(Massive)Debt:Compensation(Little)

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efm6110

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I am sure that many people on this forum have expressed concerns regarding the overwhelming amount of debt that will follow most DPT programs, but I wanted to see what people thought about this issue. More specifically, does anyone else find the average compensation for PTs to be completely ridiculous? Three years of tuition, in my area, would cost approximately $80k. I have spoke with several of the business professors and accounting professors on my campus and everyone keeps telling me the same thing when I show them the numbers...things don't add up! I understand that if a person is passionate about their field of work, monetary return may not be a concern. I too am passionate about the field of Physical Therapy, but at the same time, I am not comfortable with digging myself into so much debt. I'm just trying to see how many people share my thoughts. Also, if not, can anyone provide with any information or insight that may help me overcome my fear of having to pay off debt for 20+ years? Thanks, I look forward to hearing everyone's opinion!

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The compensation for a PT is not that of a pharmacist or an MD but with that said, the job satisfaction of a PT is often rated much higher. Now to say compensation is 'little' is incorrect, the average salary for a PT ranges in the 70-80s w/ experience depending on location. If you want to do home health or traveling PT you can make some good money. Will you get loaded being a PT? probably not, unless you become a manager or own your clinic. Can you make 70k+ in your mid 20's throughout the rest of your career? absolutely. Over time if your smart that adds up. You can also work part time teaching at Univeristy's PT dept. as well as community college courses.
As far as debt is concerned it is a lot to go to school, in my opinion too much but with the demand for PT's on the rise there is an increase in tuition repayment post graduation. Try to be smart and not add to greatly to your debt while in school with cost of living and things of that nature and you should be just fine.
 
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I agree with the above.

You can make more by working a second part-time/per diem job. With this, it is possible to make 90-100K. You just have to sacrifice your first few years after PT school. So it is possible to pay off loans sooner, but it's your choice to hold off on a comfortable lifestyle for a couple of years.
 
I can see where "efm6116" is coming from. He is looking from a practical stand point and taking a look at the numbers. You guys can't knock on the kid for just trying to get some information. He does have a valid point that when you look at the return on investment, the numbers speak for themselves. Anywhere from 80-120gs in debt and a starting salary anywhere from 50-70gs. I gotta agree with "efm6116", the pay for PTs does not seem right based on the length, cost and work needed to attain the DPT degree.

What is everyone elses thoughts on this? Is anyone worried about the long term struggle to pay off the enormous debt after graduating and making a marginal salary in comparison to the debt?
 
Check out your state schools tuition and stay away from private if the debt load concerns you. Federal loan guidelines presently limit your repayments to a max of 15% of your income, after 2014 it is reduced to 10% and after 20 years it is forgiven. But if you bust your hump the first 5 years after graduation and work home health on weekends you should be able to pay off the debt pretty quickly. I know a PT with his own practice that recently was paying 120K/year to DPTs with 3 years experience to do nursing home, assisted living, and home health care.
 
I am trying to understand why working excess job and overtime hours is acceptable when you go to school for three years and work extremely hard. if your going to school to work that hard you should be able to graduate and have a job that can offer a steady inflow of money that will allow you to pay of student loans at a normal rate while also taking on car payments, mortgage, etc.....how is that possible in the field of PT when your only making 60gs on average and your 100gs in debt? remember if you make 60gs, your actual take home is around 40gs....how does someone use 40gs to live the daily functions and also pay off loans and pay bills, go grocery shopping, pay mortgage, car payment, etc...? at that rate, it would be a nominal amount of 5grand per year going to pay of student loan debt, and with interest rates, the total repayment could potentially be 200grand for a job that averages a gross income of 60grand....how are current PTs doing this?
 
I am trying to understand why working excess job and overtime hours is acceptable when you go to school for three years and work extremely hard. if your going to school to work that hard you should be able to graduate and have a job that can offer a steady inflow of money that will allow you to pay of student loans at a normal rate while also taking on car payments, mortgage, etc.....how is that possible in the field of PT when your only making 60gs on average and your 100gs in debt? remember if you make 60gs, your actual take home is around 40gs....how does someone use 40gs to live the daily functions and also pay off loans and pay bills, go grocery shopping, pay mortgage, car payment, etc...? at that rate, it would be a nominal amount of 5grand per year going to pay of student loan debt, and with interest rates, the total repayment could potentially be 200grand for a job that averages a gross income of 60grand....how are current PTs doing this?

It's what we love to do so we do it. Like in any job, you do what you have to do to make ends meet. Young MDs moonlight and have second jobs to help pay off med school (my dad did this and I know many other MDs that have done this too). So getting a second job is not unheard of.

Relatively, look at what we do in undergrad. Many spend tons of money to get a degree that means little. I had a degree in kinesiology and all I could really use it for was to get into PT school. Where's the immediate return? The result: I worked as a PT aide making 30K/year...I definitely paid more than that for my undergrad education.

It obviously doesn't seem fiscally responsible to go to 4-5 years of undergrad and then 3 more years of PT school to make only 60-70K. But like I said, if this is what you want to do, then find a way to make it economically feasible. PTs are at the whim of insurance reimbursements, so this limits our salary.

Personally, I am sad to see potentially great pre-PTs choose different career paths due to the salary/debt issue. I see where they are coming from and it makes sense financially. Unfortunately, we may be losing out on kids that may have otherwise made this profession great (maybe the next Mulligan, Maitland, McKenzie, Paris, etc). On the other hand, it weeds out those that are in it for the money (if that's even possible). In the end, is passion enough? Is it worth getting a second job to make ends meet? Is job satisfaction enough? It all depends on who you ask. But truthfully, the only person that can answer this is yourself.
 
I am trying to understand why working excess job and overtime hours is acceptable when you go to school for three years and work extremely hard.

It isn't. Therapists should not have to pick up a second job to make 90-100k. A legally booked therapist generates somewhere between 200-280k a year, not counting what PTAs and rehabilitation techs they supervise might also generate. Hospitals use rehabilitation departments to fund other, less profitable departments instead of properly compensating the therapists.


"...how is that possible in the field of PT when your only making 60gs on average and your 100gs in debt?"

My opinion: The short answer: the profession places ever increasing demands on its new members and then does not reward them for the effort.


My opinion: The long answer: Current "fair pay" standards are rooted in the days of certified PTs. These "proto-therapist" were high school graduates with (I believe) 6 weeks of class room training. They had approximately 1/35th the entry-level education of a BSPT (and 1/70th of current DPTs). Experience was very important to CPTs as they really were trained on the job. Then came the college educated therapists (BSPTs). With clinical experience already under their belts, the CPTs became defensive, insisting that their better educated and trained peers be no better compensated or privileged than they. Thus began the long, sordid tradition of therapists being their own worst enemy in terms of compensation. This scenario repeated itself when the last CPTs and a majority of BSPTs saw the emergence of MPTs. And again when the BSPTs and MPTs saw the first DPTs enter the work force.


Following the course of events, the lay person therapist with 6 weeks of post-high school education became equivalent to the doctor of physical therapy with 7-8 years of college education and a 1-2 years worth of clinical education concurrently performed. Consequently, compensation has been adjusted for inflation and little else. Which is why you see new DPTs offered 55-65k at first hire -- excellent compensation for someone with a high school education, good compensation for someone with an undergraduate education, fair-to-poor compensation for someone with a master's degree and an abysmal compensation for one with a first professional degree.
 

It isn't. Therapists should not have to pick up a second job to make 90-100k. A legally booked therapist generates somewhere between 200-280k a year, not counting what PTAs and rehabilitation techs they supervise might also generate. Hospitals use rehabilitation departments to fund other, less profitable departments instead of properly compensating the therapists.




My opinion: The short answer: the profession places ever increasing demands on its new members and then does not reward them for the effort.


My opinion: The long answer: Current "fair pay" standards are rooted in the days of certified PTs. These "proto-therapist" were high school graduates with (I believe) 6 weeks of class room training. They had approximately 1/35th the entry-level education of a BSPT (and 1/70th of current DPTs). Experience was very important to CPTs as they really were trained on the job. Then came the college educated therapists (BSPTs). With clinical experience already under their belts, the CPTs became defensive, insisting that their better educated and trained peers be no better compensated or privileged than they. Thus began the long, sordid tradition of therapists being their own worst enemy in terms of compensation. This scenario repeated itself when the last CPTs and a majority of BSPTs saw the emergence of MPTs. And again when the BSPTs and MPTs saw the first DPTs enter the work force.


Following the course of events, the lay person therapist with 6 weeks of post-high school education became equivalent to the doctor of physical therapy with 7-8 years of college education and a 1-2 years worth of clinical education concurrently performed. Consequently, compensation has been adjusted for inflation and little else. Which is why you see new DPTs offered 55-65k at first hire -- excellent compensation for someone with a high school education, good compensation for someone with an undergraduate education, fair-to-poor compensation for someone with a master's degree and an abysmal compensation for one with a first professional degree.

Good points. kudos:thumbup:. However, do you think this is true in all PT or just in the hospitals?
 
200-280k a year is even a little low if you are really busy. 5-6k a week is a normal week with new patients and we see 20% of that. I think it would be better to get paid based on productivity, but then you get into the debate about ethical billing. It's definately an uphill battle for us!
 

It isn't. Therapists should not have to pick up a second job to make 90-100k. A legally booked therapist generates somewhere between 200-280k a year, not counting what PTAs and rehabilitation techs they supervise might also generate. Hospitals use rehabilitation departments to fund other, less profitable departments instead of properly compensating the therapists.




My opinion: The short answer: the profession places ever increasing demands on its new members and then does not reward them for the effort.


My opinion: The long answer: Current "fair pay" standards are rooted in the days of certified PTs. These "proto-therapist" were high school graduates with (I believe) 6 weeks of class room training. They had approximately 1/35th the entry-level education of a BSPT (and 1/70th of current DPTs). Experience was very important to CPTs as they really were trained on the job. Then came the college educated therapists (BSPTs). With clinical experience already under their belts, the CPTs became defensive, insisting that their better educated and trained peers be no better compensated or privileged than they. Thus began the long, sordid tradition of therapists being their own worst enemy in terms of compensation. This scenario repeated itself when the last CPTs and a majority of BSPTs saw the emergence of MPTs. And again when the BSPTs and MPTs saw the first DPTs enter the work force.


Following the course of events, the lay person therapist with 6 weeks of post-high school education became equivalent to the doctor of physical therapy with 7-8 years of college education and a 1-2 years worth of clinical education concurrently performed. Consequently, compensation has been adjusted for inflation and little else. Which is why you see new DPTs offered 55-65k at first hire -- excellent compensation for someone with a high school education, good compensation for someone with an undergraduate education, fair-to-poor compensation for someone with a master's degree and an abysmal compensation for one with a first professional degree.

Great feedback everyone! thanks for all the comments...regarding the post above, is it true that PTs who hold the minimum education levels will eventually need to transition into a DPT program to maintain their license? I know experience accounts for a lot, but if the profession is going to try and gain the accreditation it deserves, wouldn't this be a requirement?
 
My problem is that the DPT has no more authority to order test/imaging than a MPT. So if they both can practice and bill the same, why would the MPT spend 15k to get a t-DPT.

The new degree should focus on separating from the MPT not just conforming. Currently it just looks like a letter change to outsiders, not an improvement in clinical therapists. JMO
 
If it doesn't add up for you personally, don't do it. You know how you want to live and compromising your wants will lead to regrets. If you need to make more than 100k annually for the rest of your life PT is not for you. If you are content with the smaller things in life and want to live comfortably, yet still have time for your family and be a part of a great career, then PT may be just your ticket. But in all seriousness this has been beat to death way too many times to count, so if you can't accept that you will probably not get paid what you are worth and that money is your number one concern, it may never add up.

p.s. search function is your friend.

I think people almost always get paid what they are worth.

Now that the shouting and throwing things at the computer is finished, I will elaborate.

If a PT wants to make a ton of money, they shouldn't work for someone. They should work only for the patient. That means they aren't employed by a hospital (I am). they are responsible for all facets of their career. They beat the bushes for patients, they assess them properly, treat them well, charge a fair price, get paid for those services, and comply with all manner of regulations. Those patients talk to other people, talk to their doctors, and more patients come.

That same PT who doesn't do any one of those things will ultimately fail. Those professionals who take risk have the greatest potential to make a bunch of money.

Example: my uncle worked as a plumber for years. he got to the point where he was bidding the jobs, ordering the stuff, scheduling the crew, supervising the crew and yet he was still just a plumber. When he took a risk and started his own plumbing business he was not able to crack his local market right away. So, in the late 70's he packed up his wrenches and whatnot and went to Texas. He was away from his family for months at a time. He worked his tail off, maybe 80-100 hours per week because it was HIS. If he didn't do it, it didn't get done. He worked just like before but if what he did didn't work, it was HIS fault. He took a risk and because he was willing to bust his ***** he made it work. He moved back home and blew the joint away. He retired a multimillionaire at 55. Now he plays golf every day.

The point is, if you are willing to do the hard work ( I am not talking about just studying hard and getting into the school of your choosing) then you are much more likely to make the kind of money you deserve.

Me, I was all gung ho about starting my own clinic and running the show but I realized that I am not the type of detail person that can deal with all of the administrative crap that business owners have to deal with. I personally like that I have an administrator who knows and keeps up with legal changes, regulatory changes, HR changes and other things that really don't always abide by common sense and logic. If it were that easy, I would have had my own shop. I am glad that I have a billing office that deal with the insurance companies and spend hours on hold to claim the money that I bill. The peace of mind that I have by not having to deal with the "other" stuff makes it well worthwhile for me not to have my own clinic. Would I like to make more money? Sure. Is it worth the sacrifice and stress? To me, the answer is no. Do I begrudge the people that do, Hell no.

So, if you think you are going into a job you love and work 36-40 hours per week for someone else, letting them take all of the risk and become wealthy, you are misguided. If you want to make more money and count pills all day, be my guest. But don't have any illusions that you aren't getting paid what you are worth.

If you treat 14 patients per day and you bill them $150 per session, you will be paid $2100 per day. If you collect all of it you can make a boatload of money ($525k assuming 50 weeks of 5 working days and giving you 2 weeks off excluding holidays just to make the math easier) That's a lot of money. Remember, someone has to collect all of that money. So, if you are treating patients all day, the billing has to be done sometime. Insurance companies aren't open at 7pm so you have to do your calling during the day. This means that you are treating your 14 patients sometimes in the evenings (OK, most evenings) and for $150 per visit you damn well better be getting excellent results or you will be finding yourself with a lot of time on your hands.

I am getting long winded. I think I have made my point of view clear. Get over yourselves.
 
Well said truthseeker. If PT is your passion then go for it. If you want to make above the median salary then work for yourself. The same formula holds true in any line of work. Check this site out. It will give you food for thought:

http://www.ownyourownclinic.com/
 
The new age DPTs are going to have exert their influence in the political frontier more than in the past if they want anything to change. Probably the unfavorable debt to income ratio will induce more PT activists to get involved. I despise politics, but I do see the apparent need to get involved. Hopefully this mindset becomes more mainstream then in the past.
 
"However, do you think this is true in all PT or just in the hospitals?"

It is a standard prevalent throughout the profession. Large hospitals and rehabilitation companies would likely be the most adherent to said standard. Working in private practice would offer the most latitude to move outside them. And owning your own practice would see you free of them.

"...is it true that PTs who hold the minimum education levels will eventually need to transition into a DPT program to maintain their license? I know experience accounts for a lot, but if the profession is going to try and gain the accreditation it deserves, wouldn't this be a requirement?"

Likely not. There's been no prior precedent for mandatory transition; however, the profession has reached its terminal degree so it might happen. If a requirement were to be established it would likely only occur once a supermajority of practicing therapists were DPTs and voted the measure through. You may see a mass conference of DPT status on all practicing non-DPT therapists as done in other health care fields. Or if might be required for those BSPT and MSPT therapists to return to a t-
DPT program.

Personally, I'm very much against the current t-DPT model. I applaud the willingness of BS and MS therapists further their knowledge, but from what I've seen and heard the standards school to school are not concrete, and the t-DPT students do not put in the same time or effort as e-DTP students (even in light for their prior education). This causes several issues. First, the t-DPT (primarily BSPTs but to a lesser extent MSPTs) do not graduate with the engrained skill and mindset of a e-DPT, defeating the autonomous practitioner intent of the vision 2020. Secondly, it creates a false impression of the DPT within the profession and with other professionals.

"The point is, if you are willing to do the hard work (I am not talking about just studying hard and getting into the school of your choosing) then you are much more likely to make the kind of money you deserve."

Absolutely.

"But don't have any illusions that you aren't getting paid what you are worth."

I do not believe that statement applies for therapists. As I mentioned above, new therapists are ever anchored by the notion of "fair pay" established by the prior generation (which was ultimately high school graduates with a certificate earned after a few weeks of training). Reinforcing this and limiting true negotiations is the fact that schools do not provide ample business side education and the burden of student loans. I discussed this in passing here: http://forums.studentdoctor.net/showthread.php?p=7403748#post7403748

I give you my current work environment. Four therapists all working at the same hospital outpatient clinic. All treat the same number of patients a day, all basically having the same productivity and, as it is a fee-for-service profession, produce the same revenue for the hospital. Therapist A is a staff therapist with one year experience earning $33/hr (~$69,000/yr) plus benefits (say a value of an additional $10,000). Therapist B is a staff therapist with 10 years experience earning $40/hr ($83,200/yr) plus benefits. Therapist C has 8 years experience, works full time PRN and the hospital pays her $65/hr ($135,200/yr) but with no benefits. Lastly, Therapist D has 4 years experience, works locum and his agency bills the hospital $75-80/hr (or $156,000-$166,400/yr), and from that amount pays him and provides benefits.

In all of these cases the hospital continues to make a profit or they wouldn't have signed a contract with the therapists or their company, but we see the hospital willing to pay double for Therapist D than Therapist A. Therefore, one cannot say Therapists A or B are getting paid what they are worth.

"My problem is that the DPT has no more authority to order test/imaging than a MPT."

Scope of practice is determined state by state. In some direct access states the privileges of direct access are limited to DPTs. But by in large you are correct.
 
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