Tuition, Burnout, and Board Failures: Inside the DPT Crisis

WEBVTT

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You're listening to the PT Pintcast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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I want to say something to an organization

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helping us keep the lights on before we

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kick this episode off that I think you're

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going to learn a lot from.

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It's Brooks Institute of Higher Learning,

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brooksihl.org, residencies,

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fellowships down in Florida, orthopedics,

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pediatrics, geriatrics.

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If you want post-professional education,

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you want the support to get there,

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brooksihl.org is where you go.

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Just listen,

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if you're even thinking about it,

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Book a call with them and find out.

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Don't just stop at the website,

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but have a conversation.

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That is the place that a lot of

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people have gone.

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And then I don't think I've heard anybody

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in my circle anyway speak negatively about

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the experience.

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So brooksihl.org.

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Thank you for those guys for supporting

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the show for more than two years.

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Today...

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We get to talk to someone who's a

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tenured professor, research director,

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manual therapy expert,

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and somebody who's lived and worked across

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seven countries.

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I don't even know if I could name

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seven countries.

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All right, I could name seven,

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but I don't know if I've been to

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seven countries.

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Our guest today has seen higher ed from

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every angle,

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and he's not afraid to say what others

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won't.

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Oh, did your ears just perk up?

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Good.

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As PT programs expand and student debt

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skyrockets,

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he's asking the tough questions about the

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future, sustainability, quality,

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and really the future of this entire

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profession and how it plays out.

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Let's bring in our guest.

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Steve, welcome to the show.

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Thank you.

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Thanks for having me.

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You and I were just talking before I

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hit record about something that I think

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your daughter just exposed you to.

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We were talking about podcasts real quick.

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Smartless.

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And I love how they intro the guest

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where they give the movie trailer,

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then pop the guest on.

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How did I do with your intro?

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Did I miss any of the big beats?

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You can't summarize everybody's life,

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but how did I do?

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I think that's pretty good.

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I feel like I have a lot to

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live up to for the next however long

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we're here.

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You don't have to brag.

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I'm their hype guy.

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You just sit there and say, no, no,

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thank you, thank you, thank you.

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So we connected on LinkedIn.

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Yes.

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I don't even remember.

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I was looking about a half hour before

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we record to find the actual interaction.

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And that's okay that we don't have it

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because the gist of it was what I

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sort of talked about in the intro.

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You've said, you think or you feel,

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listen, at this moment in time,

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in December, twenty twenty five,

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PT education is facing a perfect storm.

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So I'll start off by asking,

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what are the biggest warning signs that

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we're ignoring as a profession or an

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educational system?

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What are the flashing lights from your

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perspective?

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um okay so first before we start so

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so nobody jumps on me about conflicts of

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interest for some strange financial reason

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i am a tenured professor you can look

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up tenured professor salary um so i'm a

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chatham in pittsburgh i do a little bit

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of work at bowling green in their hybrid

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program

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I work for the North American Institute of

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Orthopedic Manual Therapy doing an online

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course and helping with their research.

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Also help with some DSC students at

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Andrews, which is where I received my DSC.

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And not that this is relevant,

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but I work in assorted clinics whenever

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they'll have me around the Pittsburgh

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area.

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Good.

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I like how you're like,

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here's my conflict of interest.

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Boom.

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There's the first slide.

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Perfect.

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All right.

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Now we'll go back to the question.

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Right.

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And I shoveled snow for my neighbor,

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but that's not really a conflict.

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All right.

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Well, the first thing, you know,

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this is this has been going on since

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I think about twenty twenty two.

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I think there was an article storm clouds

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on the horizon and I don't know if

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we've turned our back on it.

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But I do know that whether it's state

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conference, national conferences, CSM,

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AOMT, you know,

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educators get together and we sort of talk

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about,

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we start talking about education and it

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ends up in the same sort of session,

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right, where we talk about things.

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And the big thing is, you know,

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career regret.

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We see,

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I've been in academia for fifteen years.

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And while I have some stellar students and

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students that are doing great work and

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they own clinics and they're doing

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research,

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I have students that have left the

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profession.

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They have left for either online work to

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be a rep for pharmaceutical companies or

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medical companies,

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somebody that's working with real-time

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ultrasound, MRI clinics.

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You know,

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they're sort of all over the place.

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And I think that spans from

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You know,

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I'm not sure I'm well qualified to talk

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about the reimbursement part of it.

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But, you know,

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just recently in the private practice

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section meeting down in Florida, you know,

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some guys I know that were there,

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same thing.

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We are seeing lower reimbursements where

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it's more difficult to get into some of

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these larger providers to even see

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patients.

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Even if you are fellowship trained and

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certified and have experience,

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they're not letting people into the

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system.

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So they're losing out on patients.

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So to try to coalesce all that,

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I think students are coming out with a

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high level of debt,

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which I'd like to talk about that.

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They're in the profession and they just

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can't make it work.

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They're getting burned out.

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They're getting pushed to see more

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patients, to present more billable units.

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And it's difficult.

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And this is, I think,

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says more about the profession maybe than

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education and where maybe we're going to

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talk a little bit more.

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but there is a considerable amount of

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burnout in the profession and students

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becoming therapists and then leaving the

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profession.

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Just a recent, what was it,

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career regret with PTs.

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I have the numbers here.

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Forty-one point three percent of PTs

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regretted their career based on loans and

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costs.

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And then they're leaving within ten years

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of graduation.

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Why does that?

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Why does that?

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So that's the hard data.

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That's the objective.

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But just for a second,

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before we move on to a different topic,

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why does that bother you so much?

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I mean,

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I'm going to assume it's because you're an

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educator and you care about this stuff and

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you're like, hey,

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I show up for the paycheck and because

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I like the job,

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but also I like the thing that we

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produce, which is people, not degrees.

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Right.

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So why does it bother you?

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How does it make you feel from a

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personal perspective to watch people leave

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the profession?

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you know i've i've if i've had fifteen

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classes that give or take six hundred

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students at least coming through our dpt

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program um and some of the better students

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that are forward thinking and are

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excellent clinicians and excellent

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managers um are leaving because they just

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they either have better opportunities

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they're more motivated or they can't make

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it work

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And, you know, in the end,

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this is going to sound like one of

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those platitudes that people say,

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but this is, you know, in the end,

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we're about patient care.

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Right.

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And producing the best outcomes we can.

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And when we see really good therapists

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leaving the profession for this reason,

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you know, we think about.

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you know,

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what are we doing for those patients?

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If therapists are leaving when they have

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experience and they start to develop

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mechanisms for evaluation and treatment

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and patient-focused care and

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patient-centered care and they're up with

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the research and their knowledge is

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improving,

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know that doesn't bode well for us as

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a profession in terms of just frankly

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marketing right if every time somebody

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goes to a therapist there and nothing

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against new grads but they're seeing

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somebody with without the experience or

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without that level of knowledge um my my

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suspicion and i i don't have the hard

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data here is that um outcomes are probably

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not going to be what we would like

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them to

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let's talk about something that you're

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close to but professors don't set prices

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right it's not how it works and there's

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more than one factor in how much um

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something costs or how much debt someone

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comes into right you've got interest rates

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or there's a lot of factors

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multi-factorial as we love to say at big

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meetings right but with with dpt student

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debt exploding and salaries haven't

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changed much

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If you had a magic wand,

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what do you think needs to happen at

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the program level, professional level?

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This almost feels like Sesame Street.

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These are the people in the neighborhood.

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What do those people in the neighborhood

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need to do if you had that magic

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wand to make this slow down or even

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get better?

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So let me just back up just a

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little bit.

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I would say that sometimes you have to

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dig deep for this data and for these

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numbers,

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and oftentimes it's different depending on

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what source you pull.

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Whether it's private practice, section,

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journal article, the APTA,

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the Bureau of Labor Statistics,

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it's all different, right?

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It doesn't seem to add up.

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But where I come down,

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it's let's just say an average starting

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salary of eighty five thousand.

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Granted, different New York City,

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San Francisco, Pittsburgh,

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they're all going to change a bit.

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There is some financial advice where

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people say you don't take on your maximum

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student loan should not be more than one

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point five times your first year salary.

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Got it.

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I've seen that as well.

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Yeah.

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So and we have undergraduate debt.

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Right.

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And we're asking them to take on more.

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So let's just consider I pull like one

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hundred twenty seven thousand as that

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maximum number.

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Right.

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But we know about a third of students

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have over a hundred and fifty thousand

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dollars in debt and some programs cost

00:10:22.251 --> 00:10:23.592
more than a hundred and fifty thousand

00:10:23.633 --> 00:10:23.993
dollars.

00:10:25.134 --> 00:10:27.095
My hope is that.

00:10:28.115 --> 00:10:29.557
Not sure I'm answering your question

00:10:29.576 --> 00:10:31.197
because that's that's a tough question,

00:10:31.619 --> 00:10:31.778
but.

00:10:32.523 --> 00:10:35.244
Well, you're not just saying, well, Jimmy,

00:10:35.283 --> 00:10:35.923
it's complicated.

00:10:35.943 --> 00:10:37.985
You're showing me some of the many

00:10:38.044 --> 00:10:39.804
different ways in which it's complicated,

00:10:39.924 --> 00:10:41.005
or it's not that simple.

00:10:41.385 --> 00:10:42.005
Simply by saying,

00:10:42.046 --> 00:10:44.086
how much does a DPT cost?

00:10:44.407 --> 00:10:44.547
Well,

00:10:44.586 --> 00:10:46.826
what is that person or the average person

00:10:46.866 --> 00:10:48.168
or most of those people carrying?

00:10:48.488 --> 00:10:49.587
It is undergraduate.

00:10:49.827 --> 00:10:51.168
They are going right from one to the

00:10:51.208 --> 00:10:51.369
other,

00:10:51.389 --> 00:10:52.788
or maybe they've had two or three years

00:10:53.369 --> 00:10:53.908
in between.

00:10:54.210 --> 00:10:54.929
So it's not simple.

00:10:56.210 --> 00:10:57.610
So one thing is just to get the

00:10:57.691 --> 00:10:58.630
information out.

00:10:59.110 --> 00:11:01.611
There is a tremendous variety of...

00:11:02.537 --> 00:11:05.278
costs when it comes to a DPT program.

00:11:06.158 --> 00:11:08.857
Anywhere from an in-state somewhere around

00:11:08.998 --> 00:11:11.879
forty thousand dollars all the way up to

00:11:11.958 --> 00:11:13.099
the mid two hundreds.

00:11:13.619 --> 00:11:15.859
I mean, that's just insane variation.

00:11:16.559 --> 00:11:18.700
But I think trying to let students know

00:11:19.639 --> 00:11:22.681
what the numbers are and then hopefully

00:11:22.721 --> 00:11:25.900
they can be the consumers of of our

00:11:25.941 --> 00:11:28.562
programs and look and say, you know,

00:11:30.121 --> 00:11:34.024
if if if that honda and that um

00:11:34.085 --> 00:11:35.905
mercedes they're getting me to the same

00:11:35.946 --> 00:11:38.847
location right why am i choosing the

00:11:38.889 --> 00:11:40.889
merced like like let me take a look

00:11:40.909 --> 00:11:42.571
at this and really make an informed

00:11:42.591 --> 00:11:44.712
decision agreed let me throw one more

00:11:44.753 --> 00:11:46.173
wrinkle into that too though because if

00:11:46.214 --> 00:11:48.575
we're using honda analogies and mercedes

00:11:48.794 --> 00:11:50.697
one more wrinkle on that would be if

00:11:50.797 --> 00:11:53.038
i apply to three hondas three mercedes and

00:11:53.057 --> 00:11:53.678
a lamborghini

00:11:55.177 --> 00:11:56.596
And we know seats are limited because

00:11:56.616 --> 00:11:57.437
that's how seats are.

00:11:57.777 --> 00:12:00.278
And I'm standing still with the world and

00:12:00.317 --> 00:12:01.378
time passing by.

00:12:01.398 --> 00:12:02.557
And I go, well,

00:12:03.378 --> 00:12:04.818
there's more people applying to Honda.

00:12:04.839 --> 00:12:05.818
So it's harder to get in there.

00:12:06.558 --> 00:12:08.658
Less people applying for Mercedes because

00:12:08.958 --> 00:12:09.278
they don't,

00:12:09.379 --> 00:12:10.460
they're smart and they're not even going

00:12:10.480 --> 00:12:11.039
to apply there.

00:12:11.320 --> 00:12:12.740
And very few to the Lamborghini.

00:12:14.080 --> 00:12:15.520
I have to make that decision on what's

00:12:15.561 --> 00:12:18.321
a year's worth of me standing still worth.

00:12:19.260 --> 00:12:20.100
And where'd I get in?

00:12:20.740 --> 00:12:20.961
Right?

00:12:21.000 --> 00:12:21.922
So there's one more wrinkle.

00:12:22.022 --> 00:12:23.761
And again, that's simple, but not easy.

00:12:24.946 --> 00:12:27.467
true and and you know i i would

00:12:27.687 --> 00:12:29.668
i would call linkedin the polite twitter

00:12:29.849 --> 00:12:31.570
or yeah yeah yeah for now for now

00:12:31.590 --> 00:12:34.072
it's not ruined steve and i do have

00:12:34.111 --> 00:12:36.333
some students reply to some of my posts

00:12:36.354 --> 00:12:38.414
saying you know i only got in here

00:12:38.934 --> 00:12:40.777
yeah and i really want to do this

00:12:41.076 --> 00:12:42.998
and they've taken what i think is a

00:12:43.077 --> 00:12:45.720
smart strategy and worked for a few years

00:12:45.980 --> 00:12:48.721
and banked some money and become a little

00:12:48.741 --> 00:12:50.842
bit more independent and then they get

00:12:50.883 --> 00:12:52.524
into a program that's you know

00:12:56.167 --> 00:12:56.966
And look,

00:12:56.986 --> 00:12:58.807
I am not saying that these programs are

00:12:58.847 --> 00:12:59.227
not good,

00:12:59.248 --> 00:13:00.629
that you don't get a good education,

00:13:00.649 --> 00:13:02.070
that the faculty isn't good.

00:13:02.429 --> 00:13:04.691
It's just when you look at the numbers

00:13:05.811 --> 00:13:07.631
and you look at what we know about

00:13:07.672 --> 00:13:09.653
burnout and people leaving the profession,

00:13:10.913 --> 00:13:12.095
I don't think we can ignore that.

00:13:12.154 --> 00:13:15.135
We have to really kind of look at

00:13:15.296 --> 00:13:18.018
as an educator and say, well,

00:13:18.057 --> 00:13:19.798
what is happening to these tuition

00:13:19.837 --> 00:13:20.219
dollars?

00:13:21.147 --> 00:13:23.788
And invariably, what I see, again,

00:13:23.827 --> 00:13:25.268
I don't have hard data for you.

00:13:25.288 --> 00:13:27.207
There is somebody doing this right now,

00:13:27.307 --> 00:13:28.369
but it's just not done yet.

00:13:28.428 --> 00:13:29.869
So she didn't feel comfortable sharing

00:13:30.469 --> 00:13:31.408
incomplete data with me.

00:13:32.269 --> 00:13:35.629
A lot of the newer programs are basically

00:13:36.150 --> 00:13:39.150
to stabilize institutions that are not

00:13:39.211 --> 00:13:39.791
doing well.

00:13:40.611 --> 00:13:42.772
And there are a lot of institutions not

00:13:42.812 --> 00:13:45.513
doing well because of what we call the

00:13:45.592 --> 00:13:48.312
fiscal cliff or the enrollment cliff in

00:13:48.352 --> 00:13:48.933
higher ed,

00:13:49.774 --> 00:13:50.254
which is

00:13:52.748 --> 00:13:55.908
more students or less students, right?

00:13:56.089 --> 00:13:59.110
A less population of college age students

00:13:59.470 --> 00:14:01.630
and people aren't seeing the return in

00:14:01.711 --> 00:14:05.392
investment or the value on undergrad or

00:14:05.432 --> 00:14:06.672
graduate education.

00:14:08.033 --> 00:14:10.312
That was predicted ten years ago to start

00:14:10.352 --> 00:14:11.374
in twenty twenty five.

00:14:11.413 --> 00:14:12.874
Well, guess what year it is?

00:14:14.514 --> 00:14:16.934
So I think we have to look at

00:14:16.955 --> 00:14:17.216
that.

00:14:17.596 --> 00:14:21.197
And as faculty members say, you know,

00:14:21.236 --> 00:14:21.437
look,

00:14:23.024 --> 00:14:25.950
where we have to do something proactively

00:14:26.510 --> 00:14:28.014
with our costs of tuition,

00:14:28.934 --> 00:14:30.118
what we offer students,

00:14:31.369 --> 00:14:33.529
Um, and where, where our money is going,

00:14:33.570 --> 00:14:35.350
if it all is going right back into

00:14:35.390 --> 00:14:36.671
a university system,

00:14:36.811 --> 00:14:38.032
that's concerning to me.

00:14:38.111 --> 00:14:38.351
Right.

00:14:38.552 --> 00:14:39.511
Well, let me ask you this then,

00:14:39.532 --> 00:14:40.592
because there was a pivot.

00:14:40.852 --> 00:14:42.953
There was a, this is impossible moment.

00:14:43.874 --> 00:14:45.095
Uh, maybe ten years ago,

00:14:45.115 --> 00:14:45.735
maybe a little more.

00:14:45.875 --> 00:14:46.815
I remember it was when I was in

00:14:46.855 --> 00:14:48.015
PT school or just graduating.

00:14:48.035 --> 00:14:49.015
So we're talking twenty fifteen,

00:14:49.035 --> 00:14:49.716
twenty sixteen,

00:14:50.197 --> 00:14:51.937
which is weird to know that that says

00:14:51.976 --> 00:14:52.538
ten years ago.

00:14:52.937 --> 00:14:56.458
Uh, the idea there was hybrid education.

00:14:56.999 --> 00:14:58.340
Can't work in PT, everybody.

00:14:58.399 --> 00:14:59.480
We have to be in person.

00:14:59.620 --> 00:15:00.441
That's impossible.

00:15:01.368 --> 00:15:01.988
And of course,

00:15:02.148 --> 00:15:03.889
necessity being the mother of invention,

00:15:04.229 --> 00:15:05.450
hybrid was sort of on the way of

00:15:05.470 --> 00:15:06.070
being a thing.

00:15:06.509 --> 00:15:08.211
And then a little year of called twenty

00:15:08.250 --> 00:15:08.890
twenty happened.

00:15:09.250 --> 00:15:10.532
And that's when impossible became

00:15:10.591 --> 00:15:11.412
completely possible.

00:15:11.873 --> 00:15:13.153
So hybrid education, though,

00:15:13.192 --> 00:15:16.234
was designed to meant to reduce cost and

00:15:16.333 --> 00:15:17.335
increase access,

00:15:17.855 --> 00:15:19.015
maybe have to limit where someone would

00:15:19.035 --> 00:15:22.177
have to physically be from your seat where

00:15:22.236 --> 00:15:22.797
you sit.

00:15:23.297 --> 00:15:23.918
Is it working?

00:15:23.977 --> 00:15:25.097
Is it doing those things?

00:15:25.337 --> 00:15:28.099
What do you think about the goal and

00:15:28.139 --> 00:15:29.059
then where it is?

00:15:31.850 --> 00:15:34.591
So let me preface by saying I am

00:15:35.232 --> 00:15:38.214
all for innovation, one hundred percent.

00:15:38.835 --> 00:15:41.556
I am for hybrid if that fits your

00:15:41.596 --> 00:15:42.517
learning style.

00:15:42.777 --> 00:15:43.836
I am for traditional.

00:15:43.996 --> 00:15:45.197
I am for modified.

00:15:46.019 --> 00:15:49.941
Whatever we can do to deliver succinct

00:15:50.620 --> 00:15:54.143
education to students in an affordable

00:15:54.202 --> 00:15:55.403
manner, I support.

00:15:57.355 --> 00:16:00.217
I do not see that hybrid education has

00:16:00.398 --> 00:16:03.039
lowered costs for students.

00:16:04.399 --> 00:16:05.721
There are hybrid programs,

00:16:05.740 --> 00:16:07.422
and this is all public data.

00:16:07.461 --> 00:16:09.602
You can get on the APTA or CAPTI

00:16:09.623 --> 00:16:11.024
website and find this stuff.

00:16:11.624 --> 00:16:14.365
They are as expensive or more expensive

00:16:14.446 --> 00:16:16.167
than what people like to call traditional

00:16:17.006 --> 00:16:17.567
education.

00:16:19.880 --> 00:16:21.581
Now you can live at home.

00:16:21.822 --> 00:16:23.163
That's great, right?

00:16:23.203 --> 00:16:24.283
Hopefully save some money,

00:16:24.445 --> 00:16:25.985
but there's travel costs, right?

00:16:26.005 --> 00:16:29.148
You go anywhere from five to ten weeks,

00:16:29.207 --> 00:16:31.029
give or take per year.

00:16:31.070 --> 00:16:33.051
So you're traveling, you're staying there.

00:16:35.653 --> 00:16:37.534
Some people like to say shorter is better,

00:16:37.735 --> 00:16:37.955
right?

00:16:37.975 --> 00:16:39.677
If you can get in and out of

00:16:39.736 --> 00:16:41.357
a hybrid program in two years.

00:16:42.870 --> 00:16:43.431
However,

00:16:44.831 --> 00:16:47.033
in my brief experience with a few

00:16:47.073 --> 00:16:50.256
programs, students are, man,

00:16:50.297 --> 00:16:51.837
are they stressed, right?

00:16:51.857 --> 00:16:53.179
Some of them, not all of them.

00:16:53.879 --> 00:16:56.221
They are in full-time education.

00:16:56.942 --> 00:16:58.664
They are working on their own with their

00:16:58.705 --> 00:16:59.644
hands-on skills,

00:16:59.705 --> 00:17:01.307
which we can have a conversation about

00:17:01.326 --> 00:17:02.868
whether that's the best way to go about

00:17:02.908 --> 00:17:03.048
that.

00:17:04.869 --> 00:17:08.073
And then they're working and they're also

00:17:08.114 --> 00:17:10.056
taking some online sort of evening

00:17:10.076 --> 00:17:10.516
courses.

00:17:10.556 --> 00:17:14.019
So they're fairly busy and doing a lot

00:17:14.119 --> 00:17:15.300
in that two-year period.

00:17:16.061 --> 00:17:16.962
Some people can do it.

00:17:17.282 --> 00:17:18.845
Some people are a bit stressed.

00:17:20.105 --> 00:17:21.827
But in answer to your question,

00:17:21.928 --> 00:17:23.410
has it lowered the cost?

00:17:24.029 --> 00:17:25.432
I do not see that it has.

00:17:25.531 --> 00:17:26.232
I do not see...

00:17:26.833 --> 00:17:29.273
hybrid programs being substantially less

00:17:29.394 --> 00:17:31.914
than traditional programs or the overall

00:17:31.974 --> 00:17:35.035
average of a DPT education coming down.

00:17:35.174 --> 00:17:36.316
That has not happened.

00:17:36.895 --> 00:17:38.076
Okay.

00:17:38.977 --> 00:17:40.616
Staying in this sort of area and

00:17:40.696 --> 00:17:41.396
understanding there's,

00:17:42.076 --> 00:17:43.417
it's almost like the government, right?

00:17:43.498 --> 00:17:44.637
Federal, executive,

00:17:44.657 --> 00:17:46.618
there's always branches that lean on each

00:17:46.679 --> 00:17:46.878
other.

00:17:46.898 --> 00:17:48.338
You've got programs,

00:17:48.358 --> 00:17:49.338
you've got the industry,

00:17:49.358 --> 00:17:51.119
you've got insurance, multifactorial.

00:17:51.200 --> 00:17:54.461
But from education, as enrollment drops,

00:17:55.765 --> 00:17:57.747
But programs keep growing.

00:17:58.247 --> 00:18:00.670
Are we risking quality by admitting

00:18:00.829 --> 00:18:02.211
underprepared students?

00:18:02.250 --> 00:18:04.452
Because we've got to fill the seats

00:18:04.492 --> 00:18:06.434
because filling the seats keeps the boat

00:18:06.474 --> 00:18:07.996
floating moving forward.

00:18:09.298 --> 00:18:10.358
What levers are at play?

00:18:10.739 --> 00:18:12.119
What could be in the future if we

00:18:12.160 --> 00:18:12.721
do do this?

00:18:13.755 --> 00:18:13.934
Well,

00:18:14.174 --> 00:18:16.415
our first time pass rates within the

00:18:16.455 --> 00:18:18.156
profession have dropped since.

00:18:18.676 --> 00:18:19.917
There's a KPI.

00:18:20.397 --> 00:18:21.758
Now, is that COVID?

00:18:22.358 --> 00:18:23.318
Is that a new learner?

00:18:23.919 --> 00:18:25.640
Is that social media?

00:18:26.380 --> 00:18:27.300
I mean, I don't know.

00:18:27.320 --> 00:18:29.021
It's again, multifactorial.

00:18:29.041 --> 00:18:29.821
You can't isolate, right?

00:18:29.862 --> 00:18:32.363
That's how the world works, right?

00:18:34.384 --> 00:18:36.525
So cohorts above seventy,

00:18:38.766 --> 00:18:40.286
from me just looking at the data and

00:18:40.326 --> 00:18:41.406
pulling things and looking,

00:18:42.041 --> 00:18:43.884
This is not published information.

00:18:43.923 --> 00:18:46.705
This is my going online and looking.

00:18:46.726 --> 00:18:47.246
Your lens, right.

00:18:47.266 --> 00:18:48.386
Okay.

00:18:48.406 --> 00:18:48.667
That's okay.

00:18:48.688 --> 00:18:50.588
A lot of these cohorts have more than

00:18:50.769 --> 00:18:51.690
seventy students.

00:18:52.931 --> 00:18:54.833
So that less than eighty percent

00:18:54.873 --> 00:18:56.933
first-time pass rate, right,

00:18:57.074 --> 00:19:00.017
these are programs with large cohorts.

00:19:01.057 --> 00:19:01.178
Now,

00:19:01.238 --> 00:19:03.480
does that mean they are trying to fill

00:19:03.519 --> 00:19:05.662
seats of students that traditionally would

00:19:05.721 --> 00:19:08.124
not be admitted to a DPT program?

00:19:09.236 --> 00:19:11.278
Or because of this enrollment cliff,

00:19:11.337 --> 00:19:12.919
are there less students and we're pulling

00:19:12.999 --> 00:19:14.380
on less qualified students?

00:19:14.559 --> 00:19:16.922
Or is there grade inflation?

00:19:18.544 --> 00:19:19.163
We're not sure.

00:19:19.203 --> 00:19:21.326
But typically, these are newer programs,

00:19:21.385 --> 00:19:22.707
both traditional and hybrid,

00:19:22.767 --> 00:19:24.588
mainly hybrid, but also traditional.

00:19:25.148 --> 00:19:25.970
And that's just, I think,

00:19:26.009 --> 00:19:27.830
because hybrid is just the newer format.

00:19:27.851 --> 00:19:29.833
So we see more newer hybrid programs.

00:19:31.788 --> 00:19:33.328
But those modes,

00:19:33.669 --> 00:19:35.470
they don't seem to be related hybrid

00:19:35.549 --> 00:19:37.210
versus traditional in terms of first-time

00:19:37.250 --> 00:19:37.769
pass rates.

00:19:38.089 --> 00:19:38.191
Now,

00:19:38.211 --> 00:19:40.270
the good news is the ultimate pass rate

00:19:40.451 --> 00:19:41.790
is usually high, right?

00:19:41.971 --> 00:19:42.652
High nineties.

00:19:43.192 --> 00:19:45.711
So eventually, but when you look at a,

00:19:45.791 --> 00:19:46.031
you know,

00:19:46.071 --> 00:19:48.932
at twenty percent of students starting to

00:19:49.032 --> 00:19:51.634
retake an exam, you know,

00:19:51.953 --> 00:19:56.154
that's a high number, I would argue.

00:19:56.214 --> 00:19:57.434
So anecdotally, again,

00:19:57.474 --> 00:20:00.395
just from talking to my colleagues and

00:20:00.455 --> 00:20:00.915
peers,

00:20:02.067 --> 00:20:05.867
We are starting to see unqualified or

00:20:06.628 --> 00:20:08.548
students who are challenged by a DPT

00:20:08.588 --> 00:20:09.150
curriculum.

00:20:10.650 --> 00:20:12.691
They're either failing out or they're

00:20:12.730 --> 00:20:15.291
dropping out or they're unable to pass the

00:20:16.432 --> 00:20:18.212
hardcore sciences like anatomy and

00:20:18.252 --> 00:20:20.874
physiology at a graduate or doctoral

00:20:20.913 --> 00:20:21.213
level.

00:20:22.693 --> 00:20:24.035
We still see very good students.

00:20:25.555 --> 00:20:27.076
We still see sort of the middle of

00:20:27.115 --> 00:20:29.336
the road.

00:20:29.497 --> 00:20:30.938
But why that's happening?

00:20:31.057 --> 00:20:32.519
I mean, I think it's just basic math,

00:20:32.538 --> 00:20:32.719
though.

00:20:32.739 --> 00:20:33.179
Like you said,

00:20:33.219 --> 00:20:35.759
if there's fewer students and more

00:20:35.819 --> 00:20:38.820
programs where, you know, again,

00:20:38.901 --> 00:20:40.501
anecdotally talking to people,

00:20:40.582 --> 00:20:43.182
they are going through their accept list

00:20:44.003 --> 00:20:46.404
and their wait list and everybody's

00:20:46.424 --> 00:20:46.904
getting in.

00:20:47.664 --> 00:20:49.806
So there are some programs that don't flat

00:20:49.846 --> 00:20:50.567
out reject people.

00:20:50.586 --> 00:20:52.268
They put everybody on a wait list just

00:20:52.307 --> 00:20:52.807
in case.

00:20:54.219 --> 00:20:55.640
Um, and, and I,

00:20:55.740 --> 00:20:57.681
I hate to hold that against a student

00:20:57.721 --> 00:20:59.082
that wants to become a PT.

00:20:59.102 --> 00:21:01.884
Um,

00:21:01.923 --> 00:21:03.404
but we're seeing it in the numbers again,

00:21:03.444 --> 00:21:03.664
we're,

00:21:03.744 --> 00:21:05.266
we're seeing the first time pass rate

00:21:05.286 --> 00:21:05.645
drop.

00:21:06.467 --> 00:21:07.767
Um, and we're seeing,

00:21:07.987 --> 00:21:10.189
we're seeing students leave the program,

00:21:10.229 --> 00:21:10.469
right.

00:21:10.489 --> 00:21:12.250
To leave their cohort before they're even

00:21:12.430 --> 00:21:13.611
there, they graduate.

00:21:14.090 --> 00:21:14.892
So let's go to the other end of

00:21:14.912 --> 00:21:15.291
this too.

00:21:15.352 --> 00:21:17.792
You've, you've got faculty with DPTs,

00:21:17.853 --> 00:21:19.914
PhDs, fellowship, EDDs, um,

00:21:21.028 --> 00:21:22.469
And it would be hard to argue that

00:21:22.568 --> 00:21:24.890
getting smarter people is bad, right?

00:21:24.910 --> 00:21:25.730
So I'm not arguing that,

00:21:25.789 --> 00:21:27.490
but I get to ask the questions and

00:21:27.530 --> 00:21:28.790
look smart and you got to answer it.

00:21:28.810 --> 00:21:30.251
You got the tougher job, man.

00:21:30.291 --> 00:21:31.972
So we got faculty with DPTs, PhDs,

00:21:31.992 --> 00:21:32.393
fellowships.

00:21:32.893 --> 00:21:36.835
Is that raising the bar or reacting to

00:21:36.875 --> 00:21:39.576
a broken system?

00:21:40.776 --> 00:21:42.797
Um, a little bit of both.

00:21:43.696 --> 00:21:44.238
It depends.

00:21:44.258 --> 00:21:45.597
I knew Steve, come on, we're PTs.

00:21:45.637 --> 00:21:46.999
We knew it and it depends would come

00:21:47.038 --> 00:21:47.638
out eventually.

00:21:48.035 --> 00:21:48.335
You know,

00:21:48.576 --> 00:21:49.936
it's more fun when you just put a

00:21:49.977 --> 00:21:51.999
slogan on a T-shirt or threaten to sue

00:21:52.038 --> 00:21:53.681
somebody on Twitter and then, you know,

00:21:53.740 --> 00:21:54.981
people are, you know,

00:21:55.001 --> 00:21:56.723
think you have all the answers.

00:21:56.864 --> 00:21:58.705
But, you know, look,

00:21:58.746 --> 00:22:01.409
here's my experiential answer is...

00:22:03.298 --> 00:22:06.578
I think it's thirteen to fifteen per

00:22:06.798 --> 00:22:08.019
teaching assistant, right,

00:22:09.460 --> 00:22:12.099
in a lab scenario that CAPT requires.

00:22:15.040 --> 00:22:17.020
So I would argue that that number should

00:22:17.040 --> 00:22:19.741
be a little bit less, something like ten.

00:22:20.422 --> 00:22:21.501
But technically,

00:22:22.843 --> 00:22:25.143
I would be qualified to go help out

00:22:25.343 --> 00:22:27.564
in a pediatric lab.

00:22:30.251 --> 00:22:32.454
I do not consider myself personally

00:22:32.494 --> 00:22:33.596
qualified to do that,

00:22:33.655 --> 00:22:35.979
but technically I could do that as a

00:22:36.038 --> 00:22:36.900
teaching assistant.

00:22:38.041 --> 00:22:39.222
And I think that needs to change.

00:22:39.303 --> 00:22:40.843
I think there needs to either through

00:22:40.883 --> 00:22:43.584
CAPTI or through schools need to say,

00:22:43.683 --> 00:22:43.864
look,

00:22:43.904 --> 00:22:46.546
if you're coming to help out in my

00:22:46.806 --> 00:22:47.506
spine lab,

00:22:48.006 --> 00:22:49.426
we need you to have at least three

00:22:49.446 --> 00:22:50.886
years of outpatient experience.

00:22:50.926 --> 00:22:55.848
We need you to be understanding of the

00:22:55.868 --> 00:22:56.710
way we teach,

00:22:56.910 --> 00:22:58.450
maybe the classification systems,

00:22:58.529 --> 00:23:01.290
manual therapy stuff before you come in.

00:23:02.531 --> 00:23:04.553
And that requires, right, a little bit of

00:23:05.599 --> 00:23:08.181
experience and a little bit of motivation

00:23:08.601 --> 00:23:10.682
on on the teaching assistance part.

00:23:11.981 --> 00:23:13.343
So that would be one thing.

00:23:13.383 --> 00:23:13.482
Now,

00:23:13.502 --> 00:23:14.863
I do know there was a move to

00:23:14.903 --> 00:23:17.124
and I can't remember the number of maybe

00:23:17.163 --> 00:23:19.785
as fifty fifty at this point of PhDs

00:23:19.845 --> 00:23:21.165
to fellowship trained.

00:23:21.185 --> 00:23:21.506
Right.

00:23:23.250 --> 00:23:24.231
So yeah,

00:23:24.291 --> 00:23:26.153
can a fellowship trained therapist be an

00:23:26.492 --> 00:23:27.492
outstanding teacher?

00:23:28.253 --> 00:23:29.153
For sure, right?

00:23:29.173 --> 00:23:31.415
And can a PhD be not as good

00:23:31.455 --> 00:23:32.096
as that person?

00:23:33.317 --> 00:23:35.337
But we probably have to eventually get to

00:23:35.377 --> 00:23:36.959
a place where we're looking at terminal

00:23:36.999 --> 00:23:40.080
degree, years of experience, patient load,

00:23:40.520 --> 00:23:44.143
research, involvement in the profession,

00:23:44.722 --> 00:23:47.164
and look at all those things before we

00:23:47.244 --> 00:23:48.045
make a decision.

00:23:48.125 --> 00:23:49.125
Okay.

00:23:50.830 --> 00:23:52.432
So what would be your call to action,

00:23:52.711 --> 00:23:52.872
right?

00:23:52.892 --> 00:23:54.173
We're going to go to CSM and we're

00:23:54.192 --> 00:23:55.012
going to put you on stage.

00:23:55.032 --> 00:23:56.134
We're going to live stream it.

00:23:56.554 --> 00:23:58.694
Three hundred thousand physical

00:23:58.736 --> 00:23:59.215
therapists,

00:23:59.336 --> 00:24:00.817
all the physical therapists just in the

00:24:00.916 --> 00:24:01.237
U.S.

00:24:01.277 --> 00:24:02.337
are going to be able to hear Steve

00:24:02.377 --> 00:24:04.558
for for ninety seconds.

00:24:05.298 --> 00:24:06.940
What would your call to action be?

00:24:06.980 --> 00:24:09.161
What do what do PT faculty,

00:24:09.221 --> 00:24:10.461
program leaders, clinicians?

00:24:10.501 --> 00:24:11.343
What is I mean,

00:24:11.363 --> 00:24:12.383
this is pretty much saying, Steve,

00:24:12.663 --> 00:24:14.163
you ask everybody one question,

00:24:14.544 --> 00:24:15.765
but what do they need to be doing

00:24:16.265 --> 00:24:16.665
right now?

00:24:16.685 --> 00:24:18.106
You can really only have one call to

00:24:18.207 --> 00:24:18.586
action.

00:24:19.106 --> 00:24:20.488
What would your charge be?

00:24:21.234 --> 00:24:22.715
And I know I'm asking a big question,

00:24:22.796 --> 00:24:22.955
right?

00:24:22.996 --> 00:24:23.557
And you're, you know,

00:24:23.576 --> 00:24:24.717
this is not an easy thing I'm asking

00:24:24.737 --> 00:24:24.936
you to do,

00:24:24.957 --> 00:24:25.877
but what would it be if it's a

00:24:25.917 --> 00:24:26.498
hypothetical?

00:24:27.398 --> 00:24:28.900
So in the end,

00:24:29.579 --> 00:24:31.821
we are where we are to serve patients,

00:24:32.602 --> 00:24:32.842
right?

00:24:33.123 --> 00:24:36.744
PT is not a profession in general that

00:24:37.665 --> 00:24:39.666
or medicine shouldn't be where you go in

00:24:39.707 --> 00:24:40.948
thinking, you know,

00:24:41.307 --> 00:24:42.228
I'm in this for the money.

00:24:43.628 --> 00:24:44.849
So I think we have to look at

00:24:44.869 --> 00:24:47.112
where we are now and we can't ignore

00:24:47.172 --> 00:24:47.271
it.

00:24:48.989 --> 00:24:51.891
The first thing is for educators and

00:24:51.951 --> 00:24:52.551
academics,

00:24:53.532 --> 00:24:54.973
and I probably will need more than ninety

00:24:55.013 --> 00:24:56.134
seconds for this, but I'll try.

00:24:56.154 --> 00:24:57.715
That's all right.

00:24:57.756 --> 00:24:59.538
We need to really look within and say,

00:24:59.597 --> 00:24:59.837
look,

00:25:00.198 --> 00:25:02.200
we need to make tuition more affordable.

00:25:02.480 --> 00:25:03.800
We need to look at that one point

00:25:03.861 --> 00:25:07.284
five over first-year salary and think

00:25:07.324 --> 00:25:10.046
about what it is in Pittsburgh and Kansas

00:25:10.086 --> 00:25:14.029
City and Oklahoma City and Los Angeles and

00:25:14.269 --> 00:25:16.392
figure out what is possible.

00:25:17.509 --> 00:25:18.749
And then I think we have to get

00:25:18.788 --> 00:25:22.009
a little bit confident as educators and

00:25:22.049 --> 00:25:22.390
say, hey,

00:25:22.410 --> 00:25:23.951
if we're bringing in a cohort of,

00:25:24.290 --> 00:25:25.550
let me just make this round numbers,

00:25:25.611 --> 00:25:26.652
right, of ten,

00:25:27.872 --> 00:25:30.153
and we charge them ten dollars,

00:25:30.452 --> 00:25:31.373
that's a hundred dollars.

00:25:31.553 --> 00:25:33.413
Where's that money going with the

00:25:33.513 --> 00:25:34.153
university?

00:25:34.554 --> 00:25:35.834
It's not all going to salaries.

00:25:37.474 --> 00:25:38.994
And if we're in a hybrid program and

00:25:39.015 --> 00:25:40.816
we don't need office space and we don't

00:25:40.855 --> 00:25:42.375
need the traditional lab space,

00:25:42.536 --> 00:25:43.997
I understand there are additional

00:25:44.037 --> 00:25:44.517
expenses.

00:25:45.498 --> 00:25:47.881
We need to price that accordingly to keep

00:25:47.921 --> 00:25:48.602
the profession going.

00:25:48.642 --> 00:25:48.721
Well,

00:25:49.643 --> 00:25:50.884
I'm not going to say you said this.

00:25:50.924 --> 00:25:53.867
I'll say sources have told me a lot

00:25:53.887 --> 00:25:58.594
of times PT programs are programs that can

00:25:58.653 --> 00:26:00.316
float other majors.

00:26:00.336 --> 00:26:01.938
They essentially help the university stay

00:26:01.958 --> 00:26:04.902
afloat because it's so ROI positive.

00:26:05.501 --> 00:26:06.262
I think I said that.

00:26:07.503 --> 00:26:07.683
I would.

00:26:07.743 --> 00:26:09.926
Yeah, I mean,

00:26:09.967 --> 00:26:11.607
you just and that's why I say we

00:26:11.667 --> 00:26:13.130
need to be a little bit more confident

00:26:13.210 --> 00:26:15.892
in what we're doing and looking at the

00:26:15.951 --> 00:26:18.315
growth that is projected for physical

00:26:18.355 --> 00:26:19.736
therapists in the coming ten,

00:26:19.776 --> 00:26:20.457
twenty years.

00:26:20.856 --> 00:26:22.157
Again, depending on where you look.

00:26:23.058 --> 00:26:25.821
and not be the program that props up

00:26:25.981 --> 00:26:28.384
either the overall university or

00:26:28.525 --> 00:26:30.667
universities that are running into fiscal

00:26:30.728 --> 00:26:31.288
distress.

00:26:34.131 --> 00:26:34.632
It's not fair.

00:26:34.991 --> 00:26:37.134
I'm sympathetic and empathetic to that,

00:26:37.335 --> 00:26:39.537
but it is not sustainable for the

00:26:39.576 --> 00:26:40.057
profession.

00:26:40.637 --> 00:26:43.480
not just to start a program because your

00:26:43.700 --> 00:26:45.580
university is having financial problems

00:26:45.601 --> 00:26:48.801
yeah um we're we're and and the data's

00:26:48.883 --> 00:26:50.663
out already right we're seeing people

00:26:50.702 --> 00:26:52.344
leave profession we're seeing people

00:26:52.384 --> 00:26:55.326
stressed um we can go over numbers of

00:26:55.365 --> 00:26:57.967
what this means for monthly payments for

00:26:58.007 --> 00:27:00.628
students but we have to look at affordable

00:27:00.669 --> 00:27:02.069
tuition we have to look at when we

00:27:02.109 --> 00:27:04.171
bring students in we have to advocate for

00:27:04.230 --> 00:27:05.770
students so that they can advocate for

00:27:05.811 --> 00:27:06.432
their patients

00:27:07.425 --> 00:27:09.407
Work study should be something that we

00:27:09.428 --> 00:27:09.848
give them.

00:27:09.969 --> 00:27:11.630
If they're going to help a professor with

00:27:11.650 --> 00:27:12.371
their research,

00:27:12.391 --> 00:27:14.333
there should be a stipend associated with

00:27:14.373 --> 00:27:14.594
that.

00:27:15.173 --> 00:27:17.717
Perhaps with graduate students in profit

00:27:18.397 --> 00:27:20.278
making or profitable programs,

00:27:21.019 --> 00:27:22.101
we ought to let them like,

00:27:22.141 --> 00:27:24.263
fifty percent off housing or even free

00:27:24.304 --> 00:27:24.683
housing.

00:27:25.384 --> 00:27:27.846
Universities do not want to hear this.

00:27:28.028 --> 00:27:29.788
They do not want to hear somebody saying,

00:27:30.690 --> 00:27:30.789
Hey,

00:27:31.490 --> 00:27:33.530
you made one point two million off of

00:27:33.570 --> 00:27:34.811
our program last year.

00:27:35.372 --> 00:27:36.152
I have an idea.

00:27:36.172 --> 00:27:37.712
Let's make it eight hundred thousand.

00:27:38.532 --> 00:27:40.433
They're not going to be receptive to that.

00:27:41.314 --> 00:27:41.954
But if they're not,

00:27:42.035 --> 00:27:43.315
I think we're shooting ourselves in the

00:27:43.355 --> 00:27:46.477
foot for later because eventually the

00:27:46.537 --> 00:27:47.477
market forces

00:27:48.310 --> 00:27:50.512
are gonna pull students to places that are

00:27:50.573 --> 00:27:51.313
more affordable.

00:27:52.213 --> 00:27:55.796
And it's just not gonna work for some

00:27:55.836 --> 00:27:57.557
of these universities.

00:27:57.738 --> 00:27:59.179
You got smart people making smart

00:27:59.219 --> 00:27:59.638
decisions.

00:27:59.699 --> 00:28:01.400
And that's not to say, oh, I don't,

00:28:02.059 --> 00:28:02.580
don't be quoting me.

00:28:02.901 --> 00:28:04.521
That's not to say someone who stays as

00:28:04.541 --> 00:28:07.384
a clinician is not doing a smart thing.

00:28:07.903 --> 00:28:09.005
But when someone leaves you,

00:28:09.685 --> 00:28:11.527
I left clinical practice because I said,

00:28:11.547 --> 00:28:12.788
this really isn't for me.

00:28:13.127 --> 00:28:14.729
But also that math wouldn't math even if

00:28:14.769 --> 00:28:15.910
it was smart.

00:28:16.532 --> 00:28:18.294
People are making decisions based on...

00:28:19.273 --> 00:28:20.413
I gave this analogy the other day.

00:28:20.453 --> 00:28:21.794
The coach always told us, you know,

00:28:21.954 --> 00:28:23.214
the logo on the front of the jersey

00:28:23.234 --> 00:28:24.755
is more important than the logo on the

00:28:24.795 --> 00:28:25.134
back,

00:28:25.255 --> 00:28:26.476
meaning the team is more important than

00:28:26.496 --> 00:28:27.135
the individual.

00:28:27.756 --> 00:28:28.977
And I push back on that now.

00:28:29.317 --> 00:28:30.537
The name on the back is my family

00:28:30.576 --> 00:28:30.797
name.

00:28:31.196 --> 00:28:32.718
I make decisions on that first,

00:28:33.137 --> 00:28:34.218
and then if it's okay,

00:28:34.678 --> 00:28:35.557
I play for the team.

00:28:36.078 --> 00:28:37.338
So I sort of reverse that.

00:28:37.598 --> 00:28:38.598
So I think you have people making

00:28:38.638 --> 00:28:40.559
decisions based on, unfortunately...

00:28:41.440 --> 00:28:43.382
being able to survive in twenty twenty

00:28:43.422 --> 00:28:44.623
five, twenty twenty six.

00:28:45.143 --> 00:28:47.164
And those people have signed up for.

00:28:47.664 --> 00:28:49.106
I'd love to be in a profession that

00:28:49.146 --> 00:28:49.406
does.

00:28:49.767 --> 00:28:50.027
Yes.

00:28:50.228 --> 00:28:52.048
And it helps me survive.

00:28:52.269 --> 00:28:53.589
And I get to be the greater good.

00:28:54.070 --> 00:28:55.271
I think if I was going to sum

00:28:55.311 --> 00:28:56.893
up what you were saying is let's make

00:28:56.932 --> 00:28:58.755
sure we don't penalize for people doing

00:28:58.775 --> 00:28:58.974
that.

00:28:59.295 --> 00:29:01.176
Let's make sure we all can at least

00:29:01.257 --> 00:29:01.596
win.

00:29:02.238 --> 00:29:03.358
If we don't do that,

00:29:03.638 --> 00:29:05.380
we will feel repercussions five to ten

00:29:05.421 --> 00:29:05.881
years from now.

00:29:06.749 --> 00:29:07.990
We're now, we're already.

00:29:08.931 --> 00:29:10.092
And that would be what I would say

00:29:10.152 --> 00:29:12.232
to academia, to the APTA,

00:29:12.273 --> 00:29:14.776
or to our larger organization,

00:29:15.476 --> 00:29:17.176
and to CAPTI, say, you know,

00:29:18.178 --> 00:29:18.739
when you

00:29:20.420 --> 00:29:21.942
Approve a new hybrid program.

00:29:21.981 --> 00:29:24.403
You're approving an influx of therapists

00:29:24.604 --> 00:29:25.964
across the United States,

00:29:26.165 --> 00:29:28.528
and that needs to be a consideration,

00:29:29.028 --> 00:29:30.209
right?

00:29:30.809 --> 00:29:33.251
Are we indeed going to flood the market

00:29:33.291 --> 00:29:34.313
with new PTs?

00:29:35.513 --> 00:29:36.095
Possibly.

00:29:36.275 --> 00:29:36.494
Again,

00:29:36.535 --> 00:29:38.236
depend on what data set you look at.

00:29:38.936 --> 00:29:41.118
And when you're looking at regional right

00:29:41.318 --> 00:29:43.980
programs just in the Pittsburgh area,

00:29:44.142 --> 00:29:45.482
I don't I don't want to mention schools,

00:29:45.542 --> 00:29:48.065
but there are a lot within nine miles.

00:29:48.404 --> 00:29:49.826
Pittsburgh, Boston, New York.

00:29:49.846 --> 00:29:50.346
I mean, obviously,

00:29:50.366 --> 00:29:52.429
the big metro centers have very large

00:29:53.288 --> 00:29:54.931
concentration of those programs.

00:29:55.865 --> 00:29:57.424
So we have to have somebody say,

00:29:57.464 --> 00:29:57.786
you know,

00:29:58.246 --> 00:30:00.266
there are enough there are enough programs

00:30:00.306 --> 00:30:02.846
in this area or there are enough programs

00:30:03.267 --> 00:30:07.048
that feed, you know, the whole country.

00:30:07.087 --> 00:30:08.669
And when there are programs that say,

00:30:08.729 --> 00:30:08.868
well,

00:30:08.888 --> 00:30:12.609
we're going to we're going to admit one

00:30:12.650 --> 00:30:15.410
hundred, but they only have sixty five.

00:30:16.310 --> 00:30:16.431
Well,

00:30:18.571 --> 00:30:20.074
How far down their wait list are with

00:30:20.094 --> 00:30:21.315
their qualified students?

00:30:21.355 --> 00:30:22.896
And my fear is that are we setting

00:30:22.978 --> 00:30:25.800
some of these students up for failure?

00:30:25.921 --> 00:30:27.824
And is that why we're seeing the drop

00:30:28.003 --> 00:30:29.405
in first-time pass rates?

00:30:29.665 --> 00:30:31.189
Because they drop out of the program and

00:30:31.209 --> 00:30:32.810
they're figured in that overall rate.

00:30:32.830 --> 00:30:34.853
The final thing I would add is, okay,

00:30:34.873 --> 00:30:35.554
I agree with that.

00:30:36.134 --> 00:30:38.195
But then you do have this good movement.

00:30:38.356 --> 00:30:41.638
Connie Hauser was pretty instrumental in

00:30:41.699 --> 00:30:43.819
starting a program in a rural area.

00:30:44.361 --> 00:30:47.303
Could you reward students who wanted to go

00:30:47.442 --> 00:30:49.644
and stay for a predetermined amount of

00:30:49.683 --> 00:30:49.923
time?

00:30:50.265 --> 00:30:52.066
Reduced tuition if you stay in this

00:30:52.405 --> 00:30:53.567
underserved rural area.

00:30:53.586 --> 00:30:53.707
Like,

00:30:53.727 --> 00:30:56.709
wouldn't that be great if almost the ROTC

00:30:56.749 --> 00:30:59.750
version of PT?

00:30:59.770 --> 00:31:00.332
So you...

00:31:01.251 --> 00:31:01.451
You know,

00:31:01.491 --> 00:31:03.334
you've hit on something that we haven't

00:31:03.354 --> 00:31:03.953
brought up yet,

00:31:03.993 --> 00:31:05.075
but that is very important.

00:31:05.095 --> 00:31:06.756
And that's the Department of Education

00:31:06.816 --> 00:31:10.318
reclassifying as master's level and not

00:31:10.358 --> 00:31:10.979
professional.

00:31:11.078 --> 00:31:13.141
So, you know,

00:31:14.102 --> 00:31:15.962
this may be forced upon us quicker than

00:31:16.002 --> 00:31:18.865
we think if students are only able to

00:31:19.586 --> 00:31:21.487
leverage twenty thousand five hundred

00:31:21.527 --> 00:31:23.489
dollars, I think is the number per year.

00:31:24.108 --> 00:31:25.230
So so just again,

00:31:25.289 --> 00:31:27.392
I sort of in prep for this,

00:31:27.451 --> 00:31:28.451
I looked at some numbers.

00:31:28.531 --> 00:31:30.653
So an average student.

00:31:30.773 --> 00:31:32.355
So let's just go one hundred thousand over

00:31:32.395 --> 00:31:34.157
twenty years just to make it round

00:31:34.198 --> 00:31:34.498
numbers.

00:31:34.857 --> 00:31:35.479
Right.

00:31:35.638 --> 00:31:37.039
And you can do this.

00:31:37.240 --> 00:31:40.344
Just Google loan repayment calculator

00:31:40.584 --> 00:31:41.865
comes up.

00:31:41.904 --> 00:31:44.188
So, you know, it's not that these loans,

00:31:44.627 --> 00:31:46.150
these government backed loans, you know,

00:31:46.170 --> 00:31:47.830
they're coming in at somewhere around

00:31:47.991 --> 00:31:48.632
eight percent.

00:31:48.652 --> 00:31:49.653
Correct.

00:31:49.673 --> 00:31:49.854
Oh,

00:31:49.874 --> 00:31:50.954
that's eight hundred and thirty six

00:31:50.994 --> 00:31:52.876
dollars a month over twenty years.

00:31:53.017 --> 00:31:54.018
Just for the interest rate.

00:31:54.498 --> 00:31:58.580
right no no no to repay right so

00:31:58.801 --> 00:32:01.263
you're paying almost you're you're on a

00:32:01.304 --> 00:32:02.525
hundred thousand you're paying almost

00:32:02.565 --> 00:32:04.246
double that right when you're when you're

00:32:04.806 --> 00:32:07.288
finished um and then we have these

00:32:07.367 --> 00:32:10.550
variations so so i bank with citizens

00:32:10.730 --> 00:32:13.173
right which is around pittsburgh i think

00:32:13.212 --> 00:32:15.355
it used to be mellon but anyway i'm

00:32:15.394 --> 00:32:16.816
getting all these emails like hey would

00:32:16.836 --> 00:32:17.856
you like a student loan

00:32:18.839 --> 00:32:20.041
And then in the little asterisk,

00:32:20.082 --> 00:32:22.326
it says variable rate between three point

00:32:22.346 --> 00:32:22.907
two four.

00:32:23.428 --> 00:32:24.470
That's pretty good, right?

00:32:24.490 --> 00:32:26.574
That's that same thing as five hundred

00:32:26.614 --> 00:32:27.876
fifty seven dollars a month.

00:32:29.082 --> 00:32:31.182
all the way up to thirteen point three

00:32:31.282 --> 00:32:31.682
seven.

00:32:33.363 --> 00:32:35.683
Twelve hundred a month or one hundred

00:32:35.723 --> 00:32:36.463
thousand dollars,

00:32:36.523 --> 00:32:37.923
two hundred and eighty seven thousand

00:32:37.963 --> 00:32:38.423
repaid.

00:32:40.684 --> 00:32:42.164
So you need it.

00:32:42.224 --> 00:32:43.465
You're going to need a cosigner.

00:32:43.506 --> 00:32:45.705
You're going to need to either have have

00:32:45.746 --> 00:32:49.086
your have something in savings or own a

00:32:49.146 --> 00:32:51.327
home or have some sort of collateral.

00:32:52.127 --> 00:32:53.729
And when we look at what we've been

00:32:53.788 --> 00:32:57.829
trying to do in terms of first-gen college

00:32:57.849 --> 00:33:01.612
students or socioeconomic data of students

00:33:01.632 --> 00:33:03.531
that we're really working to try to get

00:33:03.672 --> 00:33:05.212
into the PT profession,

00:33:06.673 --> 00:33:08.993
how is that going to be viable for

00:33:09.034 --> 00:33:12.895
this sect of students that are driven and

00:33:12.955 --> 00:33:15.135
motivated and intelligent and can make

00:33:15.176 --> 00:33:17.356
good physical therapists but don't have

00:33:17.396 --> 00:33:18.617
the financial means

00:33:19.357 --> 00:33:21.980
to qualify for these loans?

00:33:23.823 --> 00:33:25.324
We're getting people dropping out of the

00:33:25.344 --> 00:33:28.146
profession now at a, you know,

00:33:28.227 --> 00:33:29.868
thirty percent rate in ten years.

00:33:30.630 --> 00:33:32.592
You know, what's going to happen?

00:33:32.612 --> 00:33:33.933
I mean,

00:33:34.094 --> 00:33:35.694
I know for a fact my mortgage wasn't

00:33:35.714 --> 00:33:36.797
twelve hundred dollars a month.

00:33:36.836 --> 00:33:38.218
I don't think I've ever owed twelve

00:33:38.258 --> 00:33:39.640
hundred dollars a month for anything.

00:33:39.680 --> 00:33:40.721
But, you know,

00:33:42.053 --> 00:33:44.134
what are first of all they might not

00:33:44.153 --> 00:33:45.835
be able to get a loan at a

00:33:45.894 --> 00:33:47.615
decent rate and then when they get it

00:33:47.934 --> 00:33:49.455
this these payments are just not

00:33:49.596 --> 00:33:53.017
sustainable it's a mortgage and more

00:33:53.077 --> 00:33:56.499
mortgage uh is french for death note

00:33:56.959 --> 00:33:59.740
there's a reason for that like look that

00:33:59.819 --> 00:34:02.221
up uh i feel like we can keep

00:34:02.260 --> 00:34:04.001
going on this and maybe we will

00:34:05.066 --> 00:34:07.346
But let's do a game right now.

00:34:07.406 --> 00:34:08.246
Are you down with a game?

00:34:08.266 --> 00:34:09.407
I didn't prep you for this,

00:34:09.467 --> 00:34:11.007
but you want to play a quick game?

00:34:11.068 --> 00:34:15.909
All right, let's do it.

00:34:15.949 --> 00:34:16.170
All right.

00:34:16.210 --> 00:34:17.231
Thanks to U.S.

00:34:17.271 --> 00:34:18.670
Physical Therapy for supporting the show.

00:34:18.751 --> 00:34:21.351
A national network of clinics focused on

00:34:21.371 --> 00:34:22.331
developing clinicians,

00:34:22.431 --> 00:34:23.293
not burning them out.

00:34:23.333 --> 00:34:25.293
Leadership tracks, mentorship,

00:34:25.333 --> 00:34:25.954
career growth,

00:34:26.054 --> 00:34:27.534
and the stability to build your future in

00:34:27.574 --> 00:34:27.974
PT.

00:34:28.434 --> 00:34:29.855
If you want a place that supports how

00:34:29.954 --> 00:34:32.016
you want to practice, that's U.S.

00:34:32.056 --> 00:34:32.695
Physical Therapy.

00:34:32.815 --> 00:34:33.817
USPH.

00:34:35.405 --> 00:34:35.864
All right, Steve,

00:34:35.885 --> 00:34:37.346
the game we are going to play today

00:34:37.385 --> 00:34:41.289
is called Storm Clouds or Silver Lining.

00:34:41.648 --> 00:34:42.869
So we're talking about the storm clouds

00:34:42.889 --> 00:34:43.190
coming.

00:34:43.489 --> 00:34:44.130
You mentioned that.

00:34:45.351 --> 00:34:47.072
I'll throw out a trend or an issue

00:34:47.112 --> 00:34:48.094
in PT education.

00:34:48.454 --> 00:34:50.014
You tell me if it's a brewing storm

00:34:50.034 --> 00:34:52.657
on the horizon or a silver lining and

00:34:52.677 --> 00:34:53.938
maybe give me like a couple words why.

00:34:54.630 --> 00:34:55.891
And am I allowed to choose both or

00:34:55.911 --> 00:34:56.632
just one or the other?

00:34:57.253 --> 00:34:57.693
It's PT.

00:34:57.713 --> 00:34:58.875
You can always choose both.

00:34:58.914 --> 00:35:00.396
You can always choose independent.

00:35:00.655 --> 00:35:01.317
It depends.

00:35:01.956 --> 00:35:03.659
First up, storm clouds or server lining?

00:35:03.838 --> 00:35:05.679
Hybrid education, storm cloud,

00:35:06.280 --> 00:35:12.365
server lining, or both?

00:35:12.385 --> 00:35:15.688
I think silver lining because I am hoping

00:35:15.807 --> 00:35:18.831
that the tuition rates will rebalance

00:35:18.851 --> 00:35:19.471
themselves.

00:35:20.331 --> 00:35:21.853
And I do know several...

00:35:22.893 --> 00:35:26.213
very good educators within the hybrid

00:35:26.313 --> 00:35:29.615
space at this time perfect uh pass rate

00:35:30.356 --> 00:35:33.157
declining storm cloud server lining that

00:35:33.217 --> 00:35:36.539
is a storm cloud exponential and if we

00:35:36.559 --> 00:35:39.380
don't look at that we're in trouble new

00:35:39.500 --> 00:35:41.400
doe rules you knew i was going to

00:35:41.420 --> 00:35:42.621
bring it up somewhere there it is new

00:35:42.920 --> 00:35:45.362
doe rules which was which had happy

00:35:45.402 --> 00:35:47.322
twitter linkedin in a tizzy for the last

00:35:47.342 --> 00:35:49.664
two weeks um

00:35:50.554 --> 00:35:52.896
The only silver lining is that it's going

00:35:52.936 --> 00:35:55.898
to force programs to do the things that

00:35:55.958 --> 00:35:57.179
I've sort of suggested.

00:35:57.201 --> 00:35:59.021
Hope you're right.

00:36:00.702 --> 00:36:03.505
The rate at which we're looking is that

00:36:03.826 --> 00:36:06.648
that's a storm cloud and that's going to

00:36:06.688 --> 00:36:10.931
be a very difficult thing to navigate.

00:36:11.813 --> 00:36:13.713
AI in PT school.

00:36:13.813 --> 00:36:15.615
Is this a storm cloud or silver lining?

00:36:16.929 --> 00:36:17.170
Funny,

00:36:17.230 --> 00:36:18.992
I just met with somebody about this.

00:36:19.012 --> 00:36:20.713
Talk about an it depends answer.

00:36:20.733 --> 00:36:20.813
Yeah.

00:36:21.833 --> 00:36:22.434
How it's used.

00:36:23.054 --> 00:36:24.876
He has a silver linings.

00:36:26.076 --> 00:36:26.717
Can't wait.

00:36:30.018 --> 00:36:31.420
I'm just going to have to defer the

00:36:31.500 --> 00:36:32.460
answer to that question.

00:36:32.521 --> 00:36:34.322
I just don't know enough about it.

00:36:34.342 --> 00:36:36.684
That's a lot.

00:36:36.764 --> 00:36:40.706
If I see a Steve Karras avatar teaching.

00:36:40.726 --> 00:36:42.547
That's when we know where it is.

00:36:42.608 --> 00:36:43.949
Final rehab somewhere.

00:36:45.009 --> 00:36:45.849
That's going to be a problem.

00:36:46.436 --> 00:36:47.940
All right, last one, last one.

00:36:48.121 --> 00:36:50.909
International student enrollment shifts.

00:36:51.088 --> 00:36:52.853
Is this a storm cloud or a silver

00:36:52.893 --> 00:36:53.213
lining?

00:36:56.106 --> 00:36:56.367
You know,

00:36:56.407 --> 00:36:58.610
it's a it's a it's a storm cloud

00:36:58.809 --> 00:36:59.291
starting.

00:36:59.371 --> 00:37:01.753
I think any time we deny an education

00:37:01.793 --> 00:37:03.074
to qualified students,

00:37:04.695 --> 00:37:07.358
we're really not fulfilling our mission

00:37:07.418 --> 00:37:09.621
and we're not producing therapists

00:37:09.661 --> 00:37:11.163
qualified to give good patient care.

00:37:11.182 --> 00:37:12.744
OK, you're off the hot seat.

00:37:12.784 --> 00:37:14.367
That was a storm cloud or server lining.

00:37:14.706 --> 00:37:16.228
Last thing we do on the show, Steve,

00:37:16.248 --> 00:37:17.911
is called the parting.

00:37:19.541 --> 00:37:21.563
This is The Parting Shot.

00:37:22.083 --> 00:37:23.503
One last mic drop moment.

00:37:24.163 --> 00:37:24.983
No pressure.

00:37:25.403 --> 00:37:27.543
Just your legacy on the line.

00:37:28.503 --> 00:37:29.885
All right, just your legacy on the line.

00:37:29.905 --> 00:37:30.385
Parting Shot.

00:37:30.405 --> 00:37:31.985
I want to thank Empower EMR.

00:37:32.005 --> 00:37:33.206
They've supported the show for the last

00:37:33.246 --> 00:37:33.945
two, three years.

00:37:34.606 --> 00:37:36.126
That's the platform helping clinics

00:37:36.286 --> 00:37:37.606
simplify documentation,

00:37:37.726 --> 00:37:38.967
improve patient engagement,

00:37:39.306 --> 00:37:41.268
and get their time back.

00:37:41.891 --> 00:37:44.373
Your EMR doesn't have to be painful.

00:37:44.393 --> 00:37:45.014
That's a choice.

00:37:45.434 --> 00:37:46.516
As long as you pick the right one.

00:37:46.916 --> 00:37:48.898
Kick the tires for theirs now at

00:37:48.958 --> 00:37:50.679
empoweremr.com.

00:37:50.699 --> 00:37:53.262
That is empoweremr.com.

00:37:53.282 --> 00:37:55.003
So the mic is yours now, Steve.

00:37:55.043 --> 00:37:56.164
Parting shot, whatever you want.

00:37:56.204 --> 00:37:57.545
Your mic drop moment,

00:37:57.585 --> 00:37:58.967
soapbox statement as we wrap up.

00:37:58.987 --> 00:37:59.228
Go ahead.

00:38:00.291 --> 00:38:02.311
Students considering physical therapy,

00:38:02.351 --> 00:38:04.211
take a look at all your options.

00:38:04.731 --> 00:38:06.233
Take a look at how much money you're

00:38:06.253 --> 00:38:07.273
going to be making,

00:38:07.333 --> 00:38:08.932
what your return on investment is,

00:38:08.952 --> 00:38:14.235
and really consider the type of education

00:38:15.914 --> 00:38:17.876
and the amount of

00:38:18.907 --> 00:38:20.789
tuition that you will be charged and what

00:38:20.829 --> 00:38:23.110
that looks like over long-term payback

00:38:23.592 --> 00:38:25.452
within what you think you're going to make

00:38:25.713 --> 00:38:29.076
and what kind of lifestyle you expect from

00:38:29.096 --> 00:38:30.577
this profession.

00:38:30.637 --> 00:38:34.358
Also understand that this is an amazing

00:38:34.400 --> 00:38:35.059
profession.

00:38:35.380 --> 00:38:37.001
The rewards that you get on a daily

00:38:37.422 --> 00:38:41.344
basis are outstanding and you're going to

00:38:41.364 --> 00:38:41.644
love it.

00:38:42.885 --> 00:38:45.168
To educators, you know,

00:38:46.157 --> 00:38:48.338
We need to really think about what we

00:38:48.398 --> 00:38:52.340
do and how we deliver our education.

00:38:53.221 --> 00:38:56.322
And I think we're in the driver's seat

00:38:56.362 --> 00:38:56.623
now.

00:38:56.663 --> 00:38:58.362
There are students that we can really

00:38:58.402 --> 00:39:00.023
deliver a quality product to,

00:39:00.523 --> 00:39:02.445
an affordable product.

00:39:02.465 --> 00:39:04.786
And we have to, I think,

00:39:04.865 --> 00:39:07.327
advocate for our students who advocate for

00:39:07.367 --> 00:39:08.268
our patients one day.

00:39:09.047 --> 00:39:11.951
And think about how we best deliver this

00:39:12.490 --> 00:39:14.833
and where those tuition dollars are going.

00:39:14.873 --> 00:39:16.974
It's not going to be comfortable speaking

00:39:17.014 --> 00:39:19.617
to an administrator about why we need to

00:39:19.657 --> 00:39:21.277
do what we need to do to attract

00:39:21.318 --> 00:39:22.219
quality students.

00:39:23.320 --> 00:39:25.260
But it's something that we need to do,

00:39:25.320 --> 00:39:27.543
and we need to do it yesterday.

00:39:27.563 --> 00:39:28.804
You need to do it yesterday.

00:39:28.884 --> 00:39:29.204
Perfect.

00:39:29.224 --> 00:39:30.105
Steve, appreciate the time.

00:39:30.144 --> 00:39:30.865
And thanks for dropping by.

00:39:30.885 --> 00:39:32.047
We'll have you back soon.

00:39:32.086 --> 00:39:32.807
Yeah, I appreciate it.

00:39:32.827 --> 00:39:33.088
Thank you.

00:39:34.775 --> 00:39:35.856
That's it for this one,

00:39:36.115 --> 00:39:37.777
but we're just getting warmed up.

00:39:38.257 --> 00:39:40.159
Smash follow, send it to a friend,

00:39:40.380 --> 00:39:42.081
or crank up the next episode.

00:39:42.581 --> 00:39:43.463
Want to go deeper?

00:39:43.922 --> 00:39:47.967
Hit us at pgpinecast.com or find us on

00:39:48.027 --> 00:39:50.568
YouTube and socials at pgpinecast.

00:39:50.989 --> 00:39:53.271
And legally, none of this was advice.

00:39:53.351 --> 00:39:54.992
It's for entertainment purposes only.

00:39:55.052 --> 00:39:56.454
Bullshit!

00:39:56.753 --> 00:39:57.355
See, Keith?

00:39:57.534 --> 00:39:58.615
We read the script.

00:39:58.896 --> 00:39:59.577
Happy now?