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Physical Therapists

(D.O.T.  076.121-014)

Nature of the Work

Physical therapists improve the mobility, relieve the pain, and
prevent or limit the permanent physical disabilities of patients
suffering from injuries or disease.  Their patients include accident
victims and disabled individuals with conditions such as multiple
sclerosis, cerebral palsy, nerve injuries, burns, amputations, head
injuries, fractures, low back pain, arthritis, and heart disease.

   Therapists evaluate a patient's medical history; test and measure
their strength, range of motion, and ability to function; and
develop written treatment plans.  These plans, which may be based on
physician's orders, describe the treatments to be provided, their
purpose, and their anticipated outcomes.  As treatment continues,
they document progress, conduct periodic re-evaluations, and modify
treatments, if necessary.

   Treatment often includes exercise for patients who have been
immobilized and lack flexibility.  Using a technique known as
passive exercise, therapists increase the patient's flexibility by
stretching and manipulating stiff joints and unused muscles.  Later
in the treatment, they encourage patients to use their own muscles
to further increase flexibility and range of motion before finally
advancing to weights and other exercises to improve strength,
balance, coordination, and endurance.

   Physical therapists also use electricity, heat, cold, or ultrasound
to relieve pain or improve the condition of muscles or related
tissues or to reduce swelling.  They may use traction or deep-tissue
massage to relieve pain and restore function.  Therapists also teach
and motivate patients to use crutches, prostheses, and wheelchairs
to perform day-to-day activities and show them exercises to do at
home.

   Physical therapists document evaluations, daily progress, medical
team conferences, and reports to referring practitioners and
insurance companies.  Such documentation is used to track the
patient's progress, identify areas requiring more or less attention,
justify billings, and for legal purposes.

   Some physical therapists treat a wide variety of problems; others
specialize in such areas as pediatrics, geriatrics, orthopedics,
sports physical therapy, neurology, and cardiopulmonary physical
therapy.

   Physical therapists treat and rehabilitate persons with injuries and
disabilities.

Working Conditions

Physical therapists work in hospitals, clinics, and private offices
that have specially equipped facilities, or they treat patients in
hospital rooms, homes, or schools.

   Most physical therapists work a 40-hour week, which may include some
evenings and weekends.  The job can be physically demanding because
therapists often have to stoop, kneel, crouch, lift, and stand for
long periods of time.  In addition, therapists move heavy equipment
and lift patients or help them turn, stand, or walk.

Employment

Physical therapists held about 90,000 jobs in 1992; about 1 in 4
worked part time.

   Hospitals employed one-third and offices of other health
practitioners, including those of physical therapists, one-quarter
of all salaried physical therapists in 1992.  Other jobs were in
offices of physicians, home health agencies, nursing homes, and
schools.  Some physical therapists are in private practice,
providing services to individual patients or contracting to provide
services in hospitals, rehabilitation centers, nursing homes, home
health agencies, adult daycare programs, and schools.  These
self-employed therapists may be in solo practice or be part of a
consulting group.  Some physical therapists teach in academic
institutions and conduct research.

Training, Other Qualifications, and Advancement

All States require physical therapists to pass a licensure exam
after graduating from an accredited physical therapy program.

   Entry level education in physical therapy is available in 70
bachelor's degree and 64 master's degree programs.  The bachelor's
degree curriculum usually starts with basic science courses such as
biology, chemistry, and physics, and then introduces specialized
courses such as biomechanics, neuroanatomy, human growth and
development, manifestations of disease and trauma, evaluation and
assessment techniques, research, and therapeutic procedures.
Besides classroom and laboratory instruction, students receive
supervised clinical experience in hospitals.

   Individuals who have a 4-year degree in a related field, such as
genetics or biology, and want to be a physical therapist, should
enroll in a master's level physical therapy program.  A master's
degree is also recommended for those with a bachelor's degree in
physical therapy who are interested in promotion to an
administrative position.  For research and teaching jobs, a master's
degree is required.

   Competition for entry to physical therapy programs is keen, so
interested students should attain superior grades in high school and
college, especially in science courses.  Courses useful when
applying to physical therapy programs include anatomy, biology,
chemistry, social science, mathematics, and physics.  Many education
programs also require experience as a volunteer in the physical
therapy department of a hospital or clinic for admission.

   Physical therapists should be patient, persuasive, resourceful,
emotionally stable, and tactful to help patients understand the
treatments and adjust to their disabilities.  Similar traits are
also needed to deal with the patient's family.  Physical therapists
should also have manual dexterity and physical stamina.

   Physical therapists should expect to continue to develop
professionally by participating in continuing education courses and
workshops from time to time.  A number of States require continuing
education for maintaining licensure.

Job Outlook

Employment of physical therapists is expected to grow much faster
than the average for all occupations through the year 2005.  Growth
will occur as new medical technologies save more people, who then
need therapy; as new technologies permit more disabling conditions
to be treated; and as the population grows and ages.

   The rapidly growing elderly population is particularly vulnerable to
chronic and debilitating conditions that will require more
therapeutic services.  At the same time, the baby-boom generation
will enter the prime age for heart attack and strokes, increasing
the demand for cardiac and physical rehabilitation.  More young
people will also need physical therapy as medical advances save the
lives of a larger proportion of newborns with severe birth defects.
Future medical developments will also permit a higher percentage of
trauma victims to survive, creating additional demand for
rehabilitative care.

   Growth will also result from advances in medical technology which
permit treatment of more disabling conditions.  In the past, for
example, the development of hip and knee replacements for those with
arthritis gave rise to employment for physical therapists to improve
flexibility and strengthen weak muscles.

   The widespread interest in health promotion should also increase
demand for physical therapy services.  A growing number of employers
are using physical therapists to evaluate worksites, develop
exercise programs, and teach safe work habits to employees in the
hope of reducing injuries.

   Job prospects in physical therapy are expected to be excellent.
There have been shortages of physical therapists in recent years.
However, this situation may ease eventually as the number of
physical therapy education programs increases and more students
graduate.

Earnings

In 1992, median annual earnings of salaried physical therapists who
usually work full time were $35,464.  The middle 50 percent earned
between $26,624 and $43,628.  The top 10 percent earned at least
$52,468 and the bottom 10 percent earned less than $17,784.

   According to a University of Texas Medical Branch national survey of
hospitals and medical centers, the median annual salary of physical
therapists, based on a 40 hour week and excluding shift or area
differentials, was $37,638 in October 1992.  The average minimum
salary was $31,887 and the average maximum salary was $47,288.
Physical therapists in private practice tend to earn more than
salaried workers.

Related Occupations

Physical therapists treat and rehabilitate persons with physical or
mental disabilities.  Others who work in the rehabilitation field
include occupational therapists, corrective therapists, recreational
therapists, manual arts therapists, speech pathologists and
audiologists, orthotists, prosthetists, respiratory therapists,
chiropractors, acupuncturists, and athletic trainers.

Sources of Additional Information

   Additional information on a career as a physical therapist and a
list of accredited educational programs in physical therapy are
available from:

   American Physical Therapy Association, 1111 North Fairfax St.,
Alexandria, VA 22314.