Rantings of a PTA
As much as I dislike complaints about our profession, every once in a while I like to get things off my chest.
Until my employee handbook expressly states what my productivity will be, I do not worry about it. My yearly evaluation has nothing about productivity so my work cannot be based on it. If productivity is such an issue why don't our employers put it in writing?
In all the years I have worked and all the jobs I have had, only one employer did and it was for a per diem position to be between 75 and 80 percent. None of the full time positions ever mentioned productivity in their offer letters.
I have three children. Two of them have disabilities. One has Aspergers and Bipolar Disorder, the other has Complex Partial Seizures affecting her bilateral temporal lobes.
Looking at them no one would suspect it. Even a conversation with them would reveal little in the way of their diagnosis.
I only mention this because some people have a difficult time understanding why I need/want time off. Employers need to recognize that some of us do not live to work. I have appointments I need to attend; I have a family that needs me. And for heaven's sake, let me use my sick time or PTO/vacation time when I need to go.
If employers are not sensitive to my needs and family issues, it is time to look for another position.
We're a team, right? But does everything we say have to be repeated to our managers? Doesn't the manager have enough to worry about? I have told the team I am working with, "What we say in the therapy gym stays in the therapy gym."
I am professional enough to know when an issue is really bothering me and when I just want to gripe about something. If I want the manager to know something, I will tell them. I have even encouraged others to talk to the manager if they have an issue that concerns them.
There are times in my day that I want to question policy issues to get another opinion or two about it. This does not mean I hate the employer. It does not mean I am going to form a union and strike. I only want to get an idea of how others feel about it, that's it.
I could go on forever about my dislike of the insurance industry. My big question is "What methods do they use to determine when a patient is ready for discharge?" I know some look strictly at gait distance and discharge when the patient reaches 50 feet, even though they were max assist to stand with a Berg Balance of 20.
Most do not even care about the ADL skills. Some of our patients couldn't get dressed but could walk 100 feet, so they were sent home. We have tried to pin them down by asking what they look for, but we have yet to have a definitive answer from the insurance companies we work with.
My other question is, "When did we as therapists give up on fighting for the patients?" Is it because we know if we argue with them they will not refer any patients to our facility, or did we just get too tired of fighting? Do we only argue certain cases and leave others? And how do you determine that?
Most days are not complete for me until I begin my day with 450 minutes of work, a frantic phone call from my wife about two appointments occurring at the same time and who's going to pick up our son from school, all of us griping about how the facility runs and the insurance companies discharging half our patient load for too much progress or lack of progress. Oh, the humanity!