Full disclosure: My wife is a PT. We started dating when she was in PT school at UCSF. At that time I did not know what “P.T.” stood for, and I could not imagine why anyone would leave a job with Morgan Stanley to become a one. Especially when becoming a PT meant three years of very expensive graduate school. The average PT currently graduates with a Doctorate and over $96,149 in debt. I doubt that any profession has that level of disparity in average debt versus starting salary. According to the census, PTs makes $76,310 per year (not a starting salary, but an AVERAGE salary). I challenge you to find a profession with a higher debt/salary ratio than 1.26!
Even faced with those numbers, my wife wanted to help people and wanted to learn more about the human body. Who can argue with that? So, 14 years later, she has her own successful PT practice, and here I am, building an online physical therapy community.
And, I really do think that now is a great time to be a PT!
If you are a PT, there are at least three big trends working in your favor; Demand, Reform and Technology.
Demand (and Supply)
The Bureau of Labor Statistics estimates that PT will grow 39% from 2010 to 2020. Ranking #20 in growth out of 796 categories that the Bureau tracks -from 198,000 thousand PTs in 2010 to 276,000 in 2020. Is there really a farm system in place that can add 77,400 PTs over 10 years? With 211 PT schools and average class sizes of 40 students (according to the APTA) in the US, this could only happen if NOBOBY ever retired. A 1 in 30 annual retirement rate would almost nullify the inflow of new grads. So, either 1) the US will be a net importer of PT jobs or 2) schools will need to get bigger or 3) PTs will need to work longer, or 4) all of the above.
On top of that, I don’t think the BLS is being very sophisticated with their estimates. Their estimates only seem to mirror the growth in the population 65 and older over the same period; 36%. In addition to that, the new 65 year olds are a lot more active and are anticipating a longer lifespan than in previous generations; replacing hips and tearing tendons with abandon. IMHO, they are going to spend a lot more of their disposable income on wellness. This appears to be a trend across all ages. We are spending more on wellness. It is like coming to grips with the fact that you are going to own your Audi for more than 10 years, so you better add oil, rotate your tires, replace the water pump etc…
So, supply and demand are on your side, PT. And, you are in a “hands on” profession: your job is not moving offshore. That $94k in debt doesn’t look so bad if it comes with 40 years of guaranteed employment!
There are three legislative movements that are going to have a big positive impact on the PT profession.
First, the Patient Protection and Affordable Care Act is going to add 30 million insured Americans to the demand side of the equation. In case you have been in Ibiza for the last month, or hiding in a closet full of Thera-bands, the Supreme Court upheld this Act in a somewhat surprising decision on June 28 of this year. So, more debt for the country, but good news for PTs.
Second, there has been a systematic trend toward allowing Direct Access to PT. By the APTA’s count, 46 of 50 states have some form of Direct Access now; up from 35 in 2002. And those states with limited Direct Access are working towards getting unlimited access. California is tantalizingly close: SB924 passed through the Assembly Business and Professional Committee on June 26th, and goes to the Assembly Appropriations Committee on August 8th. Anyone up for an Egypt-style flash-mob in Sacramento? Seriously, I don’t think PTs have really begun to see the full impact of the Direct Access movement. The real benefit will be over the next ten years when consumer awareness kicks in and consumers strive to fully utilize their healthcare policies.
Third, the HITECH ACT of 2009 is about to start working in PT’s favor. I know that is hard to believe given the fact that PTs were excluded from the initial Meaningful-Use cash giveaway. Even Chiropractors got $44k for scanning their charts. But in 2014, the carrot will become a stick, and Doctors will get 1% lower Medicare re-imbursement if they don’t have EHR. PTs may not have to comply by law, but they should if they are opportunistic. The ones that do, and fit into the process flow of their referring physicians, will see something interesting take place: Doctors will need to track outcomes, and they don’t have the time to do it. Know anyone else who might be qualified? Congratulations, PT, your time has come.
When my wife started her practice just three years ago, I imagine that the process was twice as easy as it was ten years before, mainly because of the Internet. If you are starting a practice today, it is probably twice as easy as it was just three years ago. Need to incorporate? Try LegalZoom. Need to accept credit cards? Try Square. And it is more of the same across all services from scheduling to accounting; cheap if not free solutions.
The rest of the business world has been upgrading technology incrementally. Physical Therapists, as super late adopters, are positioned to make a telescopic leap right into cloud-based services and touch-pad tablets. It is like China going straight to cell phones and not worrying about the landlines.
The amount of cost that is about to be taken out of the system, and the amount of efficiency that is about to be added, are unparalleled in any other service industry that I can think of. It is not that hard to imagine a PT office where a patient taps a screen to announce their arrival, their insurance is automatically billed, a PT records their evaluation on a iPad, they are given a video home exercise program that is interactive, their course of treatment is automatically tracked online for doctors to see, their satisfaction and outcomes are monitored regularly, and it all ties into accounting and business analytics, real time.