Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 , Just as I was begining to feel a little better about the country following the Clint Eastwood Superbowl commercial. Guess I should go back to my previous plan of stocking up on bullets and food. Seriously though regarding our profesion, I believe each generation of PT's would say that things are harder now than they were 10 years ago and that they will continue to get harder. I think this is unlikely to change. Joe Ruzich, PT > > > > > Dear Group, > > The math is simple. The cycle is coming. Actuaries explain to us that a deleveraging financial economy of debt deflation can only lead to a Japanese-style deflation spiral. Economists agree that deflation is much more painful to swallow than inflation. The developed nations (the West and Europe) are in a serious downward debt spiral...currently led by Europe. In this increasingly globalized world, the developing eastern nations led by China are flush with tremendous labor capacity (over a billion ready and able to make gadgets for you straight from China, a country 4x the size of USA). This will put HUGE downward pressure on US and European wage income. Falling wages for developed economies coupled with rising wages for developing econimies. This is in the NOW and the FUTURE. > > Debt/Deflation Downward Spiral: > > Retirees and Pensions will be exhausting SS/ Medicare and Govt Pension Funds ----> massive taxes on the working class----> less discretionary income----> falling asset prices----> falling wage income----> decreased tax receipts----> More Gov't Borrowing ----> UNKNOWN CLIFF > > > European Central Banks and the US Federal Reserve are resisting this deleveraging/deflation using opposite rules of economics. > > Europe is implementing Austerity to curb the debt spiral while the USA is implementingan opposite method called " quantitative easing " or printing money by giving it to banks at 0%. It is expected that banks will lend to you and me and make a 3-5% profit margin over 0%. > Japan tried the later for 20 years and it did nothing to stop prices and wages falling for over 2 decades. THE DEMAND FOR DEBT IS TOO LOW. > Who is going to buy that baby-boomer's 5500 sqft. home on Long Island when they are empty nestors left with 25k in yearly real-estate taxes? Your 30 year college-debt paying son making 65k per year? > > How will this effect Physical Therapy? I think it's much easier to just make Pizza and still earn over 200k a year in cash income. > > Meli > Bayside, NY > > > > > Re: Future of OPPT > > Todd, > I went to a continuing ed course a couple of years back given by Arnie Cisneros, the president of Home Health Strategic Management. He pointed out some interesting facts that may be applicable to the OPPT industry. Every time that to government would increase restrictions on HH therapy and revenues, therapists would always fear that the profession would not survive. Perhaps no other segment has been more regulated and restricted more than the HH therapy industry. Each time these restrictions are enforced, therapists have learned to adapt and change the way they do business. Increasing efficiency and decreasing costs, and yes, decreasing the amount of care. But insurance and therapy companies can still show that they can still achieve good outcomes with less. > > We will have to adapt and make the necessary changes in how we practice. We should also increase our support of the APTA to continue to fight the good fight. > > Duane > Mesa, AZ. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 11, 2012 Report Share Posted February 11, 2012 I really enjoyed this thread but I'd like you all to widen your gaze a bit for this next post... The beauty of a market-based industry is that there should be answers to problems for each set of consumers: price-insensitive consumers are willing to pay higher prices for extended 1-on-1 attention, pampering, " trendy " treatments like lasers or kinesiotaping, etc. This could be describing the boutique PT practice. More price sensitive consumers will not accept the out-of-pocket cost and are willing to accept dovetailed appointment slots, " group " PT treatments, intermittent bouts of 1-on-1 and supervised thermal modalities, etc. Think WalMart vs. Neiman Marcus. Neither is " bad " . Nor, is either reflective of the " value " of the merchandise. An $8 WalMart wristwatch that costs $50 at Neiman Marcus is NOT a good value to me. We shouldn't disparage our brother and sister physical therapists who bust their butt every day trying to treat 15-20 patients under Fee-for-Service as " low quality " if their patients are happy and getting better. Neither should we assume that the boutique therapist in Island, Florida who is able to charge $75 cash money per 1-on-1 session is necessarily " high quality " if her patients aren't happy and getting better. Going forward, the high-volume PT practices (the " mills " described above) will NOT DECREASE. They will increase. High productivity is the future. The future is already here - its just not evenly distributed. But, the boutique PT practice will ALSO increase. In response to the consumers' demand. There are still a few unnecessary federal regulatory barriers to unfettered access to the boutique PT practice but I'm confident that their future is bright, too. Tim , PT www.PhysicalTherapyDiagnosis.com > > , > > I dont care for Starbucks coffee much either, I do however appreciate their marketing genius and wish that I had picked up some stock in the early days. Yes high frequency trading makes it harder for the small guy, however it is still quite possible to make money in the market, I have been and I'm no Warren Buffett. I think the same will appy to PT. I agree that things will be moving toward " boutique " practices and the mills will die. I never felt they should be around anyway. This would be a good thing for patient care, which as pointed out is really the most improtant issue. > > , > Thanks for the positive sentiments. > > Joe Ruzich, PT > Peublo, CO > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 11, 2012 Report Share Posted February 11, 2012 I really enjoyed this thread but I'd like you all to widen your gaze a bit for this next post... The beauty of a market-based industry is that there should be answers to problems for each set of consumers: price-insensitive consumers are willing to pay higher prices for extended 1-on-1 attention, pampering, " trendy " treatments like lasers or kinesiotaping, etc. This could be describing the boutique PT practice. More price sensitive consumers will not accept the out-of-pocket cost and are willing to accept dovetailed appointment slots, " group " PT treatments, intermittent bouts of 1-on-1 and supervised thermal modalities, etc. Think WalMart vs. Neiman Marcus. Neither is " bad " . Nor, is either reflective of the " value " of the merchandise. An $8 WalMart wristwatch that costs $50 at Neiman Marcus is NOT a good value to me. We shouldn't disparage our brother and sister physical therapists who bust their butt every day trying to treat 15-20 patients under Fee-for-Service as " low quality " if their patients are happy and getting better. Neither should we assume that the boutique therapist in Island, Florida who is able to charge $75 cash money per 1-on-1 session is necessarily " high quality " if her patients aren't happy and getting better. Going forward, the high-volume PT practices (the " mills " described above) will NOT DECREASE. They will increase. High productivity is the future. The future is already here - its just not evenly distributed. But, the boutique PT practice will ALSO increase. In response to the consumers' demand. There are still a few unnecessary federal regulatory barriers to unfettered access to the boutique PT practice but I'm confident that their future is bright, too. Tim , PT www.PhysicalTherapyDiagnosis.com > > , > > I dont care for Starbucks coffee much either, I do however appreciate their marketing genius and wish that I had picked up some stock in the early days. Yes high frequency trading makes it harder for the small guy, however it is still quite possible to make money in the market, I have been and I'm no Warren Buffett. I think the same will appy to PT. I agree that things will be moving toward " boutique " practices and the mills will die. I never felt they should be around anyway. This would be a good thing for patient care, which as pointed out is really the most improtant issue. > > , > Thanks for the positive sentiments. > > Joe Ruzich, PT > Peublo, CO > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 11, 2012 Report Share Posted February 11, 2012 I really enjoyed this thread but I'd like you all to widen your gaze a bit for this next post... The beauty of a market-based industry is that there should be answers to problems for each set of consumers: price-insensitive consumers are willing to pay higher prices for extended 1-on-1 attention, pampering, " trendy " treatments like lasers or kinesiotaping, etc. This could be describing the boutique PT practice. More price sensitive consumers will not accept the out-of-pocket cost and are willing to accept dovetailed appointment slots, " group " PT treatments, intermittent bouts of 1-on-1 and supervised thermal modalities, etc. Think WalMart vs. Neiman Marcus. Neither is " bad " . Nor, is either reflective of the " value " of the merchandise. An $8 WalMart wristwatch that costs $50 at Neiman Marcus is NOT a good value to me. We shouldn't disparage our brother and sister physical therapists who bust their butt every day trying to treat 15-20 patients under Fee-for-Service as " low quality " if their patients are happy and getting better. Neither should we assume that the boutique therapist in Island, Florida who is able to charge $75 cash money per 1-on-1 session is necessarily " high quality " if her patients aren't happy and getting better. Going forward, the high-volume PT practices (the " mills " described above) will NOT DECREASE. They will increase. High productivity is the future. The future is already here - its just not evenly distributed. But, the boutique PT practice will ALSO increase. In response to the consumers' demand. There are still a few unnecessary federal regulatory barriers to unfettered access to the boutique PT practice but I'm confident that their future is bright, too. Tim , PT www.PhysicalTherapyDiagnosis.com > > , > > I dont care for Starbucks coffee much either, I do however appreciate their marketing genius and wish that I had picked up some stock in the early days. Yes high frequency trading makes it harder for the small guy, however it is still quite possible to make money in the market, I have been and I'm no Warren Buffett. I think the same will appy to PT. I agree that things will be moving toward " boutique " practices and the mills will die. I never felt they should be around anyway. This would be a good thing for patient care, which as pointed out is really the most improtant issue. > > , > Thanks for the positive sentiments. > > Joe Ruzich, PT > Peublo, CO > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.