As physical therapist practices in America face staffing shortages, kids are ‘suffering,’ say experts

The physical therapist will not see you now.

Outpatient physical therapist (PT) practices are experiencing severe staff shortages, with the highest vacancy rates at 17%, according to a recent report by the American Physical Therapy Association (APTA), a nonprofit group based in Virginia. 

The report is based on survey responses from 133 outpatient physical therapy practices across the U.S., which include 2,615 clinics and some 11,000 full-time employees, ranging from support staff to PTs. The survey was conducted between May 25 and June 16.

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The pandemic may have accelerated the staffing shortage, but only 1.7% of owners of physical therapy practices cited COVID-19 as the primary reason for leaving, per the press release.

Here is more detail about the survey results — and what they mean. 

Factors driving PTs to leave

Most survey respondents said the big drivers of employee loss were salary, relocation and work-life balance issues.

Among the business owners, 37.3% cited relocation, 25.4% blamed salary and 22.9% said issues with work-life balance were the reason that employees left practices.

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“There is certainly a shortage of physical therapists, especially here in New York, and the pediatric population is suffering,” Dr. Susan Taddonio, assistant professor at Long Island University and a practicing pediatric physical therapist based in New York, told Fox News Digital.

Physical therapists are also retiring, changing careers or selling their practices to corporate entities, added Taddonio, who was not involved in the survey.

“The sad fact is that we go into physical therapy with a major desire to improve the lives of the people we serve … and the rewards at the end make meeting the costs of living and paying off student debt difficult at best,” Dr. Marilyn Moffat, professor of physical therapy at New York University in New York, New York, told Fox News Digital. 

Sizable student debts

It’s tough for many potential students to rationalize investing in a physical therapy education that may not yield a return on their investment, added Moffat, who was not part of the survey.

Students typically spend four years earning a bachelor’s degree before embarking on a three-year program to graduate as a doctor of physical therapy.

“To become a licensed PT, you need to earn a doctorate degree,” Taddonio emphasized.

“We go into physical therapy with a major desire to improve the lives of the people we serve … and the rewards at the end make meeting the costs of living and paying off student debt difficult at best.”

“This can lead to a large amount of student debt, and when compared to other fields, the earning potential is not as great — especially with [high] burnout rates and the burden the job places on one’s body.”

Meanwhile, she noted, nurses and physician assistants can graduate sooner with less debt and earn more pay.

The median annual wage of physical therapists ranges from $88,000 to $101,500, but this income only met or fell behind the inflation rate in most areas of the country between 2016 and 2021, according to the APTA’s most recent published data.

At least 80% of recent physical therapy graduates have an average debt of $142,000, per a 2020 report.

Lower Medicare reimbursements

The Centers for Medicare & Medicaid Services (CMS) is planning an additional reduction in reimbursement that will affect physical therapists in 2024, which would bring the cuts to a total of 9% over four years, according to APTA.

(Medicare reimbursements are payments that Medicare sends to hospitals and physicians for medical services they provide.)

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“On Nov. 2, 2023, CMS issued a final rule that finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues, effective on or after Jan. 1, 2024,” a CMS spokesperson told Fox News Digital.

The policy changes “reflect a broader Biden-Harris administration-wide strategy to create a more equitable health care system that results in better access to care, quality, affordability and innovation,” according to the CMS.

Although finalized payment amounts under the PFS will be reduced by 1.25% overall next year compared to the 2023 calendar year, CMS is finalizing increases in payments for many services, such as primary care visits and longitudinal care visits.

“Overall, the finalized [calendar year] 2024 PFS conversion factor is $32.74, a decrease of $1.15, or 3.4%, from [calendar year] 2023,” the CMS spokesperson said.

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Medicare patients make up a large percentage of the people that physical therapists treat, which means new graduates are finding it increasingly challenging to establish small private practices that will be sustainable. 

“In the past, we could … actually establish a nice private practice and even have that grow into several practices,” Moffat said.

“However, because the publicly held and private equity-backed major firms have and continue to buy up small practices where the bottom line is the major consideration, it is now extremely difficult — if not impossible — to think about being entrepreneurial and starting that small practice.”

Regulatory changes for remote services

Several recent regulatory changes should give physical therapists and occupational therapists more flexibility in providing services to patients, the CMS spokesperson told Fox News Digital. 

Since 2005, CMS has required physical therapists in private practices to provide direct supervision of their therapy assistants.

“CMS is finalizing a regulatory change to allow for general supervision of therapy assistants by PTPPs (physical therapists in private practice) and OTPPs (occupational therapists in private practice) for remote therapeutic monitoring (RTM) services,” the CMS spokesperson said.

“Practically, this means that physical therapists and occupational therapists will not need to be physically present to supervise RTM services.”

Long wait times for children

A particular population of patients is adversely affected by the shortage of physical therapists, Taddonio noted.

“We have seen children in the early intervention system waiting months to get a therapist,” she said.

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Early intervention services help address the developmental needs of eligible infants and toddlers with disabilities up to 3 years old and their families, Taddonio said.

They are authorized by Part C of the Individuals with Disabilities Education Act (IDEA).

“The data from early intervention reported a 33% drop [in] children being identified and serviced each year since COVID in 2019,” said Taddonio.

She has not seen pay increases for the preschool population in years — a trend she attributes largely to budget and Medicaid cuts.

“In the past 30 years that I’ve been practicing, early intervention has made two reductions in the pay rate,” the physical therapist said.

Fox News Digital reached out to the American Physical Therapy Association for additional comment.

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