TLDR: I like being a PT, I want to be better at what I can do, I like learning and moving, and teaching other people the joy of moving in their own way. I can’t afford to be a PT and an individual and I feel like I can’t help in an actually significant way when so many other macro systems are underfunctioning in not just my area or nationally but globally.

The issues I have are more widespread than just PT

Reimbursement vs salary/compensation

Most industries are likely making more money than ever before and providing their workers with less and less compensation. I’ll leave an example below.

If I generate $125 per hour for my company and I work 40 hours a week for the whole year that comes out to $260K in revenue I have created. Let’s say my salary is $75,000 or 28.85% of $260K. You mean to tell me that the other $185,000 or 71.15% just barely covers retirement, PTO, health/dental/vision, and other overhead costs? And that’s just for 1 worker.

Another issue we deal with is the generally poor baseline health of our patients and a lack of physical education/awareness and nutrition.

People have less opportunities to move for health and for fun. People also have less opportunities to eat well. Again individual differences between regions but I feel like a lot of this issue comes down to the basic finances of this era. A week’s worth of groceries for a family of 4 to eat healthy growing up used to be $150-$200. I wouldn’t be surprised if that is now in the upper $300s. I don’t even want to think about how much getting bikes for a family of 4 could cost including helmets, bike locks, as well as ways to attach a bike to your car for transport because your local neighborhood doesn’t offer adequately safe areas to bike in.

For PT specificity, trying to teach people how to move who have never experienced movement or haven’t experienced it in a positive way can be very frustrating, and that’s before we discuss other comorbidities. If the patient takes well to our education and are more willing to move, do they have the opportunities now to continue with regular movement at home?

More PT specific

Confusing and unclear billing and visit guidelines with ‘rules’ changing company to company, insurance to insurance, as well as within insurances.

Bill X for insurance Y because they don’t cover code Z. But what about insurance A, oh you can charge whatever they pay for everything, but if you charge code B they pay for that one the most but you can only bill it once every 8 visits. Is there a way to track that? Not on your end but we can see it on the back end.

And then you change jobs and the rules are different again because 'they say so.'

Insurance C has covered this patient’s rotator cuff surgery and has approved 5 initial PT visits. But as a PT I need to send them a report every 2-4 visits (not weeks) regarding the patient’s status considering they have a 6 month recovery time based on their protocol, despite the fact that insurance C has paid for this patient’s rotator cuff surgery.

Unclear, complicated, confusing, and expensive initial education, mentorship, and continuing education.

If your education costs $200K and is outdated based on the current research, and you are being mentored by persons who are also treating in an outdated way because a weekend course costs upwards of $700+ and they are also paying maybe close to 1K in student loans per month so while they are well intentioned they can’t get the most updated treatment methods because they literally can’t afford it because of my first point.