I am the dad of a PT who is 7 years out of school and I wanted to offer some advice to anyone who is considering this career. Most likely you have been lured into a desire to be a PT because you care about people, want to be in a health profession, and have read the glossy brochures from PT schools expounding on the great opportunities that will be available to you when you graduate. I am here to warn you that it is all BS designed to lure you into a field that has become oversaturated, where salaries are stagnant, where you will go into heavy student loan debt, and where you will be pushed to your ethical limits by being told by your bosses to bill for PT services that are unwarranted and most likely fraudulent (it's called productivity in the real world). These are the cold, hard facts that you will face in the real world and it is something that your PT professors will never tell you because PT schools are running a business and want as many people to enroll in their programs as possible no matter the detrimental effect that this has on the profession. My daughter has worked in skilled nursing, outpatient, and hospital settings and the health care model is the same everywhere: maximize profits to the detriment of the patient no matter what. She is totally burnt out and regrets her choice to become a PT. There are many groups on Facebook where you can read many similar sentiments that I have noted here. I hope you reconsider your choice of career. Good luck.
Please reconsider your career choice
- Thread starter PT Dad
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I'm sorry that your daughter has had these experiences and that it has caused you to see an entire profession in this light. The physical therapy profession, as do many health care professions and professions in general, certainly have issues that they face, but overall, I would still stand by physical therapy as an amazing career choice. Now a few points:
1) The debt. This is a real issue, and it is known in the profession. The president of the APTA addresses the debt crisis in basically every talk she is giving. There is a push to stop adding to PT curriculums and instead decrease the number of credits to decrease costs. While I strongly think we need to make PT school more affordable for all (as well as increase reimbursement so debt is easier to pay back), if you and/or your daughter were surprised by the debt load, that is on you. Everyone should be making informed decisions about the debt they are willing to take on, and go to the most affordable school they can.
2) PT schools as a business. Some certainly are! USA for instance, is a for profit business. Yes, it is a legitimate path to a DPT, and has enable many to become a PT and they certainly don't regret it, but the school will be making decisions like a business. It is up to each person if they are ok with this model of higher education. Public universities, the most affordable route to PT, are NOT businesses! Private schools are somewhat of an inbetween- there is certainly pressure on departments to increase class size to bring in more money, but this money is often reinvested in faculty and facilities that benefit students. I do caution about random PT programs that pop up at small liberal arts colleges, as these can be a cash cow for the school. My recommendations in general are public first, for affordability, followed by private schools that are in established medical schools or large allied health departments. Again, it is on you if you choose a school that is a business if you do not want this model.
3) Career prospects- I have never heard of a PT who had difficulty finding a job (maybe the perfect job in the perfect city was an issue, but let's be realistic). The field is far from saturated, and growth is expected. Wages, that is another issues. I agree that wages are stagnant, unless someone makes it in private practice. Future wages should be taken into account when deciding the level of debt you are comfortable with. I'd recommend getting involved with the APTA to help advocate for better reimbursement for the profession.
4) Job satisfaction. Burnout is real. We were taught about it in school, as is done in many programs. It is not a PT specific thing, but all across medicine. However, while there may be groups of PTs regretting their degree, I'm part of many facebook groups proclaiming how awesome our profession is on a daily basis. In general, I'd unscientifically say PTs are some of the happiest people at work I know.
5) Unethical practices. Unethical is unethical, and should not be done. Your daughter should be aware of many ways to report unethical billing practices, and should not partake no matter the pressure. I'm sorry this has been her experience, I have worked in many settings and never encountered it, but like any field, bad apples are out there. Now, while ethical, there may be pressure to see many patients an hour, which may conflict with what she wants/feels is best treatment/best for her health. This is allowed, some clinicians love the hustle, others don't. Thankfully, we choose what setting we work in, and can certainly find OP where the model is 1-on-1 for an entire session, as well as other settings. I like to treat one patient at time, and everywhere I've worked I've been able to.
Bottom line, I'm sorry your daughter has had bad experiences and regrets her choice. PT isn't for everyone, but overwhelmingly people do seem to love their jobs. There are real issues that face the profession, that people should think critically about when choosing the profession and choosing a school, but overall, the future of PT is quite bright.
1) The debt. This is a real issue, and it is known in the profession. The president of the APTA addresses the debt crisis in basically every talk she is giving. There is a push to stop adding to PT curriculums and instead decrease the number of credits to decrease costs. While I strongly think we need to make PT school more affordable for all (as well as increase reimbursement so debt is easier to pay back), if you and/or your daughter were surprised by the debt load, that is on you. Everyone should be making informed decisions about the debt they are willing to take on, and go to the most affordable school they can.
2) PT schools as a business. Some certainly are! USA for instance, is a for profit business. Yes, it is a legitimate path to a DPT, and has enable many to become a PT and they certainly don't regret it, but the school will be making decisions like a business. It is up to each person if they are ok with this model of higher education. Public universities, the most affordable route to PT, are NOT businesses! Private schools are somewhat of an inbetween- there is certainly pressure on departments to increase class size to bring in more money, but this money is often reinvested in faculty and facilities that benefit students. I do caution about random PT programs that pop up at small liberal arts colleges, as these can be a cash cow for the school. My recommendations in general are public first, for affordability, followed by private schools that are in established medical schools or large allied health departments. Again, it is on you if you choose a school that is a business if you do not want this model.
3) Career prospects- I have never heard of a PT who had difficulty finding a job (maybe the perfect job in the perfect city was an issue, but let's be realistic). The field is far from saturated, and growth is expected. Wages, that is another issues. I agree that wages are stagnant, unless someone makes it in private practice. Future wages should be taken into account when deciding the level of debt you are comfortable with. I'd recommend getting involved with the APTA to help advocate for better reimbursement for the profession.
4) Job satisfaction. Burnout is real. We were taught about it in school, as is done in many programs. It is not a PT specific thing, but all across medicine. However, while there may be groups of PTs regretting their degree, I'm part of many facebook groups proclaiming how awesome our profession is on a daily basis. In general, I'd unscientifically say PTs are some of the happiest people at work I know.
5) Unethical practices. Unethical is unethical, and should not be done. Your daughter should be aware of many ways to report unethical billing practices, and should not partake no matter the pressure. I'm sorry this has been her experience, I have worked in many settings and never encountered it, but like any field, bad apples are out there. Now, while ethical, there may be pressure to see many patients an hour, which may conflict with what she wants/feels is best treatment/best for her health. This is allowed, some clinicians love the hustle, others don't. Thankfully, we choose what setting we work in, and can certainly find OP where the model is 1-on-1 for an entire session, as well as other settings. I like to treat one patient at time, and everywhere I've worked I've been able to.
Bottom line, I'm sorry your daughter has had bad experiences and regrets her choice. PT isn't for everyone, but overwhelmingly people do seem to love their jobs. There are real issues that face the profession, that people should think critically about when choosing the profession and choosing a school, but overall, the future of PT is quite bright.
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I completely 100% agree with the post above. I’m sorry that you and your daughter have had a bad experience with the profession, but that doesn’t mean that everyone will, or even that the majority of people will. Not every program is cramming more and more people into the program for the sake of cash. The vast majority of programs have a set number of seats in a cohort that haven’t changed in years! The acceptance rates are so low too. If everyone was being crammed into programs, then the acceptance rate wouldn’t be so low. My program has only 28 people in a cohort and is not considering adding more. Our acceptance rate is 4-5%. They truly are striving to make great PTs and not just going after our money. I hope that you will rethink your point of view about the profession and integrity of many DPT programs.
Also, just want to add, if you truly believe your daughter's school used false claims to "lure" her in (incorrect facts on job placement, average salary, etc), please report to CAPTE, the accreditation board. However, if it is just a case of not adequately researching the school/profession beforehand, please refrain from making judgments.
It's true that you can make $100K as a welder, machine operator, miner spending $0-5000 on your education. Plus you can go to those industries right after high school. If you are chasing money, definitely there are better options than being a PT.
True about productivity and business side of clinics/hospitals in many cases. Some places are better than others. But you do not have to go to clinics where productivity requirements are 95% and where they ask you to treat 4 patients every hour. My company requires 85% productivity, but is still ok if it is above 80%. I see 6-8 people a day and have not been asked to do anything unethical or fraudulent.
Being burned out also can be managed by the choice of the setting you work at. I actually feel like my job is EASY and we laugh there every day. I never feel I am burned out. I did feel burned out while working in an outpatient setting where I had to constantly run between patients and paperwork.
PT Dad, thank you for posting your concerns! Those are definitely things people should consider and think about while making decisions about their career choices.
True about productivity and business side of clinics/hospitals in many cases. Some places are better than others. But you do not have to go to clinics where productivity requirements are 95% and where they ask you to treat 4 patients every hour. My company requires 85% productivity, but is still ok if it is above 80%. I see 6-8 people a day and have not been asked to do anything unethical or fraudulent.
Being burned out also can be managed by the choice of the setting you work at. I actually feel like my job is EASY and we laugh there every day. I never feel I am burned out. I did feel burned out while working in an outpatient setting where I had to constantly run between patients and paperwork.
PT Dad, thank you for posting your concerns! Those are definitely things people should consider and think about while making decisions about their career choices.
I've been a PT for under a year so maybe I don't have enough perspective yet, but I'm about 50/50 on this post. I have to say that job prospects have not been an issue for myself or any of my former PT school classmates, as far as I know.
I'm fortunate that productivity demands are not grueling where I work. There are productivity standards, but they are easily met by everyone working there and I'm not aware of anyone being hassled over them.
You are, however, 100% correct about the student loan burden of becoming a PT, and I talk about this every chance I get with prospective PT students because it's not something I understood well enough when I was deciding where to attend. PT as a career field does not pay well in comparison to the price of the education to become one. It just doesn't. Anyone reading this post: go to the cheapest school that you can get into. There is no more important advice regarding becoming a PT than this. And no matter what you think you know now, the debt looks a whole lot different when you're on the other side of school.
I'm fortunate that productivity demands are not grueling where I work. There are productivity standards, but they are easily met by everyone working there and I'm not aware of anyone being hassled over them.
You are, however, 100% correct about the student loan burden of becoming a PT, and I talk about this every chance I get with prospective PT students because it's not something I understood well enough when I was deciding where to attend. PT as a career field does not pay well in comparison to the price of the education to become one. It just doesn't. Anyone reading this post: go to the cheapest school that you can get into. There is no more important advice regarding becoming a PT than this. And no matter what you think you know now, the debt looks a whole lot different when you're on the other side of school.
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What does everyone think about University of Lynchburg?
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In your opinion, what is that cutoff point of costs?
Take a look at some of the posts on this Facebook group, Geriatric OT, PT, and SLP Collaborative Group, and you will see what life as a therapist is all about in the real world not in the ivory towers of academia.
Been working as a PT for over 6 years, and have many friends who are PTs. I realize I'm battling anecdotes with anecdotes, but we all love what we do, and rather than complain, are active members of alumni boards, professional organizations, and academic institutions working to make change to better the profession. I'm not a part of that Facebook group since I'm not a geriatric therapist, and seeking it out to find negativity really just doesn't appeal to me. Again, sorry you and your daughter are so miserable, and thanks for bringing up some areas of concern, but I will continue to restate the fact that physical therapy is an excellent career choice for many.
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I have two friends who are PTs who absolutely love what they do.
Both were able to find a job right out of school no problem.
Both have about 150k in debt and make around 60-70k/year. The debt to income ratio is a real issue.
Both were able to find a job right out of school no problem.
Both have about 150k in debt and make around 60-70k/year. The debt to income ratio is a real issue.
Move
To California. PTs are making 90k starting and I know this because I’m from CA and know many ppl’s salaries . I understand that the cost of living is high BUT if u save properly and don’t buy extremely expensive homes and cars right away then you will live comfortably
To California. PTs are making 90k starting and I know this because I’m from CA and know many ppl’s salaries . I understand that the cost of living is high BUT if u save properly and don’t buy extremely expensive homes and cars right away then you will live comfortably
Violet2020
USA San Marcos SPT
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Wow, over 1,000 views and only 12 replies! I think you left some students speechless.
No one can deny the debt. Here in CA I know graduates from 2016-2018 who are $200,000 in debt, living with their parents and attempting to pay off as much as $2,000/mo. From this forum, I have also heard of PTs living paycheck to paycheck due to high paychecks but high payback to the debt. I have gone to various information sessions and none of the schools dared to mention this, which is sad coming from events which are meant to inform you.
And while this is a problem that universities keep in the dark, I also believe a little more than half of the students who want to be PTs are not in it for the money, or in this case-- the lack thereof. This sounds like a bigger problem not directly with DPT as a profession but including the American healthcare system in general. I have met PTs who are happy with their degrees, so I am sorry your daughter is in a rough spot in her career. Perhaps she just needs a different workplace environment. Maybe she can use her experience in another field where she is not directly unhappy, such as educating other DPT students. I hope she finds a place where she rises above and uses her negative experience as her strength.
No one can deny the debt. Here in CA I know graduates from 2016-2018 who are $200,000 in debt, living with their parents and attempting to pay off as much as $2,000/mo. From this forum, I have also heard of PTs living paycheck to paycheck due to high paychecks but high payback to the debt. I have gone to various information sessions and none of the schools dared to mention this, which is sad coming from events which are meant to inform you.
And while this is a problem that universities keep in the dark, I also believe a little more than half of the students who want to be PTs are not in it for the money, or in this case-- the lack thereof. This sounds like a bigger problem not directly with DPT as a profession but including the American healthcare system in general. I have met PTs who are happy with their degrees, so I am sorry your daughter is in a rough spot in her career. Perhaps she just needs a different workplace environment. Maybe she can use her experience in another field where she is not directly unhappy, such as educating other DPT students. I hope she finds a place where she rises above and uses her negative experience as her strength.
From what I have seen in my limited experience as a PT, patient mills and many SNFs are all about the $$$. Depending on certain insurances, companies want PTs to bill for X number of units in order to maximize profits. This can be difficult at times because some patients cannot tolerate therapy for very long(exercise, manual therapy, etc.), thereby limiting the number of units a PT can bill. This forces managers to question therapists as to why their metrics are down and can lead to fraudulent billing. I have not seen this in hospital settings, but seems like it is getting to be more prevalent. It can become quite stressful.
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The grass is always greener....
Ups and downs exist in any profession, as do good and bad places to work and competent, awful, and exceptional employees.
If you hate it... do something else. Insurance claims review, DME sales, etc.... or move to a different company or city where you have options to work for a better business. I left a career for PT, but not without a significant amount of digging and shadowing.
Rough estimate - I’ve shadowed around 30 therapists, and I’m yet to meet one who isn’t happy doing what they do. Are there some grumps? Sure. Is it right for everyone? No.
Know your worth. Have expectations and stick to them, and if the culture sucks somewhere don’t stay.
The debt to income thing IS a tricky mess. I went to a CC for prerequisites and got into a really inexpensive state school in TX, total debt load on graduation will be about 35k. If I had to push much past the 100k mark I would have likely considered other options.
Ups and downs exist in any profession, as do good and bad places to work and competent, awful, and exceptional employees.
If you hate it... do something else. Insurance claims review, DME sales, etc.... or move to a different company or city where you have options to work for a better business. I left a career for PT, but not without a significant amount of digging and shadowing.
Rough estimate - I’ve shadowed around 30 therapists, and I’m yet to meet one who isn’t happy doing what they do. Are there some grumps? Sure. Is it right for everyone? No.
Know your worth. Have expectations and stick to them, and if the culture sucks somewhere don’t stay.
The debt to income thing IS a tricky mess. I went to a CC for prerequisites and got into a really inexpensive state school in TX, total debt load on graduation will be about 35k. If I had to push much past the 100k mark I would have likely considered other options.
D
deleted797640
Ah yes the typical "welcome to the real world" speech so I would like to respond in a similar fashion. Going into PT not recognizing the debt to income ratio, not being willing to grind out of school, expecting to live lavishly, not knowing its a business and not expecting care to revolve around money shows just how inexperienced the individual applying is. I've been an EMT, Pharmacy technician, ER scribe, Lead PT aide and some other odd off medical jobs. Working with MD's, PA's, NP's, firefighters, paramedics, pharmacists, nurses, RD's you name it and I've seen it. Every medical field is based on what insurance will reimburse the individual, and as of now many times that is based on minutes for PT. PDPM is soon to be rolled out, maybe this will change things and maybe it won't. Regardless there are options around the struggles faced by PT's in work environment. If you find outpatient chains are pushing productivity and patient per hour rates over other things like quality of care then go somewhere which has more private practice independent outpatient facilities these are very prevalent in places like CA. Have debt you need to take care of? who doesn't, many resources can be found on reddit or facebook for travel PT, home health and SNF prn jobs. Jobs for home health in San Diego, CA can range from 100-140k couple that with prn at a SNF on weekends and loan debt will be quickly paid off. Becoming a director of rehab or opening your own practice, even a cash based practice, are also good ways to gain control of what treatments will be utilized. If you want complete control of your treatment and have these other luxuries then you have to be willing to put in the work and grind up the money hungry ladder or market yourself to companies with a similar vision.
I also see you believe it will get worse with insurance changes, I mean do you know how many times similar insurance changes have been made and everyone freaked out the same way and then nothing happened. Worse case scenario is the discontinued use of PTA's in high medicare population settings due to the decreased reimbursement rate when compared to PT's this is most likely increase the hiring rates for PT's at these facilities which will counter act the decreased hiring of PT's from the elimination of minute based care and transfer to PDPM.
The fact is in the real world nothing is lala land and you have to make the best of things, recognize the downsides and move forward, nothing you mentioned decreases the value you have when you help someone's grandmother who was Dx with parkinsons (told they wouldn't walk) end up walking because you figured out it was fear avoidance causing retropulsion and not the parkinsons and treated it appropriately. Getting into PT for any other reason will leave you burned out, complaining of debts on public forums or having your dad do it.
It's unfortunate you feel the need to dissuade individuals who dream of having this job from applying instead of asking how your daughter can make more to pay off loans or what settings/jobs are available which give more freedom of practice. Heck, doctors without borders just posted they have openings for PT's, its opportunities like those which taking will help offset the negatives of PT.
I've been warning all you wannabe PTs with stars in your eyes. The demand for PTs will be shrinking.
www.apta.org
Time to Act: CMS Proposes Significant 8% Cut to Physical Therapy in 2021
Together we are building a community that advances the profession of physical therapy to improve the health of society.
www.apta.org
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Thanks for the link so that we can have a say! Much appreciated. I would quibble that this has nothing to do with demand- it has to do with greed and overpowered systems imposing themselves in the name of more cash, and undervaluing therapy as a treatment. The demand for PTs is actually growing.I've been warning all you wannabe PTs with stars in your eyes. The demand for PTs will be shrinking.
Time to Act: CMS Proposes Significant 8% Cut to Physical Therapy in 2021
Together we are building a community that advances the profession of physical therapy to improve the health of society.
And who is going to pay the bill? Private insurance will be following CMS guidelines and reduce reimbursement. I never said the need wasn't growing, but when clinics can't make a decent profit they will be cutting salaries to compensate.
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Yes, this is an overall economic reality for us right now. I'm an older returning student who has been in the workforce for a while, and even with a bachelor's degree I was making the equivalent of what a minimum wage worker made around 40 years ago, adjusted for inflation. Most of my cohort made less than half that. And we are all college educated, in many different fields. Even my engineer friends make a bit over what the minimum wage would have been back then for an uneducated worker, but not by all that much.
We have to deal with this on an overall economic level, not by dissuading people from needed professions. There are almost no professions that aren't feeling a pinch, and not everyone is cut out to be a cybersecurity specialist.
More like it has to do with years of fraudulent billing by PTs and SNFs/clinics and now the government wants its money back.
D
deleted797640
I've been warning all you wannabe PTs with stars in your eyes. The demand for PTs will be shrinking.
Time to Act: CMS Proposes Significant 8% Cut to Physical Therapy in 2021
Together we are building a community that advances the profession of physical therapy to improve the health of society.
You know it hasn't passed yet right?
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Do you really think that PTs bill more than they are worth, or that they have to navigate a system that undervalues their services?
I’m talking about all of the excessive ultrasound billing (for example) because it reimbursed more at the time.. DORs and clinic directors have caused this
I've been warning all you wannabe PTs with stars in your eyes. The demand for PTs will be shrinking.
Time to Act: CMS Proposes Significant 8% Cut to Physical Therapy in 2021
Together we are building a community that advances the profession of physical therapy to improve the health of society.
What's making you so negative towards people wanting to do PT as a career? "wannabe PTs with stars in your eyes". Just because your daughter didn't have a good experience with the turnout of her choice of career doesn't mean everyone else will feel the same way. Just shush
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Don’t feed the trolls.
This is what happens when an angry boomer gets ahold of the internet.
This is what happens when an angry boomer gets ahold of the internet.
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Do you think that the fault lies with the clinic directors, or with insurance companies undervaluing the things that heal people so that PT clinics have trouble making anywhere near what they're worth?
D
deleted797640
The fault is with playing like SNF's just trying to meet minute requirements anyway they can rather than focusing on the most effective treatment plan. This is why PDPM is coming.
D
deleted797640
I love how he never responded to the plethora of options I suggested, oh well some people are only here to complain instead of seek solutions.
Nickerson15
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What is SNF? And what is PDPM?
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He has a long history of posting weird jokes and random stuff about his daughter's experience, as if he has nothing better to do. I wonder if she knows he's on here all the time.
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Skilled nursing facility, patient driven payment model
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But does this address the issue of whether those clinics will be adequately reimbursed for their services? In the clinics where I've worked and volunteered, they focus on the patient first, but they're also mindful that how they word treatments can mean the difference between the clinic continuing or not.
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deleted797640
No but it addresses the issue of hiring PT's for the sake of having PT's just to hit numbers over the weekend or just in general. Without minute requirements to meet for reimbursement the facilities will begin to hire based on outcome measures. No one can say for sure what will happen when it comes but most likely there will be a decrease in PRN work for SNF's and a decrease in quantity of PT's employed. However, there may come with that an increase in the individual PT salary since CMS with reimburse higher if outcomes are superior to the norm and lower if they are not. If you track your own outcome measures for certain patient populations you can make a strong case for increased salary or raises.
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That sounds great. Where I am, the best PT clinic in the area (hands down) is reimbursed at one of the lowest rates because so much of what they do is manual work, and the insurance with a state monopoly does not reimburse manual work well. This is despite the great outcomes. I've had many friends and family sent there for a reason- I won't let people I care about go anywhere else. But the wonderful thing about them is that they refuse to compromise that for more cash. It seems quite wrong, though, that they make less when their patients do so much better. It's difficult to argue with a monopoly, though.
D
deleted797640
Yea it will just be for medicare tho until other insurances decide to or not to follow them.
And what is APTA doing about this? Nothing, but they have money to run commercials on YouTube and radio.
www.apta.org
Study: Burnout Comes at a (Literal) Cost to Organizations
A study of physicians adds another dimension to concerns about burnout: it also comes with a hefty price tag.
www.apta.org
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And what is APTA doing about this? Nothing, but they have money to run commercials on YouTube and radio.
Study: Burnout Comes at a (Literal) Cost to Organizations
A study of physicians adds another dimension to concerns about burnout: it also comes with a hefty price tag.
You really fascinate me, PT Dad. I see you've been a member here for a long time. If you don't mind me asking, what do you do for a living? This isn't me trying to discredit what you're saying based on whether or not you are a PT yourself- I'm just very interested by how invested you are in the APTA and the profession, and I'm curious why. It seems like you must care about your daughter a great deal- how does she feel about the recent developments?
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deleted797640
All his previous posts on here are seemingly for his daughter who I guess lacks the inability to post on forums which explains also the inability of him to respond to my comment listing a large amount of variables SHE could change to improve her position in the field. Individuals who complain but do not listen to solutions are pointless to reason with, especially if the complaints are on behalf of another. The dead sea would be jealous of this man's salt level.
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This is gonna sound like a crazy conspiracy theory but maybe he's a shill for the chiropractic industry or big pharma, trying to discredit PT as a profession or something along those lines... Either way he's definitely a troll
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I was taught in philosophy that it's important to be as charitable as possible (when I have the patience, anyway!), so I'd like to assume, for that purpose, that he is sincere. If so, perhaps this is someone who truly cares, but does not realize that his daughter and her profession are not the only ones suffering. In the US, wages have been stagnant for decades while college education and inflation have grown rapidly. A person used to be able to work part time over the summer to pay for college with no debt! That's unfathomable now.
Healthcare in our country is broken, and so is higher education. It would be nice if we could all band together to fight those problems rather than quibbling over whose career is worse, or blaming college grads for their debt. We're all getting shafted. All of us. We've got to stop letting people turn us against one another so that we don't notice how we're being taken advantage of.
That's my take, anyway. We've got to look at the big picture.
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deleted797640
True true, but there are still ways to improve your individual station which involves always looking for advancement instead of looking for things to complain about.
