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we give our pts 1 hour lunch half, 30 minutes of doc time and 30 min of lunch,

we only pay them for 30 min. that is in Iowa not sure what Pa laws state?

To: PTManager@...: thorter@...: Thu, 3 Jan 2008

08:56:31 -0500Subject: paid lunch?

Group,How much lunch/break time is everyone giving to a PT employee for lunch

and break time in an 8 hr day? Are you paying for lunch time? I am told that

legally break time must be 15 min for every 4 hrs worked in Pa which must be

paid I believe but I am not hearing that PTs are actually getting that downtime.

So, can that translate to a 1/2 hr paid lunch at least if the time is lumped

together? Are you expecting PTs to do paperwork while eating their lunch in

order to get paid for the time but not pay them if they leave the premises?I

would appreciate others solutions and the rationale behind it. Thanks,

Horter, PT Horter Physical TherapyRosemont, Pa 19010[Non-text

portions of this message have been removed]

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>

>

>A few questions.

Are they salary?

Are they professionals?

If they are salary, and professionals, and take their job of

delivering patient care seriously then they have a responsibility to

do what it takes to get the job done and documented. Yes a 1 hour

lunch is a nice thing to have, but it is a nice perk, but not

necessary in a busy facilty.

Do you believe that your referral sources ask these questions of

their employer?

If we PT's, continue to ask these types of questions, I have to ask,

are we really the professionals we really think we are? Professionals

are professional more than 40 hours per week with 1 hour lunches.

Professionals do what it takes, when necessary, to get the job done.

Patient care and documentation included.

Thank you for your time

Roll PT, OCS, FAAOMPT

Ocean Springs, MS.

clinic owner/therapist

we give our pts 1 hour lunch half, 30 minutes of doc time and 30 min

of lunch, we only pay them for 30 min. that is in Iowa not sure what

Pa laws state?

>

>

> To: PTManager@...: thorter@...: Thu, 3 Jan 2008 08:56:31 -

0500Subject: paid lunch?

>

>

>

>

> Group,How much lunch/break time is everyone giving to a PT employee

for lunch and break time in an 8 hr day? Are you paying for lunch

time? I am told that legally break time must be 15 min for every 4

hrs worked in Pa which must be paid I believe but I am not hearing

that PTs are actually getting that downtime. So, can that translate

to a 1/2 hr paid lunch at least if the time is lumped together? Are

you expecting PTs to do paperwork while eating their lunch in order

to get paid for the time but not pay them if they leave the premises?

I would appreciate others solutions and the rationale behind it.

Thanks, Horter, PT Horter Physical TherapyRosemont, Pa

19010[Non-text portions of this message have been

removed]

>

>

>

>

>

>

> _________________________________________________________________

> Share life as it happens with the new Windows Live.

> http://www.windowslive.com/share.html?

ocid=TXT_TAGHM_Wave2_sharelife_122007

>

>

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My understanding is that it is dependent on their job classification as

exempt or non-exempt. If they are exempt they are paid a set amount

regardless of the number of hours worked and lunch/breaks taken. If

they are non-exempt, and they have less than 20 minutes uninterrupted

with work duties then you must pay them the 30 minute lunch. However, I

don't believe break time is mandatory by wage and labor law - it is

optional.

Tomazich, PT

Physical Therapy Director

UPMC Passavant /UPMC Passavant Cranberry <http://passavant.upmc.com/>

FAX:

" Be kinder than necessary, for everyone you meet is fighting some kind

of battle. "

Any unauthorized or improper disclosure, copying, distribution, or use

of the contents of this e-mail or attached documents is prohibited.

The information contained in this e-mail message is intended only for

the personal and confidential use of the recipient(s) named above. If

you have received this communication in error, please notify the sender

immediately by e-mail and delete the original message.

_____

From: PTManager [mailto:PTManager ] On

Behalf Of jeff nolder

Sent: Thursday, January 03, 2008 1:26 PM

To: ptmanager

Subject: RE: paid lunch?

we give our pts 1 hour lunch half, 30 minutes of doc time and 30 min of

lunch, we only pay them for 30 min. that is in Iowa not sure what Pa

laws state?

To: PTManager@...

<mailto:PTManager%40yahoogroups.comFrom> : thorter@...

<mailto:thorter%40mindspring.comDate> : Thu, 3 Jan 2008 08:56:31

-0500Subject: paid lunch?

Group,How much lunch/break time is everyone giving to a PT employee for

lunch and break time in an 8 hr day? Are you paying for lunch time? I am

told that legally break time must be 15 min for every 4 hrs worked in Pa

which must be paid I believe but I am not hearing that PTs are actually

getting that downtime. So, can that translate to a 1/2 hr paid lunch at

least if the time is lumped together? Are you expecting PTs to do

paperwork while eating their lunch in order to get paid for the time but

not pay them if they leave the premises?I would appreciate others

solutions and the rationale behind it. Thanks, Horter, PT

Horter Physical TherapyRosemont, Pa 19010[Non-text portions

of this message have been removed]

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Share life as it happens with the new Windows Live.

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Thank you for your answers about this. I forgot to say that I also have a PT who

works 32 hrs a week so is hourly. Is she considered non-exempt now because of

the hourly status or still exempt as full-time PTs are? Is a PT always exempt no

matter what the hours are worked? If non-exempt then based on someone else's PA

law response I need to pay her the 30 min lunch because she has no other

uninterrupted time during the day. If exempt then it is my choice?

Horter, PT

Horter Physical Therapy

Rosemont, Pa

thorter@...

paid lunch?

Group,How much lunch/break time is everyone giving to a PT employee for

lunch and break time in an 8 hr day? Are you paying for lunch time? I am

told that legally break time must be 15 min for every 4 hrs worked in Pa

which must be paid I believe but I am not hearing that PTs are actually

getting that downtime. So, can that translate to a 1/2 hr paid lunch at

least if the time is lumped together? Are you expecting PTs to do

paperwork while eating their lunch in order to get paid for the time but

not pay them if they leave the premises?I would appreciate others

solutions and the rationale behind it. Thanks, Horter, PT

Horter Physical TherapyRosemont, Pa 19010[Non-text portions

of this message have been removed]

__________________________________________________________

Share life as it happens with the new Windows Live.

http://www.windowslive.com/share.html?ocid=TXT_TAGHM_Wave2_sharelife_122

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,

There have been many replies to your original email. I would refer

you first to this web site about the Fair Labor Standards Act (FLSA)

as that is the federal law that deals directly with your question -->

http://www.dol.gov/esa/regs/compliance/whd/hrg.htm.

This site is a good tool to learn more about this act, as it covers

classifying staff as exempt or non-exempt, when overtime pay is

required, etc. Another good thing to know is what is NOT required by

the FLSA. Below is copied/pasted from the Department of Labor

website:

" For example, FLSA does not require:

- vacation, holiday, severance, or sick pay;

- meal or rest periods, holidays off, or vacations;

- premium pay for weekend or holiday work;

- pay raises or fringe benefits; or

- a discharge notice, reason for discharge, or immediate payment of

final wages to terminated employees. "

As you can see, lunch breaks and other breaks during the day are NOT

required by federal law. There is a common misperception that the

FLSA requires us to provide breaks. It does not. However, if your

staff are hourly and if they work over their breaks, then we must pay

them for their time. Essentially, the FLSA requires us to pay people

when they are engaged in work activities if they are hourly. If

staff are exempt (salaried), then the set period is what they are

paid for (e.g., 40 hours per week) no matter whether they work 20

hours or they work 60 hours.

PT's can be classified as either exempt or non-exempt (salaried or

hourly) and each has its advantages and disadvantages. If you need

help with that I suggest you contact your legal counsel as they

should be able to assist you as you want to be sure you doing

everything correctly in how you are classifying your staff..

Lastly, the info above applies to the federal labor law (FLSA).

Pennsylvania may have more restrictive laws (I don't know) so I

suggest that you contact your legal counsel and seek their advice

about whether FLSA is the standard you need to follow or if you have

other state laws that have other restrictions.

Mark Dwyer, PT, MHA

Olathe, Kansas

markdwyer87@...

>

> Group,

>

> How much lunch/break time is everyone giving to a PT employee for

lunch and break time in an 8 hr day? Are you paying for lunch time? I

am told that legally break time must be 15 min for every 4 hrs worked

in Pa which must be paid I believe but I am not hearing that PTs are

actually getting that downtime. So, can that translate to a 1/2 hr

paid lunch at least if the time is lumped together? Are you expecting

PTs to do paperwork while eating their lunch in order to get paid for

the time but not pay them if they leave the premises?I would

appreciate others solutions and the rationale behind it.

>

> Thanks,

> Horter, PT

> Horter Physical Therapy

> Rosemont, Pa 19010

>

>

>

>

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,

Just a few thoughts. Since your full timers are salaried/exempt (I

assume from your second post) your are generally correct that the lunch

is " up to you " . State Wage and Hour laws typically apply only to

hourly/non exempt employees. And while I agree with many of the other

posters, I assert that the manner in which a person is paid (salaried

vs. hourly) is not what makes him/her a professional. No offense to

(I agree with your position overall), but I respectfully

disagree that " asking these types of questions " implies PTs are not

professional - finding the right answers to these types of questions is

what makes one a professional.

On another note, I believe you will find that you can legally make your

32-hour-per-week employee salaried at that level (i.e. pay him/her 75%

of what a 40-hour-per-week person would make with his/her experience

etc.) and handle the lunch the same for everyone - please check with the

State of PA and your HR person . To expand on another of '

points that I strongly agree with - " Professionals do what it takes,

when necessary, to get the job done.

Patient care and documentation included. " - I might suggest that you

give the salaried PTs a productivity target per day (not tied to hours

because they are salaried) that they are all expected to meet and let

them figure out how much time they get for lunch and everything else

that goes along with that type of model ... (when they get get lunch or

other breaks, when their patients are scheduled and for how long, how

their patients are covered when they are off ....).

My 2 cents.

Trumbull, PT, MBA

Bloomington, IL

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Roll,

you rock!

que the orthopedic surgeon, " I am sorry sir, we have to stop your

surgery now so that I can have my regularly scheduled lunch and

paperwork time "

As I have said many, many times, we as a profession can not have

things both ways. If we are going to come out of school as Doctor's

of Physical Therapy and request salaries upwards of 60k/year we are

going to have to earn it. We need to end the employee/employer

mentality now! We need to accept the professional responsiblity to

meet the needs of our clients, if we do this consistently and make

the companies we work with a profit than we should have the

expectation that we will be allowed a share of that profit, if we

continue to do this successfully and we so desire than we should

have the expectation that some form of partnership will follow. We

cannot expect partnership opportunities and profit sharing without

also expecting to share in the work and the risk and in the upward

mobility of the profession through work with our professional

association.

E. s, PT, DPT, OCS, FAAOMPT

www.douglasspt.com

> >

> >

> >A few questions.

> Are they salary?

> Are they professionals?

>

> If they are salary, and professionals, and take their job of

> delivering patient care seriously then they have a responsibility

to

> do what it takes to get the job done and documented. Yes a 1 hour

> lunch is a nice thing to have, but it is a nice perk, but not

> necessary in a busy facilty.

>

> Do you believe that your referral sources ask these questions of

> their employer?

>

> If we PT's, continue to ask these types of questions, I have to

ask,

> are we really the professionals we really think we are?

Professionals

> are professional more than 40 hours per week with 1 hour lunches.

>

> Professionals do what it takes, when necessary, to get the job

done.

> Patient care and documentation included.

>

> Thank you for your time

>

> Roll PT, OCS, FAAOMPT

> Ocean Springs, MS.

> clinic owner/therapist

>

> we give our pts 1 hour lunch half, 30 minutes of doc time and 30

min

> of lunch, we only pay them for 30 min. that is in Iowa not sure

what

> Pa laws state?

> >

> >

> > To: PTManager@: thorter@: Thu, 3 Jan 2008 08:56:31 -

> 0500Subject: paid lunch?

> >

> >

> >

> >

> > Group,How much lunch/break time is everyone giving to a PT

employee

> for lunch and break time in an 8 hr day? Are you paying for lunch

> time? I am told that legally break time must be 15 min for every 4

> hrs worked in Pa which must be paid I believe but I am not hearing

> that PTs are actually getting that downtime. So, can that

translate

> to a 1/2 hr paid lunch at least if the time is lumped together?

Are

> you expecting PTs to do paperwork while eating their lunch in

order

> to get paid for the time but not pay them if they leave the

premises?

> I would appreciate others solutions and the rationale behind it.

> Thanks, Horter, PT Horter Physical TherapyRosemont, Pa

> 19010[Non-text portions of this message have been

> removed]

> >

> >

> >

> >

> >

> >

> > _________________________________________________________________

> > Share life as it happens with the new Windows Live.

> > http://www.windowslive.com/share.html?

> ocid=TXT_TAGHM_Wave2_sharelife_122007

> >

> >

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Hello Group,

I really do not see much that is appropriate in this response. I specifically

have difficulty with the following:

1- I don't understand how mixing metaphors to rationalize your argument is of

any benefit. The surgeon gets paid for that procedure, the procedures are

scheduled with in advance and the surgeon can (and does)adjust his/her schedule

for such events.,

2- Why would anyone have such expectations as you put forth unless that was in

prior agreement with mutual stipulations as what requirements need to be met to

become a partner or have profit sharing. I think that is why some places do

these things and others do not., and

3- The overall demeanor sounds to me more like a sweat shop than a

professional setting. It makes me wonder when you would start saying that bath

room breaks are taken out of the paycheck as well. Mmm, maybe you already have.

4- Well there are other things that could be commented, but I’m stopping at

this point.

The original question seems to be just to determine a norm for lunch and work

breaks within the outpatient setting. Some responses have made it interesting

reading though. I actuality, these things can and are used by many as

recruitment and retention incentives and not points of diversion into self

serving diatribe. It really has nothing to do with whether someone is

“professional” or not.

So, if it makes good business sense to offer these benefits to employment at

your facility Ms Horter, then by all means do so. To me it doesn’t seem to

unrealistic for someone that is an income generator with your practice.

Respectfully,

Don, PT

Michigan

s wrote:

Roll,

you rock!

que the orthopedic surgeon, " I am sorry sir, we have to stop your surgery now

so that I can have my regularly scheduled lunch and paperwork time " . As I have

said many, many times, we as a profession can not have things both ways. If we

are going to come out of school as Doctor's of Physical Therapy and request

salaries upwards of 60k/year we are going to have to earn it. We need to end the

employee/employer mentality now! We need to accept the professional

responsiblity to meet the needs of our clients, if we do this consistently and

make the companies we work with a profit than we should have the expectation

that we will be allowed a share of that profit, if we continue to do this

successfully and we so desire than we should have the expectation that some form

of partnership will follow. We cannot expect partnership opportunities and

profit sharing without also expecting to share in the work and the risk and in

the upward mobility of the profession through work with our

professional association.

E. s, PT, DPT, OCS, FAAOMPT

www.douglasspt.com

A few questions. Are they salary? Are they professionals? If they are salary,

and professionals, and take their job of delivering patient care seriously then

they have a responsibility to do what it takes to get the job done and

documented. Yes a 1 hour lunch is a nice thing to have, but it is a nice perk,

but not necessary in a busy facilty. Do you believe that your referral sources

ask these questions of their employer? If we PT's, continue to ask these types

of questions, I have to ask, are we really the professionals we really think we

are? Professionals are professional more than 40 hours per week with 1 hour

lunches. Professionals do what it takes, when necessary, to get the job

done.

Patient care and documentation included. Thank you for your time

Roll PT, OCS, FAAOMPT

Ocean Springs, MS.

clinic owner/therapist

we give our pts 1 hour lunch half, 30 minutes of doc time and 30 min of lunch,

we only pay them for 30 min. that is in Iowa not sure what Pa laws state?

----Original Message----

To: PTManager@...

Date: Thu, 3 Jan 2008 08:56:31

Subject: paid lunch?

Group,

How much lunch/break time is everyone giving to a PT employee for lunch and

break time in an 8 hr day? Are you paying for lunch time? I am told that legally

break time must be 15 min for every 4 hrs worked in Pa which must be paid I

believe but I am not hearing that PTs are actually getting that downtime. So,

can that translate to a 1/2 hr paid lunch at least if the time is lumped

together? Are you expecting PTs to do paperwork while eating their lunch in

order to get paid for the time but not pay them if they leave the premises?

I would appreciate others solutions and the rationale behind it.

Thanks, Horter, PT

Horter Physical Therapy

Rosemont, Pa

---------------------------------

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Don, Don, Don,

Check out my web site, call me personally, at least have the

professional responsibility to identify yourself by more than your

first name if you are also going to insinuate that I run a sweat

shop. I have worked in PT " sweat shops " , I have allowed others to

attempt to determine how many patients I see at a time and to whom I

need to delegate services. I have watched salaried professionals who

generate less revenue than they cost the people who sign their

paychecks complain about not having enough time to eat their lunch.

I have been there done that and have seen the need for change in our

profession.

We simply will not be able to sustain the current rate of PT salary

increase that is necessary for our new grads to be able to pay their

student loans coming out of DPT programs if we do not significantly

change the old school " employee/employer " paradigm that has held back

the growth of our profession for far too long. We need to start

comparing ourselves to other doctoring professions if we wish to be

seen as equals in their eyes. My point regarding the Orthopedic

surgeon was that, yes, the surgeon establishes a schedule and

determines when and if he is going to eat lunch but he certainly

doesnt do it within the confines of an eight hour day, neither do

lawyers, dentists or others who hope to be able to meet the needs of

their clients while still generating a profit for the people who sign

their paychecks, the very same people who return that profit to the

profession through political action contributions and public

relations strategies and utilize it to promote equity growth in the

company that is necessary for the company to survive and that the

salaried employee should have aspirations to eventually have a share

of.

These changes are not just my idea, these are the ideas and concepts

utilized by successful business and professons throughout the world.

Pick up a book or simply read the writing on the wall. Things need

to change and we need to be the ones to change them or we will all be

punching clocks and hoping that the boss gives us enough time to eat

lunch.

E. s, PT, DPT, OCS, FAAOMPT

s Orthopedic & Spine Rehabilitation, Inc

Bonita Springs, Florida

>

> A few questions. Are they salary? Are they professionals? If they

are salary, and professionals, and take their job of delivering

patient care seriously then they have a responsibility to do what it

takes to get the job done and documented. Yes a 1 hour lunch is a

nice thing to have, but it is a nice perk, but not necessary in a

busy facilty. Do you believe that your referral sources ask these

questions of their employer? If we PT's, continue to ask these types

of questions, I have to ask, are we really the professionals we

really think we are? Professionals are professional more than 40

hours per week with 1 hour lunches. Professionals do what it takes,

when necessary, to get the job

> done.

>

> Patient care and documentation included. Thank you for your time

>

> Roll PT, OCS, FAAOMPT

> Ocean Springs, MS.

> clinic owner/therapist

> we give our pts 1 hour lunch half, 30 minutes of doc time and 30

min of lunch, we only pay them for 30 min. that is in Iowa not sure

what Pa laws state?

>

> ----Original Message----

> To: PTManager@...

> Date: Thu, 3 Jan 2008 08:56:31

> Subject: paid lunch?

> Group,

> How much lunch/break time is everyone giving to a PT employee for

lunch and break time in an 8 hr day? Are you paying for lunch time? I

am told that legally break time must be 15 min for every 4 hrs worked

in Pa which must be paid I believe but I am not hearing that PTs are

actually getting that downtime. So, can that translate to a 1/2 hr

paid lunch at least if the time is lumped together? Are you expecting

PTs to do paperwork while eating their lunch in order to get paid for

the time but not pay them if they leave the premises?

> I would appreciate others solutions and the rationale behind it.

>

> Thanks, Horter, PT

> Horter Physical Therapy

> Rosemont, Pa

>

>

>

> ---------------------------------

> Never miss a thing. Make Yahoo your homepage.

>

>

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Mr. s,

Thank you for your reply. It appears that you have become more than a little

defensive to my comments. That’s too bad! Perhaps, you might benefit from a

reread of my email.

As for the numerous topics which you most recently set forth, I can only say

that you are again bringing forth many topics which are approached in such a way

as to imply some logic to your argument. It really doesn’t.

One topic in particular which should be brought to the fore is that of the

DPT. If you believe that the DPT will allow an MD or DO to look at you as an

equal, then I can only say that doesn’t seem to be supported by historical

evidence. Actually, it is not my personal goal to make myself into a from of a

MD or DO. I see some who have embraced this approach for their practice of

Physical Therapy and it is my opinion that the profession and patients have

suffered because of it.

Perhaps, if one day we write our own equivalent to CPT codes which actually

reflect our profession. Perhaps, one day when we are considered as staff.

Perhaps, one day when only Physical Therapists can own and operate a

rehabilitation clinic. Perhaps, when we don’t look to a physician to approve our

decisions and treatment plans. Perhaps, when people come to Physical Therapy

directly for assistance, opinion and treatment. Perhaps, when Physical

Therapists are considered a primary health care provider and an entry point for

medical care and the subsequent referrals to other specialists. Perhaps …

Perhaps… Perhaps… Then, Physical Therapists will be viewed as equals.

If you believe that DPT is going to do any of that, well, I don’t think so. If

you believe that is going to happen with out a lot of solidarity and through the

isolated performance of a few, well, I don’t think so. If you think that is

going to happen through the current professional organization, well, I don’t

think so… If you think it is going to happen from sniping at others about how

they choose to market their practice or incentive they provide to their

employees or the way another PT signs his name, well I don’t think so.

I’ve been to your website, Mr. s. I render no opinion of it. It is your

choice to present the way you wish.

As for calling you, I can see that serving no real purpose.

Respectfully,

Don, PT

Michigan

----Last Reply----

s wrote:

Don, Don, Don,

Check out my web site, call me personally, at least have the professional

responsibility to identify yourself by more than your first name if you are also

going to insinuate that I run a sweat shop. I have worked in PT " sweat shops " , I

have allowed others to attempt to determine how many patients I see at a time

and to whom I need to delegate services. I have watched salaried professionals

who generate less revenue than they cost the people who sign their paychecks

complain about not having enough time to eat their lunch. I have been there done

that and have seen the need for change in our profession.

We simply will not be able to sustain the current rate of PT salary increase

that is necessary for our new grads to be able to pay their student loans coming

out of DPT programs if we do not significantly change the old school

" employee/employer " paradigm that has held back the growth of our profession for

far too long. We need to start comparing ourselves to other doctoring

professions if we wish to be seen as equals in their eyes. My point regarding

the Orthopedic surgeon was that, yes, the surgeon establishes a schedule and

determines when and if he is going to eat lunch but he certainly doesnt do it

within the confines of an eight hour day, neither do lawyers, dentists or others

who hope to be able to meet the needs of their clients while still generating a

profit for the people who sign their paychecks, the very same people who return

that profit to the profession through political action contributions and public

relations strategies and utilize it to promote equity

growth in the company that is necessary for the company to survive and that the

salaried employee should have aspirations to eventually have a share of.

These changes are not just my idea, these are the ideas and concepts utilized

by successful business and professons throughout the world. Pick up a book or

simply read the writing on the wall. Things need to change and we need to be the

ones to change them or we will all be punching clocks and hoping that the boss

gives us enough time to eat lunch.

E. s, PT, DPT, OCS, FAAOMPT

s Orthopedic & Spine Rehabilitation, Inc

Bonita Springs, Florida

A few questions. Are they salary? Are they professionals? If they are salary,

and professionals, and take their job of delivering patient care seriously then

they have a responsibility to do what it takes to get the job done and

documented. Yes a 1 hour lunch is a nice thing to have, but it is a nice perk,

but not necessary in a busy facilty. Do you believe that your referral sources

ask these questions of their employer? If we PT's, continue to ask these types

of questions, I have to ask, are we really the professionals we really think we

are? Professionals are professional more than 40 hours per week with 1 hour

lunches. Professionals do what it takes, when necessary, to get the job done.

Patient care and documentation included. Thank you for your time

Roll PT, OCS, FAAOMPT

Ocean Springs, MS.

clinic owner/therapist

we give our pts 1 hour lunch half, 30 minutes of doc time and 30 min of lunch,

we only pay them for 30 min. that is in Iowa not sure what Pa laws state?

----Original Message----

To: PTManager@...

Date: Thu, 3 Jan 2008 08:56:31

Subject: paid lunch?

Group,

How much lunch/break time is everyone giving to a PT employee for lunch and

break time in an 8 hr day? Are you paying for lunch time? I am told that legally

break time must be 15 min for every 4 hrs worked in Pa which must be paid I

believe but I am not hearing that PTs are actually getting that downtime. So,

can that translate to a 1/2 hr paid lunch at least if the time is lumped

together? Are you expecting PTs to do paperwork while eating their lunch in

order to get paid for

the time but not pay them if they leave the premises?

I would appreciate others solutions and the rationale behind it.

Thanks, Horter, PT

Horter Physical Therapy

Rosemont, Pa

---------------------------------

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Hi Everyone,

I've been reading all the emails going back and forth on this subject, and

finally decided to put in my two cents.

I work in an op hospital setting which includes 3 off-sites.

Lunches are non-paid (for both exempt and non-exempt staff).

Breaks are at manager discretion, but honestly its never been a big issue if

someone took a few minutes to run down to the café for a coffee or snack. The

same goes for the off-site offices, each has a break room and there has never

been any issue with taking a break here and there between patients. I think you

need to look at how you want to treat employees. I can't imagine anyone can say

that there haven't also been times when patients have no-showed/cancelled that

therapists haven't taken 'breaks' during this time as well - unless you have a

site with 0% cancellations/no-shows.

Everyone should be able to take a lunch during the day (if more than 6 hours

worked) and breaks seem to come even if there are not planned. I honestly

didn't think there would be so much discussion on what I would think is a pretty

simple issue (compared to everything else we deal with in our business), until I

began seeing all these emails.

Thanks for listening...

Kimberley R. Palma

Office Manager - ECHN Rehabilitation Services

Tel: x5579

Fax:

Pager:

_____

From: PTManager [mailto:PTManager ] On Behalf Of

Gobble Gobble

Sent: Friday, January 04, 2008 6:05 PM

To: PTManager

Subject: Re: Re: paid lunch?

Hello Group,

I really do not see much that is appropriate in this response. I specifically

have difficulty with the following:

1- I don't understand how mixing metaphors to rationalize your argument is of

any benefit. The surgeon gets paid for that procedure, the procedures are

scheduled with in advance and the surgeon can (and does)adjust his/her schedule

for such events.,

2- Why would anyone have such expectations as you put forth unless that was in

prior agreement with mutual stipulations as what requirements need to be met to

become a partner or have profit sharing. I think that is why some places do

these things and others do not., and

3- The overall demeanor sounds to me more like a sweat shop than a professional

setting. It makes me wonder when you would start saying that bath room breaks

are taken out of the paycheck as well. Mmm, maybe you already have.

4- Well there are other things that could be commented, but I'm stopping at this

point.

The original question seems to be just to determine a norm for lunch and work

breaks within the outpatient setting. Some responses have made it interesting

reading though. I actuality, these things can and are used by many as

recruitment and retention incentives and not points of diversion into self

serving diatribe. It really has nothing to do with whether someone is

" professional " or not.

So, if it makes good business sense to offer these benefits to employment at

your facility Ms Horter, then by all means do so. To me it doesn't seem to

unrealistic for someone that is an income generator with your practice.

Respectfully,

Don, PT

Michigan

s <dosrinc@... <mailto:dosrinc%40att.net> > wrote:

Roll,

you rock!

que the orthopedic surgeon, " I am sorry sir, we have to stop your surgery now so

that I can have my regularly scheduled lunch and paperwork time " . As I have said

many, many times, we as a profession can not have things both ways. If we are

going to come out of school as Doctor's of Physical Therapy and request salaries

upwards of 60k/year we are going to have to earn it. We need to end the

employee/employer mentality now! We need to accept the professional

responsiblity to meet the needs of our clients, if we do this consistently and

make the companies we work with a profit than we should have the expectation

that we will be allowed a share of that profit, if we continue to do this

successfully and we so desire than we should have the expectation that some form

of partnership will follow. We cannot expect partnership opportunities and

profit sharing without also expecting to share in the work and the risk and in

the upward mobility of the profession through work with our

professional association.

E. s, PT, DPT, OCS, FAAOMPT

www.douglasspt.com

A few questions. Are they salary? Are they professionals? If they are salary,

and professionals, and take their job of delivering patient care seriously then

they have a responsibility to do what it takes to get the job done and

documented. Yes a 1 hour lunch is a nice thing to have, but it is a nice perk,

but not necessary in a busy facilty. Do you believe that your referral sources

ask these questions of their employer? If we PT's, continue to ask these types

of questions, I have to ask, are we really the professionals we really think we

are? Professionals are professional more than 40 hours per week with 1 hour

lunches. Professionals do what it takes, when necessary, to get the job

done.

Patient care and documentation included. Thank you for your time

Roll PT, OCS, FAAOMPT

Ocean Springs, MS.

clinic owner/therapist

we give our pts 1 hour lunch half, 30 minutes of doc time and 30 min of lunch,

we only pay them for 30 min. that is in Iowa not sure what Pa laws state?

----Original Message----

To: PTManager@... <mailto:PTManager%40Yahoo.com>

Date: Thu, 3 Jan 2008 08:56:31

Subject: paid lunch?

Group,

How much lunch/break time is everyone giving to a PT employee for lunch and

break time in an 8 hr day? Are you paying for lunch time? I am told that legally

break time must be 15 min for every 4 hrs worked in Pa which must be paid I

believe but I am not hearing that PTs are actually getting that downtime. So,

can that translate to a 1/2 hr paid lunch at least if the time is lumped

together? Are you expecting PTs to do paperwork while eating their lunch in

order to get paid for the time but not pay them if they leave the premises?

I would appreciate others solutions and the rationale behind it.

Thanks, Horter, PT

Horter Physical Therapy

Rosemont, Pa

---------------------------------

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Dear Mr. ,

I understand your analogy regarding the orthopedic surgeon not working an

8-hour day and did not interpret this as " mixing metaphors to rationalize your

argument " as Don of Michigan suggested in his e-mail response.

I did not read into your e-mail that you were looking for a way out of

giving your employees lunch breaks, bathroom breaks or coffee breaks. What I

did

read into your e-mail, and please correct me if I am wrong, is that you are

interested in designating work hour breaks that will ensure adequate clinic

coverage and will meet with your state labor and wage laws. If you are able

to accomplish this task in a manner that is both fair and equitable to you and

your employees, then GREAT!

First and foremost, check with the Florida Department of Labor to determine

rules regarding breaks for exempt and non exempt employees as well as

full-time and part-time employees.

Secondly, create a break time policy for all employees and have all employees

sign off on this policy. You may want to include verbiage that states

" breaks will be staggered to ensure proper clinic and telephone coverage at

all

times. " You may also consider having therapists (if your state labor law

allows) take an early or late lunch break when they have advance notice of a

patient cancellation. Have your receptionist communicate all patient

cancellations promptly with the treating therapist.

If an employee is required to work during his/her designated break time due

to staffing shortages and/or an increased patient load due to a shortened

workweek, that employee should be remunerated for their time. Consider

adopting

a flextime policy for exempt employees and have non exempt employees notify

you or an administrator if they are required to work through their lunch

break in order that you may properly manage overtime.

Thirdly, if you have a large staff you may want to consider adopting a break

schedule that allows employees from different departments to share the same

break time versus the same employees, from the same departments, taking the

same breaks at the same time on a daily basis. It has been my experience,

over the past 19 years of providing medical and health care practice and AR

management services to physicians and therapists, that employees who smoke are

twice as likely to extend their break time if they go on break with another

smoker, and employees who are prone to gossip are twice as likely to extend

their break time if they are on break with another employee prone to gossip.

In closing, I wish you the best of luck in the future and applaud your

passion, commitment and drive. You are on the right track and while Don in

Michigan may not understand or appreciate your concerns or value your ideas and

concepts, there's a reader in Southwest Louisiana that is convinced you are

right on the money.

D. Cavitt, President

Medical Legal Alliance, L.L.C.

Lafayette, LA 70508

**************Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

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paid lunch?

Group,

How much lunch/break time is everyone giving to a PT employee for lunch and

break time in an 8 hr day? Are you paying for lunch time? I am told that legally

break time must be 15 min for every 4 hrs worked in Pa which must be paid I

believe but I am not hearing that PTs are actually getting that downtime. So,

can that translate to a 1/2 hr paid lunch at least if the time is lumped

together? Are you expecting PTs to do paperwork while eating their lunch in

order to get paid for the time but not pay them if they leave the premises?

I would appreciate others solutions and the rationale behind it.

Thanks, Horter, PT

Horter Physical Therapy

Rosemont, Pa

---------------------------------

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Dear Kim,

Please consider the cost to an employer to providing each employee with paid

breaks.  In order to calculate this cost, take the employees hourly rate (if

salaried, take the total annual salary and divide this figure by 2080 to come

up with their hourly rate).  Now calculate the hourly rate for

benefits, i.e., PTO, paid vacation, paid holidays, paid sick time, group health

insurance, CEU or professional development allowance, uniform allowance,

employer payroll tax, employer workers' compensation--percentage of total annual

salary, professional liability insurance per PT/OT/SLP/PTA/COTA/Technician or

Aid, and incidental perks/bonuses.  A simply calculation is to add 25% to the

employees hourly rate. 

Therefore, an employee who earns $10 per hour actually cost the employer

$12.50 per hour.  If this 

employee takes two (2) ten (10) bathroom or coffee breaks per day, which is

customarily paid by the employer that comes to fifty (50) minutes per week in

paid breaks and/or a cost of $541.67 per year.  This does not begin to take

into account the time employees spend on personal telephone calls while on the

clock; checking personal e-mails or surfing the Internet or non business

related matters while on the clock; time spent at the water cooler discussing

LSU's last game win or loss or the struggles they are having potty training

little Tommy unforeseeable and unplanned 

downtime due to electricity outages, telephone outages, computers problems,

etc.; and times when employees make mistake and have to redo their

work--overhead cost employers must absorb. 

Most PTs earn 2 to 3 times this hourly rate and and such, the cost to the

employer to allow these PTs to take a 10 minute a.m. and 10 minute p.m. break

cost employers between $1,083 and $1,685 per year.  Medicare's therapy cap for

outpatient combined PT and SLP services for 2007 was only $1,780.  When you

consider the cost for proving paid morning and afternoon breaks, the concept of

paying a PT for an additional 30 to 60 minute lunch break each day is not

so trite or insignificant.  It can actually mean the difference between a

clinic owner being able to cover overhead cost and keeping their practice open,

and a clinic owner having to downsize staff and reduce his/her patient load. 

PTs must learn to manage their practice as a business and given the fact that

employee salaries and benefits account for the majority of practice overhead

cost, it is not unreasonable to look at how you can reduce practice overhead

cost by reducing break time versus reducing wages and benefits.  

Sighing off my soap box.

Have a great evening and weekend.

D. Cavitt, President

Medical Legal Alliance, L.L.C.

paid lunch?

Group,

How much lunch/break time is everyone giving to a PT employee for lunch and

break time in an 8 hr day? Are you paying for lunch time? I am told that legally

break time must be 15 min for every 4 hrs worked in Pa which must be paid I

believe but I am not hearing that PTs are actually getting that downtime. So,

can that translate to a 1/2 hr paid lunch at least if the time is lumped

together? Are you expecting PTs to do paperwork while eating their lunch in

order to get paid for the time but not pay them if they leave the premises?

I would appreciate others solutions and the rationale behind it.

Thanks, Horter, PT

Horter Physical Therapy

Rosemont, Pa

---------------------------------

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Ms. Cavitt,

I did not read the same thing you did in Mr. ' comment. No

where did he say anything about meeting state and labor wage laws,

and no where did he mention " ensuring adequate clinic coverage " . In

particular, I did not read in his small comment anything that could

be construed as to say " If you are able to accomplish this task in a

manner that is both fair and equitable to you and your employees,

then GREAT! "

I am assuming you are not a therapist. Is he your client? I am just

wondering because it seems you are giving him a lot of praise for a

small blurb about his thoughts toward our profession that seem to me

to be more hurtful than helpful. I quote from your message " In

closing, I wish you the best of luck in the future and applaud your

passion, commitment and drive.. " Your intrepretation of what he

wrote is completely different than what he wrote - it seems that you

are helping him rephrase it.

From what you wrote and your company name, I am assuming you are a

lawyer and giving legal advice to/for him as an employer. Your

advice is good advice and should be the only answer needed for this

topic of conversation. Follow the law, meet the law, KEEP YOUR

EMPLOYEES HAPPY so that they will want to work for you, and KEEP YOUR

PATIENTS HAPPY. In the end, the patient is the person being served.

A happy patient has more marketing effect than any employee will ever

provide. If only Mr. had said this then Don may not have

felt obligated to write what he wrote.

And also Mr. ' analogy to this topic of the orthopedic surgeon

quitting surgery because staff has to go to lunch is not even

rational. You can't rationalize anything with irrational comments.

That surgeon is not making $60K per year (which Mr. seems to

think is a lot of money for a grad coming out with a DPT). His

metaphor is comparing apples to oranges. Although PT's are

professionals, we are and always have been treated as employees.

Lunches are built into the schedule at every place I have ever

worked - outpatient, inpatient, IRF, LTC, Skilled, etc... Are they

paid lunches - NO. Should they be paid - if you want to incentivize

an employee to work for you or to keep an employee or whatever the

market dictates, YES. You have to if your margins allow it.

Otherwise, you as the clinic OWNER take up the slack yourself and do

the work - it is your clinic.

What lunch time does Mr. provide to his therapists? What

profit sharing does he provide? What incentives does he provide to

assure he keeps good employees? Does he pay the therapist extra if

they stay through lunch to treat a patient that was late? There are

many questions I have for him because of his comments. But that

topic is not for this question that was asked. In the end, if you

want to keep good employees, you keep them happy. If they are not

good employees, then why are they still working for you.

Terry Stegman, PT, MS, BS Eng-Phy

Dear Mr. ,

I understand your analogy regarding the orthopedic surgeon not

working an 8-hour day and did not interpret this as " mixing

metaphors to rationalize your argument " as Don of Michigan suggested

in his e-mail response.

I did not read into your e-mail that you were looking for a way out

of giving your employees lunch breaks, bathroom breaks or coffee

breaks. What I did read into your e-mail, and please correct me if

I am wrong, is that you are interested in designating work hour

breaks that will ensure adequate clinic coverage and will meet with

your state labor and wage laws. If you are able to accomplish this

task in a manner that is both fair and equitable to you and your

employees, then GREAT!

First and foremost, check with the Florida Department of Labor to

determine rules regarding breaks for exempt and non exempt employees

as well as full-time and part-time employees.

Secondly, create a break time policy for all employees and have all

employees sign off on this policy. You may want to include verbiage

that states " breaks will be staggered to ensure proper clinic and

telephone coverage at all times. " You may also consider having

therapists (if your state labor law allows) take an early or late

lunch break when they have advance notice of a patient

cancellation. Have your receptionist communicate all patient

cancellations promptly with the treating therapist.

If an employee is required to work during his/her designated break

time due to staffing shortages and/or an increased patient load due

to a shortened workweek, that employee should be remunerated for

their time. Consider adopting a flextime policy for exempt

employees and have non exempt employees notify you or an

administrator if they are required to work through their lunch break

in order that you may properly manage overtime.

Thirdly, if you have a large staff you may want to consider adopting

a break schedule that allows employees from different departments to

share the same break time versus the same employees, from the same

departments, taking the same breaks at the same time on a daily

basis. It has been my experience, over the past 19 years of

providing medical and health care practice and AR management

services to physicians and therapists, that employees who smoke are

twice as likely to extend their break time if they go on break with

another smoker, and employees who are prone to gossip are twice as

likely to extend their break time if they are on break with another

employee prone to gossip.

In closing, I wish you the best of luck in the future and applaud

your passion, commitment and drive. You are on the right track and

while Don in Michigan may not understand or appreciate your

concerns or value your ideas and concepts, there's a reader in

Southwest Louisiana that is convinced you are right on the money.

D. Cavitt, President Medical Legal Alliance, L.L.C.

Lafayette, LA 70508

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>

> A few questions. Are they salary? Are they professionals? If they

are salary, and professionals, and take their job of delivering

patient care seriously then they have a responsibility to do what it

takes to get the job done and documented. Yes a 1 hour lunch is a

nice thing to have, but it is a nice perk, but not necessary in a

busy facilty. Do you believe that your referral sources ask these

questions of their employer? If we PT's, continue to ask these types

of questions, I have to ask, are we really the professionals we

really think we are? Professionals are professional more than 40

hours per week with 1 hour lunches. Professionals do what it takes,

when necessary, to get the job

> done.

>

> Patient care and documentation included. Thank you for your time

>

> Roll PT, OCS, FAAOMPT

> Ocean Springs, MS.

> clinic owner/therapist

> we give our pts 1 hour lunch half, 30 minutes of doc time and 30

min of lunch, we only pay them for 30 min. that is in Iowa not sure

what Pa laws state?

>

> ----Original Message----

> To: PTManager@... <mailto:PTManager%40Yahoo.com>

> Date: Thu, 3 Jan 2008 08:56:31

> Subject: paid lunch?

> Group,

> How much lunch/break time is everyone giving to a PT employee for

lunch and break time in an 8 hr day? Are you paying for lunch time? I

am told that legally break time must be 15 min for every 4 hrs worked

in Pa which must be paid I believe but I am not hearing that PTs are

actually getting that downtime. So, can that translate to a 1/2 hr

paid lunch at least if the time is lumped together? Are you expecting

PTs to do paperwork while eating their lunch in order to get paid for

the time but not pay them if they leave the premises?

> I would appreciate others solutions and the rationale behind it.

>

> Thanks, Horter, PT

> Horter Physical Therapy

> Rosemont, Pa

>

> ---------------------------------

> Never miss a thing. Make Yahoo your homepage.

>

>

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Dear list serve,

thank you all for your communications. I just saw an email from

evidence in motion that contained the qoute " spirited debate (even

heated at times) is foundational to positive action " . I thought it

very appropriate. The reason I post and regularly read this

listserve is to learn from others and in the hopes that i might

somehow spur some postivie action, not to judge or condem others who

do not see the world as I do.

In response to a couple of specifics:

Thank you, Mrs. Cavitt, for some excellent advice. It is much

appreciated and I hope you will continue to share your expertise with

the list serve.

Mr./Mrs. Stegman,

Your post was interesting. No, I am not a client of Mrs. Cavitt's,

though given her response I sure know who to look for if I ever need

legal adivce.

I would also like you to expand on your view that what I posted might

actually be hurtful. How so and what parts?

As to the part about my feeling of 60k being " a lot of money " for a

grad coming out with a DPT. I would say that 60k + benefits is about

all a private practice PT can afford to pay a new grad coming out of

school based soley on the reality of what that new grad can hope to

generate revenue wise in his/her first year. You do the math. I

have and I know that my company will lose money from a strictly cost

vs. revenue generated on a new grad making 60k + benefits in his/her

first year out of school. They may break even the second year and if

they continue to work hard, they may generate a small profit by year

three. The math is easy, (# of visits/ year x avg.reimbursement per

= revenue generated, entire clinic cost/# of treating therapists =

cost per therapist). The more you work, the more you make, the

higher the percantage of your cost that you are able to cover, when

you cover over 100% you have made a profit for the clinic.

As for your statement " we (PT's) are and always have been, treated as

employees " I say speak for yourself. The private practice session is

the fastest growing section of the APTA. More and more PT's are

breaking the mold of " always have been. " We are changing the

paradigm and I believe it is changing in the only direction possible

if we are to survive.

Oh, and its Dr. s (sorry, couldn't resist)

Taking up the slack in Bonita Springs, Florida

E. s, PT, DPT, OCS, FAAOMPT

www.douglasspt.com

> Dear Mr. ,

>

> I understand your analogy regarding the orthopedic surgeon not

> working an 8-hour day and did not interpret this as " mixing

> metaphors to rationalize your argument " as Don of Michigan

suggested

> in his e-mail response.

>

> I did not read into your e-mail that you were looking for a way

out

> of giving your employees lunch breaks, bathroom breaks or coffee

> breaks. What I did read into your e-mail, and please correct me

if

> I am wrong, is that you are interested in designating work hour

> breaks that will ensure adequate clinic coverage and will meet

with

> your state labor and wage laws. If you are able to accomplish this

> task in a manner that is both fair and equitable to you and your

> employees, then GREAT!

>

> First and foremost, check with the Florida Department of Labor to

> determine rules regarding breaks for exempt and non exempt

employees

> as well as full-time and part-time employees.

>

> Secondly, create a break time policy for all employees and have all

> employees sign off on this policy. You may want to include

verbiage

> that states " breaks will be staggered to ensure proper clinic and

> telephone coverage at all times. " You may also consider having

> therapists (if your state labor law allows) take an early or late

> lunch break when they have advance notice of a patient

> cancellation. Have your receptionist communicate all patient

> cancellations promptly with the treating therapist.

>

> If an employee is required to work during his/her designated break

> time due to staffing shortages and/or an increased patient load

due

> to a shortened workweek, that employee should be remunerated for

> their time. Consider adopting a flextime policy for exempt

> employees and have non exempt employees notify you or an

> administrator if they are required to work through their lunch

break

> in order that you may properly manage overtime.

>

> Thirdly, if you have a large staff you may want to consider

adopting

> a break schedule that allows employees from different departments

to

> share the same break time versus the same employees, from the same

> departments, taking the same breaks at the same time on a daily

> basis. It has been my experience, over the past 19 years of

> providing medical and health care practice and AR management

> services to physicians and therapists, that employees who smoke

are

> twice as likely to extend their break time if they go on break

with

> another smoker, and employees who are prone to gossip are twice as

> likely to extend their break time if they are on break with

another

> employee prone to gossip.

>

> In closing, I wish you the best of luck in the future and applaud

> your passion, commitment and drive. You are on the right track and

> while Don in Michigan may not understand or appreciate your

> concerns or value your ideas and concepts, there's a reader in

> Southwest Louisiana that is convinced you are right on the money.

>

> D. Cavitt, President Medical Legal Alliance, L.L.C.

> Lafayette, LA 70508

>

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Dr. s.

I hope with this debate some of the readers will be enlightened to

move to private practice. Competition makes us all better, and will

move our profession forward faster than any hospital based or APTA

marketing campaign ever could.

We are here for the patient. Check your mission statements. My motto

has always has been, if the patients are well cared for the rewards

will follow. That means that one may have to work through lunch hour,

or see a patient when it may not fit into their schedule of events

for that day.

" only in the dictionary does succcess come before work "

A quote for the Fathers book of Wisdom.

Roll PT OCS FAAOMPT

www.ptcos.com

owner/clinician

Ocean Springs, MS

> > Dear Mr. ,

> >

> > I understand your analogy regarding the orthopedic surgeon not

> > working an 8-hour day and did not interpret this as " mixing

> > metaphors to rationalize your argument " as Don of Michigan

> suggested

> > in his e-mail response.

> >

> > I did not read into your e-mail that you were looking for a way

> out

> > of giving your employees lunch breaks, bathroom breaks or coffee

> > breaks. What I did read into your e-mail, and please correct me

> if

> > I am wrong, is that you are interested in designating work hour

> > breaks that will ensure adequate clinic coverage and will meet

> with

> > your state labor and wage laws. If you are able to accomplish

this

> > task in a manner that is both fair and equitable to you and your

> > employees, then GREAT!

> >

> > First and foremost, check with the Florida Department of Labor to

> > determine rules regarding breaks for exempt and non exempt

> employees

> > as well as full-time and part-time employees.

> >

> > Secondly, create a break time policy for all employees and have

all

> > employees sign off on this policy. You may want to include

> verbiage

> > that states " breaks will be staggered to ensure proper clinic

and

> > telephone coverage at all times. " You may also consider having

> > therapists (if your state labor law allows) take an early or

late

> > lunch break when they have advance notice of a patient

> > cancellation. Have your receptionist communicate all patient

> > cancellations promptly with the treating therapist.

> >

> > If an employee is required to work during his/her designated

break

> > time due to staffing shortages and/or an increased patient load

> due

> > to a shortened workweek, that employee should be remunerated for

> > their time. Consider adopting a flextime policy for exempt

> > employees and have non exempt employees notify you or an

> > administrator if they are required to work through their lunch

> break

> > in order that you may properly manage overtime.

> >

> > Thirdly, if you have a large staff you may want to consider

> adopting

> > a break schedule that allows employees from different

departments

> to

> > share the same break time versus the same employees, from the

same

> > departments, taking the same breaks at the same time on a daily

> > basis. It has been my experience, over the past 19 years of

> > providing medical and health care practice and AR management

> > services to physicians and therapists, that employees who smoke

> are

> > twice as likely to extend their break time if they go on break

> with

> > another smoker, and employees who are prone to gossip are twice

as

> > likely to extend their break time if they are on break with

> another

> > employee prone to gossip.

> >

> > In closing, I wish you the best of luck in the future and applaud

> > your passion, commitment and drive. You are on the right track

and

> > while Don in Michigan may not understand or appreciate your

> > concerns or value your ideas and concepts, there's a reader in

> > Southwest Louisiana that is convinced you are right on the

money.

> >

> > D. Cavitt, President Medical Legal Alliance, L.L.C.

> > Lafayette, LA 70508

> >

>

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Dear Dr. ,

My sincerest apologies for referring to you as " Mr. " versus " Dr. " in my

previous list serve missive.

You are very welcome for the practice management advice.

I am not a therapist, nor am I an attorney. I am a medical practice

management consultant and the following is not a solicitation.

My company, Medical Legal Alliance, LLC (MLA) was incepted in March 1999 and

is an " alliance " of health care attorneys, estate planning attorneys,

corporate/business attorneys, financial advisors/asset protection advisors,

CPAs,

certified medical coding specialists, certified medical insurance specialists

and IT networking specialists. We even have an alliance member who publishes

a statewide medical newspaper (pro-provider of course)! The " alliance "

concept was born from the need for medical and health care providers to have

access to cohesive professional services and/or turn key business solutions.

I have provided medical practice management, accounts receivable management,

chart auditing and creation of corporate compliance policies and procedures

to over 75 medical and health care providers in Louisiana and Texas over the

past nine years, 50+ have been private practice PTs, OTs and SLPs.

Prior to incepting MLA in March 1999, I served as the CEO of a medical group

practice comprised of seven neurosurgeons, five neurologists and 60+

clinical and clerical staff members for four years. Prior to that, I served as

the

business manager for a neurosurgery practice five years. I have extensive

experience and knowledge in practice start-ups, e.g., developing practice

policies and procedures, developing accounts receivable policies and

procedures,

and developing corporate compliance programs for small group practices.

However, my passion is auditing and teaching medical and health care providers

how to manage their practices as a for-profit business.

In my 18+ years of providing medical and AR management services to

physicians and therapists, I have done so in the role of an employee, the role

of an

employer, and the role of a consultant. I understand employees want to be

paid competitive wages and benefits. I understand employers want to pay

employees competitive wages and benefits. I also understand that in a fully

managed

care environment, where reimbursement rates continue to decrease and

overhead practice costs continue increase, that solo private practice employers

are

struggling to attract and retain competent skilled labor as larger group

practices and hospitals are able to offer higher startup salaries and benefits

along with signup bonuses.

At the risk of further inciting Mr./Mrs./Ms. Stegman, $60K per year for a

new PT grad--at least down here in South Louisiana--is a very competitive

starting salary. Don't take my word, go to the Bureau of Labor Statistics

website

at _www.dol.gov/dol/stats.htm_ (http://www.dol.gov/dol/stats.htm) and enter

your state and professional designation you are interested in obtaining wage

statistics. This website will provide you with median wages and percentiles

to assist you in determining where your employee wages " fall " compared to

other employers in your same geographical local and industry.

In closing, I am not of the personal or professional opinion that it is our

responsibility as employers to " KEEP YOUR EMPLOYEES HAPPY so that they will

want to work for you, and KEEP YOUR PATIENTS HAPPY " as was stated in

Mr./Mrs./Ms. Stegman's list serve missive to me. Happiness is a state of mind

and is

not something we as employers or health care professionals have control over

and/or should be made responsible for ensuring our employees and patients

must sustain at all times.

As an employer, you choose to provide employees who smoke the same paid

morning and afternoon break as you provide employees who do not smoke yet take

coffee breaks. The employee who smokes is happy. The non smoking employee

resents the fact that employees are allowed to smoke at work and feels your

decision " only promotes " this nasty habit.

As an employer, you can choose to provide employees with paid lunch during

and paid time during mandatory monthly staff meetings on compliance, coding,

billing and patient care. The employee who realizes the necessity of these

staff meetings and is happy to have both a paid lunch and payment professional

development. The employee who had a previous engagement on this day is

unhappy, hates staff meetings, and would have preferred pizza over grilled

chicken salad.

As a therapist, you can choose to work through your lunch hour to treat a

patient who works from 8-5 and cannot come at any other time. That patient is

appreciative and happy you made this sacrifice. Conversely, another patient

is bothered and unhappy because they had to skip lunch in order to come to

therapy and must now rush back to work in lunch hour traffic in order not to

avoid yet another confrontation with their employer.

As a therapist, you can choose to waive a patient's co-pay or financial

responsibility due to financial hardship. One patient can sing your praises

and

light three candles for you at church the following Sunday, while another

patient may feel entitled to free health care services and refuse to comply

with

your POC and home exercise program, further prolonging their discharge.

In my personal or professional opinion, we are not responsible as employers

and health care professionals for

KEEPING OUR EMPLOYEES AND PATIENTS HAPPY. We are responsible as employers

and health care professionals to support, educate, empower, care for, and

professionally and responsibly treat our employees, patients and clients.

D. Cavitt, President

Medical Legal Alliance, LLC

Lafayette, LA 70808

(cell)

**************Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

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