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PT and the Greater Good

Could I Go Back Again?

Published April 19, 2011 12:11 PM by Dean Metz

Last week I described how one of my coworkers asked if I thought I could go back to working in the States again. I thought the answer would be a quick and easy, "Sure!" It wasn't.

I haven't had to fight with an insurance company in over a year. I've enjoyed autonomy that I'd never known in either Florida or New York. I can prescribe medications to my patients using the guidelines provided by the NHS. I work in a variety of services - community, outpatient and intermediate care. I am constantly challenged to improve my practice and expand my skills and the NHS supports me in that endeavor. I'm part of practice review groups that examine how and why we do what we do in order to create better processes and programs.

I like it here. I don't want to argue with an administrative gatekeeper to justify one or two more sessions for my patients. I don't want to spend numerous phone calls to MDs to give me permission (orders) to do what I know better how to do anyway. I don't want to have to take vacation or personal time in order to take a course. I don't want to be told how to practice with no input into the process myself. I don't want to have to discharge patients with potential and motivation because their insurance company denied further treatment.

Mr. Cameron is bound and determined to change (eliminate?) the NHS. I don't think he'll succeed in doing away with it; the national ethos simply wouldn't put up with that. He will change it though - probably to be more like the Medicare model in the States. I know that I could survive that change, perhaps even flourish in it, but do I want to? There are no easy answers to these questions.


Ahh, the dream job we all want.  The phone calls and pressure to get poeple what the insurance companies see as "well enough to go home" are frustrating.  I covet your situation.  Maybe someday it will be like that here in the U.S.

Karen April 20, 2011 10:11 PM

@ Janey: Great question! There is no overt display of xenophobia from the PTs and OTs I've met here (the British Ethos of politeness wouldn't go there) however I do wonder if some of the initial push back I had from some fellow therapists have something to do with that. It is something I have wondered, but don't have an accurate answer for. I met a young PT at the course in Philadelphia this weekend who had graduated last year from Glasgow Caledonian with a Masters in PT who couldn't find work here and had to relocate to Canada to find work. It actually embarrassed me a bit and I felt a twinge of guilt. This is one case where having 2 decades of experience made a huge difference.

I'm interviewing 11 individuals for the new post tomorrow! It wasn't easy to sift through a lot of qualified people to find those that had interest and experience (school placements counted) with respiratory, elderly, community AND falls prevention. Look for the results in a later post.

Cheers, Dean

Dean Metz April 20, 2011 1:11 PM

Fabulous piece, Dean. In a nutshell, you spelled out what is wrong with practicing as a PT here. I was ready to quit the field until I decided to create a niche, Yoga Physical Therapy. Since I opened my practice I haven't looked back. I do not accept insurance. I work with patients for one solid hour. No machines. No hot packs or cold packs. Pure manual work and healing exercises. It's been a risky venture. I don't take many vacations. My case load took a big hit since 2008, but it's slowly getting better. Now I love my work, and I get to practice like I always dreamed of. I could never go back to the paper treadmill or to treating 4 patients an hour.

Sharon Gary, PT - Owner, Yoga Physical Therapy April 19, 2011 9:32 PM
New York NY

There is a train of thoughts I won't burden you with that led to this question.

In a recent post, you mentioned the shortage of jobs in comparison to the number of qualified applicants there in the UK.  Have you noticed any negative sentiment directed toward you because of being a foreigner who has taken away a job from a native?  How do the views toward foreign PTs in UK compare to the views of foreign PTs in the US?

(By the way, have you finished sifting through that pile of applications?)  

Janey Goude April 19, 2011 7:43 PM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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