Perspective from Physical Therapy
want you to take the lead on this when you can.
The percentage of persons with diabetes and
diabetic-related complications (at a guess) is
about 20 percent. Whatever it is, I will say most
people are unaware of the current entitlements
associated with DM (therapeutic shoes, inserts
and modifications).
The general outcomes of a therapy program
vary from building to building. It depends on
what level of client your facility is equipped to
manage. Three-fourths of my STR patients return
home. Many of the others become LTC residents.
Much is based on the environment at their home,
the level of care that they require, and if there
is someone who can assist or coordinate this
situation for the patient.
There has been talk that physical therapy
programs are overused in the LTC population.
Of the LTC patients referred to PT, most do
benefit in some manner. We’re also quite well
aware that we can’t fix everything. It’s not unusual
for our focus to be on learning how to teach the
nursing staff on how to better manage a person’s
functional level as is. Often, we can improve
patient handling techniques well enough to
improve patient comfort and decrease the staffing
needs to manage a patient’s safe mobility. We
definitely don’t like bad referrals and often turn
down more than we should. Being good stewards
of our providers is deeply ingrained in our
training. Several years ago Medicare put a cap on
therapy services, but it was rescinded. Currently,
there is a maximum dollar amount that can be
spent on therapy services.
In my experience, occasionally, male therapists
do better with women and vice-versa. Women,
generally, listen better. Men are a little more
likely to explore the limits of acceptable behavior.
But, these generalities work both ways. I don’t
have a preference at all. I primarily want patients
who are motivated to get better and to understand
what I need them to do to accomplish this.
I came into the therapy field in a quite
convoluted way. I was deeply engaged in a dog
training hobby, when my mother-in-law, watching
me, thought that my caring and patient approach
would apply well to a career in physical therapy.
She was a nursing home director, so she felt well
assured in her advice to me. I think she also
wanted her daughter’s husband to be a little better
provider.
There is always the issue of job satisfaction. It
truly depends on the person. Some are in the
field to get a paycheck; others are truly caring.
“Rewarding,” for me, is mostly linked to my
patients’ successes and to how I interact with my
co-workers. I’m glad that twenty-five years into
this, I can still say that. The field has changed a
lot in this time. Looking back, knowing what I
know now, and with the quasi-politics involved, I
might have pursued being a veterinarian instead,
but I don’t have any great regrets. At age 50, my
bigger concern is in my ability to enjoy my career,
be effective, and make it to the finish line in a
respectable manner.
I’m asked quite regularly from prospective
students my advice on a career in rehabilitation.
“Is it worth pursuing?” The market in this region
is not so great for therapists and has left a lot of
us disappointed. Most therapists (in LTC/SNFs)
are not employed any longer by their facility, but
by a contract therapy company. In-house facilities
sometimes go to contract companies. Other
times, contract companies are dropped to return
to in-house. So, job security is a bit nerve-racking
at times. Yet, in other areas of the country, the
field is lucrative and flourishing. The schooling is
lengthier and the pay lower than ever before. Still,
it is a lifestyle and career to be proud of, and for
the altruistic at heart, it remains a good choice.
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Current Pedorthics January/February 2016
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