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Toni Talks about PT Today

You Must Like Where You Work

Published October 23, 2008 9:29 AM by Toni Patt
Last week an OT scolded me. She found out I have McKenzie credentials and couldn't believe I was working in a hospital. She told me I had to be in an OP setting treating spine patients. She even asked me why I was working in a hospital.  Shouldn't I be using those skills to treat spine patients? For her information, I work in a hospital because I enjoy it. I don't like working in OP clinics. I worked hard to get those McKenzie credentials. After awhile I realized I preferred working in a hospital. While I may be an anomaly, that's how I feel. I like medically-complex patients. I don't get that reducing derangements all day.

Her statements raise an interesting question. Why should I use my spine skills in a setting I don't enjoy when I can use my neuro skills in a setting I do enjoy? I don't think one patient population gets priority over the other. God knows there aren't enough PTs willing to work in hospitals as it is. Isn't it a good thing that I want to do that? All PTs have skills they don't use. After being in the profession for a while they gravitate toward the setting and patients they prefer. Thus we have pediatric therapists, cardio-pulmonary therapists, wound specialists and the like. I could ask my company to place me in OP clinics. But I wouldn't want to stay very long.

I chose this setting because I like those patients.  I didn't decide on hospitals because they pay more. They don't. I have a problem with PTs who take positions based only on how they pay. These are people who are in it for the money. They're pretty easy to pick out, too. Sometimes they fall into a comfortable little routine where they're not overly happy and not overly unhappy. I work with one of those right now. I know therapists who took positions in SNFs for this reason. They don't particularly like the elderly population. They also can't understand how I get their patients to do more with me. I like the elderly and it shows.  I'm worried about what's coming in the future as more PTs graduate with higher debt. That creates an incentive for making money.

If someone isn't happy it's pretty obvious to those around them. An unhappy therapist does the minimum and complains. While unintentionally doing the minimum also means patients are being short changed. If I'm not doing my best, my patients aren't getting the best. What the OT failed to realize is that I'm working where I'm happy.  So what if I save my manual therapy skills for my horses.  The patients I'm working with are improving. Isn't that the most important thing?


Are you serious? You have to put one patient back in bed and this is the way you act.  Ever herd of team play.  You are part of team and every team member is valuable including that CNA.  You pointed out that it was not an every day thing.  Bet you expect those same nurses and CNA's to carry out your maintenance plans.  There was no way you could work that transfer back to bed into your care plan?  Wonder why people think PTs are divas and prima donnas?  Your blog is the answer.

john PT January 27, 2009 6:37 PM

Good for you for sticking to your guns. I definetely think it shows when someone doesn't like their job.  We all tend to make decisions in our job that may seem to perk our interest at one point in time and then something else later. By no means have you "committed" yourself to staying in one setting based on a credential you have earned.

In my opinion, I think it's good to have at least one IP person in the department who understands MDT...I've saved a few individuals from getting an emergent LESI or uncessary surgery when I've had to cover weekends in the hospital.  

I was the opposite of you...start in IP rehab and med/surg and started taking the NDT certification courses. I've since made my way to OP and turned around to complete the MDT certification. Despite my coursework I took in NDT and prosthetic rehabilitation, in no way was I obligated to stay where I was. So unless your employer paid for your certification with the hope you would "lead" the spine clinic, I see no reason for anyone to give you any slack about your "past life" in outpatient.  

From one MDT certified clinician to another, stay where you are happy....and derangements are'll still use this skill.

Christie, Physical therapist October 24, 2008 10:27 AM

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