A Day in the Life of a Physical Therapist

By Rick Fromme

US Navy 100723-N-7214P-020 Machinist's Mate Fireman George F. Avinger practices cone drills during physical therapy in the Comprehensive Combat and Complex Casualty Care facility at Naval Medical Center San Diego (Photo credit: Wikipedia)

For those of you who recall the blog I posted back in February, “Health Care Jobs Outlook is Jammin’,” there are numerous specialties in the health care industry that are expecting above average job growth within the next ten years and more.  In its December 2013 report, Physical Therapy was among the top five health care specialties listed by the U.S. Bureau of Labor Statics’ (BLS) slated for strong growth. There are approximately 185,500 licensed physical therapists in the U.S.; that number is expected to jump to 241,700 over the next 10 years. This, despite the fact that academic requirements for becoming a Physical Therapist (PT) have become even more demanding (see below).

Like many health care professions, the ever-changing demographics of the American population is

contributing to the growth Physical Therapy. The demand for PTs is directly related to our aging American populace, particularly once-vivacious baby boomers entering their “silver” and “golden years.” Despite embracing the mantra, “50 is the new 30,” many baby boomers are becoming more vulnerable to chronic and debilitating conditions that require physical therapy services.

Physical therapist coaches wounded warrior during training session. (Photo credit: Official U.S. Navy Imagery)

PTs are highly trained to restore function, improve mobility, relieve pain, and prevent or attenuate permanent physical disabilities of patients with injury or disease. PTs help their patients to restore, maintain, and promote their overall fitness to achieve a healthier and more active lifestyle.  Clients may include accident victims and individuals with disabling conditions such as low back pain, fractures, head injuries, arthritis, heart disease, cerebral palsy and severe burns. Keep in mind many of our nation's returning vets also require long-term PT care due to the nature of the wounds they suffered serving our country.

Hence, being a PT isn’t for the squeamish. Those who don’t like dealing with patients in pain, who have serious disabilities or may have permanent physiological/motor damage, etc., may want to look elsewhere. I know of someone who, once considering a career in PT, shadowed members of a teaching hospital’s PT department for a day. First case: debriding the damaged skin off a man who’d been severely burned. Second case: moving the arms and legs of a one year-old baby who’d become quadriplegic because its parents let it crawl out on the road and was hit by a car. Third patient: caring for a motorcycle accident victim who, having suffered major head trauma, was permanently “cocooned” in a hanging mesh bed so he wouldn’t suffer from bed sores. By lunch time, they’d decided not to pursue a career as a PT.

Typical Day

Typical locations of arthroscopic surgery incisions in a knee joint following surgery for a tear in the meniscus. (Photo credit: Wikipedia)

On average a PT will see/treat ten to 15 patients per day.  Upon seeing a new patient, one that’s recently underwent single knee surgery for example, the PT undertakes a subjective exam of her/his patient. That is, they’d ascertain what kind of medical conditions the patient has, what type of injury/condition necessitated the surgical procedure, and then discuss what the patient’s goals might be in undergoing PT. Following that, objective measurements are determined. The patient’s posture is measured, levels of strength, balance and coordination, muscle performance, motor function, and range of motion (ROM) in comparison to the non-affected side are assessed and documented. They’ll look for any potential and existing problems.

Based on the examination and the PT’s evaluative judgment, the PT will determine patients' diagnosis, prognosis, and plan of care that describes evidence-based treatment strategies and the anticipated functional outcomes. The PT will usually instruct the patient about the Do’s and Don’t’s, now that the patient is post-op. This may include stretching and strengthening exercises, ice and heat protocols, medications, bracing, etc. The PT also provides the patient with an overview of what to expect whenever they’re undergoing PT sessions. Subsequently, a schedule of physical therapy is set with specific goals in mind for each session, depending upon the patient’s rate of rehabilitation. These sessions usually include strengthening and stretching, and taking steps to minimize swelling (and reduce pain) such as using ice, ultrasound, etc. Finally, as a part of the plan of care, PTs determine the patient's ability to be independent and reintegrate them into the community or workplace after surgery, injury or illness. But since PTs treat a variety of conditions across a broad range of clients, no two days are the same, which makes for an interesting work load.

First diagnosis (Photo credit: azian_ao)

The only tedium, most PT s say, is the paperwork. Like many health care providers, PTs are required to

carefully document their work with each patient. The demands of accurate record-keeping sometimes extends one’s working hours, not unlike other clinical health care workers such as nurses, doctors, etc. It may be tedious, but all professional clinicians realize the importance of accurate record keeping for every client.

Work Environment

PTs practice in a variety of settings: hospitals, outpatient clinics, private offices, home health agencies, schools, sports and fitness facilities, work settings, and skilled nursing facilities. Most full-time PTs work a 40- to 45-hour week. Depending upon one’s work situation, this may include some evenings and weekends. If a PT is part of a professional or collegiate sports team, there may be extensive travel during the season. Likewise, if they’re members of a traveling health care team (military or otherwise). Most PTs say the hours are reasonable and often flexible, allowing them to have families, enjoy their time off, pursue hobbies, take vacations, etc. The remuneration, they say, isn’t bad either; usually greater than $80k per year. Instructors and professors and those in administrative capacities can earn even more.

Approximately five dozen of the Guantanamo captives were amputees, who needed physical therapy. (Photo credit: Wikipedia)

Unlike an office desk job, where one sits in front of a computer most of the day, the physical job
requirements of a PT can be demanding. Frequently they have to stoop, kneel, crouch, lift, and stand for long periods. In addition, PTs help ambulate patients, and sometimes are required move heavy equipment (including weights, exercise equipment, etc.) Knowing and practicing the proper mechanics of lifting, moving weights in space, are essential, lest one inadvertently injures a patient or themselves. Unless you transition into a strictly administrative position, you won’t become “chair shaped” if you become a PT.

Academic Requirements

Prior to being accepted into a PT program, a Bachelor of Science degree is mandatory (usually in biology, kinesiology, physiology, exercise science, etc.) and students must pass the GRE. Scoring well on that exam, as well as maintaining a high GPA is highly recommended, as PT training/education is demanding both academically and clinically. In fact, by 2015, all programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) must award the Doctor of Physical Therapy (DPT) degree. Individuals who wish to become a PT in the U.S. must earn their DPT degree from a CAPTE-accredited program, pass a national licensure examination, as well as meet the specific licensure requirements for the state(s) in which they practice.

In this article, I discussed a typical work day of a Physical Therapist. I touched upon why PT is one of health care's fastest growing profession, described the overall responsibilities of a PT, what a typical day is like, work environment and reviewed the academic requirements — which are soon changing — to becoming a licensed PT. If you found this article useful, please leave a comment below and also feel free to share and repost it.

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found MedMasters.com. Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding MedMasters.com, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may reach Rick by connecting with him on Facebook, Twitter, Google+, LinkedIn and YouTube.  

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