1. “As an industry, we have a tremendous responsibility to offer our consumers information, tools and, of course, quality treatment”


Having sat and conversed with PT’s with other companies recently, I think that this sentence is a bunch of fluff. Don’t get me wrong, it sounds great, but it doesn’t happen too frequently. As a profession, we are hounded with productivity requirements and profit and loss statements. We got into this profession to help people, not to make mega corporations a mega-profit. Unfortunately, to the company, you are just a number. The bigger the number (see $$$) the better your number. If you have a therapist that treats you one-on-one, then you are among the few. This profession is being taken over by the “wallymarts” of physical therapy. Focused more on price than quality. For instance, if your sessions followed this game plan: warm up, stretch, manual therapy, and rehab tech or aide (see high school graduate) takes you through some exercises and then applies a hot pack with some electrodes or an ultrasound, then you are among the majority. It is harder and harder for a private (one owner, not publicly traded, not 100’s of clinics) practice owner to make it because everyone sees “wallymarts” and prefers convenience over individualized care. I am blessed because I still work for a company that allows me to treat one patient at a time. I don’t have to worry about productivity, as long as I am seeing one patient per hour that I am in the clinic. This is easy…but two every hour…this is very stressful. You should look up the term burnout. If you want to be a therapist, at least understand the world that you are entering.


  1. “Payers are pushing for new payment mechanisms: pay for performance (evidence-based medicine), higher deductibles and coinsurances, and assistance in managing spending. Relying only on insurance payments is a thing of the past”


Customers…patients…need to understand the nature of healthcare. For instance, if I could help you in 3-5 visits and you have to pay 70 dollars per visit out of pocket, your total would be 350 dollars. Now if you have to pay a 40-50 dollar copay and I decide to keep you in the clinic because the insurance is reimbursing more than I am getting from you, then I would keep you for 12 visits (average for back pain). In the end, I would make 480 dollars from you. You would have paid an extra $130 to be seen for more visits that you would have needed from someone that runs a cash based business and doesn’t take your insurance. Seek out good, quality care. Take care of your wallet, because there are some of us that will pick your pocket, shake your hand, and give you a t-shirt to advertise our clinics.


Quotes taken from:


Ziccarelli C. A Shifting Landscae: Growing your business in changing times. IMPACT. April 2016: 29-30.

Author: Dr. Vince Gutierrez, PT, cert. MDT

After having dedicated 8 years to growing my knowledge regarding the profession of physical therapy, it seems only fitting that I join the social media world in order to spread a little of the knowledge that I have gained over the years. This by no means is meant to act in place of a one-one medical consultation, but only to supplement your baseline knowledge in which to choose a practitioner for your problem. Having completed a Master of Physical Therapy degree, the MDT (Mechanical Diagnosis and Therapy) certification and currently finishing a post-graduate doctorate degree, I have spent the previous 12 years in some sort of post-baccalalaureate study. Hopefully the reader finds the information insightful and uses the information in order to make more informed healthcare decisions. MISSION STATEMENT: My personal mission statement is as follows: As a professional, I will provide a thorough assessment of your clinical presentation and symptoms in order to determine both the provocative and relieving positions and movements. The assessment process and ensuing treatment will be based on current and relevant evidence. Furthermore, I will educate the patients regarding their symptoms and their likelihood of improving with either skilled therapy, an independent exercise program, spontaneous recovery or if the patient should be referred to a separate specialist to possibly provide a more rapid resolution of symptoms. Respecting the patient’s limited resources is important and I will provide an accurate overview of the prognosis within 7 visits, again based on current research. My goal is to empower the patient in order to take charge of both the symptomatic resolution and return to full function with as little dependence on the therapist as possible. Personally, I strive to be an example for family and friends. My goal is to demonstrate that success is not a byproduct of situations, but a series of choices and actions. I will mentor those, in any way possible, that are having difficulty with the choices and actions for success. I will continue to honor my family’s “blue-collar” roots by working to excel at my chosen career and life situations. I choose to be a leader of example, and not words, all the while reducing negativity in my life. I began working towards the professional aspect of the mission statement while still in physical therapy school. By choosing an internship that emphasized patient care and empowering the patient, instead of the internship that was either closest to home or where I knew that I would have the easiest road to graduation, I took the first step towards learning how to utilize the evidence to teach patients how to reduce their symptoms. I continued this process by completing Mechanical Diagnosis and Therapy courses A-D and passing the credentialing exam. I will continue to pursue my clinical education through CEU’s on MDT and my goal is to obtain the status of Diplomat of MDT. Returning back to school for the t-DPT was a major decision for me, as resources (i.e. time and money) are limited. My choice was between saving money for the Dip MDT course (about 15,000 dollars) and continuing on with the Fellowship of American Academy of Orthopedic Manual Physical Therapists (FAAOMPT) (about 5,000 dollars), as these courses are paired through the MDT curriculum or returning to school to work towards a Doctorate of Physical Therapy degree. I initially planned on saving for the Dip MDT and FAAOMPT, but life changes forced me to re-evaluate my situation. The decision then changed to return for the tDPT, as my employer paid for a portion of the DPT program. My goal for applying to and finishing the Dip MDT and FAAOMPT is 10 years. This is how long I anticipate that it will take to finish paying student loans and save for both programs, based on the current rate of payment. I don’t know if I will ever accomplish what I set forth in the mission statement, but I do know that it will be a forever struggle to maintain this standard that I set for myself.

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