I will graduate in 2022 and what I've learned about the job market is very disheartening. 60% of the "job" openings I see are PRN shifts. 30% are Full-Time. 80% of the Full-Time jobs REQUIRE at least a year of experience. The leftover jobs that I can actually apply to either don't mention salary at all or have low-ball offers like 32$/hr or 60k$/yr.
Every Entry-Level DPT has like 6 months of internship experience (which companies make bank off of--they get a free PT working for them for 8-12 weeks), but these same companies will exploit a new grad DOCTOR of PT for 60k$/yr. If you average 80$ an hour in reimbursement they are taking most of what you earn.
Is the job market for this profession really as bleak and exploitative as it appears?
I'm going to be 180k in debt and working 50-60 hours, 6-7 days a week for at least 2 years. It looks like I'm going to get paid peanuts to do it, too.
Prepare to see PRN shifts gutted as hospital systems hedge their losses and begin mass employing part-timers to cover weekends and fill gaps in care. Others will follow suit. $65k a year may feel like a low ball to you, but that is pretty much the industry standard for a new grad in acute care. It's slightly higher in SNF and OP and even higher in HH. Even contract therapy has dried up considerably. This time last year there were over 450 contract travel assignments in California alone. Today there are less than 100 across the US.
As you may know your income is heavily influenced by reimbursement. In acute care PT services are not reimbursed for unless they are being classified as an outpatient or "outpatient in a bed". But for traditional inpatient patients, we don't directly bill for any of our services. Not exactly ideal. What you need to know is that reimbursements are not increasing. In fact every year it seems insurance eliminates reimbursable billing codes or guts it. For example vestibular CPT codes reimburse at about 25-40% of what they did 10 years ago. Or they find other ways to coerce your billing practices like preventing two separate codes from being billed at the same time. There are some insurance companies (Aetna) in our area that will not allow you to bill for Ther Act and Gait training in the same session.
Some may disagree, but I believe we are witnessing the greatest Physical Therapy dumpster fire in the history of our profession. What's in it?
1. The most expensive tuition in the history of the profession.
2. The widest debt-to-income ratio and lowest ROI in the history of the profession.
3. The largest opportunity cost and length of time to complete a PT degree in the history of the profession.
3. The most amount of for-profit PT schools in the history of the profession.
4. The least amount of action by the APTA and CAPTE to control the supply glut of PT's in the history of the profession.
5. The castration of SNF and HH revenue streams in the form of PDPM and PDGM resulting in the most significant changes to PT reimbursement in the history of our profession.
6. The lowest inflation adjusted reimbursement for most CPT codes in the history of our profession.
7. The most documentation required, liabilities, and red tape in the history of our profession.
8. And finally, the gas can. An unprecedented pandemic that crippled the healthcare system and fostered the greatest amount restructuring and cutbacks in the history of our profession.
If you have any business acumen the writing on the wall is pretty clear. This is not a sustainable or healthy model and it will most certainly fail if things do not change. I think we are witnessing a top in the PT profession. I sincerely believe over the next few years PT applicants will decline, the quality of PT candidates will go down as schools have less highly qualified candidates to choose from (highly qualified will look at better ROI professions), and I wouldn't be surprised to see some PT schools close their doors as the financial strain of COVID eliminates private schools with high tuition and low endowments. I think you'll see the same thing happen with PA schools and NP programs in the next decade as many who decide against PT choose those professions as alternatives. Already many places have undergone hiring freezes even for them because of the affects of COVID and massive increases in supply.
But there is hope, however it does not come in the form of a traditional PT pathway. It comes in the form of personal branding and non-traditional career paths working for industry/academia. For example working for DME companies, working for corporations to improve wellness and prevent MSK related claims, working for insurance companies, getting involved in tech and using our expertise in MSK to consult for startups in silicon valley, starting our own practice, getting a PhD and contributing to science, creating a personal brand (YouTube, twitch, skillshare) and free content to build a following and then monetizing that following once large enough, creating and teaching classes (fall clinics, osteoporosis prevention, etc) in your community, getting involved at a federal level with the APTA to change it from within (yes you can become a lobbyist), I could go on and on.
If you believe the value you provide is not being adequately compensated you should take a hard look at alternatives to a traditional pathway. I think many will find if they want to enjoy the quality of life and financial freedoms the PT profession has enjoyed for many decades, they will have no choice.
