Physical Therapy CE, Jobs, and News at TodayinPT.com

The brisk job market for physical therapists is running into a few potholes this year.

While jobs still are readily available, new PTs are not finding the starting salaries they need to repay their college debt. Some settings are holding off on new hiring until they see how healthcare reform, the presidential race and, most importantly, future reimbursements play out.

While these conditions may put a damper on the PT job outlook for now, the effect shouldn’t last long, said Lydia Ostermeier, president of the National Association for Healthcare Recruitment.

"This year will be a transition, but if you look at the baby boomers growing older and needing PT services, and the number of healthcare workers retiring, you are bound to have that turnover of jobs sooner or later," she said. "So we have to keep the pipeline of new students and graduates robust. Physical therapy is definitely one of the strongest careers for the future. There is job longevity there for PTs."

Ostermeier’s advice for PTs in the short-term: "If you have a job I would suggest staying put until we see how the reimbursements play out," she said. "It’s not a good time to move right now."

However, advertising for PT positions is strong, Wanted Technologies Corp. reports. The information aggregator listed PTs as the eighth most in-demand profession overall for the month of February. PTs also were the top most-advertised positions in San Francisco, Dallas, Seattle and Chicago.

Geographic hot spots

U.S. News and World Report ranked physical therapy at No. 8 on its best jobs list for 2012. The magazine’s annual analysis looks at salary level, job satisfaction and job growth predictions, the latter from the Bureau of Labor statistics, an arm of the Department of Labor.

BLS projects a job growth of 39% from 2010 to 2020 for PTs, adding 77,400 positions over the decade. This ranks physical therapy as No. 20 on the list of professions with the highest growth rates over the decade in the U.S.

But a more careful analysis of this picture shows a profession with a wide geographic disparity of job locations, said Carl DeRosa, PT, DPT, FAPTA, a professor at Northern Arizona University and chairman of the Physical Therapy Business Alliance.

"There’s a difference between job vacancies, which is how that data is gathered, and workforce distribution issues," DeRosa said. "For example in Flagstaff [Ariz.], there is a Native American reservation with a tremendous shortage of cardiologists, but down the road in Phoenix there is an oversupply of the specialty. The same is true of PTs."

This can be seen in the markets that pay the highest PT salaries right now. According to the BLS, the small Texas/Mexico border towns of McAllen, Edinburg and Mission rank as No. 1 in salaries for PTs, with annual mean wages of $120,690. Other areas on the top 10 highest paid list for PTs include Fairbanks and Anchorage, Alaska, El Paso and Midland, Texas, and other small metro cities.

While six-figure salaries are available, the average annual wage for a PT is $76,310 or $36.69 an hour, according to the BLS. But the bureau said that one-quarter of PTs make less than that, $64,230 ($30.88 an hour) or less and one in 10 make $53,620 ($25.78 an hour) or less.

School debt conundrum

The current job market is a mixed bag for students graduating with debt, said DeRosa, who owns three physical therapy clinics in Flagstaff. "Many students graduate around the country with significant debts of $100,000 to $200,000 — some in the neighborhood of even $300,000," he said.

"The good news is that these students are successful in finding positions after graduating," DeRosa said, and "the majority are finding the setting and location they want."

The bad news is that with lower Medicare and third-party insurer reimbursement rates, PT salaries aren’t at the levels that can support student loan debt, DeRosa said. "Students are stunned often about low starting salaries and how it will not allow them to pay off their loans," he said. "It’s one of the biggest problems I see in the marketplace right now."

Cautious hiring

DeRosa said he is currently not hiring at his clinics and that nationally clinics are being cautious about expanding employment until they see how healthcare reform and reimbursement policies will affect their financial futures. Those clinics hoping to support their PT staff with cash clients may find that is not a viable option, DeRosa said.

"The reality is that cash-pay services are highly dependent on the economics of the region," he said. "We’ve seen many of these cash-pay options fail because they didn’t have the patient base that could pay out of pocket."

The same wait-and-see attitude has developed at hospitals and other healthcare settings, Ostermeier said. "This is a slow time for postings, even for internships," she said. "This is usually the biggest hiring time — the first and second quarter — but there are not as many postings around the nation. Across the nation, hiring has slowed across the board."

Ostermeier, who is director of nursing and patient care services recruitment for Indiana University Health, said her organization of 22 healthcare centers across the state is proactively working to address potential cuts in reimbursements.

"We are financially healthy, but hiring has dramatically slowed since the beginning of the year," she said. "Everyone is waiting to see how their Hospital Consumer Assessment of Healthcare Providers and Systems scores turn out. The board and senior executives want to be cautious."

HCAPS scores — part of healthcare reform — will be compiled by the federal government based on assessments of patient satisfaction, which will affect reimbursement for Medicare, Ostermeier said. Third-party insurers are expected to follow the federal government’s reimbursement policy.

Critical areas of need — like nurse, PT and occupational therapist jobs — will continue to draw a demand, "but not as robust at it normally is," Ostermeier said. And that will have some effect on salaries. "It’s not causing a decrease in salaries, but what we will see this year is fewer raises and bonuses," she said. "We will be very cautious."

Niche hot spots

In- and outpatient PTs are still in demand at HealthOne, a system of seven hospitals and a rehab and occupational center in Denver, said Sonja Bren, RN, MSN, director of recruitment. Bren said she believes healthcare reform will affect out-patient PTs more because of the shorter hospital stays now for most procedures.

"If everyone is granted coverage, there will be a bigger increase in outpatient services," she said. "Hip and knee replacements are now in and out in three to four days. The followup will be a PT in an outpatient setting."

The waning of the recession also may boost physical therapy demand, Bren said. "Part of the [weak healthcare demand] was due to people who put off elective surgery," she said. "Either they didn’t have insurance, or they put it off to keep their jobs. The more people with insurance, the more they will have the services and the more people will be required for that area."

Hot areas for PTs at HealthOne are pediatrics and neurology, Bren said. But don’t expect extra pay to come with those specialties, she said. "Hard-to-fill positions may [earn] more, but it’s not something to count on," she said. "The pediatric staff doesn’t get paid more than adult. Maybe a ped/neuro — a real specific area — may get a little more."

DeRosa said the cautious job environment should last throughout the year. "There are vast uncertainties of what the landscape will look like between now and 2013," he said. "Students graduating in May and June of this year probably are going out to a more cautious environment with hiring pressures prevalent until employers have a greater understanding of the landscape."

But he, too, sees room for optimism in the job outlook of the profession in the long-term. "The need is always going to be significant because of the breadth of what PTs can offer," he said. "From pediatrics to gerontology or specialties in ortho or neuro — there are a lot of valuable niches for PTs. That’s the good news." •

Teresa McUsic is a freelance writer.