Recession Job Market

For the third part in the little mini-series on job hunting (here's the links in case you missed searching or interviewing for an OT job) I would like to address the topic of job-hunting in the midst of a recession.

The recession is not making big headlines this week, perhaps because the doomsayers have realized that we are probably not going to end up in another great depression or a post-apocalyptic nation focused solely on survival. However, it is still a topic on people's minds, especially when discussing a job search.

Occupational therapy made the headlines by landing on Time's 150 Recession-Proof Jobs list. OTRs come in at #18, and OTAs at #72. Rehab/Healthcare jobs in general were well represented on this list- PTs, PTAs, Therapy Aides, SLPs, and also RNs, LPNs, Athletic trainers, Massage and Respiratory therapists were all in the top 120.

We now interrupt this entry with a quick little note about political advocacy here. It's likely that athletic trainers have climbed their way onto the 'recession proof' list through their efforts to redefine their scope of practice on a political level. Since any individual can now be considered an "athlete," they now have a much wider base of clients to work with and places to seek employment- like outpatient rehab clinics. Recreational therapists, on the other hand, are not on this list, perhaps because they have been cut out of some Medicare legislation affecting reimbursement and their necessity to be employed in certain environments. Right now, they're trying to become a covered, required service under Medicare for additional settings. Just a little word about how you can't live as a therapist in isolation- political action is required if you'd like to continue having a job and being relevant to the rehab world. As one of my teachers said, if you don't have the time to do it, at least kick some money to the people that are working on it at your state and national associations. We now return you to your scheduled blog entry.

One thing that surprises me about the job list is that OTAs are not higher on the list, or even higher than OTs. I would think using more OTAs could be more profitable for many organizations, as long as there are not a superfluous amount of evaluations to be done as opposed to treatments. My current job is obviously one of those places since we get about 1200-1500 orders for OT/PT/SLP evals each month, so there are only 2 OTAs and 1 PTA. OT Practice recently had an article celebrating 50 years of OTA education, and the associate's degree remains a cost-effective way to get into occupational therapy.

Despite the accolades the profession has been garnering, I think that the only people who say that OT is 'recession proof' are those not currently working in healthcare. Many sites are in the midst of a soft or full-on hiring freeze. Some hospital units are closing completely, orthopedic units are trying to step up the service due to decreased elective surgeries- My old hospital was trying to see acute orthopedic surgery pts 3x for PT and 2x for OT everyday; a friend at a hospital-based SNF was trying to see subacute ortho pts 2x for PT and 1x for OT each day, which is causing their depleted staff to work overtime everyday. (Obviously the second group is salaried, keep that in mind during your job search.) PRN (as needed) nurses and therapists are seeing a dramatic cutback in use of their services, which used to be a pretty lucrative way to earn money without a full time commitment.

Though it may be callous to gripe about cutbacks on perks, that too has become the reality. Sign-on bonuses (taxed very high anyway) are getting cut. CE money is often getting cut, which is a shame, because high intesity courses that give a lot of hours are more expensive. It stands to reason that therapists might choose to stick close to home and maybe go for something based less on the knowledge they will receive and more within their price range. I don't know that it's technically fradulent to pursue CEs outside your realm of practice, but it is professionally discouraged. It wouldn't fly in my current state, since they have to preapprove everything you go to. Money for therapy supplies is likely getting slashed in budgets, so you may have to appeal to grants to get the fancy new equipment. Another cutback is in the retirement arena- matching 401K funds are dwindling. My current company still has a pension plan, which I thought had all gone kaput long ago, but they are keeping that and tossing out the matching funds.

If you work for a hospital, then at least your healthcare benefits are fairly safe. After all, they can't just deny you admission to the hospital. However, I have heard of some places charging an extra fee if your spouse's employer also offers health insurance but you chose instead to go with the hospital's plan. The wording was that the hospital couldn't afford to subsidize the rest of the county's healthcare costs. The other issue related to healthcare is that it can be hard to job-swap since a person would face up to 3 months without any benefits, especially if you have a spouse or family depending on you for coverage. If you're single with a chronic health condition (especially including pregnancy) then the issue has to be weighing into your decision as well. Related to that, it's good to pick an area that has multiple job offerings, so that you don't have to pick up and move if you want to work somewhere new. In a related situation, it would be very difficult for my husband to find a new job, so when I accepted my new position, we had to live somewhere that would be a reasonable commute for both of us. Part of the reason that we chose to move to Baltimore instead of back where our parents live is so that he could keep his job- trying to move and find 2 new jobs is stress that we're not ready for yet.

Though this post is a bit of a downer, don't be mistaken, there are OT jobs out there. You may have to take a position that isn't your dream job, but there will likely be plenty of positions available in hospitals, SNFs, and large facilities. There will probably be fewer openings in schools (these are usually limited anyway since people tend to keep those jobs when they get them) and small private practice facilities. There are also likely to be fewer openings in OT college towns since there is always a fresh supply of therapists available. But when there is a legitimate opening at any location, the current therapists will likely be stressed by trying to deal with the workload and they will want to fill their position. And if you're just starting OT school, don't be put off by the cost of the degree. Student loan debt is better to have than other types, people have used those loans for international travel and buying cars and still come out ahead. And since there will be some type of OT job available when you graduate (not necessarily a perfect one, or one that pays $100,000/year) you will be able to pay back your loans.

The jobs are out there, good luck to everyone that's looking. I have to guess that they will be a little harder to land in May or December, so you may want to start your search pre-graduation if you're expecting to get a job right after school is out. Happy hunting, everyone!

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