Wages being pushed down....

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Postby Sandmanmike » Tue Jun 12, 2012 12:28 am

ShadowChaser wrote:
ShadowChaser wrote:
Sandmanmike wrote:Love the debate here. IDTFs, much like walmart drive wages down.

. It was actually a great deal. Physicians across america (think cardiology/pulm practices) had all that empty space at night to generate more income out of existing infrastructure.

So now you have business models that thrived on the idea that for every 300$ spent on a nightly charge of staffing your return on that investment was 1800$ on the non facility charge or about $5200 within a facility, under the ideal of a 2:1 staffing ratio. Less your physician and operational expenses. Etc. Etc. Etc.

So the only way to "hedge" against the HST drop in lab census, is to either stack another patient to the mix or drop wages. Because the management expense will be the last thing to go in a private company <wink>

Feel free to troll me as necessary. Just my view on the wage war in Sleep ; )


Your comment seems to make sense. It reminded me of the new upstart in san diego trying to open a "mobile sleep lab", doing sleep studies in any given doctors office from night to night.

Have you seen this before? What salary to you give a tech that drives a "Sleep truck" that delivers a "Sleep Lab"? :-k



I've seen companies offer a similar service to attended in home studies in the past. I know that sleep testing has been placed in Hotels near hospitals and in one case somewhere in florida they were running them out of a trailor in the parking lot. So.. anything is possible?
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Postby tiredjohnny1 » Tue Jun 12, 2012 2:47 am

Hey not everything wrong with sleep happens in Florida!!!!

On second thought...maybe it does.
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Postby mebeus » Tue Jun 12, 2012 5:32 am

I have been a sleep tech for 3 years and only make 12.18 so don't complain!!
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Postby ShadowChaser » Tue Jun 12, 2012 6:51 am

mebeus wrote:I have been a sleep tech for 3 years and only make 12.18 so don't complain!!


lol... that's just plain dumb. Ppl may choose to stay at the bottom for whatever reason, but that is their choice.

If you are happy there, then go ahead and stay there, but don't expect the rest of us to be ok with sliding all the way down there with you... :roll:
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Salry

Postby Terri N » Wed Oct 23, 2013 9:59 am

I am a CRT have been in Sleep Study field for 7 years. 5 years at this sleep lab. My pay was negotiated at $21 over the years it increased to $25.
With the recent decrease in reimbursement from Medicare & Medicaid
(per our owner) our pay was cut to $22 hr. We usually get 3 - 11hr shifts.

A friend in the next county gets $29 hr through a hospital lab.
We are located in Texas. Our owner also got into HST. That has cut our in lab studies in 1/2.

He doesn't encourage me getting my Rpsgt . He said you can already do MC/Medicaid so I will not pay you anymore than you're getting now.

I'm a 20yr Respiratory Therapist - NBRC licensed in 1993 & went through a Accredited Program & have Associate of Applied Science to go with that...again local hospital didn't pay RRT but 50 cents more per Hr. No incentive to spend hundreds of dollars to take Registry exam.

IN my last seminar a speaker said DME is where the future is for RT.
I just got hired PRN & will go full time as soon as the competitive bid comes through...it's on 3rd appeal.
Sorry that was long, but in small towns of less than 30,000 we don't have many options but drive 1 hr each way to work.
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Re: Salry

Postby MrBig » Mon Nov 04, 2013 11:51 pm

Terri N wrote:I am a CRT have been in Sleep Study field for 7 years. 5 years at this sleep lab. My pay was negotiated at $21 over the years it increased to $25.
With the recent decrease in reimbursement from Medicare & Medicaid
(per our owner) our pay was cut to $22 hr. We usually get 3 - 11hr shifts.

A friend in the next county gets $29 hr through a hospital lab.
We are located in Texas. Our owner also got into HST. That has cut our in lab studies in 1/2.

He doesn't encourage me getting my Rpsgt . He said you can already do MC/Medicaid so I will not pay you anymore than you're getting now.

I'm a 20yr Respiratory Therapist - NBRC licensed in 1993 & went through a Accredited Program & have Associate of Applied Science to go with that...again local hospital didn't pay RRT but 50 cents more per Hr. No incentive to spend hundreds of dollars to take Registry exam.

IN my last seminar a speaker said DME is where the future is for RT.
I just got hired PRN & will go full time as soon as the competitive bid comes through...it's on 3rd appeal.
Sorry that was long, but in small towns of less than 30,000 we don't have many options but drive 1 hr each way to work.


That lab owner sounds like a turd.

Also, You're a RT and been in sleep for 7 yrs, you should really consider upgrading your credentials to RRT and RPSGT. It'll open up doors most likely.
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Postby cruzin' for a snoozin' » Tue Nov 05, 2013 2:40 pm

If HST has cut your in-lab testing by 1/2, either you are a very small lab, or your patients are not being screened properly. We screen all of our pts. very carefully to determine which test type is most appropriate. We've found, in fact, that only a small percentage of pts. actually qualify for HST based on current criteria. The documentation is very thorough and most are approved for in-lab testing.
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Postby somnonaut » Tue Nov 05, 2013 8:31 pm

Cruz,
Very interesting. I think that clear delineation of who should get what testing methodology is also a missing piece of the puzzle. That is why I made an index for such a thing.
It is called SIPI© 2012
Sleep Interaction Priority Index©

The word doc describing it and the Excel sheet to use it are here:
http://www.screencast.com/t/sZF6ntnMBjKz
PWD: Apneanetwork.com

Would love everyone's, especially your input.
ClaudeATapneanetwork.com
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Postby tiredjohnny1 » Tue Nov 05, 2013 9:31 pm

Thanks Somno I will check out those docs. These screening/authorization requirements are why I think that the sleep CPT codes, especially the HST codes, are improperly priced and reimbursed. While they correctly account for the typical costs associated with the technical, professional, malpractice, and other components, they do not account for the GREATLY INCREASED amount of time spent on patient screening and authorizations. Today's administrative element could not have been calculated in the original pricing of those codes. The administrative requirements to accurately screen and authorize patients, even for HST, have significantly increased, at least in my location. Yet no increase in HST reimbursement.
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Postby somnonaut » Wed Nov 06, 2013 12:25 am

TJ,
This type of miscalculation will also play into telemedicine which is fast approaching. TM was first being rolled out as the general public would be able to just call up the expert doc and have an interaction with the doc, on the patient's time scale. As we can see from CPAP compliance workings, there is no way a physician is going to allow their time to be frittered away waiting on the minutia of inappropriately prepared patients who cannot figure out technology. How in the world do they think Pt Smith will be able to provide the phsyician a modicum of information so that the physician can make an informed decision is beyond me.
What will happen is that a new phalanx of allied healthcare workers will need to be trained to go into the field to become the eyes and ears of the physician, obtaining standardized vitals, and data prior to any interaction with the physician office. This standardized data accumulation will also play into the use of algorithms to help determine the triaging of the patient and whether a first tier NP or PA can handle the issue or will it really need the physician. The real point is to KEEP THE PATIENT OUT OF THE OFFICE as much as possible.
This structured, stratified usage of the healthcare resources in this new Telemedicine world can only be accomplished by changing the long held sacrosanct patient/physician bond. The new insurance driven healthcare world order will equalize all physicians, and through EMR use, any physician can see any patient, almost like a huge mulit-patient practice. As well, this will open the patient to forming new clinican bonds with the individual who actually comes to the home to provide the true hands on interaction.
I believe we, as highly trained technologists, actually can fit this new model of allied healthcare worker, with further training as Medical Assistant, EKG tech, Spirometry tech, Phlebotomist, all rolled into one. We go, we measure, we interact with the office, we take any blood samples, and we place any Rx testing equipment...because in my world SLEEP will play a much greater part in the health of EVERYONE, and all of the components of the patients with Metabolic syndrome also need their sleep looked at, or EKG watched, Holter (yup we would do that too), actigraphy, plus various other new technologies still to be developed.

We need to retool ourselves for this new field. We need to stop kicking the ashes of a fire on the wane. Get up, and get retooled.
Patient-Centered Medical Home
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Postby akorn » Wed Nov 06, 2013 1:44 am

Somno,
Can I use this as I teach sleep screening to my students. I never want to use anything without permission. :D

I think anything I can do to help prepare my students for the field is always helpful

Amy
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Postby somnonaut » Wed Nov 06, 2013 4:14 am

IT has not been tested, nor published yet. I wanted to get a lab or office trying it to see how it might need tweaking. Have you plugged any existing cases of yours in to see how it might work?
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Re: Salry

Postby LadyCandy » Sun Nov 10, 2013 5:43 am

Terri N wrote:I am a CRT have been in Sleep Study field for 7 years. 5 years at this sleep lab. My pay was negotiated at $21 over the years it increased to $25.
With the recent decrease in reimbursement from Medicare & Medicaid
(per our owner) our pay was cut to $22 hr. We usually get 3 - 11hr shifts.

A friend in the next county gets $29 hr through a hospital lab.
We are located in Texas. Our owner also got into HST. That has cut our in lab studies in 1/2.

He doesn't encourage me getting my Rpsgt . He said you can already do MC/Medicaid so I will not pay you anymore than you're getting now.

I'm a 20yr Respiratory Therapist - NBRC licensed in 1993 & went through a Accredited Program & have Associate of Applied Science to go with that...again local hospital didn't pay RRT but 50 cents more per Hr. No incentive to spend hundreds of dollars to take Registry exam.

IN my last seminar a speaker said DME is where the future is for RT.
I just got hired PRN & will go full time as soon as the competitive bid comes through...it's on 3rd appeal.
Sorry that was long, but in small towns of less than 30,000 we don't have many options but drive 1 hr each way to work.


Hey Teri, to make things easier and to present a certification that shows potential future employers that you are a sleep specialist, have you gotten the CRT-SDS subspecialty thing? I don't know a lot about the respiratory credentials, but I have heard that the CRT/RRT- SDS can expect a similar pay grade to the RPSGT holders.

And I agree with the turd accusation previously stated about the lab owner. :)
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bam

Postby zack » Wed Dec 04, 2013 5:38 am

K-sey Complex wrote:
ShadowChaser wrote:
2.- Why not choose to lift the "bad" techs up to the good ones? Provide more training, education, opportunities for professional growth? Why choose to bring everyone down instead (including the good ones)???
The answer: Because its the easy/lazy way out.


UUggghh...... here we go... I have no idea how the hell you got that anyone is taking an easy or lazy way out of anything.... naivety?

Ever hear the old "lead the horse to water..." adage? You cannot instill work ethic in a person. You cannot give them passion or desire. You cannot give them honor. You cannot give them empathy. But what you can do is overpay someone who does not have enough of these qualities. Equally true is that anyone can be fooled in a job interview. ANYONE.
You say it's the "lazy, easy way" that is taken?? NONE of the ideas you mention MAKE anyone a better tech. It ALLOWS one to become better, IF they choose to. It is almost harder to get fired than it is to keep a job. Being a C- worker is plenty good enough in they eyes of any HR department. Does being C+ keep you from being overpaid? No. Does all the education and training in the world keep you from being overpaid? No.

On the flipside...

A tech graduates from their two year program and gets that BRPT paper. He looks around at his classmates and counts them. There's 20. Then he looks in the want ads for an entire metropolitan area and counts the job openings and finds one. He wonders "wow, where are the other 19 techs going to work when I get this job?" Good question. Then when he calls his mates to say "hey I got that ______ hospital interview coming up" 19 of them say "Mee toooo!!!!"

Meanwhile back at the batcave... A manager of a staff of 8 has a job opening and has been told "HR has completed the new salary model based on the current economic climate. $19 per to start has now become $15 to start." What can said manager do about it? Hire a $15 to start tech, that's what.
Faassstt forward 6 months. That same new tech turned out to be the best tech to come thru that lab in years. And is still working for $15. On top of that the $15 per tech is happy as pooh to have that $15 because his 19 classmates are still working at the carwash.
So... do you as a manager say "son, you don't make enough" and just start throwing money at him? Or do you say "hey it worked out absolutely perfect for the new guy and perfect for the department." So manager hires another $15 per. Then another, then another and another.... let's say all of them are great techs. Now.... are all four of those good new techs underpaid at $15?? Bare in mind that you are only worth what someone is willing to pay you.
It might just be that the four left there really are overpaid if they are being outshined by the newbies. Today's market standard is considering that there are more sleep techs than ever and more on the way.

So is anyone underpaid now? No. Not if the four good new techs ALL make the same wage and so will ALL of the ones to follow. Is anyone overpaid? Yes, the four that are making $25 to do exactly the same thing as the $15's.

So there you have it. As hard as it is to swallow.... a tech can absolutely be overpaid. A thousand techs can be. But there's a simple solution to that problem. The thousand new techs coming down the A-STEP pipe waving a BRPT flag.

Do I feel some techs are overpaid? No. Do I feel some techs are? Yes.



Dannnngggggggg.... K- Sey you have no idea how close to home that hit me and it IS hard to swallow. But you're logic is pretty hard to argue - understanding the business standpoint you're explaining.

The thing is, how do you know when and where to come to terms with it? If your not the only lab in town and you think you have to pay less and the other labs dont...then what? Hire the ones with bad ethic they good paying labs don't want?

And on the less business side... are you helping the sleep industry shift to lesser standards by being less attractive to the most competent night owls out there, or is it just time to suck it up and shed a tear and move on?
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Re: bam

Postby K-sey Complex » Fri Dec 06, 2013 4:42 am

zack wrote:
And on the less business side... are you helping the sleep industry shift to lesser standards by being less attractive to the most competent night owls out there, or is it just time to suck it up and shed a tear and move on?


Wow.. I love it when an old thread gets exhumed! (I'm being serious.) I don't know that anything that I do or don't do could help or hurt the industry as a whole. I just try to make the lab I work for a better lab and the techs I work with better techs. That's all.

What can techs do to keep high wages? Don't leave the job paying you high wages, I guess. I would never fault a damn 20-something year old for graduating an associates program and taking a job making $16 an hour. If they're happy with that, I'm happy for them.
Wages are not going up and they're not going to. 18 months later there are more new techs fighting for a job than ever.
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