Is there an Answer?

A number of the comments and/or e-mails are asking if there is an answer to fix the current issues going on in our field right now. These issues, from the productivity standards to the sub-standard salaries, are things that have developed since the creation of PPS in 1998. Reversing this trend will not happen rapidly. So no, I'm sorry but I don't have any concrete answers.

Many have suggested a union to include all therapists. As much as this would give us strength in numbers, the financial aspect of having a union could offset any gain made with salaries. Getting all therapists to join would be another hurdle to overcome. Without the support of a majority of therapists, which could take years, a union would not have a strong stance. Registered Nurses do have unions, but they are mostly limited to each individual state. The United National Nurses Union (part of the AFL-CIO) has only 27 states onboard since their organization began in 1999.

Others have suggested a walkout. This might get us some notice, but probably in a bad light. This could lead to other implications as well, such as fines for abandoning our patients. We could also end up like the air traffic controllers when they walked out years ago, and find our jobs taken by unlicensed personnel.

However, there are several things all of us can do to ensure that things don't become worse, or possibly initiate some change.

First, next year is a presidential election year so study all you can on the candidates. Find out their stand on healthcare issues, especially Medicare reform. If the issue is one that they avoid, they are probably not the best candidate for the job. If they talk about Medicare cost increases or decreasing services, they are definitely not the right candidate. When you believe you've found the right candidate, go vote for the one which you think will support issues regarding healthcare change.

Secondly, write letters to your elected officials. Let them know what is happening in the LTC field. However, it is probably pointless to write a letter complaining about your job security, productivity, and all the other concerns we deal with in our profession. What will hit home is information regarding the type of care our senior citizens are receiving in many of the SNF's today. Stress the fact that as much as many of these seniors would like to go home, there is limited time allotted for daily therapy. For any of you who have been in the field prior to 1998, include facts that have changed since PPS was initiated that affect Medicare recipients.

Finally, be an advocate for your patients. As they may have limited access to current news about the candidates, keep them informed. Many LTC residents vote by absentee ballots, or will vote via a proxy. Make sure they are aware that certain candidates may increase Medicare costs, and/or decrease benefits. An informed vote is what's needed to send a message to Washington.

Until next time, hope all your "thoughts" are good,

Tim