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Toni Talks about PT Today

The Future of Physical Therapy

Published May 3, 2012 11:49 AM by Toni Patt

This morning I had a conversation with an OT who has as much experience or more than I do. I mentioned my frustration with employers desiring low pay over experienced therapists. I don't think my tDPT and geriatric specialization have made me more attractive to employers. If anything, they have made me less attractive. Having them makes me more expensive.

Her response was interesting. She said she wasn't sure that physical therapy as we know it will exist in 10 years. All the DPT has done is drive up salaries, resulting in fewer jobs. One way employers will compensate will be the loss of jobs by attrition. Physical therapy is a female-dominated field. They will simply not fill positions when therapists quit to have children. The remaining therapists will be expected to grind out as many evaluations as possible in an eight-hour day. PTAs will do the majority of the work.

That is a grim outlook. I can't say I disagree with her. We're already experiencing the "grind out as much as you can in eight hours" phenomenon. My review of job ads shows the trend to hiring PTAs over PTs. I know there are fewer jobs overall but I can't say attrition is the cause. It is probably a contributing factor.

She summed up her comments by saying the APTA has shot itself in the foot with the DPT thing. The APTA may have shot itself in the foot, but it wasn't just the DPT thing. In its effort to enact direct access, the common therapist has been forgotten. We're the ones who grind out those eight-hour days. We're the ones who make sure things are done correctly and quality patient care is provided. While the APTA has latched onto direct access as the second coming, the rest of us are struggling to make ends meet and continue to practice a profession that has forgotten us.

More and more, I like my profession less and less. I love treating my neuro patients when I get the opportunity. I like making a difference in someone's recovery. That is happening less and less. Mostly I'm asked to see more patients in less time. I have less help and lack equipment. My patients are often more involved. I don't have the time to get to know them as people.

It used to be I wanted two things in life - to treat my neuro patients and ride my horses. Now there are days when all I want is to survive the day.


consider another field. that's all I have to say. outpatient PT pays terribly, hospitals aren't much better, but there's always the benefits, and at a SNF you're going to work your fingers to the bone treating people who are inappropriate for therapy because your bosses can bill medicare whenever you drag a dying person off of their deathbed for 60 minutes

josh, PT - pta, snf June 29, 2015 3:48 PM

I am finishing my bachelors degree in May and I have been accepted into PT and OT school. (I applied to both not sure which one to pick) What should I do! I am completely lost with what to choose. I keep hearing PT is so secure and it is so easy to get a job, then on the other hand I hear there are no jobs etc. With OT I hear it is a up and coming field or I hear it is impossible to get jobs. WHATS THE TRUTH! I would love to hear a PT and OT’s response to my situation. Thanks for the help.

Sarah Wright March 2, 2015 10:37 PM

The "Doctorate" was never legitimate except in the arrogance of this profession. It is PT school after an unrelated degree--nothing more. A graduate program has orals. DPT does not. A graduate program student teaches lower level courses for undergrads. The DPT does not. The graduate program has a thesis--a defended thesis not a short research paper that we all did. In short the DPT is and always was a fraud on the public. Between that and the general lack of ethics that is rampant in this profession it will be a pleasure to see therapists get what they deserve.

Chip, PT - PT June 22, 2014 10:38 PM

I have not been able to get full time PT work in a year and a half.  The PT job market is bad right now and probably only going to get worse.

Bill Conpalton December 15, 2013 2:10 PM

I am a PTA wil 15 years of experience in a variety of settings.  I have pursued advanced degrees that complement being a PTA. I have not had the opportunity to follow all the discussions, however I wanted to make an observations about the future trends.  I feel strongly that business success may override the optimal clinical senarios.  Heath care reform will cause a rise in the use of cost effective providers across the board.  The regulations will make the practice of medicine for physicians so stressful and less lucrative that there will be fewer individuals pursuing medical school as a career.  There will be more PA's and nurse practitioners being the prescribers as we have already seen happening.  I see a similar thing happening with physical therapy, not because its the best thing, but a way to survive the changes and evolution of the indisutry.  Physical Therapist Assistants are more affordable in delivering care.  I do not  agree that over utilization is a good option.  

I am not sure that I agree with the articles I have viewed on the phasing out of the PTA role.  The industry pressures and supply and demand probably will not let that happen. I am not trying to provide argument either way, I just know that we are headed toward perilous times that will require us to stand our ground as a profession, work together and not cause division where ever this path leads.

Tony, Homecare - PTA May 3, 2012 9:57 PM
Morgantown WV

Toni, I hear your frustration and I have experienced it myself. I think I also hear frustration with your professional organisation more than with your profession. That is one reason I have refused to join the APTA, I haven't felt like they've represented me for many years. However, you embody what a professional PT really is.  You have made a difference to many people's lives and you probably will continue to do so.

You've had rather a rough go of things as of late. Disillusionment is probably to be expected. I have a hunch that you will find a new way of working, of doing that which you do well and enjoy doing. You have had to think outside of the box to get your tDPT (and by the way, is the "t" really necessary? You are a DPT, does it matter how you got there?) Think creatively, I know you can do that or you wouldn't be a good neuro therapist. You'll find a new way to work and a new way to do the work you actually want to do.

I wish I could give you more than encouragement, but that will have to do for now. Cheers. "Keep calm and carry on" as they say in my new country.


Dean Metz May 3, 2012 2:59 PM

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