Wednesday, August 26, 2015

Life Experiences: Top 5 Awesome Scaries

Wow! It has been a while, hasn't it? Hi, everyone! Welcome back and thank you for being with me.

If you've been wondering what has been taking me so long to continue my Life Experiences series, here is the scoop:

That's right, I've joined the great folks at UpDoc Media to serve as their Chief Content Officer. It's wearing a lot of hats and grinding out the "how" behind the "why" -- and -- it has been a lot of fun. I've been able to guest host the very popular Therapy Insiders podcast and get behind the scenes into what it takes to start up and establish a digital business.

So anyway, that is what has been going on with me. On to the post!

Today's Life Experiences post covers my top five scary but awesome moments in life. They range from adventurous, to plain stupid, to the feels.

Please share with my enjoyment in...! 

Life Experiences: Top 5 Awesome Scaries

1. Snowboarding down a glacier.
In the early 2000s, I was really into snowboarding. It was a progression from my middle school and high school skateboarding years. Snowboarding was the obvious next step. I got really good in a season and began to tackle Californian black diamonds with ease. What I did not understand, was that Californian black diamonds are more like the blue diamonds... just about anywhere else.

In this same time frame, I took a snowboarding trip up to Whistler and Blackcomb up in Vancouver, Canada. It was amazing. The slopes never seemed to end and I can't even remember taking the same trail twice. That was how big the mountain was. Well, for one of the runs, we went up to the very top of the mountain. And, it happened to be a glacier. The snow was tinted blue as the way glacier crystals form, they bounce back a lot of blue light. It was actually snowing up there and the visibility was getting lower by the minute.

We knew we had to get down quick so we gunned it. The problem was, the glacier was all that there existed to the trail. Markers were hard to see so one wrong turn and you'd take a 20 foot tumble! Well, the idiot I was, we finally got passed the glacier (which was actually way too much fun) and to celebrate, I tried to jump through some slopes and trees just to show off to myself. I ended up getting stuck in 4 feet of snow between the trees and it took me 15 minutes to dig myself out and find my way back to the main trail. Course... I was in my early 20s. #ThatMadeSense

2. Getting ran over by an elephant.
Almost. In the later years of the 2000s... closer to 2008 or so, I took a trip to Africa. Tanzania to be precise. The trip wasn't so much for pleasure as it was me being a stressed out protector/body guard type situation. It was fun, though. And, terrifying. Well, stereotypically as it would be, we ended up taking a safari into the Ngorogoro Crater. It was something like a real life snippet from the Lion King. In part of this trip, an elephant decided it was interested in our Range Rover. There was an issue however. The girls in the group decided to shout greetings to the elephant. However, elephants don't really like high pitched noises. As it got closer and ready to charge, the girls screamed. Even worse. Finally, our driver and guide basically told us to ST*U before we actually did get run over by the elephant.

Like these poor souls...

3. Hiking in a forest jungle maze.
While I don't remember this so clearly, I do remember it was during my pre-teen childhood. In a trip to Taiwan, our family went to hike in some jungle forest park which resembled a mix of Kashyyyk and Endor from Star Wars. It was all fun and games until we got to the point where the "hike" was traversing mossy fallen trees to get from cliff to cliff and area to area. One wrong move and you would've fallen 20+ feet into really nasty crevices or jungle streams with who knows what was swimming in there.

Outside of being devoured by Asian mosquitoes (you know what I mean... those genetically crazy big ones from the age of dinosaurs) -- and -- with the prospect of falling to one's doom, it was actually an exhilarating trip.

4. Big Surf at PB Point
Well, as life progressed, I moved from snowboarding to surfing. I had already been surfing for quite some time; but, it just seemed much more normal as a San Diegan to make surfing my mainstay of leisure times. Well, during the late 2000s, there was some huge surf that came through in the winter. If you YouTube anything about big surf in 2007 and 2008, you'll see some inhumane footage of surfers in waves the size of buildings.

Well, I was one of the idiots that tried. Not the very huge ones. The little huge ones. Pacific Beach (PB) Point is one of those rare gems in San Diego where the break goes from a reef point and down into the beach, southward into another sandbar break called Tourmaline. This wave, under the right conditions, lasts about 30-45 seconds. It seems like it's going to close out and swallow you whole. But, thanks to the reef formations, the wave just keeps it forms just like a video game.

I rode this wave three times before deciding that it'd be good not to tempt fate. Suffice to say, each time I paddled out, it was a true question of if I was actually going to be able to make it past the breakers. And, every time I paddled to catch a wave, it was another true question of if I was going to make it down the face of the wave.

Great times. But, never to be repeated.

5. Holding my son for the first time.
Awwww.... the feels! You always hear about it, life changes when you hold your first child. It was definitely true for me. Nathan wasn't screaming, however. And, it was a little scary as I wasn't sure if he was breathing properly. Quickly, he turned blue in just a few seconds. They took him to the table, got some fluid out of his mouth, and in a snap he turned red, then angry, then sad, then happy once he was with mommy.

Then he sneezed once. It was cute.

Birth is a scary thing. It's exciting. And, it's miraculous. Yet, having a loss prior, it was such a scary experience to go through. That waiting and worry and hope. Until finally.... my son is okay, my wife is okay...  We're all okay :)

So................. That's it! Those are my Top 5 Awesome Scary Life Experiences. Thanks for joining me in this little story time share.

Talk soon & see you next time!

Friday, July 24, 2015

Life Experiences: Top 5 Travel Eats

Hi everyone!

Today, I'm finally getting around to a series on Life Experiences, to which I've been really looking forward to. It's actually the stuff that motivates me more than even business, marketing strategy, and consulting... which says something!!

I've been blessed in life to have experienced quite an interesting mix of things in life so far. From surfing, travels to Asia, Africa... snowboarding in Canada -- to helping out at a distant orphanage Mexico. I've had a round about journey in finding my martial arts identity. Also, I was once an avid surf angler (fishing) and obviously still a devoted foodie and theme park junkie.

To all this, I'm sharing because I want to be a positive reminder; that life isn't about things. Life is about experiences. At the end of it all, rarely do you hear about people who regret having accumulated things. You hear them regret having failed to experience more life.

So, today! I'm opening up this Life Experience series with..........!!!!

Top 5 Travel Eats

1. Chai. Now, "chai" is very closely related linguistically to the Asian languages in its pronounciation of "tea" as "cha." Most places don't call chai, "chai tea." That's a bit like saying "tea tea." It's just chai. When I was traveling in Africa, one morning I was tired out of my mind. The traveling conditions we were under weren't exactly amenable. We got a bit dehydrated and had a little bit of caloric deficit to the point where you forgot you were hungry and forgot you were thirsty. You actually had to be reminded to eat and drink. Well, this morning, I was introduced to the way tea was made in Africa. Suffice to say: MIND-BLOWN. Chai is interesting here in the US. However, over there, it had more flavor, more character, and strangely more class despite the ghettoness of it all. I have a suspicion it was made with whole milk, fresh milk, or even cream. Served out of thermos like container into busted up porcelain cups, after several days of hard travel it was like nectar from heaven. I'd love to experience that again.... minus the travel that came with it.

2. Ugali. Yet another experience from my trip to Africa. In Tanzania, ugali is a common food stuff of the land. On our last night in the land, we found one of the few places that was open. That was a task in and of itself. Getting there safely was another concern. Nevertheless, this place was open to weary travelers where we were served stewed meat, canned veggies, ugali, and something else I can't quite remember... all on a metal mess tray. Actually, the meal kind of looked like this:
In any case, it was absolutely delicious. Being how tired I was and that I still wasn't used to having that much food in me, I had to eat this slowly to avoid over stuffing and feeling ill. Traditionally, ugali is eaten by hand and I stuffed my face in as controlled a way as I could.

3. Vegas pizza. I don't even remember where this pizza joint is. All I remember is that we were starved. My wife and I eventually decided to take a Vegas trip. Sure enough, all things went to crazy and we got in super late, starved, and with no food options. It wasn't until we got into our hotel room that we saw a local joint delivered. We ordered the biggest pizza they could muster. And, as was customary practice for a young couple counting every penny, we made that pizza last something like 2 or 3 days worth of breakfast. Gross... haha, but ultimately truly memorable. I'm pretty sure I remember barely having enough cash to tip the poor guy who delivered it out at like 330am. Sorry... I *do* remember tipping you more the next day we ordered pizza for dinner. Thanks for your patience.

4. Stinky Tofu. I've traveled to Taiwan a good handful of times throughout my life. One of the consistent cuisines which I always try to get to is Stinky Tofu. Stinky Tofu... well, it stinks. It is fermented (hence the smell), then typically deep fried into lovely goodness which has a texture someplace between potato chips and ... something else. Typically served with a side of pickled veggies and some house sauce, it remains one of my favorite travel comfort foods when going to night markets in Taiwan.

5. Triple Play Reuben. I first learned of this on TV with Man vs Food. Available only at the Maize & Blue Deli.... Go Blue! This is the killer of all Reuben sandwiches. In my most recent trip back to Michigan, I was able to experience several things (finally!). First, a Michigan game where, several years back, we creamed SDSU. Good game. It was a little weird being from San Diego though... awkward being that I'm from Michigan, got my MBA from Michigan... people thought I was there to sell my soul to SDSU. Well, in any case, I had to be sure to try this place out. Being that I've only heard amazing things of the deli and saw it on TV... there was a certain assurance that the experience would be as good as it looked. AND, it certainly was. One half of that Triple Play would've been enough to feed a starving teenager. Both, basically would put anyone into a 2 day food coma. Suffice to say, I enjoyed it thoroughly... that along with football sized deli pickles which are hard to come back in Southern California. Yum!

So, that's it for now! Keep your eyes peeled for more Top 5 Life Experiences as I hope to post at least another 4 or 5 episodes in the near future.

Take care!

Friday, July 3, 2015

2015 New Grad Physical Therapy Job Market Outlook

It's called a "Compensation Package."

Say it with me: C-O-M-P-E-N-S-A-T-I-O-N  P-A-C-K-A-G-E.

It's everything. It's your pay grade/rate, your benefits, your perks (fringe benefits), the mentorship program, the CEU reimbursement, the tuition assistance program, the opportunity, the upward mobility, the brand name association, the exposure... everything. It's the whole kit-and-caboodle when it comes to making a judgment call on accepting, rejecting, or counter-offering a job.

But, what's normal? How do I figure out where my baseline is? Well, today you're in luck! Thanks to a #DPTstudent conversation on Facebook, I'm going to share a mid-2015 baseline for the New Grad Physical Therapy Job Market.

Here is..........!!!

The 2015 New Grad Physical Therapy Job Market Outlook

Ahh... fake out! First, there's a LOT I can speak on this topic. In fact, I could probably give a weekend seminar on this. That said, I come at this topic from the perspective of a strategic consultant as well as a former rehab director. To this, I'll highlight the interesting numbers in the top 3 categories of interest. Then, I'll close out by talking about the 6 dimensions of compensation. Enjoy!

1. The Pay
For every business model, there exists a cost of business and acceptable profit margins which they can operate within to hire employees. Those employees must live within the means of their own cost of living and acceptable work-life-balance. Essentially, employees can not cost a business more than they can pay out, and, employees themselves must be willing to work in the conditions given. Thus yields a healthy economic ecosystem.

For Physical Therapy, there are 4 major segments where pay is severely different for operating reasons. They are:
  • Outpatient
    • New grad PT ranges from $27-35 per hour.
    • New grad PTA ranges from $20-25 per hour.
    • On a regional level, the suburbs pay the best followed by urban then rural.
    • On a principles level, outpatient makes 15-25% less than in SNFs.
    • OP makes the lowest revenue per volume, which means scale is severely important. The more capacity and the more patients a business can process in their supply chain, the more money they will make and the more money they are able to pay you.
  • Acute Care Hospital
    • New grad PT ranges from $30-37 per hour.
    • New grad PTA ranges from $22-27 per hour.
    • The same regional & principle variations exist.
    • As hospitals make a lot of money, it's all about the split for them. Which department gets to keep how much of the pie per patient. This becomes a function of departmental leadership clout as well as the general job market. Most places yield a happy medium because of cost of business vs. cost of living. Eventually, no one wants to / can work at a place which pays too little. This means companies end up contracting out very expensive temp staff. After a while, upper management takes the hint and raises the pay grade.
  • Skilled Nursing, Long Term, & Acute Rehab
    • New grad PT ranges from $38-45 per hour.
    • New grad PTA ranges from $27-33 per hour.
    • Again. the same regional & principle variations exist.
    • Generally, PTs make $10/hr more than PTAs.
    • The wiggle room in negotiation has to do with the CFO's operational budget. They have set a profit margin which they basically promised the owners/shareholders which managers must make. The revenue per labor in SNF is the highest and historically (although this is changing) most stable of all the settings. For this reason, this setting pays the best -- along with the fact that this setting is the least "fun" (perk!) to work in... and more frequently than not, has questionable ethical boundaries. (Wait?! Who said that?!)
  • Home Health
    • This is the most variable in pay.
    • Many companies do not pay by the hour; rather, they pay by the service. In essence, you keep a piece of the pie for the work you do. As such, I'll translate out a full time equivalent which again, is highly variable.
    • Example: For a treatment, a PT can earn $60. For an OASIS start of care, they can earn $180. It's not time dependent but completion of service dependent.
    • New grad PT ranges from $40-50 per hour or ~$100,000 if productivity is met.
    • New grad PTA ranges from $30-40 per hour or ~$80,000 if productivity is met.
2. The Benefits

Health Benefits
Health benefits are typically one of three kinds. A classic HMO, a PPO, or a high deductible PPO with an HRA or FSA account. Typically, working for health systems like a hospital base or medical group based company will yield an HMO. The same types of firms will also offer a PPO which means you pay a lot out of pocket until you reach a magic number.

A lot of companies are going lean and are headed towards the High Deductible Health Plan (HDHP). This is excellent for very healthy individuals with no history (including family) who have a low risk lifestyle. The HRA and FSA accounts also offer some tax benefits but may require more calculation... sometimes this means you end up putting money away you never get back.

Most companies offer a 401k while some offer a 403b. Regardless, you don't really get a choice. The retirement plan is the plan and the company has made a contract with their wealth management company to provide options in a very specific way. The key is when these plan kick in and how much of it is matched. Companies that tend to pay less tend to match more; it's not uncommon for companies that pay poorly to match 5-8%. In contrast, firms that pay handsomely match none the first year, 1% the 2nd year, 2% the 3rd year, and finally 3% the 4th year of your loyalty to the company. Worth it? Meh... it's free money, right?

Adjunct Insurance
To me, this isn't really important to the new grad. Honestly, there are better options via life insurance agents. In any case, the same deal occurs here. The plan is the plan; you can't really change it or negotiate for it. For the most part, this is just a way for any given firm to be more competitive compared to the next in hopes of retaining or attracting the best talent. This is also a way for a company to protect itself from too much work comp and/or litigious complications. "Hey, we offered... you got disabled on your own." #ClassyOfThem

CEU Reimbursement & Tuition Programs
Some companies will offer unlimited CEUs while others only give a percentage of a couple hundred to a couple thousand dollars worth until you reach a certain level of seniority. Again, the same idea for retirement funds run here -- the better they pay, the less likely they will pay for your education. On the level, most corporations will give you $1000 as a good baseline. $2000 if they don't pay you all that well. If they run percentages, you get 50% of each bill reimbursed the 1st year of loyalty, 75% the 2nd, and finally 100% of all CEU costs the 3rd and going forward.

Many companies require you work one or two FULL CALENDAR months before benefits kick in. Be VERY clear about this because you may work on the first Monday of a month. However, because that date is say... March the 2nd... you will not get benefits until MAY!!! So, be crystal clear about when benefits kick in and WHY.

3. The Opportunity 
So, this is where I'm going to talk about balance. Every compensation package has 6 dimensions:
  • Pay
  • Benefits
  • Fringe (aka "Perks)
  • Balance (work-life-balance)
  • Culture
  • And, Opportunity
They are coupled in triplets; Pay, Benefits, Fringe (vs) Balance, Culture, and Opportunity. As such, there is an overall value of compensation any business can give. And, in healthcare, particularly in PT, there is certainly a limit. After all, unless creative billing or strained operations is involved... outpatient PTs all have 8 hrs to bill a max of 32 units, right? So... there exists a maximum revenue per labor unless you start taking advantage of the 8 minute rule (another talk for another time).

As such, the higher the pay, the lower the benefits and fringe. The higher the benefits, the lower the pay and fringe. The same exists for balance, culture, and opportunity. For a new grad, opportunity is very important.

The opportunity for new grad who wish to climb the administrative ladder need to pay attention to culture and balance upon interviewing/hiring in. Poor balance leads to stressed out employees and a sad culture (ie. low moral, back stabbing, grumpy people). This environment leads to lots of turn over, and therefore, the opportunity to move up and get that promotion. HOWEVER, you're not immune after the fact. You'll likely burn out just as quickly as your former boss just did. Nevertheless, it is something of interest in getting that early promotion so you can transfer laterally to a more favorable situation.

So...........! My fingers are tired. I hope that answered some questions for you students who have coursework to answer for. I also hope this helps those of you in the process of looking for a job or on the edge of graduation, taking the boards, etc.

As always, if you have ANY questions... I'm only a Tweet or Email away (too tired to link).

So, until next time, I remain yours in service!

If you want to learn more about the hiring, applying, interviewing process... here are some links: