Never underestimate the power of data. Whether it be proving the efficacy of physical therapy in stymieing opioid use among chronic pain patients or convincing payers to create clearer pathways between patients and PTs, data is the catalyst for sparking change within our industry.
But all too often, we lack the data needed to ignite that spark, which is part of the reason why my team at WebPT began conducting our annual industry survey. Each year, we collect data across the entire rehab therapy community. The 2018 survey—our biggest by far, with more than 7,000 responses—left us with some particularly fascinating findings to mull over.
As we prepare to open our 2019 industry survey, I wanted to look back on some of last year’s most compelling results. We never would have uncovered these data points without your participation, and I hope they will inspire you to take a few minutes to complete this year’s survey, which you can access here. (That said, this is by no means a solicitation for financial gain; neither I nor WebPT will financially benefit from this survey. But if you’d like to participate—and I hope you do—it’s open through February 22, and everyone who takes it is eligible to win one of 50 Amazon gift cards worth $100 apiece.)
The average DPT graduate will take 45 years to pay off student loan debt.
During our 2018 survey, we collected a lot of striking—and disheartening—stats on student loans. Of course, it’s not breaking news that higher education in the United States comes with a hefty price tag. It’s not even all that surprising that obtaining a physical therapy doctorate can be particularly costly. But, according to the 2018 survey results, more than 50% of all physical therapy grads will accrue more than $70,000 in student loan debt, and over a third will owe upwards of $100,000.
This staggering finding is only compounded by the fact that the initial salary expectation for the average new-grad PT pales in comparison to the amount of debt he or she likely will incur during schooling. Nearly three-fourths of the students who responded to the survey expected to earn $60,001–$80,000 in their first PT job after graduation, an amount that aligns with industry salary averages. The debt-to-income discrepancy is even more alarming when you consider that our physician peers typically take on similar amounts of student loan debt, but have a much higher starting salary expectation—nearly three times higher than the average PT’s starting salary, in fact.
Data is driving education reform.
While there’s still a lot to be done in the way of the student debt problem, we’re beginning to see improvements. For example, initiatives such as EIM’s DPT partnerships and the APTA’s financial literacy program are making PT education more accessible and affordable. Efforts like these are driven by awareness—and that awareness is driven by data that sparks crucial conversations within our profession. And it is my hope that this year’s survey data can keep those conversations going into 2019 and 2020.
There’s a significant gender-based gap in salary levels and expectations.
We also collected some rather eye-opening feedback on the trends around wage and gender in PT—a profession traditionally dominated by women. According to our respondents, while women are taking on more leadership roles than ever before, men still take home higher salaries overall.
More than 50% of staff therapists who took the survey reported salaries ranging from $50,000 to $90,000, with nearly a third falling in the $60,000 to $80,000 range. That said, men largely dominated the $70,001-plus salary ranges, whereas women represented a greater portion of the salary segments below $70,000. (This also aligns with the most recent US Census data , which found women in the PT profession earn 87.6% of what their male counterparts are paid.)
Additionally, per our survey, women’s salary expectations for their first job out of graduate school are significantly lower than men’s (a point that aligns with this Forbes-cited study of 66,000 undergraduate students across 318 universities). As I pointed out during last year’s State of Rehab Therapy webinar, “that begs the question: what came first? Are expectations creating the gap, or is the gap distorting expectations?”
Positive changes are happening—slowly.
But, it’s not all doom and gloom. As I mentioned above, our data showed a growing representation of females in all leadership categories (with the exception of C-level executive roles), meaning we have even more power to level the playing field. In fact, as I wrote in one of my monthly founder letters on the WebPT Blog, we have an opportunity to become an example for other industries to look to when it comes to achieving gender parity in both salary and leadership.
While wage disparity is still a very real problem in our profession, these stats have shed light on some other issues: namely, the pervasive argument that the gender pay gap is a myth. In fact, when we presented our data—which clearly showed that the gap exists—it triggered a lot of pushback from naysayers. This proves the need for even more research—and open discussion—in this area. We hope to make strides on both fronts with the 2019 survey.
Providers view insurance payers as the top barrier to patient care delivery.
One of the less shocking—although certainly telling—trends we uncovered had to do with PTs’ attitudes toward third-party payers. Our survey data showed that therapists rank insurance requirements as the number-one roadblock preventing patients from accessing physical therapy before they see a physician. The data also placed high copays and deductibles as the second most prevalent barrier.
Some payers are adjusting plans to encourage early PT intervention.
With this data, we found that PTs are ready (and willing) to take patients, but insurance requirements are still a huge deterrent to making that happen. Ultimately, this type of data is a callout for insurance payers to do something about this problem—and that’s exactly what’s happening. During a study conducted by Boston University and sponsored jointly by OptumHealth and the APTA, researchers found that patients are “10% to 25% less likely to see a PT, rather than a primary care provider, if their copay is more than $20 or deductible is more than $300.” Furthermore, “low back pain patients who accessed conservative therapies first were ‘75% to 90% less likely to have short or long-term exposure to opioids.’” This data—which connected greater access to physical therapy to a significant cut in spending on prescription narcotics—prompted Optum to make some major changes to its insurance plans in an effort to encourage more patients to seek PT as a first resort.
More practices are switching to cash-based or hybrid practice models.
Partly as a result of the aforementioned insurance-related pressures, many practices have started exploring ways to reduce their dependence on third-party payments. In fact, our data spoke to the growing popularity of cash-based practices—as well as practices that offer cash-based wellness services or use a hybrid payment model (i.e., cash plus some commercial payers). More than 20% of survey participants reported using one of these models, and in response to this data, Dr. Jarod Carter, PT, DPT, MTC, cash-based practice owner and consultant, offered the following perspective: “Rising deductibles and copays—and less overall coverage for PT—is making it much easier to attract cash-pay patients than it used to be. So, cash-only clinics are becoming more scalable as healthcare consumers with high deductibles and copays are realizing there’s often little financial difference between going in-network and going out-of-network.”
The cash-pay trend could make PT less accessible to some patients.
But, while the rise of cash-pay PT may be great for practice owners who are tired of accepting low-ball rates from insurance companies, it could theoretically make PT less accessible in lower-income areas—which could negatively impact the health of some of our country’s most vulnerable patient populations. It could also disincentivize insurance companies from making changes that would widen our reach at scale. And if more insurance payers removed the obstacles standing between PTs and patients—like Optum is attempting to do—and paid rates that kept PTs in business, perhaps fewer practice owners would feel the need to go out of network. Of course, changes like those hinge on data—including the kind we collect each year as part of our industry survey.
Physical therapists still love what they do.
With so much uncertainty in our profession, it’d be easy to assume many providers are fed up and burned out. And while that may be the case for some, of those who responded to our 2018 survey, most reported that they do, in fact, love their jobs. I believe this speaks to our wholehearted dedication to not only our patients, but also our profession.
Generally speaking, people don’t become PTs for the paycheck—they do it because they truly believe in what they do. Still, those same PTs will likely admit there are some major hurdles we have yet to overcome, and that won’t happen with belief alone. That’s why it’s crucial that we make our voices heard—even if it’s as simple as participating in a survey—and collect meaningful data that can help elevate and push the profession forward. So, I’m inviting and encouraging (and thanking in advance) everyone who works in the PT, OT, or SLP field in any capacity to take part in this annual survey—and to share and promote it within your own professional networks. This is a huge opportunity to be part of something big—to make your voices heard and join in the effort to put our industry in the spotlight and make us more relevant to important conversations happening in the healthcare community. It’ll only take you about 10 minutes, but this data could impact our industry for years to come.
About the Author
Heidi Jannenga PT, DPT, ATC/L is the president and co-founder of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi leads WebPT’s product vision, company culture, and branding efforts, while advocating for the physical therapy profession on a national scale. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has since guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.
An active member of the sports and private practice sections of the APTA, Heidi advocates for independent rehab therapy businesses, speaks as a subject-matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. In 2014, Heidi was appointed to the PT-PAC Board of Trustees. She also serves as a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice rehab therapy professionals.
Heidi was a collegiate basketball player at the University of California, Davis, and remains a lifelong fan of the Aggies. She graduated with a bachelor’s degree in biological sciences and exercise physiology, went on to earn her master’s degree in physical therapy at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her doctorate of physical therapy through Evidence in Motion. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.