Today in PT

Dangerous Curves Ahead

A recent informal APTA poll revealed that many of you are uncertain about the future, with a whopping 80% either unsure or lacking confidence that the changes associated with upcoming healthcare reform will be positive. But whether change is bad or good, it is always stressful, and everyone — including therapists, MDs, RNs, and even insurance companies — is frantically scrambling to try and make sure they will get a piece of the action going forward.

In the small, family-like outpatient clinic where I work, we just received the news that a certain large national insurance company has decided to ration its payment for PT services. Patients that have plans that allow for 60 visits per calendar year are now being arbitrarily capped at 25 visits, and those with unlimited coverage according to medical necessity are also capped at 25 visits. All cases under appeal are being denied, regardless of supporting documentation. How can they do this? It seems illegal to withhold agreed-upon services from patients who signed up for a particular plan ... is this a last-ditch effort by the insurance companies to make a profit while they still can? Is this a taste of future healthcare rationing? What about the patients' needs?

Have any of you noticed any high jinks out there with insurance companies? I’ll be interested to hear your thoughts and experiences.

Anne Ahlman, MPT

Men Matter

I always have mixed feelings around Father’s Day (which is this Sunday — don’t forget!). At the fiercely independent active senior living complex in which my mother lives, the staff always makes a huge big deal about Mother’s Day, complete with all sorts of thrilling festivities and a fancy champagne brunch. But when Father’s Day rolls around, it’s as if the men don’t exist, although there are plenty of them living there. You can practically kick the tumbleweeds around in the deserted hallways as you listen to the sound of crickets chirping in a nearby empty field — it’s like a ghost town.

Why don’t we honor our men more? OK, I understand that as we age, some men have a tougher time of things — after all, in the U.S. the male life expectancy at birth is 74.6 years, as opposed to 82.7 years for females — but perhaps this means we should value the men in our lives more, since the likelihood is they won’t be around as long. Of course, not all men are fathers (nor all women, mothers) … but still, I think they deserve equal treatment.

These thoughts may not have much to do with PT practice, but I am reminded of them by the sad faces of some of my male patients who aren’t honored for their fatherhood on this half-forgotten day. Since I tend to see all of my patients — and all people, for that matter — as being equally valuable, the societal discrepancy bothers me.

Although my own father succumbed to cancer many years ago, he used to enjoy going to the movies and having malted milkshakes or ice cream afterward. In fact, the last thing he managed to eat before slipping into a coma was a lime-flavored popsicle ... I wish now that I had the chance to spend another Father's Day with him.

What are your plans for Father’s Day?

Anne Ahlman, MPT

Shifting Sands

On some level, most therapists thrive on change. We spend our days actively seeking out even the tiniest markers of progress, looking forward to meeting new patients and solving fresh problems, and itching to get our hands on a new treatment technique. In the majority of cases, change is good, and whets our appetite for more.

But when too much is changing all around us, it can become stressful and knocks us off balance. It’s like trying to hold onto a handful of sand — when all the grains are shifting, it’s impossible to maintain your grip.

Change is especially rough when it involves losing contact with someone you value. Certain patients — and coworkers — get under our skin, and when it’s time for them to spread their wings and fly away it can be quite painful for the ones left behind. Of course, we rejoice in their successful recovery, good fortune, and improved prospects … but it can be hard to carry on in your normal routine when you’ve temporarily lost your footing.

Whenever I’m feeling vulnerable to the slings and arrows of outrageous fortune, I try to comfort myself with the thought that shifting sands can assume new and interesting shapes, and that change is a part of life that generally uncovers a fresh round of opportunities previously unseen.

How do you deal with change?

Anne Ahlman, MPT

Spoiled for Choice

I’ve been reading up on PT employment trends lately, and am finding that at least in my part of the country — the San Francisco Bay Area — PTs and PTAs are still in hot demand. Although some of the larger hospitals have suffered a hiring freeze due to the economic downturn, business is booming in the smaller clinics and they’re actively seeking help.

Of course this makes me wonder if any of you are currently looking for a new job. What factors make a PT/PTA move on? What drives you to stay in your current position? Which benefits have the most meaning to you?

In recently published APTA surveys examining national job trends in outpatient facilities, acute care hospitals, and SNFs, PT vacancy rates ranged from 13.1% to 18.6% and PTA vacancy rates ranged from 8.8% to 16.6%. Many respondents agreed that factors negatively impacting employment included inadequate time for staff development and documentation, but that despite PT staff shortages, the therapists continued to deliver quality patient care in the face of adversity across all settings. But times may be changing — how long can therapists continue to deliver quality care when they are faced with skyrocketing productivity demands and have inadequate time to document or attend CE courses?

I’m interested in learning what’s happening in your setting, and am conducting an informal survey to find out if you’re happy where you’re working. If not, why not? If you’re looking for a job, what are the three most important features you’re looking for in your “dream job”? When you’re job hunting, do you network with colleagues, surf the Internet, contact your local chapter of the APTA, or pick up the latest copy of Today in PT for job listings?

Feel free to contact me privately at pteditor@gannetthg.com, or leave a post for me here with your thoughts. You've got lots of choices out there, so don't stay somewhere if you're not happy.

Anne Ahlman, MPT