Physical Therapists

• Nature of the Work

  Physical therapists improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease. Their patients include accident victims and disabled individuals with conditions such as multiple sclerosis, cerebral palsy, nerve injuries, burns, amputations, head injuries, fractures, low back pain, arthritis, and heart disease.

  Therapists evaluate patients' medical histories, test and measure their strength, range of motion, and ability to function, and then develop treatment plans accordingly. These plans, which may be based on physician's orders, describe the treatment strategy, its purpose, and the anticipated outcome. After devising a treatment strategy, physical therapists often delegate specific procedures to physical therapy assistants and aides. (Physical therapy assistants and aides are discussed elsewhere in the Handbook.)

  Treatment often includes exercise for patients who have been immobilized and lack flexibility. Using a technique known as passive exercise, therapists increase the patient's flexibility by stretching and manipulating stiff joints and unused muscles. Later in the treatment, they encourage patients to use their own muscles to further increase flexibility and range of motion before finally advancing to weights and other exercises that improve strength, balance, coordination, and endurance.

  Physical therapists also use electrical stimulation, hot or cold compresses, and ultrasound to relieve pain, improve the condition of muscles or related tissues, and to reduce swelling. They may use traction or deep-tissue massage to relieve pain and restore function. Therapists also teach patients to use crutches, prostheses, and wheelchairs to perform day-to-day activities, and show them exercises to do at home to expedite their recovery.

  As treatment continues, physical therapists document progress, conduct periodic evaluations, and modify treatments when necessary. Such documentation is used to track the patient's progress, identify areas requiring more or less attention, justify billings, and for legal purposes.

  Some physical therapists treat a wide range of ailments; others specialize in areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

• Working Conditions

  Physical therapists work in hospitals, clinics, and private offices that have specially equipped facilities, or they treat patients in hospital rooms, homes, or schools.

  Most physical therapists work a 40-hour week, which may include some evenings and weekends. The job can be physically demanding because therapists often have to stoop, kneel, crouch, lift, and stand for long periods of time. In addition, therapists move heavy equipment and lift patients or help them turn, stand, or walk.

• Employment

  Physical therapists held about 102,000 jobs in 1994; about 1 in 4 worked part time.

  Hospitals employed one-third and offices of physical therapists employed about one-quarter of all salaried physical therapists in 1994. Other jobs were in offices of physicians, home health agencies, nursing homes, and schools. Some physical therapists are self employed in private practices. They may provide services to individual patients or contract to provide services in hospitals, rehabilitation centers, nursing homes, home health agencies, adult daycare programs, and schools. They may be in solo practice or be part of a consulting group. Some physical therapists teach in academic institutions and conduct research.

• Training, Other Qualifications, and Advancement

  All States require physical therapists to pass a licensure exam after graduating from an accredited physical therapy program, before they can practice.

  According to the American Physical Therapy Association (APTA), there were 145 accredited and 39 developing professional physical therapist programs as of June 1995. Of the accredited programs, 65 offered bachelor's degrees and 80 were master's degree programs. The bachelor's degree curriculum usually starts with basic science courses such as biology, chemistry, and physics, and then introduces specialized courses such as biomechanics, neuroanatomy, human growth and development, manifestations of disease and trauma, evaluation and assessment techniques, research, and therapeutic procedures. Besides classroom and aboratory instruction, students receive supervised clinical experience in hospitals.

  Individuals who have a 4-year degree in a related field, such as genetics or biology, and want to be a physical therapist, should enroll in a master's level physical therapy program. A master's degree is also recommended for those with a bachelor's degree in physical therapy who are interested in promotion to an administrative position, or attaining a research or teaching job.

  Competition for entry to physical therapy programs is very intense, so interested students should attain superior grades in high school and college, especially in science courses. Courses useful when applying to physical therapy programs include anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many education programs require experience as a volunteer in the physical therapy department of a hospital or clinic.

  Physical therapists should have strong interpersonal skills so they can make patients understand the treatments. They should also be compassionate and posses a desire to help the patient adjust to their disabilities. Similar traits are also needed to deal with the patient's family. Physical therapists should also have manual dexterity and physical stamina.

  Physical therapists are expected to continue to develop professionally by articipating in continuing education courses and workshops from time to time. A number of States require continuing education for maintaining licensure.

• Job Outlook

  Anecdotal reports about shortages of physical therapists that existed in recent years are no longer common. The number of physical therapy education programs has increased and more graduates have moved into the labor force. Nonetheless, most graduates receive multiple job offers and job prospects are expected to continue to be excellent. Physical therapists who are willing to work in rural areas will experience even better job opportunities.

  Physical therapists is expected to be one of the faster than the average growing occupations through the year 2005. The rapidly growing elderly population is particularly vulnerable to chronic and debilitating conditions that require therapeutic services. Also, the baby-boom generation is entering the prime age for heart attacks and strokes, increasing the demand for cardiac and physical rehabilitation. More young people will also need physical therapy as medical advances save the lives of a larger proportion of newborns with severe birth defects. Future medical developments will also permit a higher percentage of trauma victims to survive, creating additional demand for rehabilitative care.

  Growth will also result from advances in medical technology which permit treatment of more disabling conditions. In the past, for example, the development of hip and knee replacements for those with arthritis gave rise to employment for physical therapists to improve flexibility and strengthen weak muscles.

  The widespread interest in health promotion should also increase demand for physical therapy services. A growing number of employers are using physical therapists to evaluate worksites, develop exercise programs, and teach safe work habits to employees in the hope of reducing injuries.

• Earnings

  In 1994, median annual earnings of salaried physical therapists who usually work full time were $37,596. The middle 50 percent earned between $26,34 and $46,956. The top 10 percent earned at least $61,776 and the bottom 10 percent earned less than $19,968.

  According to a University of Texas Medical Branch survey of hospitals and medical centers, the median salary of physical therapists, based on a 40-hour week and excluding shift or area differentials, was $41,288 a year in October 1994. The average minimum salary was $35,074 and the average maximum salary was $51,950.

  Physical therapists in private practice tend to earn more than salaried workers. Also, many sources report that salaries are higher in rural areas as employers try to attract therapists to where there are severe shortages.

• Related Occupations

  Physical therapists treat and rehabilitate persons with physical disabilities. Others who work in the rehabilitation field include occupational therapists, corrective therapists, recreational therapists, manual arts therapists, speech pathologists and audiologists, orthotists, prosthetists, respiratory therapists, chiropractors, acupuncturists, and athletic trainers.

• Sources of Additional Information

  Additional information on a career as a physical therapist and a list of accredited educational programs in physical therapy are available from:
  American Physical Therapy Association, 1111 North Fairfax St., Alexandria, VA 22314-1488.

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