This thread is very informative and jblil is nailing some of the major issues in the profession. There is a lot there that I was seeing and posting on here when I was looking to apply to PT school 5 or so years ago. I find myself back at the crossroads of working to enter back into school. I currently am looking at the local Nursing program as well as contemplating completing a course of Organic Chemistry and just apply to Medical School (ALL but Ochem is completed due to me working to get my prereqs for Physical Therapy completed). Sadly PT has been taken off the table as a career option.
I've had such a passion for doing this for so long that I had the blinders on to reality as I attempted to justify the extremely high cost of education and the DPT. I value the preventative healthcare component, loved the idea of specializing in manual therapy, having my own gym and spa business on the side even. It's not about making millions, but it is about being able to have professional growth and being able to take care of a family. That is VERY difficult to do when you're straddled with 120K+ student loan debt in the economic climate PT is going to be facing for years.
A couple of problems I couldn't overlook:
1) the DPT - I think this is more of a hindrance to the profession as opposed to an evolution of it. While "Direct Access" exists in some shape or form in most states, the practice is for the physician in the majority of cases to write a referral for Physical Therapy services. The "Doctor" of PT has caused friction among some Physician groups and even PT groups. People are confused that it is a PhD level. It hinders professional growth by straddling individuals with high student loan debt. I talked to an old time BS PT on here that graduated back in the eighties with a total of 8000 student loan debt. The guy had it paid off in a year, and ended up going BACK to Medical School to work as an Orthopedic Surgeon. He could do that as his debt load was manageable.
2) The High Student Loan Debt - There's no way to overlook it. Most programs are 25-30 so grand per year for tuition alone. This does not include living expenses and you can't work during the program. The answer to the high student loan burden isn't increasing salary. It is an attempt to get congress to pass legislation to help "forgive" student loans. It's all dependent upon big brother. Those that do their research will learn that the only reason tuition costs are so high are due to the government getting involved in "guaranteeing" student loans to begin with.
3) Trend for decreasing reimbursement and current business model dependent on 3rd party paying sources - While the Baby Boomers are increasing in number, demand for PT services is not dictated by the number of people needing services but the ability of those people to pay and/or the third party payor source to pay. As was pointed out Medicare/Medicain are cutting reimbursement not increasing them. The reason is the demographics of the baby boomers, the increased life expectancy for those receiving benefits from these payor sources, etc.
A big problem I see is the value that the public wants to PAY for PT services is NOT IN LINE with what is currently reimbursed by 3rd party payors. The majority of people I witnessed are complaining about a $20 copay for PT services let alone willing to dish out $100 for an Evaluation.
The public really sees the Chiropractor not Physical Therapist as the primary preventative musculoskeletal expert that's going to help with say back pain, and for those that have researched the Chiro profession, their business model for an honest practice is not going so good. Their student loan defaut is very high. Is that the direction this field is going?
I can't recommend anyone I know go to school for Physical Therapy now. The only ones that benefit from the DPT are the educational instututions. I can recommend the PTA profession though. No way do I see this group going anywhere in the current medical economic climate. The community college here offers the program for a mere $100/credit. Young people are coming out with little debt making $20-30/hr. They can grow and transition to PA school.
I am in the process of applying to the local nursing program at that same college. My total tuition costs will be approximately $5000. Even WITH ALL MY EDUCATION it still makes sense (I have 2 degrees and 160 credits of undergrad study). I also am looking at Medical School in the PM&R field.
If I'm going to go high into debt as I was struggling to rationalize with PT school, I might as well just go to Medical School. I actually had a PT tell me this when I was shadowing him. He did not believe the DPT was good for the profession.
I think it was huge mistake the APTA has made. I do not see their vision of all therapy being provided by DPTs by 2020 as a reality. They've made it so PTAs not DPTs will be performing more and more of the treatment modalities. I've heard some say that PTAs might be done away with, but I do not see how this group seeing how they are looked at as equivalent from a treatment payer perspective are going anywhere.
The economic model looks to embrace more PTAs to keep the therapy business model afloat. DPTs doing more evals, paperwork, fighting with insurance companies to justify payment for services, etc.
