What's it like working at an outpatient clinic?

[manila7242]

So, back story, I've worked for 2 different physical therapy clinics as an aide. The first one was an outpatient clinic which saw a lot of different kinds of patients (vestibular, pediatrics, neuromuscular disorders such as MS, etc as well as ortho). The other, which I'm currently working at, is orthopedic. How these two operate is vastly different. I'm a little bit worried/disenchanted by the field if the latter paints a more accurate picture of what being a physical therapist will be like for me.

So, for the first clinic, physical therapists saw only 1-2 patients per hour. If the patient was a more complicated case, he/she would get a full one hour block getting one on one treatment. Initial evaluations were 60 minutes long with again one on one treatment with a physical therapist. There were many doctors that referred to us because of the quality of care, and we had a long wait list of patients. Some who didn't even get their surgery done yet (TKA, TKH, etc) were advised by doctors to preemptively schedule out their physical therapy appointments with us at least a month in advance to ensure a spot.

I've moved to a new state and now work for outpatient orthopedic physical therapy clinic, again as an aide. It's like night and day.

The therapists are expected to have 3-4 patients an hour on their schedule. On top of that, they're expected to bill ideally 5 units. That's roughly 75 minutes to 90 minutes of "treatment time" according to the front office person I work with, and that comes out to juggling 5-6 patients at any given time once you're an hour into your shift. When the therapists AREN'T billing that many units, they get a lovely meeting with the boss.

I just want to know. What is the "norm"? What is it truly like working as a physical therapist?

I'm currently applying to DPT programs and honestly do hope that I get accept to a program. However, if the latter is what the majority of physical therapists have to put up with, I'm not sure if this career path would be worth it.

Also, how's the inpatient/hospital/SNF work environment like? I've observed at a hospital and thoroughly enjoyed it, but with only observing 20 hours, I don't think I've seen the full picture. What's the workload like? Is it anything like an outpatient clinic?

I just want to know what I'm getting into before I potentially put down $100+K and 3 years into this. Don't get me wrong. I absolutely love this field and the work involved. I understand that any job has it's pros and cons.

---

Members don't see this ad.

 

[noyceguy]

So, back story, I've worked for 2 different physical therapy clinics as an aide. The first one was an outpatient clinic which saw a lot of different kinds of patients (vestibular, pediatrics, neuromuscular disorders such as MS, etc as well as ortho). The other, which I'm currently working at, is orthopedic. How these two operate is vastly different. I'm a little bit worried/disenchanted by the field if the latter paints a more accurate picture of what being a physical therapist will be like for me.

So, for the first clinic, physical therapists saw only 1-2 patients per hour. If the patient was a more complicated case, he/she would get a full one hour block getting one on one treatment. Initial evaluations were 60 minutes long with again one on one treatment with a physical therapist. There were many doctors that referred to us because of the quality of care, and we had a long wait list of patients. Some who didn't even get their surgery done yet (TKA, TKH, etc) were advised by doctors to preemptively schedule out their physical therapy appointments with us at least a month in advance to ensure a spot.

I've moved to a new state and now work for outpatient orthopedic physical therapy clinic, again as an aide. It's like night and day.

The therapists are expected to have 3-4 patients an hour on their schedule. On top of that, they're expected to bill ideally 5 units. That's roughly 75 minutes to 90 minutes of "treatment time" according to the front office person I work with, and that comes out to juggling 5-6 patients at any given time once you're an hour into your shift. When the therapists AREN'T billing that many units, they get a lovely meeting with the boss.

I just want to know. What is the "norm"? What is it truly like working as a physical therapist?

I'm currently applying to DPT programs and honestly do hope that I get accept to a program. However, if the latter is what the majority of physical therapists have to put up with, I'm not sure if this career path would be worth it.

Also, how's the inpatient/hospital/SNF work environment like? I've observed at a hospital and thoroughly enjoyed it, but with only observing 20 hours, I don't think I've seen the full picture. What's the workload like? Is it anything like an outpatient clinic?

I just want to know what I'm getting into before I potentially put down $100+K and 3 years into this. Don't get me wrong. I absolutely love this field and the work involved. I understand that any job has it's pros and cons.

I work at a very small OP clinic and see at most 2 patients an hour. All evals and follow-ups are 1 hour. I bill 3 or 4 units per patient per hour. 9 hours days and a half day Friday. I don't know if this is the norm or not but if I found myself at job where I had to juggle too many patients I would just get a new job.

 

[BiffTheFlashRogers]

I'm a first year SPT. It's not work experience, but I did a ton of shadowing in outpatient settings and everyplace that I spent time saw either 1 patient per block of time (30-60 min) or 2 patients at the absolute max. This may be the exception rather than the rule, and I'm told there are tons of shady outpatient places that you described, @manila7242, but there are definitely good outpatient practices out there.

 

[CherokeeWahine]

I work in a small, private practice outpatient ortho clinic. I see 2 patients an hour (returning patients, not new evals). My patients are usually in the clinic for 1 hour. Initial exams are 1 hour. Monday/Wednesday are 9 hour days, Tuesday/Thursday/Friday are 6 hour days. I rarely feel overwhelmed, because I'm not expected to run a "mill" and mass-treat patients.

 

[NewTestament]

I work in a small, private practice outpatient ortho clinic. I see 2 patients an hour (returning patients, not new evals). My patients are usually in the clinic for 1 hour. Initial exams are 1 hour. Monday/Wednesday are 9 hour days, Tuesday/Thursday/Friday are 6 hour days. I rarely feel overwhelmed, because I'm not expected to run a "mill" and mass-treat patients.

My last rotation of PT school was at a private practice. Most visits were 30 minutes but initial exams were one hour. I had time to properly evaluate the patient, treat the patient, and complete the paperwork.

Right now I'm a traveler at an OP clinic in Texas. Initial exams are only 30 minutes, which means I have to evaluate the pt, provide billable services (at least 8 minutes), and then prescribe at least 30 minutes of exercise so I can bill four units. I was told that every visit must be four units, even when that's not indicated. It's not unethical, but it's a business and some owners want to see as many patients as possible. Routine visits should be 30 minutes, which means the PT sees the pt for 30 minutes and then the techs can assist with the exercises. But never work at a clinic that gives you less than 45 minutes for an initial eval.

 

[manila7242]

Thank you all for reassuring me. With reimbursement rates for physical therapy services decreasing, I'm afraid that a lot of small outpatient clinics will feel pressured to turn into a "mill" to break even. PT programs turning into DPT programs increased tuition costs dramatically in the past 10 years. So I worry about loans as well. I understand that has all to do with making our profession more legitimate and whatever. However, nothing has significantly changed with direct access, and I know it's up to us to educate the public that if you get into an accident that doesn't require surgery like if you were picking something up off the floor and pulled a back muscle, you CAN go to a PT clinic to get it checked out instead of an MD, BUT a lot of insurances still require an MD referral if the patient would like to continue on with physical therapy. Until we're able to treat patients without relying on MD referral....

I'll cut this rant "short". I just worry about the future of our profession, is all.

Anyhow, I'm also applying to engineering programs as a good chunk of my degree in kinesiology counts towards a bachelor's in engineering. It would take me about the same amount of time, maybe less to get that degree. I'm hoping to either work at a medical device company as an engineer with my kinesiology and engineering degree... or become a PT. It all depends on which program wants me. My dream is actually to work with amputees or help create devices that closely simulate the human experience, either as a PT helping someone acclimate to said device or the engineer who has helped create said device.

 

[Bluecase]

I work in a place very similar to the first option you described. I have friends who work in the second. They make more money than I do but I feel like I can really treat and help the people I work with. Non profit hospital based outpatients tend to be like the first example but there are private practices out there that can be similar. You have plenty of time to go to school and find work, just be discerning in an interview about caseload requirements, paperwork requirements, autonomy with your schedule, and autonomy with how you treat (not being forced to perform a certain approach).

While I wish I made 10k more like some of my classmates I would rather stay where I am because I truly love it there


Sent from my iPhone using Tapatalk

 

[PTX2]

Thank you all for reassuring me. With reimbursement rates for physical therapy services decreasing, I'm afraid that a lot of small outpatient clinics will feel pressured to turn into a "mill" to break even. PT programs turning into DPT programs increased tuition costs dramatically in the past 10 years. So I worry about loans as well. I understand that has all to do with making our profession more legitimate and whatever. However, nothing has significantly changed with direct access, and I know it's up to us to educate the public that if you get into an accident that doesn't require surgery like if you were picking something up off the floor and pulled a back muscle, you CAN go to a PT clinic to get it checked out instead of an MD, BUT a lot of insurances still require an MD referral if the patient would like to continue on with physical therapy. Until we're able to treat patients without relying on MD referral....

I'll cut this rant "short". I just worry about the future of our profession, is all.

Anyhow, I'm also applying to engineering programs as a good chunk of my degree in kinesiology counts towards a bachelor's in engineering. It would take me about the same amount of time, maybe less to get that degree. I'm hoping to either work at a medical device company as an engineer with my kinesiology and engineering degree... or become a PT. It all depends on which program wants me. My dream is actually to work with amputees or help create devices that closely simulate the human experience, either as a PT helping someone acclimate to said device or the engineer who has helped create said device.

Perhaps you should consider dual degree programs which offer a DPT and MS/PhD in engineering.