While many office workers are finding themselves streamlined out of their jobs, there's one white-collar occupation that has seen a steady increase in demand for its hands-on skills: physical therapy. With an ever-increasing population in need of rehabilitation services, projections are for demand to continue to grow.
In a recent national survey of health-care executive recruiters by Dunhill Personnel System Inc., 43 percent of the respondents said occupational and physical therapy jobs would increase in coming years. This was the highest percentage for any health-care job on the survey.
Physical therapists, who specialize in the rehabilitation of muscles, joints, tendons and the spine, are in increasing demand to treat the growing number of elderly people, according to Patricia Helm-Williams, associate director of the department of practice at the American Physical Therapy Association, in Alexandria, Va.
On the other side of the age spectrum, more babies are surviving difficult births but are left with disabilities that must be dTC treated with physical therapy. School systems have started supplying physical therapy as part of their curriculum, Helm-Williams says. And there are the increasing numbers of people in automobile accidents or other traumas who survive because of better emergency treatment, but who then require physical therapy.
"There is a huge population with those demands," Helm-Williams says.
As a result, the ranks of licensed physical therapists have swelled from 42,220 in 1980 to 72,000 as of May 1990.
In Maryland, the number of licensed physical therapists has grown by 39.5 percent in the last five years, from 1,832 at the beginning of 1987 to 2,556 now. But even this growth is not enough to meet the need in the state, according to Stephen M. Levine, public relations chairman of the Maryland Chapter of the American Physical Therapy Association.
Typically, a prospective physical therapist in Maryland must earn a bachelor's degree in the field. That entails taking 60 credits of prerequisite courses in anatomy, physiology and other college courses and two to 2 1/2 years of specialized training, including about 4 1/2 months of clinical internship, Levine says. Then the person must pass a state licensing exam.
However, beginning next year the University of Maryland at Baltimore, following a national trend, will switch to a master's degree program that requires four years of college and two years of postgraduate training, Levine says.
Maryland schools turn out about 70 physical therapists each year along with 20 assistants, Levine says. But, that is not enough to replace those who leave the profession or to meet the growing demand.
"Access to care is somewhat limited," Levine says, adding that the situation has led to waiting lists and greater demands on the practicing therapists. "People are pressed hard to see these people," he says. The effect can lead to stress on the therapist, Levine says.
The increase in demand also has meant higher salaries for physical therapists. In 1984, a beginning therapist could expect to make about $18,000 a year, Levine says. Beginning salaries are now between $35,000 and $40,000.
Therapists work primarily in hospitals and in private practices, but they also are found in nursing homes and schools and at work sites, Levine says. Private practices have been around for decades, but they have expanded significantly in the last 10 years, he says. One reason for this expansion is a 1979 law that allows patients to go to physical therapists without being referred by a physician.
The expansion of the physical therapy business is evident at Baltimore Sports Rehabilitation and Physical Therapy in Essex. Business has doubled in the last three years, with the number of therapists at the firm increasing from two to four, according to Chris Glavaris, one of the therapists. Each therapist has about 15 patients, and an assistant works with 10, he says.
Glavaris attributes the growth to the increasing realization by doctors that a conservative approach before and after surgery is a great help to the patient. Most of the patients at the practice are referred by physicians and all are covered by insurance, Glavaris says.
The increase in insurance payments, in turn, has created a continuing conflict between therapists and insurers, who want to keep costs down. This is particularly true in the new era of managed care, in which insurers use statistical averages to determine what is appropriate care for an individual.
Glavaris attributes some of this conflict to insurers' preference for surgery, where results are measured by scientific studies, as opposed to physical therapy, where results are more subjective.
"Things need to be backed up by scientific data," he says.
Levine, of the Maryland chapter of physical therapists, also says it is important to tell insurance companies exactly what physical therapy is and teach them not to pay for something else.