Physical Therapy Careers
There are many different career options in the physical therapy field. All have different requirements, duties, training programs, and benefits. At the most basic level, the physical therapy aide requires little training and is involved primarily with transporting patients and maintaining therapy facilities.
Physical Therapy Assistants must be certified at the level of an associate degree and, as the name implies, spend most of their time assisting the physical therapist with the patient therapy. A Physical Therapist is someone with a high level of training, typically a doctoral degree, who is capable of diagnosing patient problems, designing patient treatment plans, and providing clinical care to get the patient back to a functional level. Further, there are many different environments in which those with a physical therapy degree may choose to work. Each setting has different daily responsibilities and activities. Some professionals may prefer to work in a hospital or clinic setting, while others may prefer a sport therapy center or home health care work, providing therapy to those not able or willing to leave their homes.
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Physical Therapy Aide
The physical therapy aide position typically requires only a high school education or GED and not an actual physical therapy degree. Most of the training is done on-site by the employer. The physical therapy aide works under the close supervision of a physical therapist or physical therapy assistant. The aide may work in many different environments but most will be employed in a hospital or clinic setting. Most physical therapy aides will work full-time during normal business hours. However, as hospitals provide care around the clock to meet their patients' needs, there may be a need for evening and weekend hours. The daily job duties of the physical therapy aide focus primarily on transporting the patient and maintaining the treatment area. This might involve assisting the patient into a wheelchair and pushing him to the treatment room or assisting the patient in walking. The aide might help the patient on and off of a treatment table, weight machine, or other treatment equipment or provide standing support and balance for a patient during treatment. The physical therapy aide is typically responsible for cleaning and maintaining the treatment area and equipment. This might involve wiping down equipment with a disinfecting solution, for example. The aide may also make sure the appropriate supplies are on hand, including, for example, clean towels and appropriate weights, straps, and other items used during the exercises. Some aides may also have clerical duties such as keeping records, ordering supplies, answering phones, and filling out forms.
The expected growth of the market for physical therapy aides is high. With the growing aged population and people's desire to remain active, it is projected that the demand for all physical therapy professionals will be quite high. According to the US Department of Labor's Bureau of Labor Statistics, there are over 44,000 physical therapy aides employed in the US and they earn an average annual salary of nearly $25,000.
Physical Therapy Assistant
Physical therapy assistants work under the supervision of a physical therapist. They use physical exercises, stretching, massage, and other techniques to help patients regain strength, mobility, and independence and reduce pain. The physical therapy assistant usually works in a hospital or clinical setting, but other work environments may include nursing homes or private homes. A physical therapy degree is required to work as a physical therapy assistant, typically involving completion of a 2 year associate degree plan, and one must also pass a national certification exam before he can be licensed to work as a physical therapy assistant. Certification in first aid and CPR is typically required, as well. Most assistants will work full-time and the job may include nights, and often weekend hours, in order to serve the patients' needs.
The physical therapy assistant spends much of the workday in direct contact with the patient. Duties may involve assisting patients to and from therapy sessions or equipment. Patients may need assistance getting out of a wheelchair and onto a treatment table or other piece of equipment. They may need help with stretching, lifting and general movement. The assistant may often be kneeling, stooping, lifting and standing for long periods and therefore, the assistant should be in relatively good physical shape. A physical therapy assistant does not diagnosis the patient's issues or design the treatment plan, but assists the physical therapist in carrying out the treatment. The assistant may instruct the patient on exercises and explain the effect of the treatment and why it is important. The assistant should be supportive and encouraging to the patient and be able to give instructions in a clear manner. Besides stretching and strengthening exercises, the physical therapy assistant may also assist in providing techniques such as massage, hot/cold applications, hydrotherapy, and ultrasound treatments to decrease pain and swelling. The type of patients that the assistant will be treating can vary greatly, from children to the elderly, and from athletes with injuries to the profoundly disabled and patients with diseases or strokes. With the aging population, a large number of patients are those who have recently had knee or hip replacements. The physical therapy assistant is part of a health care team and so will interact daily with physical therapists, nurses, doctors, occupational therapists, social workers, etc. and may provide observations or patient reports to the team members. The physical therapy assistant will also have many clerical duties such as filling out patient forms and reports and documenting patient progress in strength, range of motion, etc.
The physical therapy assistant field is expected to have a high demand in the future, especially as the elderly population continues to grow. The Baby Boomer population is just now reaching retirement age and they expect to live long and active lives, which will mean injuries and knee replacements for many. According to the US Department of Labor's Bureau of Labor Statistics, there are nearly 64,000 physical therapy assistants in the US and that number is expected to climb to 85,000 over the next 10 years. Physical therapy assistants are also among the best compensated of healthcare support professionals, with an average salary of more than $48,000 per year. The salary range varies considerably depending on job setting, facility size, experience, and geographic location. Assistants generally enjoy excellent benefits in the form of healthcare insurance, vacation time, and retirement plans.
With high satisfaction levels, excellent compensation, and predicted outstanding future growth, Physical Therapist has been rated one of the best, most rewarding occupations by multiple publications. There are however, several different settings in which a physical therapist may choose to work. And while many of the day-to-day techniques will be the same, each setting has different patient populations, responsibilities, and work environments. Several of these settings and their differences are outlined below.
Private practice is a setting in which those with a physical therapy degree very commonly work. In this setting, patients receive physical therapy treatments in an office or private clinic (sometimes referred to as an outpatient clinic). Most private practices treat primarily musculoskeletal (orthopedic) or neuromuscular patients. Patients may range from the very young with injuries or diseases to the very old with knee replacements. Some private practices may focus on sports-related injuries and could be located in a fitness center.
The day-to-day activities of the physical therapist would include seeing patients, diagnosing problems, testing range of motion and strength, designing treatment plans and implementing the treatments. The physical therapist works hands-on with the patient during sessions that might include stretching, massage, weight training, hydrotherapy, and ultrasound treatment, along with other appropriate techniques. The job can sometimes be physically demanding as the therapist is often supporting the patient during exercises, doing a lot of lifting and stretching, and remaining on his feet for hours a day. The physical therapist will encourage and instruct the patient on exercises. The therapist may also oversee physical therapy assistants as they perform some of the treatments. The physical therapist will interact with other health professionals, such as physicians and occupational therapists.
Private practice is attractive to some because they can be their own boss and private practice shows the greatest potential for income. It would not be unusual for a physical therapist in private practice to make well over $100,000 once his practice was established and growing. However, starting a private practice is a risky enterprise; many don't make much profit and fail, the hours can be extremely long, and some find that the amount of time spent with administrative duties is not to their liking. One has to be extremely well organized and enjoy the business side of the profession to succeed in private practice. There are tremendous costs associated with starting a private practice: renting and perhaps renovating an office, purchasing expensive equipment, hiring office workers and assistants, and paying for supplies and utilities. To start a practice, financing, either from investors or a bank loan, will be needed. In order to establish a private practice, marketing must be successful in establishing a client base; and developing relationships with physicians who will make referrals to the clinic is essential. The private practice will have to deal with billing and workers compensation insurance issues and will need to do its own accounting or hire someone to do it. Those in private practice will also have to deal with staffing issues, hiring and firing and dealing with benefits and taxes. It can sometimes be a delicate balance between trying to control costs while at the same time providing high quality patient care. That said, the successful private practice can make the owner quite affluent and allow him to run his own business.
Alternatively, one can often be hired to work in a private practice setting by the owner of the practice. The pay for this position is at the lower end of the scale for physical therapists, approximately $75,000, but the employee bears none of the risks associated with being the business owner and may work a more regular schedule. Benefits such as health insurance are sometimes not as good in private practice versus a large hospital which has the benefit of a large number of employees, but there are variances.
Hospital Therapy Clinic
Many professionals with a physical therapy degree are employed in a hospital setting. This setting may take different forms. In an “acute care” setting, the patient has been admitted to a hospital for a short duration due to illness, accident, or surgery. The goal in this setting is to provide therapy that will allow the patient to be discharged as soon as he is stable and has an appropriate place to go, which may sometimes mean discharging him to a rehabilitation hospital or “sub-acute” facility. A “rehab hospital” is a specialized facility that is designed for patients who need intense therapy. The patient may receive many hours of physical and occupational therapy a day, sometimes 2 or 3 sessions for a total of 3 or more hours per day. The goal is to get the patient mobile and functional and able to care for himself. A sub-acute setting is a specialized rehabilitation facility in which the therapy is less intense, typically less than 3 hours per day.
The job of the physical therapist in these settings is to decrease pain, improve mobility and function, and increase the independence of their patient. Among many possibilities, patients may have had a recent surgery such as knee replacement, may have had a stroke that limited the use of part of their body, or may have been involved in an accident. The physical therapist will examine the patient's history, assess the patient's needs, mobility, range of motion, and strength and design a treatment plan for that patient. The therapist then implements the plan involving hands-on treatment with exercises, stretching, massage, hydrotherapy, and other treatments. He will instruct the patient on proper performance of exercises, how to use assistive devices such as crutches, and ways to improve his health and prevent re-injury. The therapist will encourage the patient throughout the therapy and build trust with the patient. A physical therapist will also document patient progress and make appropriate modifications to the treatment plan, as well as interact with, and make recommendations to, other members of the health care team such as physicians, nurses, physical therapy assistants, and occupational therapists. One advantage of working in a hospital setting is the presence of administrative support. The physical therapist does not have to deal with issues such as billing, dealing with insurance companies, purchasing and maintaining equipment, etc. Physical therapists working in the hospital setting have an average salary of approximately $75,000 per year. Benefits in the hospital setting are often excellent in terms of health insurance and can sometimes include 401(k) or other retirement benefits.
A small number of those with a physical therapy degree choose to pair with other healthcare professionals whose practice is in line with the methods and use of physical therapy. Some, for example, might choose to be employed in the office of an orthopedic surgeon who then refers his patients to the physical therapist for treatment. Still others may work in the office of a chiropractor. Chiropractors are licensed healthcare professionals who have earned a Doctor of Chiropractic degree from an accredited college. Chiropractors diagnose and treat patients with disorders of the musculoskeletal system, usually focusing specifically on the spine and manipulation of the spine. Chiropractors are often dealing with some of the same problems and patients as a physical therapist, including for example, those with back pain, sports injuries, or limited mobility. Therefore, it is perhaps not unexpected that they should sometimes share their office with a physical therapist. Further, the chiropractor and the physical therapist often use some of the same techniques and equipment. For example, both use exercise, massage, stretching, hot/cold treatments, traction, and ultrasound to treat their patients.
Physical therapists who work in this clinical setting will have an environment, and daily activities, similar to those working in an outpatient clinic setting. They will treat primarily musculoskeletal (orthopedic) or neuromuscular patients. Their day will consist of treating patients, diagnosing medical issues, assessing range of motion and strength, designing a treatment plan and implementing the therapy with hands-on treatment of the patient. The therapy might involve exercise, stretching, massage, and other methods in order to improve the patient's mobility, strength and function and to decrease pain. The physical therapist will instruct the patient on exercises and activities that he can perform at home and may teach the patient the proper use of assistive devices. The therapist will document the patient's progress and interact with other health professionals on a regular basis. As with all physical therapy settings, the job can be somewhat physically demanding as the therapist is on his feet for many hours, kneeling, stooping, and lifting or supporting the patient during various exercises. Pay for physical therapists working in the office of a chiropractor or other healthcare professional averages $76-77,000 per year. Benefits such as health insurance are variable but are often not quite as good as those of a hospital setting, which has the benefit of a large employee base.
Physical therapist working in the home healthcare industry is a growing segment of the profession. A home healthcare physical therapist provides treatment of the patient in the patient's place of residence whether a home, nursing facility, group home, hospice or elsewhere. While the majority of home healthcare patients are senior citizens, any type of patient may require home healthcare. Like other professionals with a physical therapy degree, the home health therapist works to improve the mobility of his patients and decrease their pain; he just does it in a non-clinical setting. This has its own challenges because certain exercise and treatment equipment will not be available but on the other hand, it gives the therapist an opportunity to determine the real challenges facing the patient in their return to normal health and independence. The therapist may notice the steepness of the sidewalk or steps, the layout of the house, or the furniture or loose rugs that may present challenges or risks to the patient's recovery or future safety. Physical therapists in this setting often find deep satisfaction from the more personal relationship they develop with the patient and the patient's family.
Similar to other areas of practice, the therapist will evaluate the patient, test strength and range of motion, assess challenges, and design and implement a treatment plan. The treatment plan may need to be more limited in scope because of the lack of certain equipment but a good therapist will improvise and find a therapy that works for that patient. The physical therapist will document the patient's progress and make appropriate adjustments to the treatment plan. The home healthcare therapist will also interact with other healthcare professionals such as doctors, social workers, nurses, and occupational therapists. The job has physical demands, as there is a lot of lifting and supporting patients, bending, kneeling, and physical manipulation. Home healthcare physical therapists may be employed by hospitals, home health agencies, clinics, government agencies, or may even be self-employed. Home healthcare is often a good setting for therapists wishing to work part-time. Because the job involves travel, a valid driver's license is usually required. Physical therapists employed in the home healthcare setting are among the highest paid, with salaries averaging over $83,000 per year.
Nursing Care Facilities
Physical therapy is useful in treating older individuals. The aged are more prone to injuries from falls and physical therapy can help ease pain and, importantly, improve balance and strength to help prevent future injuries. Many conditions treated by physical therapy are often associated with the older population, conditions such as arthritis, recovery from joint replacement, and limited use of muscles due to stroke. Therefore, it is not surprising that nursing care facilities often employ many physical therapy degree professionals to restore and maintain the best possible mobility and well-being of their residents. As an example, most elderly suffer from arthritis of the spine or elsewhere. Physical therapy can improve strength, balance, and range of motion and reduce the pain associated with the disease. And physical therapy does not have the unwanted side effects of pain medications or surgery. There have been many studies documenting the benefits of physical therapy to the health and well-being of nursing home residents. In fact, nursing home residents who receive physical therapy are much more likely to be discharged to the community and live independently than those who do not receive therapy.
The daily tasks of a physical therapist working in a nursing care setting will be fairly typical of other types of therapist, although perhaps, the treatments will be less intensive and more specifically designed for the older population. Many of the therapists that work in this setting will have earned board certification in Geriatrics. The physical therapist will work hands-on with the patient to assess physical problems, test strength, balance, and range of motion and then design and implement a treatment plan for the patient. The therapist will use various treatment methodologies such as stretching, exercise, balance training, massage, hot/cold treatments, etc., to decrease pain and improve the health and mobility of the patient. As with any physical therapy degree position, this job is somewhat physically demanding as the therapist is involved in lifting, supporting, and manipulating the patient and is often stooping, bending, and kneeling. The therapist will instruct the patient on exercises, practices that will lessen the likelihood of injury, and the proper use of assistive devices such as walkers. The physical therapist will document the progress of each patient, modify the treatment plan as appropriate, and interact with other health professionals such as physicians, nurses, occupational therapists, and social workers. Compensation is at the high end of the physical therapy pay scale, with salaries averaging approximately $79,000 per year. Benefits vary but are generally very good in this setting.
Last Updated: 02/27/2013