Jul 13, 2015
13
0
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DPT / OTD
Does anyone work in hand therapy or know anything about it (like how long it takes to get certified, job outlook, and what you have to do to get your certification?)? I am looking into this part of the field and would love to hear any feedback
 

cb31

2+ Year Member
Feb 14, 2015
158
68
Status
Pre-Occupational Therapy
Does anyone work in hand therapy or know anything about it (like how long it takes to get certified, job outlook, and what you have to do to get your certification?)? I am looking into this part of the field and would love to hear any feedback
You can work at a hand therapy clinic right out of OT school, but you have to be an OT for at least five years before you can sit for the certification exam. You also have to have a lot of hours doing work with the upper extremity which is why most people who aspire to be a CHT will just work for a hand therpay clinic under a CHT to learn the ropes. I'm not sure on the outlook, but its a job that is important so I highly doubt it will go away any time soon. They can make reaaaally good money too.
 

resot

7+ Year Member
Nov 6, 2011
99
34
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Rehab Sci Student
I'm not sure where people get the impression that CHTs get "really good money," but I disagree.

Outlook: tough to say. Hand therapy is a small niche. Hospitals usually just employ 1 or 2 hand therapists (unless they have a big hand surgery department). Most other hand clinics are privately owned clinics. As a result, the same problems that plague outpatient clinics plague hand clinics as well: decreasing reimbursement from insurance which increase productivity demands.

Going back to the money though, because insurance is constantly trying to decrease reimbursement, salary is affected. The hand clinic where I work has been trying to hire some PRN help. However my boss is having a hard time finding someone because new grads keep asking for an outrageous hourly pay, and she simply can not afford these individuals and their demands.

As a comparison: these new grads were asking for 10+ more dollars an hour than she paid CHTs who have over 10 years of experience (and even what she pays herself as a CHT with over two decades of experience).

I've spoken to a Hospital OT who works in their large hand therapy department, and she stated that CHTs get paid 3% more in salary than their non certified coworkers. She doesn't think taking the exam is worth it and has no plans to take it (she also has over 2 decades of experience).

Yes, if you own your clinic and it is wildly successful and you are able to keep your sanity with high productivity, then you may be making 6 figures. But going into hand therapy does not unequivocally equal big bucks. If anything, my classmates who went into hand therapy after graduation were among those with the lowest hourly rates (SNFs offered people much more and even pediatric clinics offered more).
 
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cb31

2+ Year Member
Feb 14, 2015
158
68
Status
Pre-Occupational Therapy
I said CAN make reaally good money which is a true statement. I did not say WILL always makes good money! I've met CHTs that have made close to the six figures. I do agree that insurance/where u work plays a big part.... At the end of the day u can make pretty good money in just about any area of OT if u "play" the system right.

And of course people I've met and research I've done into a career that I most likely will go into will be different than another person...

But we all have our opinions, and this forumn is a great place for [perspective] students to see/learn ALL the sides.
 
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occupationalguy

2+ Year Member
Aug 9, 2016
242
204
Status
DPT / OTD
I've met CHTs that have made close to the six figures. I do agree that insurance/where u work plays a big part.... At the end of the day u can make pretty good money in just about any area of OT if u "play" the system right
@resot it's the biggest rumor in OT, and for some reason it keeps getting perpetuated. I think part of it is that CHTs have to take an additional exam, so naturally people assume they get paid more. I have not seen that in my level II, I have heard CHTs say they regret taking the exam and bothering with all the trouble, since salary is the same nearly, and in many cases worse than other settings. I 110% agree with you that our salary is intimately tied to reimbursement, and reimbursement is going down; we already have the therapy cap at $1900 per patient, and the cap is set to expire in a few years. I don't have faith that AOTA will successfully repeal efforts to recap us once it expires.

@cb31 I want to address your points:
You're right to state that if a therapist works very hard she or he can make a decent salary. I would hesitate to ever say we make "great" money if you factor in the amount of debt some of the students here are taking on. For example, a student who attends Samuel Merritt will pay around 130k for an OT degree. Factor in the additional undergrad debt.
The average OT salary is 75k, I posted a thread on salary stats. Average salary for a starting OT is about 50-65k and those salaries hit a ceiling relatively quickly. Very few OTs working 9-5 jobs make 6 figures, and insurance reimbursement is why that is the case. Why would a company pay you 100k a year? For example, in my clinic I routinely bill for 1 hour of therapy I provide to clients who need it (4 units) and nearly all the insurance companies will pay us for just 1/2 hour of therapy (2 units). I could make a laundry list of the time, and modalities we employ that just are not billed. We have cascade billing now too: if you provide a service reimbursement shrinks as time goes on; this is to incentivize you to use less time and cost the insurance company less. The insurance companies count on the fact that we care about our patients and will provide them services which we just won't be paid for; and of course we do.
In turn your employer will often place pressure for you to take on more clients to take into account the time you aren't being paid for. If you expect to make $50 an hour, you have to ask yourself: am I bringing in many times that amount to my company? If not, you're not likely going to make that much money.

I think we are teetering at the point where our degree is poised to become less palatable, and people with the skill set we have may take a second glance at other fields with similar debt amounts and higher incomes.

I must say I love this field; but, I have no delusion that I'll make great money. I'll make a living, hopefully a middle class one.
 
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Feb 21, 2014
26
9
Status
Pre-Rehab Sci [General]
If you're really set on hand therapy, there are residencies in OT now that can "fast track" the process to board certification.

Right now there is only one site approved for hands but there are 3 more in development (keep in mind residencies just started a few years ago)

Basically you work for less pay for a set amount of time (12-18 months typically) at these residency programs, but at the end you can reduce the number of years required to apply for board certification.

Check it out!: http://www.aota.org/Education-Careers/Advance-Career/Residency/ResidencySites.aspx
 

occupationalguy

2+ Year Member
Aug 9, 2016
242
204
Status
DPT / OTD
If you really really want to get hands in the bag, I suggest the Indiana Hand Clinic, and the Philadelphia one. Those are the big dogs in the CHT game.

I'd caution anyone who dreams of big $ due to being a CHT to look at the stats- they don't support that. Do it because you love it, of course.

My biggest critique of hands is that it feels a bit "assembly line" at times. A lot of the same modalities over and over and over. If being creative is very important to you, you might prefer something like neuro, or peds?
 
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