Productivity: Why Bother Speaking Out?
I was asked in a private message, "What are your goals in speaking out about the productivity issues facing therapists in nursing homes (and private practices) today?" A good question! We can whine and complain all we want; very little will come of that activity. If we complain to excess, people will stop listening. So what do we do?
Here is why we need therapists to get research active! It would be interesting to see how outcomes compare between facilities that are productivity-focused versus those that are more patient-centered. Facility-provided outcome data would probably not be helpful. If a facility is willing to fudge data just to get patients on program, how likely would it be to manipulate other data as well?
Instead, what would the re-hospitalization rate look like? How would patients rate their own improvement? What would rates of return to work or sports look like? There is a whole PhD project waiting to be designed and written about this.
I still haven't really answered why I'm speaking out. As bothered as I am that my fellow therapists are being mistreated, I'm even angrier that patients will be the ones really suffering from being on this rehab conveyor belt. If you're working at 90% productivity regularly, tell me, how well do the majority of your patients meet their goals? Could they have done better if you had time to case conference with family or other professionals?
How many patients had limited improvement because they weren't really appropriate in the first place? How much money is being spent from scant resources on unnecessary treatment? What is happening to our professions' reputation? Struggling to meet insane productivity levels hurts more than just the therapy staff.
Maybe, like me, you're not in a place to pursue this as a PhD project. I'll talk about an interesting approach to effecting change on a local level in the next blog post.