I work in a physical therapy facility with two therapists and two orthopedists and have a lot of respect for the physical therapy profession even though I intend on going to medical school. The two therapists have only been here for a short period of time, and we are also a relatively new practice trying to build a business and expand our patient volume. The problem is, the owner of the company is so intent on getting new patients that he will schedule so many patients onto the schedule, including an evaluation even when the therapists are treating four patients at a time. I'm a secretary and he will often tell me to try to schedule 20 patients on the schedule in a given day, and have the therapist treating four sometimes even 7 in one hour with only one aide! Is this even ethical? I can only imagine how the patient level of care can go down as a result and patient outcomes won't end up being favorable. Does this normally happen in pt facilities (I imagine it probably doesn't). I think very highly of therapists and hate it when higher ups try to make money off of providers and forget that they are the main reason why a business is even operating. Just wanted to get the opinions of other physical therapists and I apologize for the long post...
Does this happen to all therapists???
- Thread starter serene88
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Awesome post! This is my biggest fear with the future of the profession, mostly due to the lack of reimbursement that is a possible inclusion in the health care bill. I work at a large prestigious outpatient PT center that is also home to my university's head orthopedic division. We see over 300 patients a day! Average PT see's about 20 a day (8 hr shift w/ no break) and they are paid very poorly, especially to start (45K ish) w/ a DPT. The average patient for 2009 was billed about $150 for a visit, 20x150= 3000/day/therapist... do the math- somebody is getting rich and its not the person who is working their rear end off. How/will this be fixed?
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Not ethical. Maybe not even legal. If the therapist is treating more than one person or maybe two at a time, they are doing group therapy. Any timed code requires 100% attention to the patient during that time period. If they are treating 4 at a time, I would guess that it might be fraud. If they are billing the group therapy code, then it would be fine.
I would run away if I were you.
I would run away if I were you.
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It may be legal. If the clinic doesn't treat Medicare patients, then the 8 minute rule typically wouldn't apply and the need for the group therapy code would be much less.
If the clinician is seeing primarily post-operative cases, they could probably see upwards of 20-22 clients and still give fairly good care.
Personally, I would think that if most of the patients are non-operative, with spinal pain, I think the volume described in the original post is far too high.
If the clinician is seeing primarily post-operative cases, they could probably see upwards of 20-22 clients and still give fairly good care.
Personally, I would think that if most of the patients are non-operative, with spinal pain, I think the volume described in the original post is far too high.
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I agree with Jess. Currently I see 2/hour. Anything more than 20/day seems excessive and probably affects quality of care. If seeing medicare, definitely should be billed as group codes. Unfortunately, there are a ton of mills out there that look at volume over quality (sometimes this is why PTs have higher salaries in those settings). There should be a balance of both.
My boss used to see 3 patients an hour. He was able to juggle patients (with his aide....which was me a few years back), however, he has since seen 2 patients an hour since it does improve quality of care (from his experience).
The clinic where I am now, we currently see upwards of 25 or so patients per therapist. Each therapist has their own tech that works with them. On average, a therapist will typically see around 17-20 patients per day. While I understand other peoples thoughts on quality of care, I could not imagine only seeing two patients per hour and 16 in one day. I would feel like that is way too slow; sometimes 18 seems to drag. I will however, agree that at times the company seems to care about "numbers", but you have to keep the lights on somehow.
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I've actually had experience seeing 3/hour when I was in clinicals and was able to handle it. However, where I work now, each PT has an aide and works awesome with 2/hour. Definitely not boring. Gives me more hands-on time whether it be manually, education, or exercise specifics. I think where I see the difference is the feedback from the patients. We get a ton that have been to other practices where they thought they were getting good care being shuffled between 2 other pts (sometimes 3). I'm sure the care was good but many have told me that they do see a big difference.
Ultimately what matters is that the pt gets better (no matter how many you treat in an hour). I suppose it can depend on the population you treat (pro/elite athletes, adolescents, medicare, etc).
