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Home Health really stunts career for new grads..True or False?

Discussion in 'Physical Therapy' started by Newptstudent88, Jul 14, 2017.

  1. Newptstudent88


    Feb 9, 2017
    When I speak with Physical Therapists and the like, I hear that working for a home health agency is not a good idea for a new grad as their skills as a therapist are stunted. They say it's because students haven't yet been able to use the skills they acquired in PT school and in. Home health setting, there is not much mental stimulation required.

    My thoughts are that if you want to end up in home health why not just start there since there is a strong demand, plus it would help to pay student loans off faster since they generally pay more. Lastly, I also think that because the PT programs have more clinical experience required before graduating, that one could get sufficient exposure in different settings if they wanted to.
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  3. truthseeker

    truthseeker Senior Member 10+ Year Member

    Sep 2, 2004
    I would say that given the assumptions you are making (that you know you want to go into home health) then you are correct. However, lets say you work for your first 10 years in a home health setting and then want out. you get tired of the hoarder houses, and the stale cigarette smoke, and the rough neighborhoods, and the travel and want to work in an outpatient setting. I sure as hell wouldn't want you as my therapist after having an ACL reconstruction or acute back pain that came on for no apparent reason.

    IMO it certainly does not require you to use as many problem solving skills as an outpatient clinic would, or a hospital setting. My recommendation to all new grads is to go somewhere where you can use all of your skills for the first 5 years or so. Then and only then should you specialize. You simply don't know enough about any of the areas of PT to do it exclusively for the rest of your professional life.
    mao3122 likes this.
  4. Bones26

    Bones26 5+ Year Member

    Dec 18, 2011
    The issue with HH and new grads is that it's almost as if you're working in a vacuum, and you're a baby PT. You're not in a gym working alongside other PTs or in IPR/SNF/acute care where you at least share an office with other PTs. You're likely to have little to no mentorship or even a second set of eyes and ears to check things out or bounce ideas off of during lunch. I don't recommend new grads starting out in HH or in any setting where they will be the only PT. It's a disservice to yourself and patients. In my opinion a better path is similar to truthseeker's: spend at least 3 years in a setting where you can really learn with solid mentorship. Then break out in HH or be the only PT in a SNF supervising 3 PTAs (for example).
    jadedphysiotherapist likes this.
  5. NewTestament

    NewTestament 7+ Year Member

    Nov 4, 2010
    Good points. There is no mentorship. You don't use manual skills. You don't need any differential diagnosis skills. You don't do a lot of movement analysis. But I think HH can be a good way to start for several reasons:

    1) It pays better and when you have $150k in debt, this isn't a small consideration. HH agencies are hiring everywhere and can pay well.

    2) I hate it when people say HH doesn't require any skill. You still need: 1) interpersonal skills; 2) the ability to evaluate a home and a patient; 3) the ability to take a lot of data and summarize it; 4) the ability to deal with logistics; 5) the ability to work with a team; 6) the ability to manage a caseload; 7) the ability to form a plan of care; 8) basic knowledge of ther ex; 9) basic knowledge of gait; 10) basic knowledge of medical equipment.

    If you want to transition to outpatient, then take a bunch of con-ed courses, watch some DVDs, and watch a bunch of webinars. It's not that hard to get up to speed. I've worked with several outpatient PT's who transitioned to OP without much problem. You'll probably be more knowledgeable than the outpatient therapist who has been doing the same thing for 10 years. Will you be an OCS? No, but you don't need to be.

    You don't work personally with other PT's but every 1-2 weeks I have case conference and I'm always on the phone with my PTA's.
  6. USP45

    USP45 7+ Year Member

    Jan 12, 2009
    Most home health companies are joke/scam/low-rent craptastic enterprises anyway, and that comes from a guy who has been doing 15-20 hours per week in HH alongside an outpatient career for the past decade.

    I would NEVER recommend that a PT start out in home health unless your ONLY motivation is money. Its brainless, corrupt, and not conducive to growth of skills.

    IMO there is no substitute experience-wise for a solid 5 years spent in outpatient or inpatient therapy before you go anywhere else.
  7. NewTestament

    NewTestament 7+ Year Member

    Nov 4, 2010
    It looks like I lost this debate based on the number of "likes."
    truthseeker likes this.


    Dec 10, 2016
    Hi there. Disclaimer, I'm an OT, not a PT. But I am a relatively new grad (2 years) who has worked primarily in SNF with about 25 percent of my time in home health. I've been home health exclusively for 2 months. Aside from the issues your fellow PTs raised, the biggest problem I see as a new-ish grad is whether or not you'll get to use your skills at all. Depending on your company, you may spend most or all of your time doing evals, re-certs, and discharges, with very little treatment time. Your PTAs may do most of the treatments. So skills may not grow if all you do is churn through paperwork. Now, some HH companies will use PTs exclusively, in which case you can find other ways to keep your foot in other doors. But if you never treat, you'll never grow. I've been pool in a local hospital since I graduated, and I'm going full time next month. I like home health, but I'll grow as a therapist a lot more going into the hospitals.
  9. Newptstudent88


    Feb 9, 2017

    By saying it is a scam, what do you mean exactly?
    Is it false advertising in terms of the pay offered? Do they lie about hours and locations or the job description? Or is it just a non stimulating environment? Thanks

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