Anyone else work in the rehab world, PT, OT, ST? Considering a career change?

[+ Kman]

I currently work in occupational therapy...going on 10 years and 13-14 years total in healthcare. Since October the therapy world has become, IMO, a shit show and reimbursement rates were slashed. Then, I am not sure when this is supposed to happen, but there is supposed to an additional 8% cut in therapy reimbursement! Point being not a lot of opportunity to be getting a raise anytime soon as well as rehab companies going under, potential pay cuts, which some companies have done. So, curious if anyone else works in the field and maybe considering a career change?

[+ FrankR]

I currently work in occupational therapy...going on 10 years and 13-14 years total in healthcare. Since October the therapy world has become, IMO, a shit show and reimbursement rates were slashed. Then, I am not sure when this is supposed to happen, but there is supposed to an additional 8% cut in therapy reimbursement! Point being not a lot of opportunity to be getting a raise anytime soon as well as rehab companies going under, potential pay cuts, which some companies have done. So, curious if anyone else works in the field and maybe considering a career change?

Forgive my ignorance, but what changed in October? Is this an industry wide change or just your State? I can certainly understand you concern if this is impacting you directly.

[+ Kman]

Forgive my ignorance, but what changed in October? Is this an industry wide change or just your State? I can certainly understand you concern if this is impacting you directly.

.

 

It was an industry change, basically we were told that doing group (2-6 patients at a time) or concurrent (2 patients at a time) is a beneficial way to complete therapy and you will be reimbursed at a higher rate...now it’s not mandatory but it’s an option. But the therapy companies are now pushing for group and concurrent treatments because that is where they will make their money...so in the facility I work in it’s just not feasible day in and day out a lot of them are younger and could care less if they ever saw therapy, or they are focused on getting their drugs and alcohol. So when groups and concurrent aren’t done the reimbursement rate is lower and so we have been seeing layoffs and lots of companies have been doing lay offs to save money and so there is supposed to be another 8% cut in October I think which will probably create more layoffs. So yeah...jump ship now? Or

[+ sniper]

Shouldn't mandating group be some sort of privacy violation? I realize it's not the most obvious thing to want to keep confidential, but you can't keep someone's medical info private if you are treating them with multiple observers.

 

I am not in the field but I know a lot of PTs who have abandoned the insurance model altogether and went solo and charge cash. Others only take insurance as out-of-network so they can charge what they think is reasonable and the patient makes up the difference. May not be as feasible for OT or in your location depending on local income levels.

[+ Kman]

Shouldn't mandating group be some sort of privacy violation? I realize it's not the most obvious thing to want to keep confidential, but you can't keep someone's medical info private if you are treating them with multiple observers.

 

I am not in the field but I know a lot of PTs who have abandoned the insurance model altogether and went solo and charge cash. Others only take insurance as out-of-network so they can charge what they think is reasonable and the patient makes up the difference. May not be as feasible for OT or in your location depending on local income levels.

.

Exactly! The confidentiality piece is tricky and people don’t have to be in a group if they don’t want to.

 

Yeah going solo might be a good idea but around here (Minnesota) the market is saturated with occupational therapy so that would be tough.

[+ Pensant]

I’ve heard the same from PT’s, who are now required to get a doctorate, with the attendant 6-figure debt. The only providers who seem happy to me are nurse practitioners and physician assistants, particularly in highly reimbursed specialties like orthopedics.

[+ Kman]

And the other thing is CMS/Medicate don’t give a damn anymore...nothing to do with the patient all about how to save a few dollars...

[+ sniper]

There is zero political will to spend more but the reality is the population is aging and total medical needs are increasing. My sister's nursing home has gone from being, in her words, "not THAT bad - it's just like a really crappy resort" to somewhere I am afraid to go 24 hours without seeing her in person. She's wound up on IV fluids for dehydration twice because nobody noticed when she was having trouble feeding herself.

[+ Kman]

There is zero political will to spend more but the reality is the population is aging and total medical needs are increasing. My sister's nursing home has gone from being, in her words, "not THAT bad - it's just like a really crappy resort" to somewhere I am afraid to go 24 hours without seeing her in person. She's wound up on IV fluids for dehydration twice because nobody noticed when she was having trouble feeding herself.

This is a sad reality all over, the minimum standards for nurses/aides to patients is like 1 to 10 (maybe that varies by state) and usually that isn’t a big issue in transitional because can get themselves up and dressed and let their needs be known but in long term care many require a lot of care and nursing staff don’t have a lot of time and rush through everything

[+ Eric Hassan]

I currently work in occupational therapy...going on 10 years and 13-14 years total in healthcare. Since October the therapy world has become, IMO, a shit show and reimbursement rates were slashed. Then, I am not sure when this is supposed to happen, but there is supposed to an additional 8% cut in therapy reimbursement! Point being not a lot of opportunity to be getting a raise anytime soon as well as rehab companies going under, potential pay cuts, which some companies have done. So, curious if anyone else works in the field and maybe considering a career change?

 

i have my BS and MS in occupational therapy and spent 14 years practicing before i left 5 years ago to go full-time in sex work. in my time as a practiciing clinician, i saw repeated funding cuts, new vague rules, limitations on treatment, changing (expanding) documentation needs, higher productivity requirements, and a general decline in the ability of professionals such as OTs, PTs, and STs to provide the best care possible because of these things. i eventually left the last company i worked for because after a significant medicare fine, the company laid off thousands of people, eliminated rehab supervisors and directors (a year before i had been a director and stepped down because i wanted to do more direct patient care, and i would have lost my job if i had stayed), and morale was super low.

 

what i can tell you as someone who made the career change is that the skills you have gained as an OT will carry you far. i always say that as an OT i had to walk into a room with a 90 year old lady who had never met me and was sick, and and in less than 15 minutes i needed to convince her to take off her clothes while i watched and scrutinized how she did it - if you can do that smoothly, you can handle almost anything. also, you've probably gotten used to knowing what 15 minutes feels like, or when an hour is up - you can imagine how valuable that is. also, you've probably developed a natural skill for making people feel comfortable, for having difficult conversations, for providing a complete experience in the time allotted, for setting goals and measuring progress, for finding humor in awkward situations, for keeping track of multiple people and changing situations over a perid of time, and coming up with solutions to problems and alternatives to typical ways of doing things. i regularly use the skills i developed as an OT in my work as a sex worker.

 

the flip side that i want to present is that sex work is not for everyone. if you're only running away from something (a changing healthcare situation) you might want to think twice - healthcare has forever been a shit show, and what seems like trouble now will become the new normal - when i entered the healthcare world, there were people then bemoaning a system that felt good to me. funding will come and go, rules will change, morale will drop and come back up - but people will keep being sick and getting injured. but if you are considering this choice because you are looking to something (a new opportunity to use your skills and interests), i wou;dn't hesistate to advocate for you giving it a shot. but do what i did - make sure you have your license and continuing ed up to par, and give yourself a year, then evaluate. you can always go back to OT if you find sex work is not for you, or not making you the money you need or want.

[+ Kman]

i have my BS and MS in occupational therapy and spent 14 years practicing before i left 5 years ago to go full-time in sex work. in my time as a practiciing clinician, i saw repeated funding cuts, new vague rules, limitations on treatment, changing (expanding) documentation needs, higher productivity requirements, and a general decline in the ability of professionals such as OTs, PTs, and STs to provide the best care possible because of these things. i eventually left the last company i worked for because after a significant medicare fine, the company laid off thousands of people, eliminated rehab supervisors and directors (a year before i had been a director and stepped down because i wanted to do more direct patient care, and i would have lost my job if i had stayed), and morale was super low.

 

what i can tell you as someone who made the career change is that the skills you have gained as an OT will carry you far. i always say that as an OT i had to walk into a room with a 90 year old lady who had never met me and was sick, and and in less than 15 minutes i needed to convince her to take off her clothes while i watched and scrutinized how she did it - if you can do that smoothly, you can handle almost anything. also, you've probably gotten used to knowing what 15 minutes feels like, or when an hour is up - you can imagine how valuable that is. also, you've probably developed a natural skill for making people feel comfortable, for having difficult conversations, for providing a complete experience in the time allotted, for setting goals and measuring progress, for finding humor in awkward situations, for keeping track of multiple people and changing situations over a perid of time, and coming up with solutions to problems and alternatives to typical ways of doing things. i regularly use the skills i developed as an OT in my work as a sex worker.

 

the flip side that i want to present is that sex work is not for everyone. if you're only running away from something (a changing healthcare situation) you might want to think twice - healthcare has forever been a shit show, and what seems like trouble now will become the new normal - when i entered the healthcare world, there were people then bemoaning a system that felt good to me. funding will come and go, rules will change, morale will drop and come back up - but people will keep being sick and getting injured. but if you are considering this choice because you are looking to something (a new opportunity to use your skills and interests), i wou;dn't hesistate to advocate for you giving it a shot. but do what i did - make sure you have your license and continuing ed up to par, and give yourself a year, then evaluate. you can always go back to OT if you find sex work is not for you, or not making you the money you need or want.

 

Thank you for the advice @Eric Hassan! I would say it is part I am wanting to run away because its unstable and things are changing and the other part is looking for a new opportunity. Never considered sex work to be honest but yeah therapists can handle just about anything including getting an elderly woman to get dressed in front of us!