Backup plan in case the PTA license becomes obsolete

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sd13 in Astoria, New York

36 months ago

I recently transferred into the PTA program in my community college. I was at first excited about my upcoming career change. However, after all the horror stories i read in these boards, im now worried about the future of this profession. If this new law hits the PTA field hard, would i still be able to use most of my 68 credits that the PTA offers towards a bachelor degree in another field with good job prospects?

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Riley in Mishawaka, Indiana

36 months ago

Just because the APTA passes it, it really means nothing. For example, joint mobilizations with PTA's years ago. APTA passed it, but it just wasn't feasible, so nobody adopted it. PTA's arent going anywhere. I look back on when I was just a tech, I knew nothing compared to what I know now. PT's would have to teach them everything in order for techs to even act like they could perform certain tasks.

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roseannadanna in Hope Mills, North Carolina

36 months ago

Riley in Mishawaka, Indiana said: Just because the APTA passes it, it really means nothing. For example, joint mobilizations with PTA's years ago. APTA passed it, but it just wasn't feasible, so nobody adopted it. PTA's arent going anywhere. I look back on when I was just a tech, I knew nothing compared to what I know now. PT's would have to teach them everything in order for techs to even act like they could perform certain tasks.

Sorry but I disagree, it means everything as insurance companies restrict and limit coverage allowances for PTA reimbursement. If business aren't reimbursed for services due to its principal employees credentials than the positions will be eliminated. Simple economics.

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T in San Diego, California

36 months ago

"Worrying is like paying on a debt that may never come due."

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T in San Diego, California

36 months ago

Ughh have to retype this....

There is way too much "doom and gloom" and "the sky is falling" talk in here. I dont think PTAs will become obsolete. Can you think of any job in healthcare that has become obsolete?

I think PTAs might not be used as much in the outpatient setting but in SNFs and hospitals they will be. All the PTs Ive talked to and the instructors at the PTA school said not to worry, that they will fight it and that the PTA profession isnt going anywhere. This has been covered in the other threads - Massage therapists, PT techs and ATCs CANNOT do the job that PTAs do. Sure they have SOME knowledge but not as extensive as PTAs. And I dont see how they will allow patients to suffer at the hands of these not-as-skilled workers to save a buck or two.

If I was going in for physical therapy, and a massage therapist or a PT tech, with possibly nothing more than a high school diploma,was working on me I would be very wary.

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pta student in Chesterfield, Missouri

36 months ago

Really Mike? In what setting are athletic trainers more than capable? Inpatient work in a Hospital setting... NO (buzzer sounds)! Free Hint: be specific. I work as an Inpatient Rehab Tech in a Hospital and an AT doesn't do that type of rehab nor are they competent to do so. Why would an AT be working on patients in the PACU, ICU, med/surg, neuro, or any other floor in the hospital? AT's are in athletic care (didn't you get the memo :)), so a PTA isn't going to need to be able to know or do what an AT does and a PTA doesn't need to know or do what an AT does, unless they just want to be responsible health care team members who know what each others function and purpose is. AT's and PTA's are two separate professions and the ONLY overlap is SOME orthopedic conditions with a SIMILAR modalities and/or treatments for these SAME (SOME) orthopedic conditions, but TWO DISTINCTLY DIFFERENT patient populations with DIFFERENT ENVIRONMENTS (an athlete is not a patient (who could be an old person, a mom, an obese person, pediatric, etc.). Patients in the ICU, PACU, med/surg, neuro, etc are not the same patient population AT's are trained and educated to rehab, so where are you coming from?

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pta student in Chesterfield, Missouri

36 months ago

outpatient orthopedic rehab is a one aspect of the large field of physical therapy. So it follows to say that it's a small portion of the pie. Work-related injuries, exercise related injuries, weekend warriors, and athletes is a very specific narrow population with narrow pathology. I don't see how APTA is losing on not including an AT to be part of the physical therapy team in any setting. Plus chiropractors, acupuncturists, massage therapist (one's competent in orthopedic or neuromuscular massage) take up a large chunk of that pie of population you mentioned and do a wonderful job if not a better job than an AT in my opinion. If I were part of that population group you mentioned (and I have been), I would never see a physical therapist or an AT. CAM practitioners are leading the way in outcomes in this narrow patient population group in my experience as former collegiate athlete (I did triple jump).

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pta student in Chesterfield, Missouri

36 months ago

AT's do play that role, I've seen them in plenty of outpatient clinics with physical therapists who have a business centered around treating the narrow patient population with those narrow common pathologies associated with those activities of daily living you mentioned. What role is an AT missing out on in the rehab team? I personally think AT's get a large chunk of their business taken from CAM practitioners such as chiropractors, acupuncturists, massage therapists, some osteopaths not PTA's. PTA's are trained specifically for the treatment role in the all encompassing broad field of physical therapy as AT's are not (as you have clearly mentioned with outpatient rehab with those "active" populations with their associated pathologies) and rightly so. Are you saying AT's want to work under physical therapist like PTA's? Or what really is the issue here?

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pta student in Chesterfield, Missouri

36 months ago

Why would an AT care about medicare patients? APTA loves to lobby all kinds of stuff don't they. I would venture to say most "sports medicine PT clinics" in St. Louis only have physical therapists, but none have PTA's. They all hire techs to fill that role so they can make more money for their business. I know because I worked as tech at an outpatient clinic system in several locations called St. Louis Physical Therapy based in Chesterfield, MO. Regardless of the APTA and their filing of RC 3-11, it goes on anyway in private practice where it is hard for them to get caught. I would say the only security for PTA's is inpatient work only and outpatient private practice is gone unless the supervising PT wants the best care for his or her patients. I know Rehab Care and Pro Rehab have AT's in their clinics alongside PT's. And they are pretty big here in St. Louis and have a lot of different locations, so I would think the job market would be okay for AT's here.

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Future PTA in Seattle, Washington

36 months ago

Mike has been on about this stuff for months here. The bottom line is simple: You knew what you were getting into. PTA's do the job of PTA's, and AT's do the job of AT's. There is a reason for that.

We went to school to be PTA's, why should AT's be able to do our jobs? Even if they did have the qualifications (which I don't buy in the least)since when does qualifications alone qualify you to do a job?

Let's say for example I want to be a teacher tomorrow. I go into an elementary school and I say the following: I love kids, I've got a Master's degree, and I've got years of experience teaching at the college level. I want to transition into being an elementary school teacher. They say to me: Yeah, well where is your teaching certificate? Where is your degree in education? And then I say to them, "but I've got experience that's just as good as these teachers, arguably better, and I know for a fact I'd be just at good at it."

See the problem here? I'm not qualified solely based on the fact that I DON'T HAVE THE ACADEMIC QUALIFICATIONS. Just like you aren't qualified to do the job of a PTA. This how the job market works Mike. Your argument is garbage, end of story.

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Future PTA in Seattle, Washington

36 months ago

Slight correction: The only word I meant to capitalize in that sentence above was the word ACADEMIC. That is the key word...

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lisamarie in Hickory, North Carolina

35 months ago

roseannadanna in Hope Mills, North Carolina said: Sorry but I disagree, it means everything as insurance companies restrict and limit coverage allowances for PTA reimbursement. If business aren't reimbursed for services due to its principal employees credentials than the positions will be eliminated. Simple economics.

I work in Home Health and already feeling the changes. Quite a few PTA's were just laid-off because of medicare reimbursement cuts.

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Jack in Lake Worth, Florida

35 months ago

I've been a PTA since 1995. I remember prior to 2000 before PPS was introduced the shortage of PT's in the USA. They were allowing hundreds of foreign educated PT's to come in to the country to treat the medicare patients. They had to be the worst therapist I have ever worked under.It was allowed due to the fact of a PT shortage at that time. Now with the baby boomers arriving to the medicare ranks and with the education requirements for a PT to be a DPT and the amount of paper work involved for the PT, the job of the PT to treat the patient in mass numbers such as a SNF or Hospital without the PTA will be an impossibility. Additionally with salary reductions to the PT's and the increase of paper work and the rc3-11 proposal to reduce the PTA you will see PT's dropping out the of medical field as fast as the nurses did and are still doing.I know PT's already refusing to do evals for HMO patients because the rehab companies are getting less money and can not pay the PT's at the old rates. Imagine the PT that has to do the eval, rehab meetings, family conference, discharge, group therapy sessions, one on one sessions with multiple patients in the rehab facility at the same time, and etc. all without the PTA and getting less pay for it. TRUST ME IT AIN'T HAPPENING. If it does just like the nursing field it will be total breakdown of the system and sub-standard care to the patient. I have four more years to age 67 and retirement. Like the late John Lennon said "i'm just sitting, watching the wheels turn round and round."

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PTA in Enola, Pennsylvania

35 months ago

Riley in Mishawaka, Indiana said: Just because the APTA passes it, it really means nothing. For example, joint mobilizations with PTA's years ago. APTA passed it, but it just wasn't feasible, so nobody adopted it. PTA's arent going anywhere. I look back on when I was just a tech, I knew nothing compared to what I know now. PT's would have to teach them everything in order for techs to even act like they could perform certain tasks.

Right On!!! PT's depened to much on skilled PTA's. We can not be replaced by techs, it will never happen.

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bluelineman in McKinney, Texas

34 months ago

lisamarie in Hickory, North Carolina said: I work in Home Health and already feeling the changes. Quite a few PTA's were just laid-off because of medicare reimbursement cuts.

A lot of mom & pop home health companies are going to go under.

Once again the APTA hangs PTA's out to dry. That's why they won't get any more of my money.

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Jack in Lake Worth, Florida

34 months ago

I've contact a few liability attorneys who were totally unaware of this possible new protocol rc3-11. They reacted to the news as sharks circling the bloody waters. As one of them told me if a PT decided to by pass a licensed PTA who is qualified under the state law to treat a patient, for an untrained un-licensed individual wholly based upon the PT belief that that person can perform the task, and if injury is sustained by that individual not only would the treating individual be liable, but the PT themselves. The APTA by passing rc3-11 has just put the PT into play for every ambulance chasing attorney out there. Prior to rc3-11 PT's were basically left alone. Think about this folks, you see the attorney commercials on TV, they sue a ham sandwich if they could. I also sent letters to my Congressman and State and US Senators as well as the Governor and Attorney General. I think it's important for the attorny's as well as the law makers to be made aware of the lack of care soon to be put upon the public. Please everyone do the same. It only take a few minutes but the results if we PTA's don't take action to protect our license will be no one fault but our own. Don't trust the APTA to save the PTA.

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Student Perspective in Springfield, Missouri

34 months ago

PTAs may not dissapear off the map but they may not get paid as well as they used to if RC3-11 passes. National Labor Bureau of Statistics puts the national average PTA wage close to $50,000. Currently for my area hospitals pay on the lower end of that. Now if Medicare catches wind of this, that a tech or any monkey can do our job, then Medicare will snap at the chance to not reimburse our services. My teacher told me that in the state of Kansas reiumbursement for the PTA is at $0.

Seeing as a large majority of pateints are on Medicare in the hospital and outpatient settings then its quite possible we will financially starve.

The APTA does not have the same power as STATE LAW. When I was in Arkansas state law declared that it was already up to the PTs discretion who can and can not provide physical therapy services. State law doesnt care what the APTA claims. The private practice for years now has been paying techs to perform our duties. Its so common thats why RC3-11 has come forward. Its already occuring, they just want APTA to catch up to the current times.

PTS who are pro PTA have financial stalk in us. They teach our classes and write our books. They may be in the APTA but they may not be strong enough to confront the private practice which I hear is the majority of the APTA. I read from one PT's blog that such PTs in the area of education are delusional and out of touch with the actual field. There are some stong opinions!

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PTA in Weston, Florida

34 months ago

Well said, and very interesting discussion.

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Student Perspective in Springfield, Missouri

34 months ago

Got some information today from my instructor who goes to the house of delegate meetings and is close to one of the members on the task force. Essentially the task force has come up with some ideas or new language in regards to the PTA profession that will be introduced this summer. These are simply grass roots ideas and not a foundation for anything solid. Perhaps the most interesting was transforming the PTA role to include examination and evaluation procedures that are normally a PTs job. Think of PTAs being more like physician assistants (we'd have to go back and get more schooling)but the diagnosis part would soley be up to the PT. When I asked how PTs might feel about that and whether they'd think we were infringing upon the PT's role not much was said in response because the idea has not been brought forward yet.

The other ideas or options were not as exciting and didnt seem to put the PTA in the best position for a solid career unless of course the RC3 does not pass. But my gut feeling, based on what I heard this sounds more like bargaining. My guess is RC3 will pass and the role of the PTA will be forced to change... now whether that change is in our favor or not could be a toss up. It depends on who is doing the hardest steering.

But another thing talked about today is WHY would PTs want PTAs to be members of the APTA? Currently a PTA is worth HALF a vote in any decision making. That and PTs have their doctorate or masters degree. Why would they want someone with an associates dictating the path of their career? That would be like allowing techs to call the political shots for PTs and PTAs.

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Future PTA in Seattle, Washington

34 months ago

How are PTA's dictating the career paths of PT's? Not sure I understand that one...

PT's. however, are certainly trying to dictate the career paths of PTA's with this bill. All PTA's are doing is attempting to keep THEIR jobs.

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Student Perspective in Springfield, Missouri

34 months ago

PTAs are NOT directing the career path of PTS for two reasons.

1. PTAs are worth only half a vote in any decision making within the APTA. So it takes TWO PTAs to equal one full vote.

2. There are very few PTA members within the APTA.

The APTA and certain PTs whine and moan that PTAs dont care enough about their career because they are not politically involved etc. etc. etc. But if you ask ME- and this is the important part you missed- I dont think they really want you in the APTA or getting to a point where your vote holds any weight or power. You get it?

IF a PTA was given a WHOLE vote and IF PTAs swarmed the APTA then and only then could PTAs sway the career path of PTs. That would piss people off who like things the way they are... few PTA influences.

If they thought you were so radically important why wouldnt they give you a full vote? Even if you pay their membership fees on a yearly basis you are still worth HALF a vote, half a person, half a thought. Sounds like a crummy club to me!

However, APTA does direct change and it can define you as obsolete if they vote it so. However, do you know how much money there is in PTA schools and PTA teachers and PTA books? If you become obsolete those individuals lose money. And the chance that there ARE PTs that love us and patients that love us and facilities that find us important- they will fight for us.

The PTA role has stagnated in my mind while the PT profession has progressed. If we dont pick up pace and become more important- either by redefineing our professional roles, getting advanced education, or what have you... then yeah, you may end up working for minimum wage. We need to evolve or become extinct.

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bluelineman in McKinney, Texas

34 months ago

Student Perspective in Springfield, Missouri -

I completely agree with what you said.

How come our APTA dues aren't half of the PT dues? We get only half the representation. The APTA is definitely rigged in the PT's favor. It is for their self preservation. I was a member for a few years starting in 1997. I never felt like I got any sort of representation. I got a few magazines, which I usually threw away. In fact, the FREE subscription to "Advance" magazine has always been better IMO. I was a member off & on for a few years. In fact I even cancelled my membership when the company I was working for paid for it. I didn't even want to waste THEIR money.

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Student Perspective in Springfield, Missouri

34 months ago

Bluelineman-

That would make too much sense... half vote and half price membership. In my school they push you so hard to LOVE LOVE LOVE the APTA. They even throw in that cliche,"Ask not what the APTA can do for you, but what YOU can do for the APTA." I cant take people seriously when they rip that line off John F Kennedy.

APTA has been around for a long time. At this point after all the so called inspirational speeches have been given and you STILL cant get PTAs to join, participate, and stay active within it; then you have to seriously ask yourself if what you are doing is effective.

PTAs are poorly represented regardless of the APTA- we dont really have any leaders. Perhaps if RC3 11 passes it may stir things up enough that we get organized and possibly form our own group with our own interests and means to protect and progress what we do. I know there is a PTA caucus or what have you but that sounds as mighty as a kitten. They've been around a long time too and you never hear them roaring.

I just dont know, I dont know what the answer is. Personally I hate politics.

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PTA in Weston, Florida

34 months ago

The PTA caucus is made up primarily of older PTAs who own private PT practices. They hire a PT who then supervises the PTAs, but the practices are run by the PTAs, i.e. the PTA who owns it does the business management and sales. So, the PTA caucus is useless for the average PTA. They are protecting the same interests as the PTs pushing RC 3-11, reimbursement preservation, and maximizing the bottom line profit margin.

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Mike in Corry, Pennsylvania

34 months ago

PTs success is tied with Medicare. The ONLY reason PTs (or PTAs for that matter) make so much $$ is because of Medicare's reimbursement. Not only is there tremendous pressure on Medicare reimbursement to go DOWN, Medicare is fiscally insolvent. Private insurance rates are tied in with how much Medicare reimburses. If Medicare reimbursement decreases, so do they.

The APTA has done a wonderful job dividing the profession. PTAs vs PTs. PTs vs DPTs. I see this profession going down into the toilet because Medicare will be a think of the past.

There may be a lot of people that could use PT, but public perception of the career is still very sad (many think PTs do massage and are equivalent to Personal Trainers), and many complain of $20 copays. The success of the profession has been tied into the illusion that it is "free" (or relatively) for the patient. I think those days are behind us.

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PTA in Weston, Florida

34 months ago

Mike, beautifully said. I just came back from an orientation for the new class of 2012, (just-accepted PTA students) at a local college. A student asked the program director in front of the newbie(and highly uninformed) students "Can you comment on RC 3-11?". The PTA program director, looked down immediately, turned red as a tomato, with anger, embarrassment and humiliation, and said "not right now", paused for a few seconds to recover from the kick to her stomach, and continued by saying "unless it will impact whether you want to forfeit your seat or not, but you look like you want to stay, don't you?". I was floored. They're keeping new PTA students in the dark and they're naive enough to accept it. She said they would discuss RC 3-11 later on, once they start the program, in other words... let me take your money first for at least a couple of semesters before you're wise to the fact that we're keeping you in the dark. They even told the class that this year, for the first time, they will not allow any deferment as they have done in the past, i.e. they're not going to allow anyone accepted in 2012 to defer to 2013. A clear sign of desperation. They want to make sure they get your money before the APTA finalizes RC3-11 this July 12th, because once the news gets out, those who defer till next year will change their minds and bail before they spend any money. I was shocked how few people even heard of RC 3-11, something that will impact their careers negatively. I'm sure they're going to play down the impact when and if they ever discuss it. PTA programs are terrified of RC 3-11, they're enrollment will drop significantly.

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Nicholas in Narragansett, Rhode Island

34 months ago

That's very interesting PTA student. So what are you going to do? Would it be wise not to join? I'm supposed to start mine march 26th and I don't know what to do. It would have been a perfect job for me because I love helping people and especially hands on.

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Sucker in Hollywood, Florida

34 months ago

Would that happen to be Edelstein or Holodak?

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Student Perspective in Springfield, Missouri

34 months ago

PTA in Weston- I was unaware that the PTA Caucus was primarily PTAs with a private practice. Would you also say the entire APTA is private practice aside from the forced membership of students? Granted every PT and PTA I've spoken with private practice or not was not a member of the APTA and not a single one of them had anything good to say about the APTA. I was also told by one PT that he believed the APTA would eventually end up shooting itself in the foot because membership is so polarized.

If thats the case why doesnt APTA redefine its name to simply be those practioners in the private field. Then have a seperate group for those practioners not in the private sector? Or is that redundant? In the big scheme of things is the private practice the only thing that matters?

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Student Perspective in Springfield, Missouri

34 months ago

Mike in Corry- I agree with the public perception bit. I had a patient ask me if I went to school to be a professional counter since I was counting his reps. In other words he didnt see the worth in my role as a PTA and granted it was the day of his Eval and he had no previous experience within physical therapy. So there is this public ignorence towards our line of work.

Mike, if you dont mind I would like you to explain to me the Medicare part you were talking about. Are you saying this will happen because of Obamacare or because Medicare is being drained due to the fact that the demand is so high and there are not near enough financial contributors to Medicare?

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Student Perspective in Springfield, Missouri

34 months ago

PTA in Weston- I experienced the same thing with our instructors! They were first very bold prior to the vote on RC3, that it would NEVER be voted for. Then, when it was voted for and the class was told about it you could tell the students were pissed off and confused. When we started asking more questions about it the teachers would quickly change the subject and now its almost this forbidden topic. My peers dont enjoy talking about it obviously because we were halfway through the program when we found out... we graduate this May when the final vote is taken.

I also noticed PTA instructors do NOT like ANYONE who has the nerve to debate with them. They are not even professors by title and yet they act as though they walk on water. They told us a military or tough perspective on education will make us the best PTAs. They forget we are paying consumers, having paid for their services and expect quality product... not for us to participate in their power games.

When I was on my clinicals I mentioned RC3 to the PTs and PTAs around me who absorbed the information with disbelief. It was as if I was telling them to believe in unicorns or something. Then came the quick,"That will never happen! Medicare and insurence companies will not allow it." or "This will never happen here at my location."

Some working PTAs are not even phased by what I tell them... as though Im speaking about the weather.

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Student Perspective in Springfield, Missouri

34 months ago

Nicholas in Narragansett, Rhode Island said: That's very interesting PTA student. So what are you going to do? Would it be wise not to join? I'm supposed to start mine march 26th and I don't know what to do. It would have been a perfect job for me because I love helping people and especially hands on.

What am I going to do? I HOPE I can get a job when I graduate and I HOPE there is quality work for me in the years to come. If the PTA profession tanks or I get paid peanuts I figure I will go back to school for some other degree. Which sucks but I have to earn a living.

The profession of PTAs, like I said needs to evolve quickly or be wiped out like the dinosaurs. Ironically it will be the schools that will do the most fighting because they will lose perhaps millions in revenue if the profession dies out.

Any research I found on this profession prior to joining paints it in the most ideal light. Its not until you are knee deep in it that you see its limitations and political problems. However, that may be ANY job you pursue. Indeed the threat of RC 3 does more than add a thorn to the profession.

I wish I could tell you what to do but I cant. I like to think of myself as a realist, however the idea that I might have been royally screwed by my choice in profession keeps me ridiculously hopeful that it will pan out.

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Mike in Corry, Pennsylvania

34 months ago

"Mike, if you dont mind I would like you to explain to me the Medicare part you were talking about. Are you saying this will happen because of Obamacare or because Medicare is being drained due to the fact that the demand is so high and there are not near enough financial contributors to Medicare?" -- Student Perspective in Springfield, Missouri

Medicare has been known to be a huge problem for decades now. Not only do to Geographics, but general economics. America's economic infrastructure can not support these programs. America doesn't produce things anymore. The resource-based welfare economy doesn't produce wealth. Asking kids to maintain these programs is unsustainable from both a Geographic and Economic perspective.

Regarding Obamacare, it's nice to put all kinds of requirements on an unemployed workforce getting their unemployment check FROM the Govt, but the whole thing looks pretty shaky with a World Reserve Currency that other nations are looking to get out of because of the financial policies at the Fed Reserve. Some countries won't accept the Dollar anymore. They are "diversifying" toward metals.
Obamacare is about patting Special interests on the back (Insurance companies, Lobby groups, etc). It's not about the people. So a lot of promises, but that's all it looks to be.

This isn't a problem of one administration though. This has been known for decades now. No one wanted to fix it responsibly and clean up the corruption in Politics, the Media, the responsible way. So now we get to see it correct itself I believe.

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JoeC7 in Orlando, Florida

34 months ago

That is kind of sad to see whats going on with PTA's. I do believe they play an important role, so hopefully this RC3 act doesn't come into play. I will, however, tell you some of the perceptions of an ATC on here are not correct. An ATC by no means is limited to the athlete population/orthopedics. I am an ATC and worked in a neuorological clinic. The reason they wanted ATC's is because of our broad scope of practice. Primarily, they wanted a profession with the injury evaluation/assessment skills to oversee certain parts of rehabilitation, such as improving ADL's, conditioning, injury pervention, and conditioning. I never felt limited what so ever, because our studies prepare us to serve in many different settings. We can decide our own course of treatment, modalities, assessments, etc. without the supervision of a PT. Typically an AT undergoes 4 years of education from an accredited program, takes a rigorous board exam (BOC), and 80% of AT's go on to obtain their masters in a a concentrated area.

I do not mean to belittle a PTA, but ATC's typically have 6 years of education, along with other professional certifications. They can assess, diagnose, treat at their will under a license of a physician. They do not need to check in with an MD unless a case needs to be further evaluated/beyond the scope of practice.

A PTA basically administers what a PT prescribes in term of rehabilitation. This includes exercises, modalities, parameters on modalities, etc. They do not call the shots...where an ATC can and does. To compare the fields in the first place is just silly! When an ATC works in a clinic, it varies on the roles they play depending on the setting. ATC's work in a wide range of health care, providing services from high school, college, and professional athletics. They work as physcian extenders in hospitals, clinics, industrial settings...and this continues to grow.

I hope PTA's stick around, but don't speak about another profession before having facts!

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Student Perspective in Springfield, Missouri

34 months ago

Mike in Corry, Pennsylvania said: "Medicare has been known to be a huge problem for decades now. Not only do to Geographics, but general economics. America's economic infrastructure can not support these programs. America doesn't produce things anymore. The resource-based welfare economy doesn't produce wealth. Asking kids to maintain these programs is unsustainable from both a Geographic and Economic perspective."

Because of an assignment I had to do I researched more on this topic. You are absolutely right about Medicare being something we can not financially support especially in this economy.

According to the APTA Medicare caps physical therapy at $1,880 dollars and this amount is not renewed with a new diagnosis. This applies to all facilities other than the hospital which has exceptions to this.

However when you have people who exceed the cap and you throw in Medicaid and the uninsured you have billions of dollars that is owed to the hospital. So who pays the bill? The hospital has to get paid! And here is the ugly part I hated learning about- "Cost Shifting".

This billion dollar bill is spread out to the clients with private insurance- thus the higher costs of insurance. I mean, if people are asking WHY is health insurance so expensive, its because the paying consumer is footing the bill of unpaid Medicare costs (and the like).

Futhermore in 2010 Blue Cross Blue Shield (in the state of Kansas) declared they would only reimburse PTA's by 50%. The costs of running a clinic remain the same and according to the ADVANCE article I read supervision policies are also holding us back.

This is really depressing. RC3 may come as a surprise to most but once you start digging around its practical from a financial standpoint. That and as much as I love what we do, our profession and APTA limits us from being more significant.

Is it possible to turn the Titanic around?

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PTA in Hollywood, Florida

34 months ago

I agree, and I know people who work in Medical Billing and they've told me that large Medicare reimbursement cuts are coming. I too read about the BCBS cuts in Kansas, and they predict that this is coming in the near future from Medicare also. Once Medicare decides to cut PTA reimbursement rates by 50%, ALL of the private insurance companies will follow. These Medicare cuts coming down the pipeline are in part responsible for the APTA motivations behind RC 3-11. Once cuts are implemented, the days of $55,000/year average PTA salaries will be over. I wouldn't be surprised if PTAs average $38,000/year after that. That's what they are making in my area in Outpatient. Only then, will more PTAs and PTA students wake up and realize what happened, and it will be too late for the profession.

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Nicholas in Narragansett, Rhode Island

34 months ago

PTA in hollywood are you saying to stay away or that the average salary will decrease to 38k and it will still be a viable profession?

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Mike in Corry, Pennsylvania

34 months ago

"Student Perspective in Springfield, Missouri"

I hate to point fingers in the blame game, but the "baby boom" generation has not done a good job AT ALL of preparing for their most vulnerable years. How are us kids going to correct the Juggernaut they've neglected for two so and up decades now? With ALL the known co-morbidities associated with being OBESE, and an estimated ~70 percent diseases resulting from BEHAVIORAL issues, they've put their kids in a very tough position. The ONE thing that could have been accomplished in the Healthcare "reform" is some sort of monetary INCENTIVE for RESPONSIBLE weight maintenance/ reduction. As a nutrition guy, Fat mass loss (specifically) is largely confirmed alone to decrease morbidity of just about every single Chronic disease significantly. It is well established. Weight/
BMI/Fat Mass, etc are all easily measured, accurate, quick, and objective. It's an idea. What's been missing is ACCOUNTABILITY. One thing everyone could do (especially the Baby boomers) to drastically reduce healthcare costs is simply lose some weight. It's not a cosmetic issue but a health issue - a costly one that drains resources over time.

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Mike in Corry, Pennsylvania

34 months ago

Another thing they could do (and should have happened years ago), is re-establish the CURRENCY back to an asset-based standard. We have had (since Nixon) a "fiat currency" when he took us off the Gold Standard in the 60s. It was foolish for the public to allow that to happen because that blasted off the decline of value of the American currency. It took away the power from the people, and gave it to Washington. Dumb idea as we see they haven't been holding back on spending us into oblivion making a ton of promises they look to default on with "tax payer" dollars. Of course tax payer dollars coming from Government jobs don't help much.

So the Titanic has been driving directly towards the iceberg for quite some time now due to neglect. The sad thing is the majority of people still don't see it. The whole thing rests upon the strength of the currency which is tied to OPEC as the "World's Reserve Currency". The World doesn't like our irresponsible fiscal practices (printing money to pay debts). They are seeing the currency as "risky" and "diversifying". So us kids aren't going to be able to bare this burden when they are old and fragile. They've been driving it towards the iceberg for years and now that we're about to hit they're bailing giving us the wheel to correct it.

I am not too optimistic it can be corrected. America by and large is still sleeping. The Politicians showed their hands who they are working for - the Bankers and special interests. Political reform (getting rid of the Hegelian Dialectic) left - right paradigm that THEY control would be a good start. These people have sold out this country, but we still believe the Media? Huge correction coming I think. Sad it didn't get done responsibly. America the land of the fat off the fruit of other Countries labors for years now and it's all coming home to roost I think.

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Mike in Corry, Pennsylvania

34 months ago

One last thing... Why are the Doctors, Nurses, Nurse Assistants, etc all understaffed running around in circles to a level in which patient safety is compromised while the "administrators" are making the big bucks. Who's doing the work in "healthcare". Looks to me a whole lot could be getting done by taking out the middle men twiddling their thumbs getting in the way of the patient - provider relationship. Decentralize decentralize decentralize. You don't need some guy in Medpac or whatever to determine whether a service is worthy to be paid for when the patient does a pretty good job of quality control. If it's a worthy service, they pay. If not, they don't. Cost inflation throughout the entire system that doesn't need to be there. $7 for a Tylenol at the Hospital? And they wonder WHY Health care is so much? Getting rid of a lot of people that don't need to be there = cost reduction.

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Student Perspective in Springfield, Missouri

34 months ago

PTA in Hollywood, Florida said: Once cuts are implemented, the days of $55,000/year average PTA salaries will be over. I wouldn't be surprised if PTAs average $38,000/year after that. That's what they are making in my area in Outpatient. Only then, will more PTAs and PTA students wake up and realize what happened, and it will be too late for the profession.

Currently in my area PTAs are not making the national average of $55,000 a year. That or I cant get anyone to confess that they are making $55,000. An out patient PTA did tell me she was making $35,000 a year... if thats the norm around here and if everything goes through like you said, those wages will drop even more.

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Student Perspective in Springfield, Missouri

34 months ago

Mike in Corry, Pennsylvania said: "Student Perspective in Springfield, Missouri"

I hate to point fingers in the blame game, but the "baby boom" generation has not done a good job AT ALL of preparing for their most vulnerable years. How are us kids going to correct the Juggernaut they've neglected for two so and up decades now? With ALL the known co-morbidities associated with being OBESE, and an estimated ~70 percent diseases resulting from BEHAVIORAL issues, they've put their kids in a very tough position....One thing everyone could do (especially the Baby boomers) to drastically reduce healthcare costs is simply lose some weight. It's not a cosmetic issue but a health issue - a costly one that drains resources over time.

Medicare started up in 1965 so when you think about it, it hasnt been around a long time. What were people doing to prepare for retirement before then? Someone told me that the only way to get people to stop eating McDonalds every day was to hit their wallets. In other words if you are obese and choose to eat crap all the time and lead a sedentary life style then you pay more for health insurance.

There is more education and resources today on getting healthy and being fit but do people take advantage of it? Nope! We have a society that enables others to not take accountability for their actions, like you said, and in return the whole of society has to pay for it. I totally agree with you.

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Student Perspective in Springfield, Missouri

34 months ago

Mike in Corry, Pennsylvania said: One last thing... Why are the Doctors, Nurses, Nurse Assistants, etc all understaffed running around in circles to a level in which patient safety is compromised while the "administrators" are making the big bucks. Who's doing the work in "healthcare"....Getting rid of a lot of people that don't need to be there = cost reduction.

Hospitals are BIG businesses that say their number one priority is patient care but really its making money and THEN patient care. I get that to a degree but at the same time there needs to be some sanity. Just like with the RC3 thing... will patients be safer and receive BETTER care without us? I sincerely doubt it.

Furthermore this link - www.mopt.org/memberonly/newsletters/11/aprilmayjune.pdf
(dated last year) states "RC 3 was adopted (Yes 233; No 167 by an electronic vote) with amendments to language including Proviso – doesn‘t go into effect until July 1, 2012."

Our teachers claimed that it needed ONE MORE vote in order to really count so to speak. But this sounds like it was voted for and will go into place.

Everyone I talk to about RC3 claims the insurance companies and Medicare will not tolerate such changes. Mostly because of liability issues. But that argument doesnt sound solid... Insurance companies are not going to save the PTA profession with their devotion to patient care. Right?

Here is an interesting link I found where a PT is arguing FOR RC3

blog.myphysicaltherapyspace.com/2011/04/accountability-in-physicaltherapy-rc-03-11.html

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PTA in Hollywood, Florida

34 months ago

Student Perspective in Springfield, Missouri said: Currently in my area PTAs are not making the national average of $55,000 a year. That or I cant get anyone to confess that they are making $55,000. An out patient PTA did tell me she was making $35,000 a year... if thats the norm around here and if everything goes through like you said, those wages will drop even more.

That's exactly correct. The $55k average around here is for SNF which of course pays more cause it's a less desirable environment for many. Outpatient pays much less cause there are more interested applicants applying, simple supply and demand. But yeah, at least in Kansas, Blue Cross Blue Shield was saying that PTAs should be making $25k to $30k when they decided to cut PTA outpatient reimbursement rates by 50% (their logic was that the level of education did not merit $50K/year).

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Meh82 in Memphis, Tennessee

34 months ago

We PTA don’t need a Backup plan in case the PTA license becomes obsolete; we need a plan to keep our license from becoming obsolete! Assuming that RC3-11 will go into effect on July 11th, I as a PTA member of the APTA will quit and will call on all PTAs and those opposed to RC3-11 to withdraw membership this seems common sense as the APTA will have proven that they do not represent their PTA members.
PTAs still have a HUGE trump card, State Law! RC 3-11RC and RC 4-11 Through RC 12-11 are Regulations or standards adopted as rules by the APTA to implement, interpret, or make specific the law enforced or administered by the Physical Therapy Practice Act. Laws are created by statutes that originate from legislative bills originally introduced by either the State Senate or the Assembly. State Laws governs the practice of physical therapy in that state. State law supersedes all regulations. On July 11th when the regulation goes into effect I will call my state board and inform them of the changes, explain the potential for reduced patient care/safety and remind them that PTAs are trained, tested, licensed and represent the minimum safe standard for the Implementation a Physical Therapist POC.
I as a PTA will do this on July 11th 2012 if RC 3-11 goes into effect. I am in contact with members of my class and the current PTA students enrolled at my Community College and have urged them to do the same. I hope that we will be able to out up an organized front against the APTA’s new regulations.

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Jack in Lake Worth, Florida

34 months ago

I continue to do my own research on the RC3-11 and have spoken to many physicians in the South Florida region concerning this matter. To my shock they all stated if the PTA is eliminated and that the State of Florida allows the PT to determine who will treat the patient based upon the PT concept that the individual they so choose to perform that specific task, even though they are not licensed or educationally trained specifically for the physical therapy then why do me need a PT. I asked what do you mean by that. To my amazement (and it makes sense) they stated that they the physician would train there own people to treat the patient therefore by passing the PT and receieving all the monies instead of sending it to the PT. I asked them can you legally do that? They stated if the State allows a PT to do it than why not the physician. I think the APTA is in for a rude awaking. If what these physician state they would and can do it would mean that the PT could become obsolete. Wouldn't that be something.

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Mike in Waterloo, Illinois

34 months ago

Meh82 in Memphis, Tennessee said: explain the potential for reduced patient care/safety and remind them that PTAs are trained, tested, licensed and represent the minimum safe standard for the Implementation a Physical Therapist POC.

But there are also other qualified individuals who are able to do the job as well if not better in certain situations. In outpatient rehab (where most of this seems to be important) certified athletic trainers (licensed healthcare providers), massage therapists (often licensed?), and a variety of fitness professionals.

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Future PTA in Seattle, Washington

34 months ago

You're a real one trick pony here Mike. Why do hang out here? You're not even a PTA. Its just sad that you have nothing better to do than dream of being a PTA.

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Meh82 in Memphis, Tennessee

34 months ago

Mike, Indeed there are other qualified individuals... If a PT Decides, after a Patient Assessment, that Massage Therapy is needed then the PT should refer the patient to a LMT who has their own training, license, and a skill set, which is outside of the scope of practice of a PT, In Tn. where I am licensed the law states that a PT can not hold themselves out to be or provide service as a Massage Therapist. The same can be said for ATC's. It is not safe or appropriate for a PT to supervise an Individual that has any skill sets that are outside of the PT's scoop of practice! All PTA’s skill sets falls within the PT's scoop of practice or "PHYSICAL THERAPY", Therefore It is appropriate for a PT to supervise a PTA. Moreover sense PTA's are trained, tested and licensed on skills of Physical Therapy, They represent "The minimum safe standard for the Implementation a Physical Therapist POC or PHYSICAL THERAPY.

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Mike in Corry, Pennsylvania

34 months ago

Future PTA in Seattle, Washington said: You're a real one trick pony here Mike. Why do hang out here? You're not even a PTA. Its just sad that you have nothing better to do than dream of being a PTA.

Actually at this point I'm dreaming of any viable career path. I keep hitting brick walls. I've spent 2+ years post BS degree preparing for entrance into a DPT program. I've tutored a number of Pre-PTAs in the sciences.

Why do I poke my head in? Because I'm interested in what's going on in the world. I have a lot of time and money invested in Therapy. I like to know what is going on.

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