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Physical Therapist Assistants in the United States: An Interview with Professor Chris Joyce

May 29, 2018

As the world's population becomes increasingly active and increasingly older, the demand for physical therapy services has grown. Coupled with an expanding scope of practice, physical therapists and assistants are being sought out for their expertise in movement analysis and rehabilitation. In Europe, the demand for physical therapy parallels that in the United States and Canada, however their healthcare system does not currently include the profession of physical therapist assistant. Looking for solutions to this imbalance of demand and supply, a Swiss journal recently interviewed Professor Chris Joyce to explore the history, advantages, challenges and function of the physical therapist assistant in the physical therapy profession and in the United States healthcare system. The interview was translated into German and French, but a portion of it was made available below:

What role does the physical therapist (PT) have when working with PTAs?

The PT’s responsibilities include interpreting the referral from the MD, performing the evaluation and developing a POC, determining if there are interventions that need to be performed specifically by the PT, performing the re-examination and the discharge, and overseeing documentation. The PT is also responsible for determining the extent of assistance from the PTA, which takes into consideration: the PTA’s expertise and training, the patient’s condition and complexity, the federal and state statues, the frequency of re-examination.

There are different levels of PT-PTA supervision depending on the insurance the patient has and the state the PT/PTA are practicing in. In some instances, the PT needs to be physically present for direction or supervision. In other situations, the PT needs to only be available by telecommunication. There is variability in the type, frequency, and presence of supervision.

Most often, the PT does not directly supervise the PTA during patient care, however they work closely with the PTA to discuss the progress, challenges, treatments and outcomes of a patient. For example, if the PTA wants to amend the plan of care to include a different goal or intervention, they can suggest to the PT to make such changes.

How attractive is it to work as a PTA? Can PTAs train to become PTs?

PTAs can train to become PTs but will have to apply to PT school and go through the entire PT curriculum. There is not a “bridge” pathway to become a PT if you are already a PTA. The starting salary for a PTA has quite a range depending on the state and setting the therapist works in, but a general range is $45,000-$65,000. Regarding job market, this following is from the APTA website:

Job Outlook

There is a high demand for physical therapist assistants in the workforce despite the economic downturn. According to the Bureau of Labor Statistics, employment of physical therapists is expected to grow by 40 percent from 2014 to 2024, much faster than the average for all occupations. The need for PTAs is expected to increase into the foreseeable future as the U.S. population ages and the demand for physical therapy services grows.

Who employs the PTAs? Where do they work: hospitals, institutions, private practices, sports clubs?

PTAs can work in any place a PT is employed, including but not limited to: Acute Care, Sub Acute Rehab, Skilled Nursing Facilities, Outpatient Clinics, Schools, Home Health, Hospice, Workplace and/or Industrial Organizations, Research Centers, Government.

The vast majority of PTAs, approximately 72%, work in hospitals or privately owned physical therapy practices. Others work in home health, schools, and rehab units. 28% of PTAs work part-time (APTA Website).

What are some of the main benefits offered by the system including PTAs?

Having a PTA profession allows for greater access to physical therapy. It offers the opportunity for students to go to school for just two years, become licensed, and work in the healthcare field. The PTA programs are rigorous and the curriculum is very dense, however the cost of tuition is substantially less than the DPT and the student will graduate with much less student debt in a shorter amount of time.

Physiotherapie-AssistentInnen in den USA. Interview mit Chris Joyce. physioactive 3/2018.