I could use some insight...

[CrustyRusty]

So, application season is coming to a close and I've managed to get into 3 PT programs and was waitlisted at 3 others. This was my second round of applications and a hard won outcome for sure. With that said, I've been questioning my choice to go into PT as I've gotten more experience in clinics in my area. I have had the privilege to work under and observe several very talented therapists, but I have also seen the seedy side of billing practices and some ethical models that I find myself questioning, especially in my most recent PT tech job. I feel like a total tool for feeling so lukewarm about the prospect of going to PT school since I know what it means to be rejected from my first round of applications. There is also the reality that I will lose the ability to disappear for backpacking trips and won't be able to be a climbing bum when the mood strikes, but I'll find time for those once I'm out of school somehow.

My point is that I am having cold feet about my decision because much of my recent experience, as well as some of my previous experience, has taught me through negative examples. I am feeling a bit apprehensive about finding my way into a situation like that after graduating. I have faith that I'll be able to handle the coursework and the transition from where I live now to where I'm attending school. The debt is terrifying, but it seems like people get that figured out (I'm looking at upwards of $90,000 just for for tuition...ugh). I know that insurance regulations are constantly in flux and that reimbursement is in a steady decline, but that doesn't matter much. I try to keep life simple and tend to live cheaply (read that as I've been pretty much broke for a long time) and don't think I would know what to do with a $60,000 salary. I just don't want to find my way into a career where I have to compromise my own ethical standards for the benefit of someone else's bottom line. I began pursuing PT because I wanted to help people in a way that has been meaningful in my own life and the lives of people who are close to me. I was not doing that at my last job. I also read all kinds of negativity about PT as a career on the ol' interwebs, but thats likely because I'm searching for solutions to a problem that people like to vent about. Am I being ridiculous? Am I selling my soul by going for the DPT?

Sorry for the huge post, but I'm making no progress by ruminating and I could use some insight. Thanks!

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[jblil]

I found that working for large hospital systems is "better" than working for private PT practices, as there is less emphasis on making a buck at all costs. A large hospital is likely to have several PT settings, e.g., everything from inpatient-acute to outpatient to home-health, so it can provide continuity of care for its patients.

OTOH, living on $60K/year is fine if you're single. But what if you get married and have to support a spouse + kids (eventually)? Think hard and run a few scenarios before you commit.

 

[CrustyRusty]

I have been interested in checking out acute for sure. It seems like it might be more in line with what I would like to get out of PT as a career but it's obscenely difficult to get observation hours in acute care where I live, I've tried multiple times. I definitely appreciate the input. It's hard to know what things are really like when you are seeing the career field from the perspective of an observer or as a tech. I'm ready to start working toward some other priorities in my life, but I don't really know what all that looks like right now. I know I want a career that won't force me to compromise what I feel is right for the sake of making money, but I realize that there's a certain amount of that pretty much everywhere. I'm just interested in the perspective of some people who have seen all of this first hand and how they approach PT to make it work for them. Anyway, thanks for the response!

 

[Bluecase]

If this helps- I hated observing before school. I found it boring and tedious. I didn't have any ethical qualms I was just bored- in outpatient ortho. I was lucky enough to get inpatient acute hours and loved it- thought that was my calling. Fast forward 6 years and now I work in outpatient ortho and sports for a hospital based outpatient setting. I really like where I am and what I do. It's very different observing or working as a tech and actually doing it yourself at a place that makes you happy.


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[CrustyRusty]

I figured that would be the case. I suppose I'll have to wait and see how I like some different settings once I'm doing my clinical internships. I just need to keep reminding myself that I only have limited experience as an observer and a tech and that those hours have been in the microcosm of PT that is my town. Thanks for the response, I appreciate the input!

 

[jadedphysiotherapist]

I have been interested in checking out acute for sure. It seems like it might be more in line with what I would like to get out of PT as a career but it's obscenely difficult to get observation hours in acute care where I live, I've tried multiple times. I definitely appreciate the input. It's hard to know what things are really like when you are seeing the career field from the perspective of an observer or as a tech. I'm ready to start working toward some other priorities in my life, but I don't really know what all that looks like right now. I know I want a career that won't force me to compromise what I feel is right for the sake of making money, but I realize that there's a certain amount of that pretty much everywhere. I'm just interested in the perspective of some people who have seen all of this first hand and how they approach PT to make it work for them. Anyway, thanks for the response!

Your productivity may very well be influenced by your own debt. 90k is A LOT for only tuition. The interest rates are 5.3 and 6.3 right now fixed. Large health systems are usually more immune to shadiness and have more interdisciplinary respect. I've actually been surprised at what goes into acute care in checking lab values, imaging, and assessing motor and sensory damage on patients as well as good care in educating the families as to what setting is best following discharge.

That being said, the paperwork is very tedious now but some people, like myself, like documentation for accuracy and remembering progressions.


Make sure you're okay financially and where you'll be before deciding. You will also have classmates and other health field practitioners who will make you sick ethically. It's all on you after the productivity minimal standard levels for how many patients you are expected to see is established

If this helps- I hated observing before school. I found it boring and tedious. I didn't have any ethical qualms I was just bored- in outpatient ortho. I was lucky enough to get inpatient acute hours and loved it- thought that was my calling. Fast forward 6 years and now I work in outpatient ortho and sports for a hospital based outpatient setting. I really like where I am and what I do. It's very different observing or working as a tech and actually doing it yourself at a place that makes you happy.

My head has so many progressions and organization per medical issues for each patient now though compared to when I shadowed. I was bored shadowing most of the time as well.


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[westcoastin]

I found that working for large hospital systems is "better" than working for private PT practices, as there is less emphasis on making a buck at all costs. A large hospital is likely to have several PT settings, e.g., everything from inpatient-acute to outpatient to home-health, so it can provide continuity of care for its patients.

OTOH, living on $60K/year is fine if you're single. But what if you get married and have to support a spouse + kids (eventually)? Think hard and run a few scenarios before you commit.

Is 60k more or less the ceiling for a hospital based PT setting based off the numbers you have seen?

 

[jadedphysiotherapist]

Is 60k more or less the ceiling for a hospital based PT setting based off the numbers you have seen?

That's a low starting salary currently. Ceiling is probably closer to the average mid 80s hospital FTE 40 hrs

Edit: Below shows you can hit 105k and that's 40 FTE seniority I assume.

 

[Bones26]

Where I live the ceiling is approx $105,000.

 

[DesertPT]

To second what was said above, I always hated observing but loved being in the clinic as soon as my first rotation started and I could actually put my hands on pts. I've never been particularly psyched about OP ortho but still really enjoyed my rotation in this setting a lot, I think just because I was finally out of the classroom and not just being a fly on the wall the entire time. An 8 hour day of standing in the corner and watching somebody do their job is brutal but it is a necessary part of the process.

 

[Bluecase]

Is 60k more or less the ceiling for a hospital based PT setting based off the numbers you have seen?

That shouldn't even be entry level for that setting. Ceiling is much higher for a PT whose been treating for 30 years or so.



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[CrustyRusty]

Thanks for the perspective everyone, I appreciate it! It's kind of relieving that I'm not the only one who felt some frustration of one kind or another while building a resume for PT applications. I will strive to keep all of this in mind as the fall approaches and will keep my hopes up for my clinical rotations.

 

[jadedphysiotherapist]

That shouldn't even be entry level for that setting. Ceiling is much higher for a PT whose been treating for 30 years or so.



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Hospital admin and insurance would love that ceiling but yeah that doesn't exist