Interviewer: Lukas DanielInterviewee: Stacey Howell, PT, DPTPlace of Employment: Three Rivers TherapyDate: March 26, 2015

Informational Interview

Daily Work Routine and Work EnvironmentQ: What do you do on a typical day in this position? A: Our office hours are Monday through Thursday 7am to 5pm and Friday 7am to 12pm. I start seeing my first patient at 7:00. My last patient is typically at 4:30. I provide patient treatments, do initial evaluations, progress reports for patients who are returning to their doctor or nearing the end of their treatment/prescription, and supervisory visits for my Physical Therapist Assistant. Along with patient care, there is a lot of paperwork involved. Documentation of all treatments and care provided to each patient is required after each visit. Q: What part of this job do you find the most challenging or satisfying? A: Trying to keep up with the documentation requirements for Medicare is challenging. Dealing with the new insurance plans with increasing co-pays that are required for the patient to pay per visit is also challenging. Some patients that need therapy cannot always afford to come because they have a $30 to $50 co-pay that they have to pay per visit. This is difficult for patients who are on a fixed income and need therapy 2 to 3 times a week. At times, there are patients who are not the most pleasant or cooperative. Dealing with these patients can be a challenge. Q: What are some of the rewards of your occupation? A: Helping patients regain their functional independence is satisfying. Knowing that we helped them learn to walk again after a stroke, return to living on their own after having a knee replacement or hip replacement is rewarding. Seeing an athlete return to sport after their rehab post-injury is satisfying, as well. Questions to AskQ: How did you get started in this field? A: I was always interest in the health profession. I knew I wanted to help people. I wanted something that would be conducive to family life as well as rewarding. While in middle school, I read the book/autobiography Joni by Joni Eareckson Tada, which tells of her rehabilitation and struggles following an accident resulting in quadriplegia. Reading this book which detailed Jonis rehab process sparked my interest in physical therapy. Q: How was Three Rivers Therapy founded?A: My brother also went into the field of physical therapy. In 1998, we started the process of opening our own outpatient office to provide services to our rural area. Residents in our area that needed physical therapy had to drive 30 minutes to an hour to receive physical therapy prior to our opening in 1999. Q: What is unique about your organization?A: We are a small, family owned business. We are known in the community by many. To provide better services for our clientele, we are open extended hours Monday through Thursday, opening at 7am so patients can attend therapy before work or school. This assists our patients in not having to take time off to attend their therapy. Q: What personal qualities or abilities are important to being successful? A: Being flexible to help meet the needs of our clientele / being willing to work 7 days a week, even holidays, for a patient who requires therapy more than the typical business hours. Being friendly and having good communication skills. Being dedicated and determined. Q: What are typical hiring procedures?A: A physical therapist has to be licensed with the state of SC, or whichever state they are seeking employment. A perspective hire would have to submit as resume. An interview would be conducted by me or the other co-owner. Q: What areas of knowledge are most important for advancement in this field? A: Keeping up with all of the insurance changes and requirements. We also have to attend 30 hours of continuing education every 2 years to renew our license. Staying abreast of the advances in surgical procedures and protocols. Q: If you were starting out again, would you do anything differently? A: When I first started out after graduation from MUSC, I worked at hospital in acute care. There I was able to rotate through them different areas of the hospital, which included Medical/Surgical, Orthopedics, Neurology, and Outpatient. I then worked for a smaller community hospital as director of the physical therapy department. Here I worked with patients in acute care and outpatient. I also had to perform duties as department head. I, then, worked in home health. As I was working in home health, my brother and I were laying the ground work and getting the paperwork and construction completed to open Three Rivers. Once we opened our facility, we then contracted to the home health company that I had been employed with. This allowed us to have some income while we were building our clientele and report with the physicians in the immediate and surrounding areas. All that being said, I think the areas and facilities that I worked in prior to opening my own business helped me become a more well-rounded therapist and was an asset in owning my own business. I do not know of anything I would change in this journey thus far. Q: What are the toughest challenges you face in this field?A: Documentation requirements and insurance reimbursement.Q: Is there a demand for people in this occupation? A: With the aging population, there is a demand for people in this occupation. As the baby boomers are coming of age, there are more people who are at a greater risk of falls and are requiring joint replacements as well as the many plethora of other problems that come with aging. The surge in year round athletics with children/students going from one sport right into another sport is also contributing to the need of therapy services as we deal with sports-related injuries and overuse injuries. Q: What special advice would you give a person entering in this field? A: Stay on your A game. Soak up as much knowledge as you can. Stay open minded. When you go into this field, you may be thinking you want to work exclusively with pediatrics or geriatrics or sports med. As you get into your studies and see the many areas that are available to explore, you may find another area of interest, or you may stick with your initial goals. Knowledge you gain in one area may cross over into other arenas of care. Q: What opportunities for advancement are there in this field? A: While most graduates start as a treating therapist, there is room for advancement into a supervisory role. There are roles as directors and administrators. Some aspire to become a professor. There are also some specialty certifications that are available. These usually require completion of certain courses and passing an examination. Q: How do you see jobs in this field changing in the future? A: Over the past couple of decades, physical therapy has advanced from a bachelor degree program to masters program to a doctorate program. I think the main change we are facing as a profession is leaning to cope and deal with the many reimbursement changes that are occurring with the many changes in insurance and healthcare regulations. If things progress as they are going, I think the market for physical therapists may decline somewhat as the insurance companies themselves are paying out less and requiring the patient to pay out more. Many patients cannot afford to do this. If they have to decide whether to go to therapy or pay for groceries, they will not come to therapy.