Other OT-Related Information Ask an OT about anything OT!

Discussion in 'Occupational Therapy [ O.T.D ]' started by DanOTR/LNMT, 05.14.14.

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  1. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    Hey guys! My name is Dan and I'm an OT over here in Maryland. I've seen and done just about the whole darn gamut in OT - I started out as an intern in forensic psych, got my first job in acute inpatient hospital working general surgery and abdominal surgery (with a geri-psych job on the side), and moved onto jobs in subacute rehabs, skilled nursing facilities, inpatient acute rehab, outpatient ortho/neuro, adult developmental disabilities, pediatrics (autism specifically), education, and now I've found myself as a certified myofasical pain specialist in the outpatient pain management setting working on cervical and upper extremity/hand cases alongside managing therapists, assistants and techs. It's been a heck of ride, but it only gets better as I go along!

    I'm sure you guys have seen my posts in the six figures thread (and how to break 100k as an OT via PRN jobs or full time jobs) as well as my scattered advice on some of the less explained aspects of OT (how you really get paid, Medicare, PT and OT, etc). I get a lot of questions about the real life aspects of OT, so I wanted to make a thread where anyone can ask just about anything! I mean it - go for it, ask me anything. I'll do my best to respond as quickly as possible, and if I get a ton of questions, I may just answer everything in video format.

    Ask away!
     
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  3. keyboardmouse

    keyboardmouse 2+ Year Member

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    Awesome stuff.

    How's the scope of private practice?
    Do a lot of people go into private practice? Reasons if no?
    Also could you make decent $$ if you do own a private practice?
    Thanks in advance
     
  4. trep

    trep

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    Being a male in OT, do you feel that there is somewhat of an inherent awkwardness (for lack of a better term) about being a male in pediatrics? I only ask because I felt this way when I was doing my volunteering hours in a pediatric setting. Firstly, not only are women notoriously more ubiquitously involved with children (in therapy, teaching, care-giving, etc.), but in today's society people tend to be extremely solicitous of men around their children due to the fallacious association of pedophiles being predominantly male. I felt kind of awkward in the pediatric environment as a volunteer because while I wanted to actively participate with patient treatment as much as possible, I often found myself hesitant because of the sensitivity of some parents which made me feel rather awkward and hyper-aware of my behavior and interactions and how they may be perceived.

    I know many men must feel this as I've talked to others about it (both men and women) and they agree. What are your thoughts on this?
     
    Last edited: 05.14.14
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  5. mgeagle

    mgeagle

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    Dan you are amazing and being a dude headed to OT next school I must say I appreciate how refreshing it is to hear a perspective of the field from a guy cause that is usual not the case lol. I do have a few things I wanted clarified though if you don't mind, so my goal is to specialize in geriatrics (and eventually the neuro side of things), work in a SNF cause I LOVE THAT SETTING (the elderly are awesome!!!!) and I want to do a full-time job[​IMG] and prn for weekends as well. Would it be possible for me to do prn in a SNF? If I were to go PRN can it be just Saturday or is it Saturday and Sunday only? What would be some realistic salaries for that situation? I apologize if this is at all redundant to anything you have already said. I just wanted a more specific view. Thanks in advance!!!!!
     
  6. keyboardmouse

    keyboardmouse 2+ Year Member

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    Dan, would you recommend becoming an independent contractor 1099? I heard that's where the OTs make the most money.

    Hows the job availability in that situation?

    How hard is it to find a place to work as an independent contractor?

    How to set it up?

    Lastly, is it recommended?
     
  7. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    Excellent questions, guys. Once I get myself home from the office, I will address everything!
     
  8. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    The scope of private practice is really determined by two things - what private practices are in your area, and who is running it (whether its you or someone else, even if its not an OT running the show). If you decide to go and start your own practice, then it can be just about anything you want to apply OT towards (I've seen things from aquatic therapy, to horse therapy, to splinting, to low vision, to adaptive equipment, etc.)! If you're looking for a private practice to work for, expect a lot of hand clinics and pediatric services. If that's your cup of tea, then by all means - private practices tend to pay a bit more and are generally more flexible.

    Now, do a lot of people go into private practice? Actually...no. I would say a vast majority of clinicians don't end up in private practices due to the simple fact that people don't tend to leave private practice jobs, coupled with the fact that private practices are often small with few available positions. As for those who start private practices, once again, a large majority don't start their own. It's a calling - it's a lot of very difficult work to establish your own business, alongside the small margin of error that comes with it. I managed to end up working for a private practice owned by two PTs, though...and it is AWESOME.

    If you own a private practice and it's successful? Well, that's where the highest possible income is for OT, but just like any other small business venture, it's really a bit of a gamble. When it does work, though...it's great money, but it really becomes your life. Choose wisely. My bosses are making a killing off of my efforts, now that I think about it.

    EDIT: Let me expand a little more on this one with some bullets about the pros and cons:
    Pros:
    • The pay is not regulated by a bunch of administrators who have no clue the job duties you as a therapist perform. Instead of being paid based upon reimbursement rates from Medicare, for example, you're paid for your skills. This is a great thing and how it should be...but those times are long gone. The company I work for starts their therapists off at, bare minimum, $86k based on experience.
    • Considerably more intimate setting with both your co workers and patients. In private practices, you'll often see small teams therapy "bad asses" who brainstorm about cases together (wether or not they're even involved), offer perspective and help each other come up with very effective treatment plans. In our office, it's me, a PT, and a PTA (the PTA especially is absolutely incredible; you'll often find that assistants are just plain heroic in their skills).
    • More flexibility; no absurd chain of command to go through to take a PTO day, no waiting to schedule appointments with your invisible higher ups, more leeway in benefits (I have my employer pay me $250 in cash every month for health insurance so I can maintain my private plan, for example).
    Cons:
    • Cancellations. Dear god, cancellations. God forbid if you work in a private clinic and a raindrop or snowflake hits the road. Nothing is worse than setting up for a booked solid day, only to have more than half of the patients no show or cancel. Depending on the demographics you're working with, this may happen more or less often; I'll be brutally honest, it's the low SES bracket that tends to be the most prone to cancel/no show.
    • It can be difficult to advance in private practices when there are few places to advance to. In fact, I either recommend a private practice job to gather experience and then apply to a higher position, or to come back to private practice jobs after getting experience and applying to a hire position there.
    • I've been in situations where, if patient load or reimbursement is poor for that pay period, you may get paid less than you normally do. When the clinic loses, so do you.
     
    Last edited: 05.16.14
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  9. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    I really like this question.

    Being male in our profession can have some considerable impacts on your ability to do your job. This has been most evident for me in the pediatric setting and in any setting that has required me to work ADLs in the bathroom. I cannot tell you how many times I've been turned down by older women especially when it comes to bathroom ADLs, and that's totally okay. It never needs to be a production - there are always other people to pick up that particular brand of slack, and your bosses won't care. Personally, I don't really miss those days; I could prattle on endlessly on how OT is unfairly generalized as "ADLs", which is probably my least favorite aspect of OT (albeit a necessary one).

    As for the real question about pediatric setting - it's really how you present yourself. It's okay to feel self aware and awkward as a student. It's even okay as a new grad, really. The awkwardness is not necessarily you as a person coming through, but just you as a learning clinician learning the not-so-obvious boundaries that parents and children place (and how they're not interchangeable between the two) on you. As you become more understanding and confident about the services you're providing, so will your interaction between you and the children/parents. This is about the most of it - the final bit is that you're going to learn how to put up with skeptical and sometimes rude parents. The best way to get revenge against this unfair stereotype is just to be damn good at your job, frankly.

    My sister is actually a teacher - she says no matter what, the parents are the worst part of any pediatric job. Don't let them get under your skin and just be yourself, as cliche as it is. As soon as I let go and let myself be my entirely goofy self with the kids and the parents, things were never awkward again. Kids are generally too honest, innocent, and silly to even care about how bad of a singer you are, how awkward you are, or how you're nervous. They just want to play and explore the world through play. Play with them back and the peds world is yours - its one of the most important lessons I've learned in OT as a whole, and it has helped my interaction with all my clients beyond it. Laughter by itself is perhaps one the greatest therapies you can offer a client.
     
    Last edited: 05.15.14
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  10. Merc Zero

    Merc Zero

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    This is awesome. You are such a great resource! I have a question! What type of degree would I need to acquire in addition to a MOT in order to secure a tenure track position at a university or assume a supervisory role in a clinical setting? I have seen some programs that offer a MOT/ Phd in Rehab science or some other Phd coupled with a MOT, would attending any of these programs make me an attractive candidate for such positions ? I have a strong interest in research but would also like the flexibility of taking on additional responsibilities in a clinical setting if such opportunities were to become available. I like the idea of these programs because I would not have to stop mid career and go back to school to obtain a Phd or advance doctoral degree. I could sort of just get everything out of the way and focus on acquiring experience. Also, does having an OTD factor in when apply for supervisory positions ? I hear that there isn't any difference pay between a master's or doctorates. Or is it mostly due to experience ? Thank you!
     
  11. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    If you're seeking to specialize in geriatrics, then you're in for a treat - I'd say that the profession is roughly 75% geriatric jobs due to the sheer control of the market that medicare has. Furthermore, I'd even go as far as saying that a majority of the jobs you'll have access to as a new grad are SNF jobs. There are others just like you who love the SNF setting; there are a lot of pros about it, including:
    • Higher pay. As a new grad especially - you won't find any other particular setting starting off that will pay you as much. Some places I've seen around here will gladly start a new grad off at 75-80k, which is fantastic as the rehab world is not fiscally kind to new grads.
    • Your appointments are scheduled for you and most SNFs have gone to digital documentation, meaning more treatment time and less administrative work.
    • PRN jobs are in abundance for SNF jobs. Covering one of your questions, you most certainly can work PRN on the weekends and full time during the week. In fact, 90% of PRN jobs are in SNFs, so you won't have your shortage if you want to change the scenery on your weekends. You can pick any day or pattern of days you want for PRN as you make your own schedule, even!
    • You will learn a ton about the most pervasive disorders and diseases in therapy, how to manage them, and how to hone your most basic and important therapeutic skills. Your people skills, conflict resolution skills, and skills of persuasion will also grow considerably in the SNF setting.
    • Given that SNFs are generally well stocks with therapy equipment, you can get very creative with your treatments. This is highly encouraged.
    • You will be regarded as an expert by other staff and families (rightfully so). Its so rewarding in its own right. Doctors, RNs, and other staff will depend on your perspective and assessment skills.
    As with every setting, though, there are things you need to watch out for:
    • Productivity levels. When you guys enter the clinical world, you will realize that productivity is what makes the world go round. Every job you will ever have will hinge on it. It will become a household word for you. SNFs are the most nefarious about productivity levels, expecting sometimes absurd levels of productivity (if its at or above 90%, RUN). Most good companies will cap their productivity levels around 75-80%, perhaps just a little higher. Anything more will leave you burnt out, rushed, and unwittingly flirting with some very dangerous ethical boundaries. Medicare rules will also make this even more sticky, but thats another discussion.
    • Like a PT is cornered into gait training, you will be cornered into ADLs. I personally do not like that fact, but insurance companies do and your job will revolve on ADL outcomes.
    • Sign on bonuses are a trap. Sure, one SNF will offer you 3-5k on sign on, but...they'll pay you in small incitements throughout two years. What if you hate your job and quit, breaking your contract? Welp, guess who gets to pay the company back for all that bonus money? Yup.
    • You will be guilt tripped and sometimes bullied into extra PRN hours, seeing patients who are over Medicare B cap, or seeing patients who are just not appropriate for therapy. SNFs can be so much about the bottom line that you may do things you don't always agree with.
    I don't want to make it sound all doom and gloom - SNFs are great places to work, but be very careful about who you choose to work for. Do your research and look around at company reviews and pay very close attention to tropes about productivity before saying yes at any interviews.

    Now, lets say that you do find an SNF that you love (it happens more often than not!) - if you want to get your foot in the door with neuro, boost your earning potential, and TRULY help patients in the SNF setting, go for your CSRS certification (Certified Stroke Rehab Specialist). CVAs (strokes) are the most common neurological condition you'll find in SNFs, and perhaps the most integral diseases to understand as an OT (I cannot stress this enough). Understanding stroke rehab intimately by itself will put you so far ahead of your peers - being certified in it will open doors to incredible jobs as a clinical specialist. Certifications (and adding more letters after your name) is perhaps the best way to boost your earning potential and to self direct your OT destiny. I highly recommend the CSRS certification in your case, and oh my goodness will you love your work.

    The rest of the questions will be answered tomorrow morning! Sorry about the wait, guys!
     
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  12. RedHeadOT

    RedHeadOT

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    Dan, thank you for all the wonderful information. It's awesome to be able to ask you questions! I'm definitely interested in having a PRN job in addition to whatever I do during the week, but I am still a little confused about how they work.

    As a therapist, do you sign a contract that states you will spend X amount of hours per week on certain days, or does the facility simply call you when they need someone to cover extra hours as long as it is on days you state you are available?

    Also, at the facility I completed my hours of observation, it seemed like the PRN therapists were given the worst patients. The other therapists basically left the patients they didn't really want to deal with for the people doing PRN work. Is this typical? If you are interest in a PRN job, are you more likely to have difficult patients?
     
  13. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    This is a pretty unique question, actually. A large majority of OTs do not go into independent contracting (1099); its good money not because of the pay rates (which, once again, are a little higher), but because most of the tax breaks that companies claim on you when they hire you on suddenly become YOUR tax breaks. I did a short stint as a contractor, and there are agencies out there that specifically staff independent contractors to short term (13 week) positions at various facilities. This method of contracting makes finding a job a complete non-issue, because someone else is finding the jobs for you. All you need to do is accept the job.

    That is, unless you decide to go VERY independent in the 1099 fact of opening up your own practice. I outlined that above in another post. I'll be forward with you; unless you go independent and team up with an angency, companies have no real desire to hire you because they generally have to pay you more and they have to shoulder your tax burden.

    Lets go into pros and cons, as usual (assuming this discussion is about being an independent through an agency)
    Pros:
    • You will earn a bit more than your peers in the same exact positions. You'll also see more money through less income being taken out of your checks in the form of taxes.
    • If you go through staffing agencies to find jobs, you'll never have to worry about looking for jobs, as someone else will be doing this for you.
    • Do you get bored easily and like constant changes in scenery? This is perfect for you. Assignments, as they call it, are short and are usually around 13 weeks - this means that you'll collect experience in a whole bunch of different facilities.
    • You will singlehandedly save a lot of different facilities from crippling gaps in staff and you will be cherished for it. You will be needed and you'll be treated as such.
    Cons:
    • Yeah, uh, remember how I said that you'll get less taxes taken out of your paychecks? April is going to be your least favorite month of the year when you run the risk of owing thousands back to the IRS.
    • Agencies get the joy of taking a small fraction of whatever your assignment is paying you. They find you jobs...but then you get taxed by them.
    • If you end up hating wherever you've been assigned, then its a nightmare trying to get out of it. Places are needs based (based upon what facility needs a gap filled); you may end up going to quite a few crappy SNFs that are struggling to keep themselves above the crushing grip of the state regulation boards.
    • Your chances of refining specific skills gets pretty diminished when you're being pulled all over the place, expected to make up for holes in productivity . Your job will be primarily about making money and catching facilities back up fiscally, instead of perhaps providing the best services.
    Some people take this route and swear by it. It will make you very adaptable as a therapist and you'll see and experience OT faster than any other method.
     
  14. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    Thank you, thank you!

    If you're looking for a tenure track, I feel that the easiest way to get into that kind of position is a Doctor of Education degree. I've been told that a PhD in OT for academia is okay, but can come off as somewhat redundant, according to some associates that I had back in my short stint in education. The Doctor of Education degree is a fairly easy degree to obtain, can be done online, and is one of the most competitive degrees you can earn for academia in OT.

    For a supervisory role in OT? Well, you can certainly achieve that with the MOT given your experience, track record, finding the right fit for you, etc. There is no degree requirement for supervisory roles in the field - the management positions are often given to more experienced OTs who have strong clinical judgment and time management skills that they can pass down to their subordinates. To be forward - management positions are often given to clinicians who have something to offer in either education and furthering staff skills or, more commonly, have skills to offer that will boost productivity of their staff.

    Now, is there a degree that can help you secure these management positions? Certainly - given you have some experience. An OTD with a concentration in administration would be a very strong statement in getting you into higher level management/administrative positions. Couple that with experience, a strong grasp of medicare/insurance reimbursement (SNF), education and corporate maneuverability (hospital) and you may even find yourself in some director seats someday.

    As for the last question - no, there isn't necessarily a difference in pay for the two degrees, but only if you look at it concretely. It IS a big step up in pay if you realize that the OTD, coupled with a little bit of experience, will open up higher level jobs to you much faster if you can prove that your furthered education will contribute to the bigger goal of a given company. Someone with ten years of experience and an OTD will have a considerable edge over one with just an MOT (demonstrates commitment to self betterance, advanced practice, administration, etc.)

    I honestly feel that people who go for their OTD now will put the best use to the advanced education - someday looming in the future, its inevitable that OT will require an arbitrary entry level doctorate to keep up with the Jones' (thinly veiled reference to PT). Just remember that the OTD is a vehicle that needs experience as a fuel to actually run.
     
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  15. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    You're absolutely welcome! :)

    PRN jobs are probably the biggest reason why I was able to get as far as I have thus far, believe it or not. I cannot recommend them highly enough, but its really best to be educated about how they work in order to utilize them at maximum effect...and to protect yourself.

    So, as a therapist, you don't have to sign any contracts as a PRN - you apply to the position, you go through an interview (as a formality - facilities generally will hire PRNs on the spot to get them to work ASAP) and just jump right in. You'll LOVE the fact that most places will have you attend paid orientations when you get signed on ($60 dollars an hour for two days to sit on your hands and eat free food).

    Your second assumption about how facilities will call you and ask is entirely how it works. From there, the day is just like any other day at the facility (except with less management meddling, a slower pace, etc. if you're working a weekend) If you haven't seen it already, I'll repost the blurb I wrote about PRN work:

    Now! I love that you asked the second question. The answer to "do I get the bad patients no one wants" is both yes and no. To explain:
    1. PRN caseloads are often a smattering of patient who either are new admits need evaluations before the dreaded 48-72 hour window for medicare (when a patient enters a facility in a SNF, for example, if they are not evaluated by a therapy service within 48-72 hours, then the facility gets dinged), patients who missed treatments during the week due to appointments/refusals, or patients who need some extra therapy to reach certain measures that the facility needs to meet in patient time.
    2. Sometimes, you may end up with a rather "optimistic" caseload where they hope you'll be able to score more time on the chronic refusers. This is the "yes" part - sometimes, managers can and will use their PRN staff as pack mules for the difficult patients to maximize productivity of their full time staff.
    3. For the rest of the brands of patients in the first bullet of this list, that's where the answer is no. More often than not, its more so a combination of all three kinds of patients.
    If you want a PRN job, look around for SNFs in particular - they usually have the highest patient censuses, high rates of admission, more rehab equipment, and they pay better than any other setting for PRN (here in MD, generally $53-$67 per hour). Just be very adamant about what hours you want to work and you'll find that its a very lovely partnership to have with another company.
     
  16. tbmflsm

    tbmflsm

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    Hi Dan. Thanks for taking the time to do this. I too am a male, interested in OT.

    Are schools and the market becoming more competitive to applicants?

    Is there a niche in the psychiatric area of OT, or is this location based? Is it a more tedious area in regards to treatment? OT I believe did get its roots in psych.

    I hear of OTs working abroad. Is there an organization for this (networking with others) or pick a place and go?

    Whew, okay. That's it for now. I have a lot of questions. :)
     
  17. mgeagle

    mgeagle

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    Dan thank you so much for this!!! I am going into an entry level OTD program and I have seen a lot of people bash the degree because to them it just appears to be a waste of money and time compared to the MOT, but I have thoroughly researched the matter and I too believe that in the long term it can help me be a better clinician and gain more responsibility in the field as the years go by.
     
  18. Merc Zero

    Merc Zero

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    Thanks Dan! That was awesome advice, I truly appreciate your insight and wisdom! There are so many options in completing a degree nowadays, I will be sure to increase my search to online programs as well. That way I can work full time as an OT and still work towards an advance degree of my choice.
     
  19. keyboardmouse

    keyboardmouse 2+ Year Member

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    Thanks a lot Dan. This is some great info. Again, thanks for the replies.
     
  20. amjadjamal

    amjadjamal 2+ Year Member

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    hello, I had a few questions:

    • Dan are you a hand therapist?

    • How much do hand therapists make in general?

    • How does an OT make 6 figures working 40 hours a week? is that even possible?

    • What is the OT salary cap?
    • Hows the job market?
     
  21. Kidamnesiac

    Kidamnesiac 2+ Year Member

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    Mgeagle,

    I have been one criticizing the supposed superiority of the OTD over an MSOT. I never meant to put the degree down. I have had previous experience in graduate school, and I just know that some degrees are essentially the same, with the big difference being offering more time for a student to study, write a thesis, narrow their focus, or figure out what they want to do in their career. My problem is interpreting the words in the degree to mean something that they don't. To a layperson, an Ed.D., ThD, DPharm, etc... can mean Dr. so and so, but in the field, while it still means something, it's not treated with the same respect as a PhD or MD. I just don't want to conflate the two, like those of us with an MSOT are somehow lesser as practitioners; especially depending on where we do the degree. I'm hearing the point will be moot as the field will require an OTD soon. Anyways, rant over; I wanted to throw my two cents in and apologize if I put the degree down in any way!
     
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  22. mgeagle

    mgeagle

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    Thanks for the apology! By no means do I mean to run down MSOT or MOT either, I have run into therapists who are in the position I aspire to be in and they have their MOT and they are very good at their job. As long we reach our goals in the end and are happy with our purpose in life the method to get there doesn't matter as long as you get there. I apologize if I made it seem like an OTD was head over hills superior to an MOT, it's just the route I want to take.
     
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  23. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

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    Alright, more questions!

    • I am not a certified hand therapist (yet), although I am about to apply to take the test for it. I work with hand and upper extremity work daily, though. I am a certified myofascial pain specialist for the upper extremity and I treat exclusively hand patients refered from pain management interventionalist MDs.
    • CHT (certified hand therapist), in general, start off around 85k, which is pretty damn good considering that's the low end! The high end, I've seen, is 110k. You need quite a bit of experience and a lucky break, though. You most likely won't find that kind of salary without a management position, though.
    • As an OT who makes around $125k (this is not meant to be a braggart comment), I can say its possible to do! To be perfectly forward with you, you are going to need experience, (documented and certifiable) expertise in the field, and most likely a management position. I made a post about it to explain the how and why it can be hard to obtain and how you can get there (and how I ended up there); I'll quote it below:
    • If you want a blueprint to get into six figures at or under 40 hours a week, I can't necessarily spell it out for anyone because there was many different factors that landed me where I am (experience in nearly every OT field, clinical certifications and expertise, multiple different jobs performing different roles, and a very strong grasp of how reimbursement and productivity maximization works), but perhaps if someone asks nicely enough, I can shed some more insight.
    • There really isn't such thing as an OT salary cap...but before I get carried away with that fairy tale statement, I should actually explain how, invisibly, there is. For clinicians, there is a cap that depends heavily on how much your services are getting reimbursed for, times the amount of patients you see. Assuming you're being paid as a clinician (as 90% of OTs are), IN MY EXPERIENCE under the best circumstances (I once worked a SNF PRN that gave me 40 hours a week at $55 an hour, which was fun while it lasted) and my official gross was roughly 109k, if I recall correctly. Of course, once the gaps in the full time staff were gone, they were happy to see me go as I was robbing them blind. If you are management/administration/private practice owner/educator/researcher or any other position that doesn't get paid based upon insurance reimbursement of service, then the sky is technically the limit. Beileve it or not, even MDs are stymied by the same reimbursement problems...and they're getting the much shorter end of the stick at the moment.
    • The job market. It all depends on the field you want to go into. There are so many SNF jobs that companies are constantly trying to outdo each other to get their hands on you, no matter if its full time or PRN. Acute inpatient hospital jobs are also wide open. Outpatient jobs are a little bit more difficult to find, as are school jobs. Pediatric jobs are either absurdly abundant or very rare, depending on how close to a city you are. Management jobs are also fairly open if you have the experience (strangely, jobs will ask for management experience for even entry level management jobs). Private practice jobs are difficult to come by, but always worth it. Psych jobs are also very difficult to find - the present figure of OTs in psych rests at 3% as of last year. However, no matter what, the market is so good that if you want to switch jobs, you'll always find at least something.
     
    amjadjamal and peachiepizzazz like this.
  24. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
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    Status:
    DPT / OTD
    I haven't forgotten you! I'll be replying to this tomorrow morning - these are a lot of good questions I want to do justice! Sorry for the wait!
     
  25. amjadjamal

    amjadjamal 2+ Year Member

    Joined:
    03.28.14
    Messages:
    33
    could you? please? pretty please?lol

    by the way thanks Dan, you a re freaking awesome…always be active on here for us lol.
     
    OT412 likes this.
  26. keyboardmouse

    keyboardmouse 2+ Year Member

    Joined:
    04.25.13
    Messages:
    43
    Hey Dan,

    How does one get into a management position?

    Do they have to do something special? I mean all jobs require experience so how would one go on about getting experience in the management department or EVEN be considered for such spots?

    Dan, also to be in the management position, could you do that with a MOT or need an OTD degree at most places to be even considered?

    thanks again.
     
  27. FutureOT1483

    FutureOT1483 2+ Year Member

    Joined:
    02.15.12
    Messages:
    3
    Status:
    Rehab Sci Student
    Hi Dan,

    I am starting my Level 2 FW soon and ill be in an acute setting for my physical dysfunction rotations. Do you have any advice or recommendations since you previously worked in an acute setting?

    Thank You
     
  28. tbmflsm

    tbmflsm

    Joined:
    09.06.13
    Messages:
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    Status:
    Pre-Health (Field Undecided)
    Thanks Dan - I appreciate all the helpful info here, it sure beats going on the Indeed forums.
     
  29. Emily722

    Emily722

    Joined:
    10.25.12
    Messages:
    44
    Status:
    Pre-Rehab Sci [General]
    Hi Dan,

    I'll be starting my MOT program soon and I am curious about taking traveling assignments. Mainly because I think it'd be a great way to see more of the county and OT while paying down some debt with the higher income. Any thoughts/experience with traveling? It sounds very similar to the independent contracting with staffing agencies you talked about earlier, is it the same thing?

    Thank you!
     
  30. keyboardmouse

    keyboardmouse 2+ Year Member

    Joined:
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    Oh no! Did we scare Dan away with our questions?!!?!??
     
  31. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
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    Status:
    DPT / OTD
    Phew. Sorry for the wait, guys - it was an absolutely insane week at the clinic. I'll be making a killing in overtime this week, though. Silver linings!

    So! To answer your first part - its actually a two parter, just because the answer to that question is yes, and then no.
    You see, schools are really ramping up the intensity of their screening for OT programs universally. This is largely because the awareness of OT as a profession has skyrocketed over the past decade or so, and it continues to do so exponentially. Also, if you haven't noticed either, many prospective students for PT have switched paths into OT for the simple reason of less schooling. The DPT requirement for entry level practice was a somewhat recent change that roughly equates into 1-2 more years of schooling in a grad school environment, where tuition is just deadly. Why go to school and pay more money to enter a profession that does many of the same things as an OT (and gets paid about the same, sometimes a little less)?

    Is the market getting more competitive? Nope. Once you get your degree, companies will be clamoring over themselves to get your employment. By all means, go onto indeed.com and just look up occupational therapy, for example. Look at all those jobs! Those are generally just entry level jobs, too - the rabbit hole goes so much deeper. If there's one thing you guys don't have to worry about, its competition for your jobs.

    OT indeed did get it's roots in psych - at Sheppard Pratt Hospital, specifically (a great factoid for school, also a mere half a mile walk from where I went to school, Towson University in MD). It's a bit of a niche kind of job for OT anymore, since OT's presence in psych has dwindled down to a meager 3% out of all OTs. I wouldn't go as far as saying that it's location based, but I generally find that there are more psych jobs near or in cities (but this isn't always the case). My experience in psych as an OT was in the acute inpatient and PHP (partial hospital program) settings, where I lead group therapy on coping skills for community reintegration, as well as some individual treatment. I LOVED the group therapy, it still to this day was some of the most effective and fun therapy I've ever delivered. The individual kind of thing, though...I actually did find tedious. You'll find that people tend to be more open to learning about coping skills when they're surrounded by people with similar issues - in fact, group therapy is truly about the art of having the group run itself, with you as a facilitator.

    As for working abroad, I don't actually know if there's an agency for it, or even a network...but I can find out for you. I know some classmates went and did their fieldwork in Australia, and there was some sort of network available for them. I'll check into it for you.
     
  32. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
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    Status:
    DPT / OTD
    • Well, one does not simply walk into Mordor. There's a really backwards trend right now in OT management (really rehab management, since most positions have you manage OT/PT/SLP) where most positions want you to have management experience before you apply...but how do you get the experience if you can't get in? In certain fields (I find this common in acute hospital settings and subacute rehab), there is a linear track into leadership positions based upon time and your level of skill. Overall, this is generally a safe way to get yourself management experience - however, in all traditional sense, these positions are pretty much clinical positions with administrative responsibilities. If you want to keep your ties to the clinical end, I recommend seeking a job with this kind of track. In fact, I recommend seeking jobs with these kind of tracks in general for starter level management jobs.
    • Do you have to do anything special? Well, you don't HAVE to, but there are things you can do to really truly help your case. If you haven't pursued a track like I outlined in the previous bullet, there are things you can do to enhance your leadership skills and management skills to help make you worthy for such positions. I HIGHLY recommend you load up on certifications and CEUs on healthcare/therapy management, Medicare management, productivity maximization, and personal communication skills. Dump these onto your resume en masse and paint yourself out as superstar management material to whoever you're applying for.
    • If you want something even more instant gratification-esque, look for assistant director of rehab jobs. They generally just require some clinical experience, but they are a great way to immerse yourself into the administrative side of things with a mentor figure and a safety net.
    • You definitely don't need an OTD to be considered for these things; a MOT is just fine. In fact, I'll be truly honest with you - I have yet to meet someone with an OTD in the clinical setting despite all of my travels and time in the field. They generally find themselves involved with private practice, academia, or administration. If you want to end up in those kind of echelons, then an OTD will really help your case. Academia, in general, does not smile fondly on those with just a masters.
     
    keyboardmouse and mgeagle like this.
  33. mgeagle

    mgeagle

    Joined:
    08.11.13
    Messages:
    140
    Status:
    Pre-Rehab Sci [General]
    One does not simply post awesome things on a forum!!! Dan you're the man!!!!
     
  34. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
    34
    Status:
    DPT / OTD
    I loved the acute setting - its where I had my first FW level 2 and my first job as well. It truly is the best place to learn, and I highly recommend it as a FW site and even as a first job. The knowledge you'll gather from the acute setting will set you beyond your peers in other settings, in my brutal honesty.

    I do have a couple bites of advice:
    • Practice up on transfers. I recommend you practice up on your stand pivot transfers, especially - the stand pivot transfer is perhaps the most useful and safe method of transfer, and a must for those at the Mod A (moderate assistance) level and beyond. If you haven't had a whole lot of experience with transfers yet, then ask your supervisor for some practice. They will gladly help you through feeling out transfers! I think transfers were the scariest skill to learn as an OT student, but with a little hands on practice, they become a second nature skill very quickly. Oh - and always keep a gait belt on you. Hospital gowns make for terrible handle bars during transfers. Finally, keep some safety pins on you. More on that later.
    • Before you begin moving your patient from the bed/chair in their room, step back, and survey the whole room. I won't overload you, but the big things to keep in mind are the height/incline of the bed, do you have the appropriate assistive devices (walker, cane, W/C, etc) close enough to you and the patient, and lines and tubes. Lets talk about lines and tubes.
    • I had THE WORST time with learning lines and tubes. Lines and tubes are all of the lines that are attached to your patient and must be safely manipulated for safe transfer. The most common ones are peripheral IVs in the arms, Jackson Pratt drains (small abdominal drains shaped like grenades that hang off your patient), oxygen lines, and foley catheters (honorable mentions go to chest tubes and wound VACs as well). Be sure to practice diligently at positioning the IV pole/foley into places where they remain safe before, during, and after transfer - and always remember to safety pin JPs to the hospital gown before transfers, only to unpin them after! If you're good with puzzles, then the lines and tubes will be an easy affair.
    • Impress your supervisor and be a better OT by performing manual muscle testing of the lower extremity as well when you evaluate (OTs are stupidly conditioned to think "OT for the arms, PT for the legs", which I cannot even begin to tell you how stupid that line of thinking is) your patients. In fact, evaluation of the lower extremities will tell you, before having to do anything, how well this patient can tentatively transfer, maintain standing positions and balance, perform LE ADLs, and perform bed/functional mobility. I cannot stress this enough - it will save you time, effort, risking patient falls, and it will make you a better therapist to become observant of the lower extremity.
    • Learn to love your nurses. They are your windows into patient function, patient status, and they know their patients better than anyone in the building. Always check with them first before seeing a patient! Furthermore, never hesitate to ask one for help, especially with moving your patient for difficult transfers. A strong alliance with nursing staff will make your life easier and will truly benefit every one of your patients.
     
    Sunny324 likes this.
  35. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
    34
    Status:
    DPT / OTD
    I'll get to this one after I get myself some groceries. I'll be back soon!
     
  36. amjadjamal

    amjadjamal 2+ Year Member

    Joined:
    03.28.14
    Messages:
    33
    Hey Dan good to see you back buddy!

    I had a few questions for you:

    1) What certifications do you have besides the OT...cuz I remember reading you saying something like "it pays more to have a long list of letters after your name"

    2) which ones do you recommend for a better $$ deal while looking for work or PRN

    3) Which settings do you recommend New OTs to look into for their first year. Its not a wise idea to start off with PRN off the bat is it? Is SNF a good choice?

    4) Is it possible to get like 4-5 PRN jobs rather than getting a fulltime SNF job or something like that to maximize capital?

    5) I hope its not too hard to break that six figure barrier, I have read what you wrote but the national salary data kinda puts me off...


    thanks

    p.s. I am going for the MSOT program..is it a negative for me that I wont be an OTD and if I decide to open up a private clinic? or will there be an extra preference for OTDs or better PRN/SNF salary?
     
    Last edited: 05.23.14
  37. keyboardmouse

    keyboardmouse 2+ Year Member

    Joined:
    04.25.13
    Messages:
    43
    holy moly thanks for great answers there!

    How much of an experience do companies require for managerial positions?director or assistant director jobs? These are the 6 fig jobs arent they. I dont figure you could Overtime in these could you?

    tbh do you think there would be issues with MSOT setting up a private practice as compared to an OTD?

    edit: I guess AJ has the same last question as I do.
     
  38. werdna

    werdna 2+ Year Member

    Joined:
    12.14.12
    Messages:
    47
    Status:
    Occupational Therapist
    Any advice/tips for negotiating starting salaries/hourly wage?
     
    peachiepizzazz and RedHeadOT like this.
  39. Makingmoves2014

    Makingmoves2014

    Joined:
    10.19.13
    Messages:
    244
    Status:
    Pre-Health (Field Undecided)
     
  40. Makingmoves2014

    Makingmoves2014

    Joined:
    10.19.13
    Messages:
    244
    Status:
    Pre-Health (Field Undecided)
    Are you excited to start the program this summer. I'm looking forward to apply to the program! When did you apply? My grade point average is sitting close to an 3.0…The whole process has me feeling apprehensive. I'm looking into Tennessee State University also. I don't know if I should wait until summer grades are posted or just apply when OTCAS opens up. OTCAS takes a while to post the grades anyway…..I just need some advice when I should apply. The young lady in the admissions office at Tennessee State University informed me that the committee doesn't starting reviewing the applications until October…..I'm at a standstill. I want to apply to Creighton right away. Contemplating!!!
     
    mgeagle likes this.
  41. keyboardmouse

    keyboardmouse 2+ Year Member

    Joined:
    04.25.13
    Messages:
    43
    Hey Dan..since you answered the questions about independent contractor 1099 earlier..you took in consideration that we are going through an agency.

    How about an independent contractor 1099 that DOESNT go through an agency?

    In this situation how's the job outlook?easier to find jobs? Higher pay(any rough estimates)?pros and cons? Did u ever try doing that (why not if no)?
    And would it be more paying if we look for SNFs as an independant contractor not with am agency? Recommend this route to a new grad..or recommend it at all?

    Thanks in advance.
     
  42. keyboardmouse

    keyboardmouse 2+ Year Member

    Joined:
    04.25.13
    Messages:
    43
    Btw does anybody know what LMNT stands for? Wondering what Dan has after his name. :)
     
  43. Makingmoves2014

    Makingmoves2014

    Joined:
    10.19.13
    Messages:
    244
    Status:
    Pre-Health (Field Undecided)
    I was wondering about the NBCOT? If you study a lot is it impossible to pass. I have a fear that I will graduated from a OT program and will have a hard time passing the NBCOT. Does it depend on the program? I know at the end of the day it depends on the student. Occupational Therapy school is an investment and I want to get best out of it.
     
  44. alansda

    alansda 10+ Year Member

    Joined:
    07.16.05
    Messages:
    108
    Location:
    San Jose, CA
    Status:
    Occupational Therapy Student
    I think it's NeuroMuscular Therapy
     
  45. msot4me

    msot4me

    Joined:
    03.10.14
    Messages:
    18
    Status:
    Rehab Sci Student
    Hi Dan, I have a question regarding something you said on a previous post. You said that if someone earns less than $83 k a year, they get to claim the loan interest rate on their taxes. My question is, how did you hear of this? Does this apply to every OT regardless of their state of residence? I'm just surprised that I've never heard of this before.
     
  46. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
    34
    Status:
    DPT / OTD
    1. Right now, I have a couple certifications - I started out with a massage modality, long ago, called Neuromuscular Therapy, hence NMT. This certification is an interesting one, and it really brought me up to speed with soft tissue manipulation (school did a poor job educating me on that) and introduced me to the absolutely crazy world of muscle pain. Once I was able to appropriately apply it to my patients, I was seeing results in our chronic pain patients that others were not quite achieving with conventional means, which was a big encouragement and primary motivator to continue down the rabbit hole. I wouldn't recommend the NMT certification if you don't practice outpatient, however. It's hard to use otherwise. Down the rabbithole of muscle pain I went, and I discovered the Certified Myofascial Trigger Point Therapist certification, which prompted me to take classes and immerse myself into the literature and research of muscle pain as a concept and construct. This, singlehandedly, was one of the biggest turning points for my patients and for my career, to be honest. A startling 90% or so pain cases that come through any clinic's door are primarily caused by muscle pain, and an intimate understanding of muscle pain and orthopaedics in regards to occupation, posture, and activity modification make the OT field in general a virtual playground in the pain management field. Personally, I never imagined I'd have this much fun with OT. Following that, I decided to go for my Certified Pain Educator certification, which required a fairly difficult board exam and plenty of studying. As you can probably tell, pain management is really my personal window and paradigm in OT. I'm also VERY interested in the upper quarter (where I do all of my pain management practicing anyways), and I am presently preparing for the CHT boards and a certficate in Mastery of Upper Extremity Diagonistics, Evaluation, and Treatment through MedBridge (who I cannot recommend highly enough). Presently, my name reads Dan OTR/L, NMT, CMTPT, CPE.
    2. Well, that's really quite a tough question. It really depends entirely on where your interests are. I'd say the Certified Stroke Rehab Specialist (CSRS) in particular will place your feet firmly in the door for higher paying clinical jobs - strokes will always be a common diagnosis, and perhaps the most important diagnosis to understand as an OT. Strokes also take quite a bit of continued rehab in no matter the setting, so the CSRS will make you infinitely more marketable.
    3. I personally recommend the inpatient hospital acute setting for new grads. It's knowledge dense, fair paced but intense work that will adapt you to different stages of a massive number of diagnoses, sharpen your professional communication skills, exponentiate your knowledge of medical diagnoses/lines and tubes/critical thinking skills/conflict resolution and so on. If you understand how to work in the acute inpatient setting, the rest of the settings come much easier when you do enter them, and you'll enter with an expanse of knowledge that many of your peers will not have. Furthermore, hospital inpatient jobs often have greater room for upward mobility professionally, and incredible benefits associated with them.
    4. Is it possible? It definitely is, and I did for a while, actually. I did the whole patchwork of 4-5 PRN jobs over the course of nearly a year, and let me tell you - it was not easy. It will force you to time manage yourself like never before. The trick is to target places that have the most vulnerable full time staff pools, such as places with staff that rotate off during summer and winter breaks to accomdate for their kids being home, for Jewish Holidays, and for larger SNF companies (RehabCare, ManorCare, FutureCare) or ones will lower staff retention rates. Just keep in mind that finding fulltime PRN work may mean up giving up weekend days and holidays, which are commonly days other people don't want to work. Finally, just keep in mind that while you'll be getting paid roughly $55 dollars an hour, sometimes you won't be given a full 8 hours on a PRN day, refusals and cancels mean that you lose money, and you will get absolutely destroyed on your taxes. Yes, you entirely can break six figures this way, as I earned about $110k in that span of time (there were even some periods where I wouldn't have any work for a straight week or two)...but by the time that was over, I was begging for a steady job. PRN home health pools are another great way for maximizing capital, as well, as some places will pay you $80-90 per eval and $75 per treatment.
    5. The national salary data is somewhat misleading. They only report the most general of figures, based upon a median of a lot of more popular jobs (peds, SNF, and acute hospital especially) with the most basic titles. None of the figures include senior/clinical specialist/manager positions, so take it with a grain of salt.
     
  47. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
    34
    Status:
    DPT / OTD
    1. Often, I'd say that 2-3 years of clinical experience will put you into the running for an entry level manager position. Director jobs usually take a bit more experience as a manager, but are not altogether unacheivable. The assistant director jobs, though, can be accessed fairly right off the bat. The trick is finding one - they're not a very common title! Look closely at SNFs in particular for that kind of title. And yes, many of these jobs can break six figures. It's the most conventional way to get there, really.
    2. To both you and AJ, in opening a private practice, an OTD is not a requirement - however, the knowledge that often comes standard in an OTD program will prepare you far beyond one with an MSOT. Opening a private practice is one of the most popular reasons why people go for their OTD to begin with, so smart OTD programs build the requisite knowledge into their coursework. Opening a private practice takes a particular brand of knowledge and diligence that I personally never found in my MSOT program - in fact, I was given a fairly weak glossing over of the financial aspect of OT in the one class that was supposed to equip me with this knowledge. The primary focus of that class had been forcefully shifted to an emphasis on using my university's students as mini-lobbyists to protect our medicare cap funding - imagine my annoyance that I'm still paying that off via student loans.
     
  48. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
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    Status:
    DPT / OTD
    This is a tricky question.

    First and foremost, as a new grad, expect to be slapped with a flat figure with no room to budge. Frankly, those without experience or extra qualification have no leverage to negotiate their salary - only one person in that interview room holds that chips in that situation, and it just isn't you.

    When you do get experience and advance certifications, though, that's when you can play hardball. When you start gathering chips to bring to your interview, you'll hit a pretty nifty realization - places aren't just interviewing you. You're interviewing them. You're also deeming each place worthy of your employment. That is exactly that game you need to play. You're a skilled clinician with a skillset that no one else has.

    This is where you fight dirty. Do your research on what jobs pay what. Ask people throughout your career how much they're getting paid at where they work (more often than not, they're happy to tell you); create an internal storage for all this information, and hang onto it, and USE it. Therapy is a business - one of the biggest expenses for a business is to lose a potential employee with a high skillset to another competitor. Are they offering you $78k at your interview for a SNF job? Remind them that RehabCare, for example, is offering $82k right off the bat. Remind them that your advanced certifications in stroke rehab, for example, could tenatively be used to develop streamlined programs to enhance productivity and eval/treatment of CVA patients...and that you didn't see anyone else on their staff with that kind of certification. Point out everything that they don't have, but you do.

    This process is usually at its most open in private/smaller practices, where pay is heavily based upon experience. I've seen jobs with a pay range of $75-93k...and anyone can fall anywhere on the line with the right combination of words.
     
  49. alansda

    alansda 10+ Year Member

    Joined:
    07.16.05
    Messages:
    108
    Location:
    San Jose, CA
    Status:
    Occupational Therapy Student
    Great advice. I'd like to add that it's worth a try for even new grads to try to negotiate with employers. There's an in-depth article here that goes over specifics about how to navigate the salary conversation (written for engineers but our field is also in-demand). This is a tidbit from the article:

    Employer: “We were thinking $80,000.”
    Applicant: “$80,000 is interesting (*) but not quite where we need to be to get this done. Do you have any flexibility on that number?”
    Employer: “I think I can convince HR to approve $84,000 but that is the best I can do.”
    Applicant: “I appreciate that. $84,000, huh. Well, it isn’t quite what I had in mind, but the right package offer could make that attractive. How much vacation comes with the package?”
    Employer: “20 days a year.”
    Applicant: “If you could do 24 days a year, I could compromise on $84,000.”
    Employer: “I think I can do that.”
    Another bit I learned from it is that other parts of the employee compensation package (like taxes, benefits, 401k contributions, etc) are a very significant part of the costs to the company compared to just the salary, so there's ways to use that to your advantage during the negotiation
     
    Last edited: 05.27.14
  50. MEOT

    MEOT

    Joined:
    05.27.14
    Messages:
    8
    This has to be one epic thread and thanks to Dan for helping us out. Heck, thanks to Dan I decided to actually sign up.

    Dan, I was reading through all these threads and I have various questions. I will try to keep the same numbered format to make it easier for everybody.

    1) From your posts it seems like you can focus on any one area of OT, and in your case you have focused your whole practice mainly on pain management? Is my understanding correct? If true, I think its great that you can take one area of your OT and practice that, and make a career out of it. Its just like specialization and its my interest also.

    2) Being a guy..how awkward is the whole OT scene? I mean are there parts of the schooling and job that you find that you are or were uncomfortable with being a guy?

    3) Like others, the pay is also an important issue for me. Is it possible to pick up 50 hours (if needed) worth of PRN work a week? I mean the pay would be great then and the so called "six figure"barrier would be easy to break.

    4) I have been in indeed.com occupational therapy forums and there is whole thread on "OT Burnout" and there are tons of OTs who are burnt out and think they are stuck, or made a mistake into this field. Would you happen to know if you ever felt the same?

    5) Certifications….When does one go for those certifications- during OT schools or after (when exactly)? And you said you recommend two: CSRS and Myofascial Trigger Point Therapist certification. How long would it take to get these two certifications and what else can an OT do to increase their paycheck?

    6) Say you're a new grad and then you do those certifications, do you qualify for a higher salary maybe higher than 90k$? What would realistically be the range?

    7)Lastly, since there is a whole issue about OTs not being as well known as PTs, how does OT (if they want to own a private practice) make themselves known? Can one also set up an exclusive pain management setting or are hand therapists the main $$ makers in the private practice sector?

    I know these are a lot of questions but these are the things that are always running through my mind and I feel like you are the perfect person to ask!

    thanks.
     
    amjadjamal, OT2735 and peachiepizzazz like this.
  51. DanOTR/LNMT

    DanOTR/LNMT 2+ Year Member

    Joined:
    05.10.14
    Messages:
    34
    Status:
    DPT / OTD
    I'll be making my rounds again by tomorrow morning - I especially like the NBCOT question. Hot damn that was a hard test.
     
    amjadjamal likes this.

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