APTA Physical Therapy Workforce AnalysisA Report From the American Physical Therapy Association

December 2020

©2020 American Physical Therapy Association. All rights reserved. 2

Introduction

The goal of workforce planning is to optimize access to physical therapy. By analyzing and forecasting workforce supply and demand, it’s possible to identify shortage areas, evaluate employment potential, and bolster advocacy that improves health care delivery.

This report uses data from multiple sources to evaluate the physical therapy workforce as of 2019. (It is important to emphasize that while this report was released in 2020, the data was collected prior to the COVID-19 health crisis, which affected employment across health care. For more on the effects of COVID-19, see APTA’s report “Impact of COVID-19 on the Physical Therapy Profession.”)

Data sources include APTA’s membership database and practice profile survey, the Commission on Accreditation in Physical Therapy Education, the Federation of State Boards of Physical Therapy, the Bureau of Labor Statistics, the United States Census Bureau, and analysis by Deloitte of the Census Bureau’s American Community Survey.

You will note differences in the data from these sources. Wherever possible, we have noted differences in how these sources report their data.

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Geographic Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Number of Licensed Physical Therapists Per 100,000 People by State . . . . . . . . . . . . . . . . 4

Number of Licensed PTAs Per 100,000 People by State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Number of Employed Physical Therapists by State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Number of Employed Physical Therapist Assistants by State . . . . . . . . . . . . . . . . . . . . . . . . 5

APTA Physical Therapist Membership by State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

APTA Physical Therapist Assistant Membership by State . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Median Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Sex and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Median Salary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Median Salary by Sex and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Race and Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Race and Ethnicity of Physical Therapists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Race and Ethnicity of Physical Therapist Assistants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Race and Ethnicity of the U.S. Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Projecting the Supply and Demand of PTs Through 2030 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Physical Therapist Supply and Demand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

PTA Projections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

APTA Workforce Planning History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

©2020 American Physical Therapy Association. All rights reserved. 4

Geographic DistributionAs of 2019, there were 312,716 licensed physical therapists and 127,750 licensed physical therapist assistants in the United States, according to data from the Federation of State Boards of Physical Therapy. Based on the U.S. population, there are 95 physical therapists per 100,000 people and 39 physical therapist assistants per 100,000 people. The maps below show a breakdown of these numbers in each state.

Number of Licensed Physical Therapists per 100,000 People by State

60

84

58

66

62

117

55

56

61

54

52

9093

65

52

74

94

55

89

52

109

112

38

80

98

74

57

78

82110

76

113

59

6277

73

7189

68

44

56

34 76

113

66

54

6548

42

Number of Licensed PTs per 100,000 People by State

67

43

Washington, D.C.

34 117

Number of Licensed Physical Therapist Assistants per 100,000 People by State

30

31

53

27

34

22

23

32

48

15

40

5317

20

45

67

17

31

27

28

19

36

18

49

27

39

40

31

4441

27

33

29

4356

41

4542

37

17

44

2 40

23

24

17

4520

52

Number of Licensed PTAs per 100,000 People by State

14

6

Washington, D.C.

2 67

©2020 American Physical Therapy Association. All rights reserved. 5

PT Employment by State

480

5,590

1,260

6,160

6,720

760

1,890

15,400

4,920

920

3,170

1,10011,800

2,890

2,300

8,220

640

6,310

17,710

1,380

7,860

1,250

1,570

1,660

1,150

4,490

1,630

4,670

8,0607,540

4,540

1,270

2,960

2,6502,340

2,080

5,05010,170

1,390

5,430

13,750

6101,070

3,930

5,100

21,730

1,9903,600

2,770

640

790

Washington, D.C.

480 21,730

The maps below show the U.S. distribution of PT and PTA employment as of 2019, according to data from the Bureau of Labor Statistics.

Number of Employed Physical Therapists by State

Number of Employed Physical Therapist Assistants by State

PTA Employment by State

170

1,600

760

1,580

2,930

150

800

7,550

3,290

280

1,580

3905,330

810

1,550

6,040

130

2,820

5,410

600

1,420

330

470

650

280

2,480

810

1,590

3,5402,520

1,880

350

1,490

1,5701,240

1,030

2,6203,980

590

2,570

6,780

190 340

630

1,500

5,750

1,3702,900

1,790

190

Washington, D.C.

240

7,550130

©2020 American Physical Therapy Association. All rights reserved. 6

The maps below show the U.S. distribution of PT and PTA membership in APTA as of 2019, according to the association’s member database.

APTA Physical Therapist Membership by State

243

2,423

523

2,702

2,859

388

1,028

5,844

1,727

422

1,111

4134,776

1,330

742

3,200

714

2,638

6,207

510

2,688

498

691

1,076

557

1,777

626

2,205

2,7022,455

1,551

545

1,061

1,309953

1,303

1,5643,226

567

2,311

5,278

424 461

1,161

2,111

8,364

6661,707

869

APTA Physical Therapist Membership by Stateas of 12/31/2019

397

316

Washington, D.C.

243 8,364

APTA Physical Therapist Assistant Membership by State

31

243

88

273

415

15

195

1,194

346

61

258

40451

150

214

524

19

274

487

140

102

23

56

261

59

302

177

194

483191

193

25

200

211231

170

238401

90

212

1,255

7 28

154

255

942

96137

202

APTA Physical Therapist Assistant Membership by Stateas of 12/31/2019

60

26

Washington, D.C.

7 1,255

©2020 American Physical Therapy Association. All rights reserved. 7

Median Age

PTs PTAs Data Source

40 34 APTA (2019)

42 41 BLS (2019)*

41 37 Data USA (2018)**BLS and Data USA combine PTAs and physical therapy aides when reporting age.

Sex and Gender Sex refers to a person’s biological characteristics. Gender refers to a person’s social identity. For purposes of this report, it is unclear whether PTs and PTAs were self-reporting their sex or gender, or if options other than “male/man” or “female/woman” were available to respondents.

PTs PTAs Data Source

Women Men Women Men

65% 35% 71% 29% APTA (2019)

68% 32% 63% 37% BLS (2019)

70% 30% 68% 33% Data USA (2018)*BLS and Data USA combine PTAs and physical therapy aides when reporting sex/gender.

Median Annual Salary

PTs PTAs Data Source

$85,000 $52,000 APTA (2016)

$89,440 $58,790 BLS (2019)*

$78,350 $48,022 U.S. Census Bureau (2018)**BLS and Census combine PTAs and physical therapy aides when reporting salary data.

Median Annual Salary by Sex and Gender According to a Pew Research Center analysis, in 2018, in the U.S. across all professions, women earned 85% of what men earned. Based on APTA data, female PTs earned 90% of what male PTs earned, and female PTAs earned 91% of what male PTAs earned. Similarly, based on Data USA data, female PTs earned 80% of what their male counterparts earned, and female PTAs earned 89%. This information shows that regardless of the economic data, gender wage gaps are notably present, and the physical therapy profession is not immune to this systemic issue.

PTs PTAs Data Source

Women Men Women Men

$81,118 $90,000 $50,000 $55,000 APTA (2016)

$67,550 $84,281 $34,493 $38,870 Data USA (2018)**Data USA combines PTAs and physical therapy aides when reporting salary data.

©2020 American Physical Therapy Association. All rights reserved. 8

Race and EthnicityBlack and Hispanic/Latino PTs and PTAs are underrepresented in the physical therapy profession, compared with the general population based on U.S. Census data.

APTA is seeking to address this gap through numerous activities, including expanded student recruitment efforts to diversify the pipelines into the profession, formal recommendations to the Commission on Accreditation in Physical Therapy Education regarding accreditation standards and required elements that would improve diversity in PT and PTA education programs, the development of a standing committee on diversity, equity, and inclusion, and various DEI fundraising efforts, including the two-year Campaign for Future Generations.

Visit apta.org/DEI to learn more.

Race and Ethnicity of Physical Therapists

PTs APTA (2019) Data USA (2018)White (not Hispanic) 84.3% 76.7%Black (not Hispanic) 2.5% 3.6%Asian (not Hispanic) 6.9% 12.9%American Indian (not Hispanic) 0.4% 0.2%Hispanic/Latino 3.5% 5.3%Other 2.4% 1.4%

Race and Ethnicity of Physical Therapist Assistants

PTAs APTA (2019) Data USA (2018)*White (not Hispanic) 81.2% 73.8%Black (not Hispanic) 3.4% 5.8%Asian (not Hispanic) 4.0% 7.0%American Indian (not Hispanic) 1.0% 0.0%

Hispanic/Latino 8.0% 11.8%

Other 2.5% 1.7%*Data USA combines PTAs and aides when reporting race and ethnicity.

Race and Ethnicity of the U.S. Population

U.S. Population per U.S. Census Categories (2018)White alone Relates to White (not Hispanic) in previous table 60.22%Black or African American alone Relates to Black (not Hispanic) in previous table 12.32%Asian alone Relates to Asian (not Hispanic) in previous table 5.56%American Indian and Alaska Native alone Relates to American Indian (not Hispanic) in previous table 0.67%Hispanic or Latino Relates to Hispanic/Latino in previous table 18.27%Native Hawaiian and Other Pacific Islander alone Relates to Other in previous table 0.17%Some other race alone Relates to Other in previous table 0.25%Two or more races Relates to Other in previous table 2.54%

©2020 American Physical Therapy Association. All rights reserved. 9

Projecting the Supply and Demand of PTs Through 2030Using the data and methodology described below, APTA’s model shows that projected increases in the national supply of physical therapists is outpacing expected growth in demand for services based on an increase in the U.S. population who have health insurance.

Based on current graduation, licensing, and attrition trends, the model predicts an estimated surplus of 25,235 physical therapists by 2030.

This projected imbalance provides opportunities for the profession to correct existing imbalances in the geographic distribution of physical therapists, meet increases in demand due to changing population characteristics, and continue expanding in emerging areas of practice.

Physical Therapist Supply and Demand (All numbers in thousands)

2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031Year

190K

195K

200K

205K

210K

215K

220K

225K

230K

235K

240K

245K

250K

255K

Phys

ical

The

rapi

st F

TEs

(in th

ousa

nds)

220K221K

218K

223K

212K

228K

217K

224K

214K

227K225K

215K

233K

230K

237K

253K

226K

212K

241K

222K

249K

215K

245K

219K

Licensed PTsDemand

©2020 American Physical Therapy Association. All rights reserved. 10

MethodologyAPTA’s model uses the workforce-to-population ratio method of modeling. The intent of APTA’s model is to determine if the supply of physical therapists is keeping pace with increased demand from population growth over a 10-year period.

Thus, the model does not account for potential changes to service delivery or patient demographics that could happen within this time frame. Furthermore, as the base year of the model is 2019, the model uses data collected prior to the COVID-19 pandemic and does not make assumptions about the impact of COVID-19 on physical therapist supply and demand. This impact will be reflected in future projections as the data becomes available.

To calculate supply, APTA uses data on the number of new entrants to the workforce minus attrition from the profession. New entrants include recent graduates from U.S. physical therapist professional programs who pass the licensure exam and internationally educated physical therapists who obtain licensure in the United States. Attrition includes individuals transferring to other occupations or exiting the labor force altogether. The percentage of physical therapists who practice part time also is factored into the model, thus supply is represented as full-time equivalents, or FTEs.

To calculate demand, APTA uses the current ratio of FTE physical therapists to the U.S. population with health insurance, as reported by the U.S. Census.

PTA ProjectionsUnfortunately, there is not enough data available on the attrition of physical therapist assistants to make reliable projections on the future supply of PTAs. Should this data become available, APTA can use its model to project both the supply of and demand for PTAs.

APTA Workforce Planning HistoryAPTA’s history of workforce analysis dates back to the 1990s, when the association produced research briefings on workforce demographics, recruitment and retention, the impact of policy and payment on workforce, and other trends.

In 2010, APTA commissioned a Workforce Task Force to develop a model to more accurately project physical therapist supply and demand through 2020. The resulting APTA Workforce Model included three scenarios based on differing levels of attrition, which projected either a shortage or surplus of physical therapists. The model used data from APTA member surveys, the Federation of State Boards of Physical Therapy, and other publicly available sources.

In 2012, APTA began collaboration with FSBPT and the U.S. Health Resources and Services Administration on a minimum data set, “A consistent set of data elements to be collected on all licensees at regular intervals in order to understand workforce needs related to access to health care” (FSBPT, Winter 2015, Federation Forum, “The Minimum Dataset”). Unfortunately, the minimum data set has not progressed as quickly as hoped due to lack of support from state agencies, unwillingness or lack of ability for FSBPT to ask questions on membership renewal beyond those required, lack of resources, confidentiality concerns, and changes in HRSA staffing, resulting in changes in support for the project.

In 2013, APTA cohosted, with the Canadian Physiotherapy Association, the International Workforce Summit and generated ideas on how to facilitate global workforce planning. APTA also began sharing workforce data through the association website.

The APTA Workforce Model was maintained until 2017. After seven years of running the model, APTA determined it was important to reevaluate the methodology and data sources. In 2020, as reflected in this report, the equation in the model that determines demand for physical therapists was updated to align with best practices in workforce planning. The model now assumes that supply equals demand in the base year.

APTA’s 2020 House of Delegates adopted the position “Workforce Planning” (HOD P06-20-41-33), which states the association’s support of and participation in workforce planning efforts with other stakeholders to meet the needs of the profession and society. At the same time, the House charged APTA to engage in workforce supply planning in a reaffirmation of the association’s commitment to disseminate results of national and regional research related to PT and PTA workforce supply and demand. This report is the result of APTA’s commitment.