Interviewer: Lukas Daniel

Interviewee: Stacey Howell, PT, DPT

Place of Employment: Three Rivers Therapy
Date: March 26, 2015
Informational Interview
Daily Work Routine and Work Environment
Q: What do you do on a typical day in this position?
A: Our office hours are Monday through Thursday 7am to 5pm and
Friday 7am to 12pm. I start seeing my first patient at 7:00. My last
patient is typically at 4:30. I provide patient treatments, do initial
evaluations, progress reports for patients who are returning to their
doctor or nearing the end of their treatment/prescription, and
supervisory visits for my Physical Therapist Assistant. Along with
patient care, there is a lot of paperwork involved. Documentation of all
treatments and care provided to each patient is required after each
visit.
Q: What part of this job do you find the most challenging or
satisfying?
A: Trying to keep up with the documentation requirements for
Medicare is challenging. Dealing with the new insurance plans with
increasing co-pays that are required for the patient to pay per visit is
also challenging. Some patients that need therapy cannot always
afford to come because they have a $30 to $50 co-pay that they have
to pay per visit. This is difficult for patients who are on a fixed income
and need therapy 2 to 3 times a week. At times, there are patients
who are not the most pleasant or cooperative. Dealing with these
patients can be a challenge.
Q: What are some of the rewards of your occupation?
A: Helping patients regain their functional independence is satisfying.
Knowing that we helped them learn to walk again after a stroke, return
to living on their own after having a knee replacement or hip
replacement is rewarding. Seeing an athlete return to sport after their
rehab post-injury is satisfying, as well.
Questions to Ask
Q: How did you get started in this field?
A: I was always interest in the health profession. I knew I wanted to
help people. I wanted something that would be conducive to family life
as well as rewarding. While in middle school, I read the
book/autobiography Joni by Joni Eareckson Tada, which tells of her
rehabilitation and struggles following an accident resulting in

quadriplegia. Reading this book which detailed Jonis rehab process

sparked my interest in physical therapy.
Q: How was Three Rivers Therapy founded?
A: My brother also went into the field of physical therapy. In 1998, we
started the process of opening our own outpatient office to provide
services to our rural area. Residents in our area that needed physical
therapy had to drive 30 minutes to an hour to receive physical therapy
prior to our opening in 1999.
Q: What is unique about your organization?
A: We are a small, family owned business. We are known in the
community by many. To provide better services for our clientele, we
are open extended hours Monday through Thursday, opening at 7am
so patients can attend therapy before work or school. This assists our
patients in not having to take time off to attend their therapy.
Q: What personal qualities or abilities are important to being
successful?
A: Being flexible to help meet the needs of our clientele / being willing
to work 7 days a week, even holidays, for a patient who requires
therapy more than the typical business hours. Being friendly and
having good communication skills. Being dedicated and determined.
Q: What are typical hiring procedures?
A: A physical therapist has to be licensed with the state of SC, or
whichever state they are seeking employment. A perspective hire
would have to submit as resume. An interview would be conducted by
me or the other co-owner.
Q: What areas of knowledge are most important for
advancement in this field?
A: Keeping up with all of the insurance changes and requirements. We
also have to attend 30 hours of continuing education every 2 years to
renew our license. Staying abreast of the advances in surgical
procedures and protocols.
Q: If you were starting out again, would you do anything
differently?
A: When I first started out after graduation from MUSC, I worked at
hospital in acute care. There I was able to rotate through them
different areas of the hospital, which included Medical/Surgical,
Orthopedics, Neurology, and Outpatient. I then worked for a smaller
community hospital as director of the physical therapy department.
Here I worked with patients in acute care and outpatient. I also had to
perform duties as department head. I, then, worked in home health.
As I was working in home health, my brother and I were laying the
ground work and getting the paperwork and construction completed to

open Three Rivers. Once we opened our facility, we then contracted

to the home health company that I had been employed with. This
allowed us to have some income while we were building our clientele
and report with the physicians in the immediate and surrounding
areas. All that being said, I think the areas and facilities that I worked
in prior to opening my own business helped me become a more wellrounded therapist and was an asset in owning my own business. I do
not know of anything I would change in this journey thus far.
Q: What are the toughest challenges you face in this field?
A: Documentation requirements and insurance reimbursement.
Q: Is there a demand for people in this occupation?
A: With the aging population, there is a demand for people in this
occupation. As the baby boomers are coming of age, there are more
people who are at a greater risk of falls and are requiring joint
replacements as well as the many plethora of other problems that
come with aging. The surge in year round athletics with
children/students going from one sport right into another sport is also
contributing to the need of therapy services as we deal with sportsrelated injuries and overuse injuries.
Q: What special advice would you give a person entering in
this field?
A: Stay on your A game. Soak up as much knowledge as you can.
Stay open minded. When you go into this field, you may be thinking
you want to work exclusively with pediatrics or geriatrics or sports
med. As you get into your studies and see the many areas that are
available to explore, you may find another area of interest, or you may
stick with your initial goals. Knowledge you gain in one area may cross
over into other arenas of care.
Q: What opportunities for advancement are there in this field?
A: While most graduates start as a treating therapist, there is room for
advancement into a supervisory role. There are roles as directors and
administrators. Some aspire to become a professor.
There are also some specialty certifications that are available. These
usually require completion of certain courses and passing an
examination.
Q: How do you see jobs in this field changing in the future?
A: Over the past couple of decades, physical therapy has advanced
from a bachelor degree program to masters program to a doctorate
program. I think the main change we are facing as a profession is
leaning to cope and deal with the many reimbursement changes that
are occurring with the many changes in insurance and healthcare
regulations. If things progress as they are going, I think the market for

physical therapists may decline somewhat as the insurance companies

themselves are paying out less and requiring the patient to pay out
more. Many patients cannot afford to do this. If they have to decide
whether to go to therapy or pay for groceries, they will not come to
therapy.