy" and make little money and do exactly what the real doctors tell you to do?" Sorry for the rant, but lets do something about this. What kind of legislation is out there.
I have waited for things to get better for the last 5 years, they have only gotten worse. What can we do????????
Joined: January 31, 2005
Are you an APTA member? Are you working with your state section to address some of these things, esp the referral for profit situation with the Orthopods?
There are many things ongoing in all the areas you talk about.
On private practices: if you limit yourself to referral only business and need reimbursement from 3rd party payers, then I'm sure life is difficult for you. Have you thought about a cash practice? On saving our profession -- our standards of practice and research are rising every day. There is ample evidence to suggest the "real doctors" you speak of do a fairly poor job of managing most musculoskeletal problems and that we can do much, much better.
On competing with DCs - do you really want to do this? The subluxation-based practitioners have patients that I don't want (ie they want fairy tale treatments and tons of passive care) and the few science-based ones (we are lucky to have a few post on this board from time to time) have fairly similar troubles to you. Though their scope of practice is generally much more free. Perhaps they do laugh at us, but you might consider not being jealous and as a group, start laughing at them: [URL=http://www.chirobase.org]www.chirobase.org[/URL]
Better reimbursement? Cash practice. LMTs and personal trainers do it all the time. Needless to say, we are much more qualified than them.
"I didn't go to school for 7 yrs to max out at 65k." I think if your primary aim in going to college is to get a certain amount of money, then you have no business in healthcare anyway. Go get your JD or MBA and start a business in another area, the cost-benefit is much better. However, if you got your education because you love the work, then perhaps you are over-valuing the numbers in your salary?
On saving the profession, our best days are ahead of us. We are producing more FAR MORE quality research than any of our traditional competitors (DCs and ATCs) and our stock is on the rise. Change takes time. Perhaps you can start here: http://physicaltherapy.typepad.com/evidence/
While I respect your response, I cannot relate to some of your ideas.
As far as a cash business. I have heard this before. But what I SEE is people bitching about $20-35 copays. How can you expect them to pay for a whole treatement? Massage feels nice and is seen as a luxury service and that is why many will pay cash. Personal trainers are often for people who already have money and just want an exercise coach. Money is usually not an issue. But money is an issue to the common patient. The common patient is like you and I, and they are not interested in paying cash if they can get a good therapist covered by insurance. I know the DC and the MD are not the best at musculoskeletal problems, but the fact is the patient is likely to believe the MD more than you on most occassions. Certainly you can educate many, but I have learned to not openly contradict the MD. As far as the money comment and saying that I should have gone into business, tHis is exactly why I think P.T. is in trouble. Most are martyrs and feel dirty if they try to advance themselves financially. We won't go anywhere if we don't demand a pay that is consistent with the necessary service that we all believe in.
Joined: May 15, 2004
From: Sonora, CA
you are certainly not alone in your frustation. everyone i know is concerned. those who are motivated are working with their chapters of the apta to move us forward. consider getting involved and adding your "rant" to thousands of others, it will be more effective that way.
I think if you take a long view of the profession, from where it was 25 or 30 years ago to where it is today you would have to say it has made a lot of progress. Some of the changes have been for the worse, but most of these are due to changes in the whole healthcare arena.
Again and again I hear PT's asking for more money, saying they should "demand a pay that is consistent with the necessary service" they provide. The problem with this is they are only seeing it from their own viewpoint. You get paid for what others think you are worth, not what you think you are worth. So how do you add apparent value to what you do? If you are just doing your job, you aren't.
Its all about perspective: I entered the profession 2+ years ago. I got my DPT ( paid a bit too much ;) ) but feel that my 70k salary is fair. I didnt enter PT to make millions, but to have a fun job, help folks, and be respected. The physicians I work with ( not for ) give me total contol over what I do with my patients. Of course Ive had some 90 y/o MD demand bedside U/S...but I just said "No"...this is not the norm. Most physicians recongnize that PT's know more about nueromuskuloskeletal problems than they do. I agree with Jason...the best days are ahead. Join the APTA and represent your profession with pride...we have skills that no other profession can really claim to have. As we educate the public/ and other healthcare professionals about our skills...I think it can only get better.
Joined: January 31, 2005
I think Randy makes good points as well.
Clydes- If you aren't happy about money or about your "cultural authority" relative to the MD, then please don't go to med school. My physician friends have similar concerns to yours plus they work longer and are exposed to much greater medicolegal liability than I am. I am glad I chose the route I did. If you are no longer happy, then perhaps Terry's advice from the other thread about an alternate profession is right for you. Best of luck. J
Joined: March 21, 2005
Clydes, you mentioned in another thread about maybe law school. I thought this was kind of funny. I found a law school message board and they were having a similar thread about making money in their profession. Exerpts [QUOTE]I laugh at people who went to lawschool to make a lot of money and end up at a large firm, and are then miserable. There are much easier ways to make money that require a lot less student loans. [/QUOTE] [QUOTE]If I simply wanted to make a lot of money, I sure and hell would not be going to law school. For me, the legal profession is about helping others. [/QUOTE] [QUOTE]I didn't chose to go to law school for the money either. Hell, if I wanted money, I'd be getting my MBA at another area school where starting MBA salaries make starting law salaries look like chump change. I chose law school to work in a field directly related to my interests. [/QUOTE]Clydes - Do you enjoy being a PT?
Joined: May 9, 2004
From: West Palm Beach
PT i snot a profession to make huge bucks, though it can be done. You need to think out of the box, find a nich crowd, and start charging cash. I and some others I know get between 150-300 per session with patients. The money is out there, but it shouldn't be what keeps you in the profession. Being a PT is a fun job, you are challenged, deal with people, it is casual, low stress, etc etc etc, sure you can make 150 as an investment banker year 1-5 but you'd be working 120 hours a week and stressed out of your mind. Take the skills you have learned and put them to a bigger use, start a consultation business for ergonomics, start a program where you do training for young athletes for cash, treat spinal pain for cash, etc etc etc. Money is to be made, but 75K a year for 35 hours a week is not so bad, not many people make that kind of money with such a good career that you can do anywhere. I mean how much do you think a genreal practitioner makes these days? 125 if lucky with lots of liability and lots of malpractice insurance, not many people in this country makes 6 figures and higher, if you'd be happier with law school then go that route, maybe you can combine the two and do some sort of health law, any way you choose be happy and be successful. Make your own path, not too many people are going to pay you 150K a year because you want it, you need to establish your worth, or make your own worth, good luck, Ben
Well, this is the first P.T. forum I joined and I wrote these posts to get a feel for how others felt about the profession. For the guy that asked, YES, I do like being a P.T.. And why do you ask? You think because I am not happy with the pay, that I don't like the job? Or perhaps that maybe I don't care and am not motivated. That couldn't be further from the truth. It is a job and you do have to look at it mathematically at times. Right now, the math isn't good. They want 7 years of school at 20+k a year. The salaries are not good for those numbers. As far as law school, they are having similar salary woes. But they have much greater potential. Many professions have greater potential. I wish we had the earning potential that I fell is justified with 7 years of education. I just wish as a whole, the profession was interested in financial advancement. One day on this forum, and I get the impression that people are happy with their income. I am happy with the job, the flexibility, my coworkers, but not the income. It appears many P.T.s are not interested in financial advancement. They love their job and that is good enough for them. My guess is that things will get better for us. According to my old school, enrollment is way down and maybe PTs will be in demand. We certainly don't get many volunteers anymore. Although, I did read a recent article that schools are not requiring volunteer hours anymore. Why??? They said it was because they were getting too much negative feedback from clinicians regarding the profession. So, I guess the schools want to continue to pump them up and tell them how great it will be. Why wouldn't they? They are in the business of education. Don't hold it against me. I am a foot soldier like yourselves and believe in P.T. But I can't say I am as satisfied with the financial aspect of this job.
Oh, almost forgot. Who can I write? I don't know if the APTA is the answer. Most of the older P.T.s i know, no longer belong. They feel it is too weak and just takes your money and fills your box with advertisements. How can we help to make a change?
Joined: May 15, 2004
From: Sonora, CA
The APTA is the only game in town, they are our professional association. You don't have to love them or agree with everything the do, but let your voice be heard by the people who can make a difference. I get frustrated by the people who say the APTA doesn't represent their agendas---how can it if you don't belong and make your opinions known at Chapter meetings, town halls, etc...Just my two cents. Good luck in your decisions regarding PT as a continued career. Honestly, your not unique in your concerns and there are people trying to work on it.
thanks for the help Jay! I would love to let the APTA know how i felt. But last I checked, they wanted $450/year for me to be a member of the ortho section. That is a lot of cash and when they told me that it doesn't go to lobbying, I was out. Why can't we organize our own letter campaign. If all you do is donate your cash to the APTA and you think you are doing enough to solve this problem, I think you are wrong. I know of many experienced P.T.s who no longer contribute because they don't see enough action. I believe most P.T.s do not belong. Why is that?
Joined: September 2, 2003
P.T. is like any profession, if you want to increase your compensation you can't rely on someone else, you must open your own business. Business is tough (direct access or not), the most succesful clinics utimately will be the ones that do the best job of making their clients better.
I don't agree that Chiropractors laugh at us, they have their problems too.
Finally, I don't agree that we aren't respected by MDs. If they didn't respect us they wouldn't sent their patients our way.
Joined: September 2, 2003
"thanks for the help Jay! I would love to let the APTA know how i felt. But last I checked, they wanted $450/year for me to be a member of the ortho section. That is a lot of cash and when they told me that it doesn't go to lobbying, I was out. Why can't we organize our own letter campaign. If all you do is donate your cash to the APTA and you think you are doing enough to solve this problem, I think you are wrong. I know of many experienced P.T.s who no longer contribute because they don't see enough action. I believe most P.T.s do not belong. Why is that?"
I believe membership should be manditory. Fees should be more like $4500 ($450 is peanuts compared to other professionals). The organization needs to be strong and needs full time salaried professionals.
Joined: March 1, 2004
[QUOTE]For the guy that asked, YES, I do like being a P.T.. And why do you ask? You think because I am not happy with the pay, that I don't like the job? Or perhaps that maybe I don't care and am not motivated. That couldn't be further from the truth. [/QUOTE]Clydes, You started this thread entitled "I am mad as hell and I am not going to take it anymore" with three exclamation points. Now, forums like this are fairly difficult to effectively communicate, but to me your tone appears to be pretty aggressive and pretty angry. People give you strong responses and then you come back with the above quote. This is fairly confusing to me, but again, these forums can be difficult to effectively communicate in.
According to your posts, money appears to be more important to you than anything else this profession has to offer. If that is the case then I am sorry to say that you are not going to be a millionaire doing this. Jason, in my opinion, provides the best advice above. Join the APTA and get involved with your local state chapter. I personally think your excuses for not joining the APTA are weak. I do however believe that you are motivated, like you mention above. How about using that motivation, starting with joining the APTA and participating in your local chapter? Get involved!
I'll add my thought here as I did in the other forum. Take it to the people! The APTA can lobby and get things done, they have gotten things done but which has more impact on an insurance company or a senator: A letter from a PT, or PT organization, saying they want more money; or from a patient saying they need PT and they will do business or vote for the one who helps provide it for them?
The title was of the thread was written as such to get attention, it worked. Folks, please get off your high horse that asking for more money makes you bad. I was just curious to see how others felt. YOu make me out to be a money hungry bastard. At one time I thought maybe having commercials like the drug companies do would be helpful. Yes, i know they have more money than us. But what about a t.v. campaign to motivate MDs or others to refer to their physical therapist. Nurses have commercials. As for the comment that the dues should be $4500, you must be kidding right?? Tell me what I should do, other that donating to the APTA and I will do it.