Trends in PT salary.

[apod823]

Hi Everyone,

So I have been heavily considering attempting to attain my DPT from a state school in NY and I had a question about salaries. I know the profession is not geared towards those who are looking to make big bucks but it would be remiss of me not to consider compensation. Anyway, I'm seeing everything from 55k-70k starting salary along with median salaries anywhere from 75k-85k. http://physicaltherapysalary.org/

I've also seen a steady trend of increasing salaries for PTs: http://www.advanced-medical.net/wp-...5/How-Much-Does-A-Physical-Therapist-Make.jpg.

Can anyone comment on the trends they have seen? What can an aspiring PT hope to make. I only ask because prices of education are sky-rocketing.

Also, anyone who has gone the traveling PT route, can you give me some insight as to the experience and compensation?

Thank you.

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[jblil]

http://dptfinances.wordpress.com/2012/07/10/hello-world/

 

[apod823]

Thank you for the response.

I'm hearing a lot of turmoil about the future of PT. I'm assuming that means that wages will either stay put or go down. This is worrisome as I'm considering making the move in that direction. I begin shadowing this week as I slowly leave my cog.neuro ph.d. program (no stopping that, i'm sick of it).

I'm also hearing mixed things about travel PT. I am totally willing to travel for a couple of years to pay back my loans as soon as possible but from what I understand, that is in shortage too? Is that a temporary trend that you have seen before or is it going to be the status quo from now on?

 

[jblil]

I have no doubt that salaries will either stagnate or go down. It's simply supply and demand. The question is, would you be ok with doing something you love, but getting paid less than you expected? Each of us will need to think it through for himself/herself.

As for traveling, read this thread:
http://forums.studentdoctor.net/threads/salary-for-traveling-physical-therapist.376354/

Another good resource on travel PT (register to read the forums):
http://www.therapistcentric.com/join
The latest posts on that board are not very optimistic.

I think one of the unknowns is the ACA and its long-term effects on the medical professions.

 

[apod823]

Well... decreased salary, increased debt, decreased opportunities for extra income and all of these downturns despite an increasing need for PTs due to aging baby boomers. This is quite an interesting turn for what I figured to be my best option to find happiness in career form. I begin shadowing soon and I will go through with it just to see how much I do enjoy it anyway but this is not encouraging.

Any silver-lining you might want to throw in?

 

[jblil]

Silver lining: after you go through PT school, you'll know so much about your body (from a MSK perspective) that you'd know how to avoid most injuries if you play sports...

Seriously, I think everything hinges on your personal circumstances: if you are single, have no obligations, carry little or no debt and enjoy living simply then PT can be a very viable career. However, if you have 150K of school debt and have a family to support, then it becomes a lot less attractive.

Have you thought about going to med school or becoming a PA? Most of the forecasts I've seen say that we're heading for a physician shortage, and PAs would be called on to fill that gap.

 

[apod823]

So i'm entertaining everyone's opinion, so if you feel fit to comment on my situation, go right ahead:

I am 24, owe 20-25k in debt from my undergrad experience (prestigious private university, B.A. in psychology with most if not all of my pre-med pre-reqs). No family, no obligations otherwise. I enjoy having room mates, i don't need to spend too much money.

If i went to PT school, it would be after completing 1 or 2 courses and shadowing for a couple hundred hours and I'd apply next november for a 2018 graduation. I enjoy the empathetic connections I could have with my patients and have always been interested in fitness (training others and such). If i went to school, i'd go for an in-state tuition school which in NY will still run me about 60k when all is said and done. I'm just not certain if 80-100k of debt is a good place to be when starting salaries are anywhere from 55-65k. Does that seem tenable? I'm not certain but hopefully shadowing shows me an answer one way or another.

 

[skitd103]

I think it's funny how negatively some people talk about the future of this career on this board. It's easy to find negatives about any career. Give me any job and I can research some speculative risks. Truth is: just pick a job you love and one that has some security and you'll be fine. You can come out of PT school with a job that pays 60k or a job that pays 90k (someone just graduated last year from my program in the Midwest and is making 85k). If you really want to make more, then pick up some extra home health shifts on the weekend or evenings. There is someone who posted a thread about how they make around 100k, I believe, doing that. It's all about perspective, if PT is your passion then do it. Yes, it is smart to be realistic but at the same time, you have the capability to do whatever you want with your career. Opportunities are out there and will always be. It's not so much about the job as it is the person. Just my 2 cents.

 

[apod823]

That's what I tell myself and why I'm not abandoning the idea. That being said, if it comes that PT's actually start making significantly less money, then it's just a matter of investment. This is a game of speculation and It seems like things aren't going to get better so I'm just trying to wrap my head around how much worse it can be.

Other than that, yeah, 65k starting and picking up money on the side sounds good. Traveling for 2-3 years to cut down on debt sounds great too. Working up to an 85k salary and then considering opening a clinic sounds like a 15 year goal to me too. I don't mind that... I mind spending tens of thousands of dollars and realizing that I'm getting 45k a year because some major shift happened between now and 2018.

 

[skitd103]

I'm curious what you have backing your thoughts that things are going to plummet for our profession? While there is uncertainty in the whole healthcare field due to the reform, I have not talked to one professor or PT who thinks we are in serious danger. There are even clinics out there running purely cash-based and they seem to be just fine.

 

[apod823]

The entire thread jblil posted seems to point in that direction. I can see the logic behind the arguments and that is worrisome. I certainly am not suggesting it will plummet but that seems to be a growing undertone on these forums which is why exhausting possible perspectives on the subject. I think I may have clicked on every single link regarding physical therapy trends on google. That is by no means conclusive evidence but there does seem to be reason to worry.

 

[skitd103]

Haha yeah I agree with that undertone which is sad because it really might be deterring some bright minds from our profession. Fortunately, I have never seen this expression of the career in real life. I think people spend way too much time on the internet sometimes. As for google, you can click on 5 different links and they will give you 5 different mean salaries. It is easy to become obsessed and stressed out with your future. It's rational up to a certain point. But if this is something that is truly worrisome for you and could potentially cause you some psychological hardships in the future, then maybe it is best to explore your other options. If you do choose the PT route, having all this additional stress is not going to help you one bit while you are in school.

My advice is to go and talk to some PTs in person (preferably ones involved with APTA since they may have a better understanding of our outlook) and talk to them about your concerns. Weigh your pros and cons and determine if you are in it 100%. If you're not 100%, choose a different career. No point in going through life worrying or unhappy! Now if you'll excuse me, I have to get back to studying for my test Wednesday Hope I've helped!

 

[apod823]

Cheers! That is good advice. I have been stressing myself out with trying to escape my Ph.D. so I think i'm going a little overboard. Truth be told, I'm sure everything will be just fine and i'm optimistic that this can be a life-long career that will prove financially, emotionally and spiritually fruitful for me. I can't wait to start shadowing!

 

[jblil]

I'm curious what you have backing your thoughts that things are going to plummet for our profession?

I don't think things are going to "plummet" for our profession, but there are just too many PTs entering the workforce each year. For ex., in my state (NC), we went from 3 DPT programs to 8. Sooner or later, this excess supply is going to translate into wage stagnation or decline. And let's not forget that Medicare is tightening the screws... You can read the discussion in this thread:
http://forums.studentdoctor.net/threads/starting-salary-for-dpt-new-grads.931151/

Job markets are very local, just like the real estate market. Some areas can be saturated with PTs while others still show robust growth. But I think that over the long run, things will get tougher.

For the record, I am in my second year of DPT school and was aware of the situation before I started. I live simply and have no problem with earning 55K-65K doing something I like.

 

[Lasombra]

Sooner or later, this excess supply is going to translate into wage stagnation or decline. And let's not forget that Medicare is tightening the screws...

I'm not sure I know enough about the demand side to be convinced that this is a major problem, at least not yet. The best I've seen is that post on another thread talking about staffing agencies in a couple regions seeing fewer job listings. Maybe I've bought into some hype, but don't the nature of the profession (one-to-one with a fairly high time per patient) and the overall demographics (growing and aging population) predict greater demand for services as well? I'd be interested to hear your thoughts.

Also, on a tangent: I got a strange comment from a PT a few weeks back -- I asked about declining Medicare reimbursements, and he said that his clinic bends over backwards to work with Medicare because they pay the most. This is a private outpatient clinic. Maybe he just meant that they get a lot of Medicare patients, I didn't think to ask -- but I only saw two patients over age 60 in 30 or so hours there.

 

[apod823]

Truth be told, I would be very much content with a salary hovering around 75k-80k after a few years with the option of travel for a bump. Honestly, I'm looking at PA programs as well and while I would need some more pre-reqs for both (when did pre-med become insufficient for PA or PT?!), I think I would enjoy PT more.

I'm also wondering about the increased call for PTs for geriatric populations (which, aside from neurology, would be the direction I head). Here's hoping someone realizes that PT is a money saver long term and med reform begins to favor the field a bit more.

 

[jblil]

Lasombra - it's true that baby-boomers turning 65 will swell the ranks of the elderly and they will be covered by Medicare. However, the funds to pay for this aging population's healthcare are not growing at the same rate, if they are growing at all. So we have more people needing care, and a finite amount of money to pay for it. The end result is lower reimbursement on a per-patient basis: the numerator (the funds) is constant or growing very slowly, while the denominator (the elderly population) is ballooning. Case in point: in 2013, if you are over 65 and covered by Medicare, as an outpatient you cannot exceed $3,700 for PT and Speech Therapy combined. Actually the cap is lower, at $1,900 but you can go up to $3,700 if the PT documents his/her services as "medically necessary." You can talk to any PT who has been in the business for 5 years or more and they will tell you about dwindling reimbursements. Add to this mix the rather large number of PTs entering the system every year, and I think the days of easy money for us are truly over.

Medicare is the 800-lbs gorilla in this zoo, so when it lowers its rates, other insurance companies follow suit. And those companies only pay a percentage of the Medicare rates. In other words, paltry as they may be, Medicare's reimbursement rates are the highest. In addition, our healthcare system is so designed that those for-profit insurance companies act as the gatekeepers between the patient and the healthcare provider (MD, PT, OT, etc). Because they are for-profit, they will ensure that they won't lose money - so who gets the short end of the stick? The patient, who sees limits imposed on his visits, and the healthcare provider, who has to accept lower reimbursements.

There are ways to fix the system and the financial shortfall but unfortunately they are rather unpalatable for both political parties. And you can be sure that lobbyists for the insurance companies are hard at work to preserve the status quo. Hey, we have the best Congress money can buy...

 

[apod823]

Is $1,900-3,700 insufficient for PT expenses?

Also, knowing fully well that this is a mystery, are there any indications of how the ACA will impact the profession?

 

[jblil]

Is $1,900-$3,700 sufficient? It's probably not enough for some patients. But that's all health providers have to work with, so they will make sure they don't go above it.

It's even more absurd with Medicaid, which is largely run by the states (Medicare is federal): in NC, if you are an adult and covered by Medicaid, you can only have 3 PT visits per year, period. When I did my clinical rotation over the summer, I saw several Medicaid patients with serious ailments that would require at least 8-10 visits. Yet they can only have 3. It broke my heart to tell them "sorry, today is the last time I can see you." So if you're under Medicaid and break your leg in Jan and exhaust your 3 sessions, then break your hip in July - too bad for you. No more PT under Medicaid.

ACA's impact: I don't think anybody knows. Considering how the roll-out has unfolded up to now, I expect another clusterf.... I am in favor of the ACA, but the incompetence of the folks in charge of implementing it is mind-boggling. One of my previous careers was in the software industry, and we spent months in testing even though our websites were 1/100th the complexity of healthcare.gov.

 

[apod823]

Is there a resource I could use to find what each state's policy on medicaid is in terms of PT? Honestly, I would love to work in Maryland ( Baltimore county if possible), so I want to see what the deal is there.

By the way, thank you for taking the time to help address these questions.

 

[jblil]

I found this by googling Medicaid + Maryland + "physical therapy":
https://mmcp.dhmh.maryland.gov/docs/ot_pt_sp_manual_2010.pdf

It's for 2010 though, so you may want to check if there's a newer version. I think the best thing is to chat up a few PTs; invite them out for lunch or for coffee and pick their brains. Talk to a variety of folks: private practice PTs, hospital PTs, Home Health PTs, etc so you can get the entire picture.

 

[okramango]

jblil: Your posts are always so interesting and enlightening. Thank you for taking the time to share your thoughts!

There are ways to fix the system and the financial shortfall but unfortunately they are rather unpalatable for both political parties. And you can be sure that lobbyists for the insurance companies are hard at work to preserve the status quo. Hey, we have the best Congress money can buy...

I'm curious about what types of solutions you are referring to here?

 

[jblil]

Hi okra - good to hear from you. How is the first year going for you?

Solutions for the Medicare shortfall: basically we have 2 ways to attack the problem, raise revenues or cut costs.
Raise revenues: if you look at your paycheck (or your past paychecks, since you're in school full-time now), you'll see that 1.45% is automatically deducted from your gross salary. That amounts goes to the Medicare fund. Increasing that percentage to 2% or 3% will bring in more revenues. However, since the words "tax increase" trigger anaphylactic shock in GOP members of Congress, I don't see it happening anytime soon.

Cut costs: we're talking about care rationing here. Would it make sense to perform "heroic measures", which by the way are often very expensive, to keep an elderly patient alive? Where do we draw the line? Do we let a 95 y-o die peacefully, but try to do our best to keep a 90 y-o alive? Lots of ethical questions here... And although it may be easy for some to say "yes" to care rationing, when that patient is one's own parent or grandparent, suddenly the debate is no longer so academic. Democrats in Congress will never go for care rationing because it would mean political suicide and losing the vote of the elderly - who, unlike the young, do go to the polls.

Personally, I think a compromise solution would be best: raise the Medicare tax some, combat fraud, and perform a cost-benefit analysis on all medical procedures to determine which ones are worth doing. However, most Congress members are too busy working on their own re-election campaigns to think about what's going to happen to our country 20, 30 years down the road. Sometimes I wonder if they even care...

 

[apod823]

Seeing as neither of those things are going to happen, I'm wondering if any particular fields of PT will fare better than others. I hear groaning about outpatient services. Anyone have any perspective?

 

[okramango]

Hi okra - good to hear from you. How is the first year going for you?

Thanks again for another insightful post. My first semester has been great! It was definitely an adjustment in the beginning, but I'm much more settled now. Hope your second year is going great, too.

One of my visions is to eventually have my own cash-based PT practice. I really don't like the idea of for-profit insurance companies dictating health care.

 

[jblil]

apod823 - I think all areas of PT will be affected to some degree. IMO geriatrics will have the strongest growth, due to demographics, but will also see the most financial constraints. So it should be relatively easy for PTs to find jobs in a SNF. How much will such a job pay 3 or 5 years from now? I have no idea.

I think there will have to be a change in our healthcare model. The current way of doing business for hospitals is to pile on procedures: more tests, more lab work, more consultations, more surgeries because in the end more procedures equals more money. I went for a routine check-up not too long ago, and was surprised at the “upsell” the clinic tried to get me to buy. It was done in a subtle way, but it was still an attempt to sell more procedures and thus get more money out of my insurance. This model is referred to as the “fee-for-service” model.

The other thing hospitals do currently is to grossly overprice every procedure, knowing full well that those prices will be negotiated down by insurance companies. It’s exactly like buying a car in the pre-internet days: you’d see a MSRP figure on the car window and you’d be foolish to pay it. Usually you’d spend hours haggling with a salesman, and in the end pay an amount less (in some cases, much less) than the MSRP. Today, the car salesman is the hospital administrator, and the haggler is the rep from the insurance company. BTW, hospitals negotiate different rates with different insurances so you’d pay different amounts for the same procedure, depending on which insurance company you’re affiliated with.

So what does the future hold and how does PT play into it?

Some hospitals are going to a capitation model to replace the “fee-for-service” model. In capitation, a hospital receives a flat fee per month for taking care of members of a managed-care plan, regardless of how much those folks use or do not use the hospital’s services. The idea behind capitation is that most members will not need, or need very little, healthcare services in a given period and this will balance out the minority who do require extensive healthcare. Capitation would also provide an incentive for hospitals to implement more preventive care and screenings to catch diseases before they develop and become more costly to treat, which would eat into the hospital’s profit. More emphasis would also be put on things like weight-loss programs, wellness programs, etc. With capitation, hospitals make money by keeping people out of the hospital, which is a radical change from the current “fee-for-service” model.

The problem with PT today is that it’s still largely, even exclusively, seen as something you do after you have had surgery or after you have been hurt, to get back to normal. To align with the capitation model, PTs should provide preventive services to help keep people healthy. Examples would be working with the elderly and teach them how to remain active safely and how to prevent falls; educate the younger folks in avoiding typical injuries in sports; working with desk-bound sedentary workers or specific patient populations (diabetic, MS, obese, etc) to help keep them on a healthy trajectory.

As PTs, it’d be nice for us to find forward-thinking health organizations that have a significant wellness program which includes physical therapy as a preventive measure. I think that’s where the future lies. But change comes slowly in the healthcare field and the capitation model is yet to be adopted widely; if you are going to be working in the PT field for the next 30 or 40 years, I think it’d be useful to keep this model shift in mind and think about ways you can align with it.

 

[jblil]

http://www.drjarodcarter.com/is_pt_school_worth_it/

Make sure you read the comments too, as they touch on reimbursements from insurance companies (as of mid-2013), debt load, cash-based PT practices, etc.

 

[housestark]

jblil, thank you for creating the salary survey. Looking at the data for the 2013 graduates, 6 received less than 50k and did not negotiate their salaries! One was in a residency program, so negotiation was probably not an option. I'm curious why someone would not negotiate? If you did negotiate, what did you say? I'm astonished their salaries are low because I've talked to PTAs who make around 50k, and obviously salary varies by region and years of experience, but I did not think DPTs would get less than 50k. I have friends working as clinical lab techs with bachelor degrees making 55-75k. I try to stay optimistic and I'm not giving up on becoming a PT yet, but this is slightly depressing... I completely sympathize with OP's financial concerns.

 

[jblil]

Why would someone not negotiate? - it's hard to say... In a negotiation, two parties are pitted against each other, and the contest is often "won" by the party who has the stronger leverage. A new-grad PT without much experience would not have much leverage. And if the geographical area has several schools cranking out PTs like cookies in an Oreo factory, then our poor new-grad will have no leverage to speak of. It's just supply and demand: you don't want to work for that salary? Step aside, because plenty of others will.

To negotiate your salary successfully, you need to know 2 things: the "going rate", and your value to the employer.
I started the salary survey to give new grads an idea of the prevailing offers. Granted, it is not perfect but it will give you a rough idea of what others are getting as a starting salary.
As for your value to the employer: if you had a previous job before going to PT school, find a way to leverage the skills you had acquired in that career. If you were in marketing, mention to the employer you can help with designing flyers or spruce up the website for the practice. If you speak a foreign language (esp. Spanish), you could help tap a market niche that had been neglected till then. If you went to PT school straight from undergrad, try to "specialize" in one area while in PT school by taking some extra electives, working with a prof/clinician, helping write a research paper, etc. Always ask yourself, what is my competitive advantage? You will need one, in order to negotiate successfully. Otherwise you don't have a chance.

 

[lee9786]

This thread is very informative and jblil is nailing some of the major issues in the profession. There is a lot there that I was seeing and posting on here when I was looking to apply to PT school 5 or so years ago. I find myself back at the crossroads of working to enter back into school. I currently am looking at the local Nursing program as well as contemplating completing a course of Organic Chemistry and just apply to Medical School (ALL but Ochem is completed due to me working to get my prereqs for Physical Therapy completed). Sadly PT has been taken off the table as a career option.

I've had such a passion for doing this for so long that I had the blinders on to reality as I attempted to justify the extremely high cost of education and the DPT. I value the preventative healthcare component, loved the idea of specializing in manual therapy, having my own gym and spa business on the side even. It's not about making millions, but it is about being able to have professional growth and being able to take care of a family. That is VERY difficult to do when you're straddled with 120K+ student loan debt in the economic climate PT is going to be facing for years.

A couple of problems I couldn't overlook:

1) the DPT - I think this is more of a hindrance to the profession as opposed to an evolution of it. While "Direct Access" exists in some shape or form in most states, the practice is for the physician in the majority of cases to write a referral for Physical Therapy services. The "Doctor" of PT has caused friction among some Physician groups and even PT groups. People are confused that it is a PhD level. It hinders professional growth by straddling individuals with high student loan debt. I talked to an old time BS PT on here that graduated back in the eighties with a total of 8000 student loan debt. The guy had it paid off in a year, and ended up going BACK to Medical School to work as an Orthopedic Surgeon. He could do that as his debt load was manageable.

2) The High Student Loan Debt - There's no way to overlook it. Most programs are 25-30 so grand per year for tuition alone. This does not include living expenses and you can't work during the program. The answer to the high student loan burden isn't increasing salary. It is an attempt to get congress to pass legislation to help "forgive" student loans. It's all dependent upon big brother. Those that do their research will learn that the only reason tuition costs are so high are due to the government getting involved in "guaranteeing" student loans to begin with.

3) Trend for decreasing reimbursement and current business model dependent on 3rd party paying sources - While the Baby Boomers are increasing in number, demand for PT services is not dictated by the number of people needing services but the ability of those people to pay and/or the third party payor source to pay. As was pointed out Medicare/Medicain are cutting reimbursement not increasing them. The reason is the demographics of the baby boomers, the increased life expectancy for those receiving benefits from these payor sources, etc.

A big problem I see is the value that the public wants to PAY for PT services is NOT IN LINE with what is currently reimbursed by 3rd party payors. The majority of people I witnessed are complaining about a $20 copay for PT services let alone willing to dish out $100 for an Evaluation.

The public really sees the Chiropractor not Physical Therapist as the primary preventative musculoskeletal expert that's going to help with say back pain, and for those that have researched the Chiro profession, their business model for an honest practice is not going so good. Their student loan defaut is very high. Is that the direction this field is going?


I can't recommend anyone I know go to school for Physical Therapy now. The only ones that benefit from the DPT are the educational instututions. I can recommend the PTA profession though. No way do I see this group going anywhere in the current medical economic climate. The community college here offers the program for a mere $100/credit. Young people are coming out with little debt making $20-30/hr. They can grow and transition to PA school.

I am in the process of applying to the local nursing program at that same college. My total tuition costs will be approximately $5000. Even WITH ALL MY EDUCATION it still makes sense (I have 2 degrees and 160 credits of undergrad study). I also am looking at Medical School in the PM&R field.

If I'm going to go high into debt as I was struggling to rationalize with PT school, I might as well just go to Medical School. I actually had a PT tell me this when I was shadowing him. He did not believe the DPT was good for the profession.

I think it was huge mistake the APTA has made. I do not see their vision of all therapy being provided by DPTs by 2020 as a reality. They've made it so PTAs not DPTs will be performing more and more of the treatment modalities. I've heard some say that PTAs might be done away with, but I do not see how this group seeing how they are looked at as equivalent from a treatment payer perspective are going anywhere.

The economic model looks to embrace more PTAs to keep the therapy business model afloat. DPTs doing more evals, paperwork, fighting with insurance companies to justify payment for services, etc.

 

[redrose424]

This thread is very informative and jblil is nailing some of the major issues in the profession. There is a lot there that I was seeing and posting on here when I was looking to apply to PT school 5 or so years ago. I find myself back at the crossroads of working to enter back into school. I currently am looking at the local Nursing program as well as contemplating completing a course of Organic Chemistry and just apply to Medical School (ALL but Ochem is completed due to me working to get my prereqs for Physical Therapy completed). Sadly PT has been taken off the table as a career option.

I've had such a passion for doing this for so long that I had the blinders on to reality as I attempted to justify the extremely high cost of education and the DPT. I value the preventative healthcare component, loved the idea of specializing in manual therapy, having my own gym and spa business on the side even. It's not about making millions, but it is about being able to have professional growth and being able to take care of a family. That is VERY difficult to do when you're straddled with 120K+ student loan debt in the economic climate PT is going to be facing for years.

A couple of problems I couldn't overlook:

1) the DPT - I think this is more of a hindrance to the profession as opposed to an evolution of it. While "Direct Access" exists in some shape or form in most states, the practice is for the physician in the majority of cases to write a referral for Physical Therapy services. The "Doctor" of PT has caused friction among some Physician groups and even PT groups. People are confused that it is a PhD level. It hinders professional growth by straddling individuals with high student loan debt. I talked to an old time BS PT on here that graduated back in the eighties with a total of 8000 student loan debt. The guy had it paid off in a year, and ended up going BACK to Medical School to work as an Orthopedic Surgeon. He could do that as his debt load was manageable.

2) The High Student Loan Debt - There's no way to overlook it. Most programs are 25-30 so grand per year for tuition alone. This does not include living expenses and you can't work during the program. The answer to the high student loan burden isn't increasing salary. It is an attempt to get congress to pass legislation to help "forgive" student loans. It's all dependent upon big brother. Those that do their research will learn that the only reason tuition costs are so high are due to the government getting involved in "guaranteeing" student loans to begin with.

3) Trend for decreasing reimbursement and current business model dependent on 3rd party paying sources - While the Baby Boomers are increasing in number, demand for PT services is not dictated by the number of people needing services but the ability of those people to pay and/or the third party payor source to pay. As was pointed out Medicare/Medicain are cutting reimbursement not increasing them. The reason is the demographics of the baby boomers, the increased life expectancy for those receiving benefits from these payor sources, etc.

A big problem I see is the value that the public wants to PAY for PT services is NOT IN LINE with what is currently reimbursed by 3rd party payors. The majority of people I witnessed are complaining about a $20 copay for PT services let alone willing to dish out $100 for an Evaluation.

The public really sees the Chiropractor not Physical Therapist as the primary preventative musculoskeletal expert that's going to help with say back pain, and for those that have researched the Chiro profession, their business model for an honest practice is not going so good. Their student loan defaut is very high. Is that the direction this field is going?


I can't recommend anyone I know go to school for Physical Therapy now. The only ones that benefit from the DPT are the educational instututions. I can recommend the PTA profession though. No way do I see this group going anywhere in the current medical economic climate. The community college here offers the program for a mere $100/credit. Young people are coming out with little debt making $20-30/hr. They can grow and transition to PA school.

I am in the process of applying to the local nursing program at that same college. My total tuition costs will be approximately $5000. Even WITH ALL MY EDUCATION it still makes sense (I have 2 degrees and 160 credits of undergrad study). I also am looking at Medical School in the PM&R field.

If I'm going to go high into debt as I was struggling to rationalize with PT school, I might as well just go to Medical School. I actually had a PT tell me this when I was shadowing him. He did not believe the DPT was good for the profession.

I think it was huge mistake the APTA has made. I do not see their vision of all therapy being provided by DPTs by 2020 as a reality. They've made it so PTAs not DPTs will be performing more and more of the treatment modalities. I've heard some say that PTAs might be done away with, but I do not see how this group seeing how they are looked at as equivalent from a treatment payer perspective are going anywhere.

The economic model looks to embrace more PTAs to keep the therapy business model afloat. DPTs doing more evals, paperwork, fighting with insurance companies to justify payment for services, etc.

@DesertPT where ya at

 

[jblil]

I can't recommend anyone I know go to school for Physical Therapy now.

I wouldn't go that far - but I'd certainly advise folks to think long and hard before embarking on this endeavor, esp. if they'll take on big loans. The return on investment is not the highest, for a DPT degree. If $ is the main driver, a PA or NP degree would be more suitable.

The only ones that benefit from the DPT are the educational institutions.

Agree 1,000%.

 

[DesertPT]

@DesertPT where ya at

Thanks for the shout out, lol. Meh, that post was too long and too full of bias-based and ill-informed statements to write up a full blown argument against every point. Suffice it to say that I generally disagree with most of it. Not that I'm hating on the person who posted it...they made the decision that was best for them. But their description of the PT field does not represent the general consensus of PTs nationally. There are so many of these "sky is falling" posts on this website that you have to pick your battles.

But my opinion is that the physical therapy profession, despite its challenges, has a very exciting future that I am very proud to be a part of. All of my classmates would agree with me. I'll also say that personally believe that the scope of practice and body of knowledge that PTs have justifies a doctorate degree, and I am glad I am receiving the level of education I am. Additionally, if there was less APTA hating and more APTA supporting, a lot more could get accomplished that furthered our professional status.

If PTs would have the attitude that they are members of a doctoring profession with a body of expertise that is hugely important for the health of our society and they should be proud of their professional organization, instead of this old school view that says I just want to get my education over with as quickly as possible then punch the time clock at 8 and 5 each day without giving it a lot of thought, we would be able to see so much more professional recognition and growth. The DPT is instilling in students these kind of attitudes that students of former generations haven't had as consistently. The nasty comments that a minority of PTs make about the move to the DPT is 100% unproductive. There are few professions that have as much in-fighting and within-profession bashing as PT, and that is something that needs to change. I hope as the majority of PTs become DPTs over time there will be less and less of these cynical, happy to be subservient to physicians type attitudes out there.

Of course I making broad generalizations here and am oversimplifying very complex topics and most PTs don't just fit into these molds. We could have a several pages-long discussion on each of these subjects, but lets just leave it at that, for today at least.

Wouldn't mind hearing your opinion too @redrose424

 

[redrose424]

Thanks for the shout out, lol. Meh, that post was too long and too full of bias-based and ill-informed statements to write up a full blown argument against every point. Suffice it to say that I generally disagree with most of it. Not that I'm hating on the person who posted it...they made the decision that was best for them. But their description of the PT field does not represent the general consensus of PTs nationally. There are so many of these "sky is falling" posts on this website that you have to pick your battles.

But my opinion is that the physical therapy profession, despite its challenges, has a very exciting future that I am very proud to be a part of. All of my classmates would agree with me. I'll also say that personally believe that the scope of practice and body of knowledge that PTs have justifies a doctorate degree, and I am glad I am receiving the level of education I am. Additionally, if there was less APTA hating and more APTA supporting, a lot more could get accomplished that furthered our professional status.

If PTs would have the attitude that they are members of a doctoring profession with a body of expertise that is hugely important for the health of our society and they should be proud of their professional organization, instead of this old school view that says I just want to get my education over with as quickly as possible then punch the time clock at 8 and 5 each day without giving it a lot of thought, we would be able to see so much more professional recognition and growth. The DPT is instilling in students these kind of attitudes that students of former generations haven't had as consistently. The nasty comments that a minority of PTs make about the move to the DPT is 100% unproductive. There are few professions that have as much in-fighting and within-profession bashing as PT, and that is something that needs to change. I hope as the majority of PTs become DPTs over time there will be less and less of these cynical, happy to be subservient to physicians type attitudes out there.

Of course I making broad generalizations here and am oversimplifying very complex topics and most PTs don't just fit into these molds. We could have a several pages-long discussion on each of these subjects, but lets just leave it at that, for today at least.

Wouldn't mind hearing your opinion too @redrose424

I'll post an opinion in a few hours, actually about to go meet the dean of my program to have a discussion about some of these things

 

[jesspt]

" If PTs would have the attitude that they are members of a doctoring profession with a body of expertise that is hugely important for the health of our society and they should be proud of their professional organization, instead of this old school view that says I just want to get my education over with as quickly as possible then punch the time clock at 8 and 5 each day without giving it a lot of thought, we would be able to see so much more professional recognition and growth. The DPT is instilling in students these kind of attitudes that students of former generations haven't had as consistently. The nasty comments that a minority of PTs make about the move to the DPT is 100% unproductive. There are few professions that have as much in-fighting and within-profession bashing as PT, and that is something that needs to change. I hope as the majority of PTs become DPTs over time there will be less and less of these cynical, happy to be subservient to physicians type attitudes out there."

There's a lot wrong in this paragraph.

 

[jblil]

There's a lot wrong in this paragraph.

Why do you say that? I am asking, not questioning.

Personally, I think that a lot of younger PTs are quite 'passionate' about the field, which is good. But I have also been around long enough to become somewhat cynical.

 

[lee9786]

Why do you say that? I am asking, not questioning.

Personally, I think that a lot of younger PTs are quite 'passionate' about the field, which is good. But I have also been around long enough to become somewhat cynical.

I know the posted is directed toward JessPT, which I've found to be one of the most knowledgeable PTs posting on this forum and probably out in the field, but in my experience I've found a large portion of people looking to get into the field haven't really researched the issues past a superficial level enough to get into a DPT program. I think many are heading in with the blinders on driven by their 'passion', which I think is being taken advantage of by educational institutions. From what I hear, they are increasing the number of DPT programs. Why not I would the income potential for doing so has to be phenomenal. All of it collected off young, idealistic minds with borrowed funds now directly from the government. This in turn will increase supply of therapists, which I think you mentioned here or elsewhere on the forum.

How will payment structure methods such as move to P4P change reimbursement for therapy services? Working in a Skilled Nursing setting, I've seen first hand how important Therapy is reimbursement to help the facility pay the bills. Every morning the Administrator is looking at Therapy and how so and so is skilled to make $$ ultimately, but the reimbursement model looks to change. Everything is timed out now with codes for treatment. A documented improvement is needed to continue with therapy services. Where are a lot of question marks, and a lot of them going on with so many people getting into dangerous (in my mind) levels of student loan debt for the DPT which does not offer more than a bachelor's. It looks to be a move partially for Therapists to compete with Chiropractors in the public sector who the public already largely refers to as "Doctor". My problem is if one looks at the Chiro field, they will find that honest practitioners don't have a very good income potential.

That is all fine if someone student loan debt matches their annual income (which is supposed to be the benchmark of making good financial decision regarding one's educational debt level). We seemed to have abandoned that concept altogether rationalizing taking on at least twice this in exchange of getting a 'good career'. The only reason why students can take out so much in loans is because that is what the government alots. It doesn't cost as much to train a therapist as what they're charging. No way would a private lender agree to pay so much money out to a student for a degree. The colleges would have to reduce the costs down what the market will pay.

But everything has become so dependent upon the Government. The lack of me being able to charge in the free market the equivalent costs of obtaining the therapy skillset is a huge reason why I've chosen not to pursue this career field. There are cash-based PT clinics but this is the exception rather than the rule. The idea of having a private practice seems to be going by the wayside as things get more and more corporate. Unfortunately you're not the only one that has grown cynical of it all.

 

[ranvier]

Find some private practice PTs in your community and talk to them. The business side and economics were not well represented when I earned my DPT.

 

[jesspt]

Why do you say that? I am asking, not questioning.

Personally, I think that a lot of younger PTs are quite 'passionate' about the field, which is good. But I have also been around long enough to become somewhat cynical.

It's not the degrees that makes them passionate. It's their youth. It's their personality and drive that either keeps them passionate or lets them become something less so. The DPT doesn't automatically grant drive.

" If PTs would have the attitude that they are members of a doctoring profession with a body of expertise that is hugely important for the health of our society and they should be proud of their professional organization,

...

we would be able to see so much more professional recognition and growth.

I agree that more PTs should have pride in the profession and should support the APTA. Does that mean that I (or my peers) can't criticize it on occasion?

instead of this old school view that says I just want to get my education over with as quickly as possible then punch the time clock at 8 and 5 each day without giving it a lot of thought,

Why is this view "old school?" Having been in the profession a while, I have yet to see any correlation between the entry-level degree obtained and the work ethic of the employee.

The DPT is instilling in students these kind of attitudes that students of former generations haven't had as consistently

This is just patently untrue and the original author (@DesertPT ) has no frame of reference to make the comparison.

I hope as the majority of PTs become DPTs over time there will be less and less of these cynical, happy to be subservient to physicians type attitudes out there."

Why will the DPT impact this? Check out your local physician owned practice. I just looked at the web site of the one closest to my clinic, and half of them have a DPT degree.

We had direct access in 28 states prior to the first DPT program even being initiated. One the frustrations from more experienced PTs is that many DPT students and recent graduates act like the fight for direct access is a revolution that started with them. DPTs are standing on the shoulders of giants and in my opinion, many of them don't seem to realize it.

 

[DesertPT]

DPTs are standing on the shoulders of giants and in my opinion, many of them don't seem to realize it.

@jesspt I'm glad you called me out here. I totally agree with your post above. Most of what was said in my previous post was written with a high degree of bias and a lack of objectivity as you have accurately pointed out.

I still believe that the negative attitudes I described in my post are counter-productive for the profession, but you are right in that there is no correlation between degree and presence of these attitudes. The thought process that triggered my erroneous correlation was along the lines of the BSPTs and MPTs that I have heard and seen bash the move to the DPT, and sometimes even DPT grads, for unsubstantiated reasons. It's ok to criticize an organization, but some have become anti-APTA in general because of their personal negative opinion of the DPT transition. Which is totally unhelpful to the profession to say the least.

Then following this train of thought, the rest of my post was a largely irrational word-vomit. Thanks for calling BS on me. One should certainly put a little bit of critical thought into their words instead of just clicking submit after stream-of-consciousness typing.