5 Biggest Issues in Physical Therapy in 2023 (+ Overcoming Them)

Like many healthcare fields, physical therapy is often an incredibly fulfilling opportunity for professionals to help their patients minimize pain and successfully recover from injuries, surgery, and more. But the satisfaction of a job well done cannot be its own reward.

Since the COVID-19 pandemic, issues in the field of physical therapy have only become more complicated — but not unsolvable. Physical therapists need to understand the reasons behind the challenges related to telehealth, burnout, and education, so they are prepared to face them head-on.

1. Adapting to telehealth

The widespread adoption of telehealth options across the healthcare sector has pushed PTs to change their practices to meet new patient expectations for treatment. But most PTs are used to interacting with their patients almost exclusively in person, from explaining the details of a patient’s injury and treatment plan to showing them how to do their at-home exercises.

Some PTs might have trouble adapting to telehealth, whether it’s because they lack training on how to provide physical therapy services virtually or they’re worried that they can’t deliver high-quality patient care via telehealth. There is also the risk that patients might accidentally injure themselves while performing exercises without direct supervision, which makes physical therapy delivered via telehealth especially complex.

Physical therapy will always require in-person appointments to some degree, but clinics need to offer telehealth options to stay competitive. Here’s how PTs can adapt to the new world of telehealth physical therapy:

• Experiment with different delivery options: Try using video conferencing to demonstrate exercises to patients and observe as they perform their home exercise protocols (HEPs). You can also supplement your services by providing educational content through asynchronous options, like videos of how to correctly perform exercises to avoid injury and anatomy diagrams that outline how the treatment plan will help.
• Consider a hybrid approach: Clinics don’t have to fully transition to a telehealth practice. Instead, PTs can evaluate and diagnose patients during in-person sessions, then administer a treatment plan virtually. PTs should follow up with patients often so they can answer questions and adjust any HEPs as needed.
• Incorporate physical therapy apps to remotely monitor your patients: You can’t observe your patients as they practice their exercises at home, but mobile apps are the next best thing. For example, Exer Health’s motion AI platform measures a patient’s range of motion and form so you can review their performance whenever, wherever.

2. Mitigating physical therapist burnout

Burnout has become one of the fastest-growing issues in physical therapy in the past few years, especially since the onset of the COVID-19 pandemic. And physical therapy burnout comes with a hefty price tag; employee turnover and reduced hours cost the healthcare industry an estimated $4.6 billion per year.

To provide effective patient care, PTs have to connect with patients so they can understand their challenges and create a treatment plan. This often adds significant emotional stress, particularly if patients struggle with pain during physical therapy. To reduce the risk of burnout or mitigate its effects, PTs should try these tips:

• Evaluate your options: Trying to simply push yourself through a period of burnout will likely make it worse. Instead, talk to your supervisor so you can work together to find other solutions, like experimenting with a flexible schedule or changing productivity expectations.
• Ask other PTs about their experiences with burnout: If you feel yourself burning out, chances are other PTs have been where you are. Reach out to coworkers, classmates, and other peers to learn about how they deal with burnout. Many professional organizations like APTA also offer resources to help PTs overcome burnout.

Collaborate with your colleagues: Physical therapy is a very hands-on practice, and PTs often fatigue quickly after working with patients all day. By sharing the responsibilities of care with physical therapist assistants (PTAs) and occupational therapists (OTs), PTs will have a lighter workload and more time in between patients to complete documentation.

3. Managing the cost of education

The rising cost of education — from increasing tuition to continuing education requirements — poses a major obstacle to physical therapists, who often struggle to keep up with student loan payments once they start working. On average, physical therapy graduates carry around $116,000 in education-related debt alone — nearly three times the national average of $39,000.

In the past two decades, education requirements in physical therapy have grown from a bachelor’s degree to a master’s degree and now to a Doctor of Physical Therapy (DPT) degree. On top of that, PTs are often required to complete a minimum amount of continuing education (CEU) credits each year so they can keep up with ongoing research, learn about new techniques and treatment options, and maintain their licenses to practice.

Here are some strategies PTs can try to help balance the costs of their education:

• Look into loan repayment options: With repayment assistance programs, PTs commit to working in a high-demand area for a certain period of time in exchange for federal and state programs to repay a portion of their student loans. If you have federal student loans and work for a government agency, you can qualify for Public Service Loan Forgiveness after making payments for 10 years.
• Try job-hopping: One of the most effective ways to get a raise is to actually find a new job. Most employers offer a 3% raise for internal promotions, but a new job gives you the chance to negotiate a much higher salary increase. Look for new opportunities every one to two years, negotiate a pay raise of at least 5–10%, and eventually, you’ll be able to stay in a role long term with a much higher salary than if you had stayed with one employer.
• Switch to travel physical therapy: With so many tax breaks for travelers, like tax-free housing and relocation costs, travel physical therapy can help you save hundreds or even thousands of dollars in tax savings alone. Take a couple of years to network and grow your experience, and you’re sure to succeed as a traveling PT.

4. Improving limited patient access to PT care

Although physical therapists are technically allowed to evaluate and provide treatment to patients anywhere in the United States without a physician’s referral, many states still impose arbitrary restrictions on direct access.

Limited access to physical therapy increases healthcare costs for patients, who often see multiple specialists or try other treatments like prescription medications before they can see a physical therapist. But the expansion of direct access would enable PTs to diagnose and treat more patients, who would also be empowered to decide where and how to seek treatment.

Accessibility is one of the most common issues in physical therapy because it has a direct impact on patient adherence, which often determines the success of patients’ treatment plans. Common barriers to access include transportation, proximity to clinics, cost, wait times, and a lack of knowledge about physical therapy. Here’s how PTs can improve accessibility for patients, regardless of restrictions on direct access:

• Offer additional support beyond the clinic: Physical therapy doesn’t end when the patient leaves the clinic. PTs can make treatment more accessible by offering education and self-management strategies so patients can continue physical therapy after the end of their sessions. You can also post free resources online, like video tutorials of exercises for injuries or preventative care, to reach potential clients looking for help.
• Build relationships with non-PT providers: Rather than seeing other providers — such as surgeons, physicians, and chiropractors — as your competition, develop positive relationships and show them the value of physical therapy for their patients. In addition to referring more patients to your practice, non-PT providers can also prepare them for the physical therapy experience, so patients get the most out of their treatments.

Ensure continuity of care remotely: The growing use of digital health tools has extended physical therapy from the clinic to patients’ homes. For instance, Exer Health sends patients daily prompts to answer questions about patient-reported outcomes (PROs), like their pain levels and “percentage of normal,” so PTs can stay in tune with their patients on a whole new level.

5. Adopting new technology

The rapid shift toward digitization in the healthcare field can be daunting, but technology is a force multiplier for patient care, not a replacement for a human touch.

Research shows that 90% of patients want technology-driven healthcare. Leveraging technology to help deliver care can make physical therapy more convenient and accessible to patients, ultimately improving patient retention by making it easier for patients to communicate with their PTs and receive treatment. Consider these suggestions for how to incorporate technology to resolve common issues in physical therapy:

• Collect patient performance data: With better data about their patients’ progress, PTs can make data-driven decisions when adjusting their HEPs. Software like Exer Health uses artificial intelligence to gather precise data as patients perform their at-home exercises, which can better inform your treatment plans and overall practice.
• Try wearable technology: From exo suits that help patients stand and walk to smart clothing with sensors that measure patients’ movements and biometrics, wearable technology has taken some major strides forward in recent years. You don’t have to use every wearable you can find, but this technology enables you to evaluate rehabilitation in your patients’ everyday lives, so you can provide timely feedback.

Tackle issues in physical therapy with confidence

The most common issues in physical therapy today put a lot of pressure on physical therapists to deliver exemplary patient care, even with limited time and resources. But taking proactive steps to directly address these challenges can empower you to discover new approaches to providing care that support positive patient outcomes.

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Photo by Gift Habeshaw