Saturday, May 28, 2022

Re: How many each year does our profession lose?

Additional replies withoutposting restrictions to my original question:

>>This last issue of O&P Business Newsbrought this back to mind. Does anyone have any idea how many graduateprosthetists and/or orthotists are we losing each year because they cannot finda residency is it 10% – 20% or what? The number I know of just keeps growing.>>

Al Pike, CP(E)

I wish I had repliedearlier I just fired a resident who marched into my office demanding an$85,000.00 per year salary. Threatening these types of offers were on thetable. I told him to pack up his stuff and go take one of those offers.

Is someone lookinginto how the residency program can possibly evolve to make sure no O&Pstudents are lost for this reason only?

Unless Medicare backsoff their new enforcement regulations, I see a 20% decrease in practitioners.Reimbursement is very low and some patients are just not worth the struggle.Sad but true. Residency’s are hard to get because the demand is not there fornew practitioners. This is a new climate for our profession.

The down side is thatthe amount of paperwork, cost and supervision
can be so burdensomethat companies do not have any incentive to do it again.

From residents sidethey are told that they can make salaries that currently are just not out thereand when they do have
an interview they aresurprised with the offer. A facility today does not have the same payment levelthat we had even 5 years ago and the field is being encroached upon by Doctors,PTs, OTs and the internet. This is reality and not some story from the schoolsas to how valuable they are. The push for higher educational standards hasincreased the gap between what was an entry level position and that of anexperienced practitioner and with shrinking reimbursement it is harder for acompany to justify increased cost of hiring residents. In the end when a companyhires a resident we are looking for a commitment beyond the 12 months.

I have had thisfeeling for a couple of years. We have this proliferation of O&P schoolsturning out a much larger number of graduates NUPOC is turning out more thanever. There is much less orthotic work than ever because the suppliers areselling more sophisticated one size fits a few off the shelf orthotics to everyclinic in the country where med techs and office staff are dispensing kneebraces etc. There are fewer amputations being performed and now ourreimbursement is getting crushed. We need to shut down schools like thedentist’s did a decade or more ago .. there will be a lot more of bitterdisappointed grads with big student loans and a lot of theory but not much realpractical work experience working at starbucks.

For the most part, mystudents have been able to find residency positions as long as they are willingto relocate.

In past years,graduates of the prosthetics only certificate program struggled to findprosthetic residency positions. Several of them decided to take the orthoticpractitioner education and then were then able to find a residency.

From my perspective,the biggest problem is the lack of an adequate resource for identifying openresidency positions.

There may be anotheraspect here as well. I’ve talked to two female graduates that had a hell of ahard time regarding residency. One quit and became an PT and the other ended upworking in an office that was owned by a women. It isn’t difficult to imaginesome of the situations they encountered.

I personally rememberhow hard it was to get information about O&P (pre-internet days) when I wastrying to jump in. I had practitioners lie (and I never have forgotten theirnames!), exaggerating the difficulty and educational requirements at the time.

I always figured ifyou want something bad enough, you’d make it happen.

We field a lot ofcalls for resident positions. Many want to make 45-60k per year. That have hadminimal patient interaction, squeaked into school without much time at afacility prior, and are told by the schools that they are clinicians nottechnicians. We hire residents to watch and learn, then perform undersupervision, then get certified and move on. This is costly. We stay busy in Oand P, residents tie our hands for the first 3 months or more. If they cannotor will not mix plaster, strip molds, sweep up, and other wise work with ourtechs and clinicians, they are of no use to us. The residents we hire must bepart of the team. Play in any position. And be ready to catch any ball thatcomes to them (no matter how low they have to stoop to get it).


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