Guest guest Posted June 4, 2012 Report Share Posted June 4, 2012 I am the Director of Rehab for a small acute care hospital in northern California. We have a sizeable outpatient practice with eight FTE PT's and two PTA's. California allows a PT to supervise two PTA's. As a cost saving measure, we are being encouraged by hospital administration to ramp up our ratio of PTA's to PT's. I have experienced some resistance to doing so from the staff because of the increased workload required of a therapist to treat their own patients and to also be responsible for the patients that a PTA treats. Would any of you be willing to share with me what ratio you have in your outpatient department. I would welcome input from both hospital based and private practice settings. I would also be interested in knowing if you have an identified model for utilization. For example, do you use the team concept where a PTA is assigned to a specific PT or does a PTA receive patients from all PT's? And are the PT's who supervise the PTA's allowed to have a reduced patient load? Thank you for sharing. Maddox, PT, MPH Director of Rehabilitation Ukiah Valley Medical Center 275 Hospital Drive Ukiah, CA 95482 maddoxrg@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2012 Report Share Posted June 5, 2012 The savings from PTAs is generally overstated, and your staff are getting to the reason---administrators tend to calculate dollar savings based only on cost per treatment, as if PTAs are simply cheap, one-to-one substitutes for PTs. But as we all know, PTAs are assistants to the PT, not case managers, and the time required for PTs to direct cases is very real. (It's frankly alarming to hear that " PTs do evaluations, PTAs do treatments. " ) Various factors affect the calculation of course, but we've found that for every 8 hours of PTA time the PT must put in about an hour of supervision---an hour that is otherwise non-productive, i.e. there is no billing associated with it. So if you employ 2 PTAs for each PT you can figure two hours per day of non-billable time for the PTs. That obviously pinches the cost savings, especially when the factor of lost flexibility is considered. As an aside, around here certain practice venues push the limits of the regulations, and make assistants their primary caregivers. For that they pay exceedingly well, which pressures the salary levels of assistants generally upward in all categories, making them an even poorer deal for the high-quality outpatient practice. Dave Milano, PT Rehabilitation Director Laurel Health System ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Maddox Sent: Monday, June 04, 2012 10:14 PM To: PTManager Subject: PT to PTA ratio I am the Director of Rehab for a small acute care hospital in northern California. We have a sizeable outpatient practice with eight FTE PT's and two PTA's. California allows a PT to supervise two PTA's. As a cost saving measure, we are being encouraged by hospital administration to ramp up our ratio of PTA's to PT's. I have experienced some resistance to doing so from the staff because of the increased workload required of a therapist to treat their own patients and to also be responsible for the patients that a PTA treats. Would any of you be willing to share with me what ratio you have in your outpatient department. I would welcome input from both hospital based and private practice settings. I would also be interested in knowing if you have an identified model for utilization. For example, do you use the team concept where a PTA is assigned to a specific PT or does a PTA receive patients from all PT's? And are the PT's who supervise the PTA's allowed to have a reduced patient load? Thank you for sharing. Maddox, PT, MPH Director of Rehabilitation Ukiah Valley Medical Center 275 Hospital Drive Ukiah, CA 95482 maddoxrg@...<mailto:maddoxrg%40ah.org> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2012 Report Share Posted June 5, 2012 The savings from PTAs is generally overstated, and your staff are getting to the reason---administrators tend to calculate dollar savings based only on cost per treatment, as if PTAs are simply cheap, one-to-one substitutes for PTs. But as we all know, PTAs are assistants to the PT, not case managers, and the time required for PTs to direct cases is very real. (It's frankly alarming to hear that " PTs do evaluations, PTAs do treatments. " ) Various factors affect the calculation of course, but we've found that for every 8 hours of PTA time the PT must put in about an hour of supervision---an hour that is otherwise non-productive, i.e. there is no billing associated with it. So if you employ 2 PTAs for each PT you can figure two hours per day of non-billable time for the PTs. That obviously pinches the cost savings, especially when the factor of lost flexibility is considered. As an aside, around here certain practice venues push the limits of the regulations, and make assistants their primary caregivers. For that they pay exceedingly well, which pressures the salary levels of assistants generally upward in all categories, making them an even poorer deal for the high-quality outpatient practice. Dave Milano, PT Rehabilitation Director Laurel Health System ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Maddox Sent: Monday, June 04, 2012 10:14 PM To: PTManager Subject: PT to PTA ratio I am the Director of Rehab for a small acute care hospital in northern California. We have a sizeable outpatient practice with eight FTE PT's and two PTA's. California allows a PT to supervise two PTA's. As a cost saving measure, we are being encouraged by hospital administration to ramp up our ratio of PTA's to PT's. I have experienced some resistance to doing so from the staff because of the increased workload required of a therapist to treat their own patients and to also be responsible for the patients that a PTA treats. Would any of you be willing to share with me what ratio you have in your outpatient department. I would welcome input from both hospital based and private practice settings. I would also be interested in knowing if you have an identified model for utilization. For example, do you use the team concept where a PTA is assigned to a specific PT or does a PTA receive patients from all PT's? And are the PT's who supervise the PTA's allowed to have a reduced patient load? Thank you for sharing. Maddox, PT, MPH Director of Rehabilitation Ukiah Valley Medical Center 275 Hospital Drive Ukiah, CA 95482 maddoxrg@...<mailto:maddoxrg%40ah.org> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2012 Report Share Posted June 5, 2012 Dave, while i agree with almost 100% of what you stated. As an " administrator " , i do see the other side of the coin.Yes, we do many calculations to find better ways to make hospitals and clinics more financially viable. My only comment to this would be that it might depend on who the PTA is. I have worked with many PTAs in my career and many of them were very good. Two or three of them were exceptionally good, able to work relatively independently, and the only difference between these PTAs and new PT grads might be the initials behind there names when treating patients. I understand that we are discussing a PTA and a PT and they have defined different roles and I am not suggesting that a PTA can replace a PT in any manner. A PTA with 20 years of experience in the ortho world might also object to the idea that they need one hour of supervision a day from a PT? I would think that the 1 hour a day would be a good standard to go by most of the time, but might make an exception once in a while. Just my two cents. Jeff Nolder, MSPT, MHA Vice President of Clinical Services Cherokee Regional Medical Center ext 207 > ** > > > The savings from PTAs is generally overstated, and your staff are getting > to the reason---administrators tend to calculate dollar savings based only > on cost per treatment, as if PTAs are simply cheap, one-to-one substitutes > for PTs. But as we all know, PTAs are assistants to the PT, not case > managers, and the time required for PTs to direct cases is very real. (It's > frankly alarming to hear that " PTs do evaluations, PTAs do treatments. " ) > > Various factors affect the calculation of course, but we've found that for > every 8 hours of PTA time the PT must put in about an hour of > supervision---an hour that is otherwise non-productive, i.e. there is no > billing associated with it. So if you employ 2 PTAs for each PT you can > figure two hours per day of non-billable time for the PTs. That obviously > pinches the cost savings, especially when the factor of lost flexibility is > considered. > > As an aside, around here certain practice venues push the limits of the > regulations, and make assistants their primary caregivers. For that they > pay exceedingly well, which pressures the salary levels of assistants > generally upward in all categories, making them an even poorer deal for the > high-quality outpatient practice. > > Dave Milano, PT > Rehabilitation Director > Laurel Health System > > > > -- Quote Link to comment Share on other sites More sharing options...
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