Careers
In Physical Therapy
Physical therapy is the area of health care
concerned with the rehabilitation of individuals who have been physically
disabled by diesease or accident or born with a physical handicap. By
attempting to restore function and prevent further disability, physical therapy
assists patients in reaching their maximum performance in learning to live a
normal life within the limits of their capabilities.
The primary goal
of physical therapy is to restore bodily functions, relieve pain, or help
prevent permanent disability following a disabling injury or disease. Typical
physical therapy patients might include accident victims, handicapped children,
disabled individuals with such conditions as multiple sclerosis, cerebral
palsy, nerve injuries, burns, head injuries, fractures, low back pain,
arthritis, cardiac disease and stroke sufferers.
There are three levels
of physical therapy practitioners: the professional physical therapist, the
physical therapy assistant, and the physical therapy aide. Each position
requires different type and degree of education and skill.
The
Physical Therapist
Nature Of The Work:
After receiving a
referral from a physician, a physical therapist evaluates the patient's medical
history; tests and measures the patient's strengths, weaknesses, and range of
motion. The therapist then prepares an appropriate treatment plan, based on the
extent of the patient's disability or injury in terms of neuromuscular,
musculoskeletal, sensorimotor, cardiovascular and respiratory functions.
Treatment often includes exercises for increasing muscle strength,
endurance and coordination for a patient who has been immobilized or lacks
flexibility. A technique known as passive exercise is commonly employed by
physical therapists in their quest to restore the patient's range of motion. By
manually stretching and manipulating stiff joints and unused muscles,
therapists are able to increase and maintain the patient's flexibility. As
treatment advances, therapists encourage patients to use their own muscles to
increase range of motion. Eventually, treatment evolves to include the use of
weights and other forms of resistance training to improve strength,
coordination, balance and endurance.
A physical therapist may also
apply massage, heat, cold, ultrasound, traction, water or electrical
stimulation to the affected area, all of which are designed to relieve pain or
change the patient's physiological condition. When necessary, the PT will also
instruct the patient in the proper use of assistive devices, like crutches,
wheelchairs and prostheses (artificial limbs, etc.) to perform daily activities
and teach them exercises which they can continue to do at home.
Physical therapists must continually document and evaluate the
patient's progress and report all information to the referring physician and
insurance companies. Patient documentation is used to track progress, identify
areas requiring additional or less attention, for legal purposes and to justify
and explain billing.
Working Conditions:
The physical
therapist may work in one of several locations, including general, specialized
and long-term-care hospitals; schools and societies for crippled children;
private physician or physical therapy practices; nursing homes; public health
agencies; and rehabilitation or research centers.
Most physical
therapists put in a forty-hour work week, which may include evenings and
weekends. The work can be quite physically demanding, often requiring stooping,
kneeling, crouching, lifting and standing for long periods of time. PT's may
have to lift or move heavy equipment in addition to assisting patients to turn,
stand or walk. Working in the physical therapy field may also be frustrating
and emotionally taxing when patients do not improve.
Training And
Education:
The most popular methods of achieving accreditation in
the field of physical therapy are: (1) graduating from a four-year bachelor's
degree program; (2) graduating from a twelve-to-sixteen month certificate
program, after completion of a bachelor's degree in a related field; or (3)
obtaining a master's degree in physical therapy after completion of a
bachelor's degree in a field related to physical therapy. All three programs
require a minimum of four-month's clinical experience and education in the
direct care of patients in a health care facility.
Educational
requirements in physical therapy are currently undergoing a transition.
Professionals and experts in the field are coming to believe that a master's
degree better prepares students for the growing body of knowledge and for
independent practice. It is quite likely that most bachelor's degree programs
will be extended to master's degree programs, although this change will take
some time to implement. For the next few years, however, a bachelor's degree is
the acceptable level of education.
The bachelor's degree curriculum
typically consists of introductory science courses such as chemistry, anatomy
and physiology. Advanced courses include specialized courses like biomechanics,
evaluation and assessment techniques, therapeutic procedures and research. In
addition to classroom instruction, students are required to receive supervised
clinical experience.
Licensing for physical therapists is required
throughout the United States. Certification is required in all 50 states, the
District of Columbia, and Puerto Rico and can be obtained by passing the
required examination in the state where the physical therapist wishes to
practice.
Employment Outlook:
In 1992, physical
therapists held about 89,000 jobs with about one in four working part time.
Hospitals employed approximately one-third of all full-time physical
therapists. The private practices of other health care practitioners employed
one-quarter of full-time PT's. The remaining percentages were divided between
home health agencies, nursing homes and schools. A growing number of physical
therapists are self-employed, electing to open their own offices or contract
their services out to hospitals, rehabilitation centers, nursing homes, adult
day-care programs, and schools.
Employment opportunities for physical
therapists are expected to grow considerably faster than the average for
occupations through the year 2005. Much of this growth is due to the continuing
advancements in medical care and technology, which results in more people who
are recovering from disabilities. And as the "baby boomer" generation ages, and
people continue to live longer, the "graying of America" will result in
additional opportunities in rehabilitative services. Currently, the elderly
account for only 12.6 percent of the total population, and require over 20
percent of all physical therapy services.
Earnings:
Physical therapists employed full-time in
private hospitals earned an average of $17.01 an hour in 1993. This excludes
premium pay for overtime and for weekends and holidays. Pay scale varies in
different parts of the country or state. For example, among metropolitan areas,
earnings ranged from $14.83 in St. Louis, Missouri, to $20.52 in San Francisco,
California.
The Physical Therapy Assistant And
Aide:
Nature Of The Work Physical Therapy
Assistant:
The physical therapy assistant works under the watchful
eye of a licensed physical therapist in the rehabilitation of disabled persons.
The physical therapy assistant helps conduct complicated therapeutic
procedures, but may perform routine procedures independently. The PTA may test
and evaluate patients, apply stimulants and modalities (such as massages,
ultrasound treatments, electrical stimulation, hot/cold packs and traction),
assist patients in performing exercises and train patients on the proper usage
of assistive devices all under the express supervision of the physical
therapist. Assistants help to monitor the patient's progress during treatment
and report any abnormalities or changes to the directing
therapist.
Nature Of The Work Physical Therapy
Aide:
Physical therapy aides are responsible for keeping things
running smoothly. They keep the treatment area clean and organized, wash
towels, sheets and pillowcases, and prepare each patient individually for
therapy. Aides usually greet patients in the waiting area or hospital room and
then escort them to and from the treatment area, either by wheelchair or a
willing arm on which to lean.
Job Conditions:
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Most
physical therapy assistants and aides work in general and specialized
hospitals, while others seek employment in the similar health care environments
as licensed physical therapists private practices, public health facilities,
nursing homes, rehabilitation centers, and schools for crippled and handicapped
children. The hours may vary depending on the type of facility and whether the
employee is full- or part-time. A large majority of private physical therapy
offices have weekend and evening hours to accommodate their patients' work
schedules.
Training And Education Assistants:
PTA's must
generally posses an associate's degree from an accredited physical therapy
program in order to practice legally. They must also be licensed by the State
Board of Medical Examiners in whichever state they choose to work. Forty-one
states require that assistants pass a written examination before granting a
license. Additional requirements include certification in first aid and CPR
(cardiopulmonary resuscitation) and a specific amount of clinical training. The
need for qualified assistants is so great, however, that some states are
offering temporary licenses to individuals who have taken their exams but have
not yet received the results.
A typical physical therapy assistant
program consists of two years, or four semesters, of course work including
algebra, anatomy, physiology, biology, chemistry and psychology. Most of these
core courses can be taken at the community college level. However, admission to
the actual PTA program may require patience, as it is not unusual for colleges
to have long waiting lists of prospective applicants. Once enrolled in the
actual PTA program, study is divided between academics and clinical or "hands
on" experience. Educators and employers alike consider clinical hours as an
integral part of the program. However, if a full-time school program is not
possible, don't despair. There are other avenues available to becoming a
licensed physical therapy assistant.
Jeff Dale has been in the physical
therapy business for over ten years. He began as an aide at Angelview Crippled
Children's Society. Not having the time or money to devote towards a full-time
scholastic program, he immersed himself in his work instead. He learned all
that he could by keeping his eyes and ears open, and not being afraid to ask
questions or try new things. After some research, he discovered that his five
years of full-time work under the guidance of a registered physical therapist,
plus a mere 15 units of college credit, qualified him to petition the physical
therapy board. He was allowed to take the licensing exam and is now a licensed
physical therapy assistant and Program Director of Physical Therapy at the
Carlotta, a highly respected nursing facility in Southern California. Jeff's
story is an example of how a commitment to a career and a persistent attitude
can result in success.
Training And Education Aides:
Since physical therapy aides are not licensed the requirements for
employment are obviously not as strict as for assistants. The typical physical
therapy aide is over eighteen years of age and has a high school diploma. Most
employers require that the aide complete on-the-job training at a hospital or
clinic. The length and content of the training programs depends on the type of
duties the aide will be expected to perform. As mentioned previously, it is
possible for an aide to advance to the position of assistant by challenging the
board, but usually only if an adequate associate degree program is not readily
available and usually only after many years of experience in the field. It may
be easier, and definitely quicker, to enroll in a two-year program at your
local college.
In addition to training, and equally important, are
strong interpersonal skills and a genuine desire to help and comfort others. A
strong back is also a plus, as aides often assist patients in getting in and
out of wheelchairs or hospital beds, with walking and standing, and with
various routine exercises at the direction of the physical therapist. Aides
must also periodically move and lift office and exercise equipment as part of
their job responsibilities.
Employment Outlook:
In 1993,
over 62,000 people were employed as physical therapy assistants and aides. Over
fifty percent work in hospitals or private offices, the remaining number are
employed by clinics, nursing homes, schools, and administers of home health
care. The relatively new and growing field of sports medicine also employs a
fair amount of physical therapy assistants and aides.
The physical
therapy industry is currently experiencing a shortage of licensed assistants,
according to employers. Therefore it is not surprising that the opportunity for
employment is expected to increase considerably well into the 21st century.
Experts predict that the need for qualified physical therapy assistants and
aides will grow by 93% through the year 2005. This means that those
contemplating careers as physical therapy assistants or aides can expect growth
in this area at four times the average for all other occupations.
Earnings Physical Therapy Assistants:
Earnings for
physical therapy assistants vary greatly from city to city and state to state.
Overall, average starting salaries ranged anywhere from $24,000 to $29,000 per
year in 1993. Wages for PTA's working in a hospital setting tended to be
somewhat lower than their private office counterparts, who reported earnings of
$30,000 to $35,000 annually. But as compensation for lower wages, PTA's in
hospitals are typically offered a "clinical ladder" which is a structured path
of advancement and an opportunity to work with a more varied and diverse
patient population.
Earnings Physical Therapy
Aides:
Depending on prior experience and training, aides can expect
to make anywhere from $5 to $9 dollars an hour or between $10,400 and $18,700
annually. Location plays an important role in determining salary range. As
usual, aides in major cities earn more than those in rural areas. And, as with
PTA's, aides in hospitals or clinics generally earn less than those working
within the private practice sector.
For more information on a career as
a physical therapist, assistant or aide contact the following organizations:
American Physical Therapy
Association
1111 North Fairfax St.
Alexandria, VA 22314
Mayo Online Career Center
School of Physical Therapy
Mayo Foundation
Rochester, MN
55901
Physical Therapist Assistant Program
Los Angeles Pierce
College
6201 Winnetka Avenue
Woodland Hills CA 91364
Or contact
the university or community college in your area.
Careers In Occupational Therapy
The other
critical player on the rehabilitation team is the occupational therapist.
Occupational therapy is concerned with the physical and psychological
rehabilitation of individuals who become disabled due to illness or injury, or
those who suffer from emotional, psychiatric or developmental problems. In
occupational therapy, the rehabilitation process involves educational,
vocational, and recreational activities or "occupations." Similar to physical
therapy, careers in occupational therapy consist of the occupational therapist
and the occupational therapy assistant, each requiring a different level of
education and expertise. Occupational therapists sometimes employ aides, but
not as frequently as do physical therapists.
The Occupational
Therapist And Assistant
Nature Of The Work:
The
licensed occupational therapist's main goal is to restore a patient's health,
independence and self-reliance by evaluating the patient's individual needs and
then teaching the patient to understand and compensate for his or her
disability through planned activities and therapy. For example, by implementing
both manual and creative activities, an occupational therapist can help achieve
or restore coordination and mobility of an injured or deformed limb. For the
mentally ill or emotionally disturbed the occupational therapist can simulate
social situations through closely monitored group activities that will help the
patient experience and adjust to social relationships and interaction. A good
occupational therapist concentrates on the patient's strengths and downplays
weaknesses by giving the patient an opportunity to accomplish tasks and to
acquire skills that will help restore self-confidence and emotional stability.
Occupational therapists employ all kinds of activities during treatment,
anything from cooking to using a computer. Depending on the patient's existing
levels of competence, the occupational therapist may first teach the patient to
care of his or her daily needs like brushing teeth, dressing and eating. As
they become more proficient in seeing to their personal needs, the occupational
therapist will then concentrate on helping them find and keep a job, rounding
out the rehabilitation effort by helping them become financially independent as
well.
For individuals who have permanent functional disabilities spinal
cord injuries, cerebral palsy, or muscular dystrophy, for example the
occupational therapist designs or provides adaptive equipment such as aides for
eating, drinking, pulling up socks and "grabbers" for reaching unreachable
objects. The OC may also specially create aides for a patient's unique needs,
be they personal or work-related. Occupational therapists also instruct
severely disabled individuals in the use of computer-aided adaptive equipment,
such as microprocessing devices which allow cerebral palsy patients to
effectively communicate.
Occupational therapists operating in mental
health facilities treat mentally ill, mentally retarded, or emotionally
disturbed individuals. Typical patients might include alcoholics, drug addicts,
depressives, anorexics, and those suffering from stress-related disorders. To
help these people regain or acquire control over their lives, OC's administer
activities which help them learn to cope with daily life, from paying bills to
using public transportation effectively.
Occupational therapy
assistants work under the direct supervision of a registered occupational
therapist. Most assistants work very closely with the patients, helping them,
observing them, and reporting progress, development, and abnormalities to the
therapist. The assistant may also teach patients self-care, creative and
work-related skills. OTA's often make simple splints and adaptive equipment as
authorized by the therapist. And provided a registered occupational therapist
is on the premises, the assistant may work independently when conducting
maintenance therapy programs and exercises.
Working
Conditions:
Occupational therapists and assistants often work with a
wide variety of health care professionals. An entire medical team may consist
of physicians, physical therapists, vocational counselors, nurses, teachers,
speech pathologists, as well as others. Occupational therapists and assistants
generally work a forty-hour week. A large percentage work in hospitals,
although many find employment in community mental health centers,
rehabilitation centers, home-care services, nursing homes, day care centers,
schools for handicapped children and the mentally retarded, and research
institutions. Occupational therapists and assistants must be physically fit.
They must often stand for long periods of time and move equipment and immobile
patients.
Training And Education:
The minimal requirement
for a career as an occupational therapist is a bachelor's degree from an
accredited institution. Most states require a license to practice in this
field. In addition to a degree, OC's must pass a national certification
examination given by the American Occupational Therapy Certification Board.
Essential coursework in the occupational therapy program includes
physical, biological and behavioral sciences and the application of
occupational therapy theory and skill. Completion of the program also requires
six months of supervises clinical internship.
The training requirements
of an occupational therapy assistant consists of either a two-year associate
degree program or a one-year intensive certificate program in a community
college or vocational/technical school. A minimum of two months' supervised
practical experience is also mandatory for completion of either program.
Graduates of accredited programs may then take the American Occupational
Therapy Association examination to become certified occupational therapy
assistants (COTA's). A COTA may advance to the position of therapist if certain
criteria are met, including at least four-years' experience and passing scores
on the certification examination.
High school students interested in
studying occupational therapy in college should prepare with courses in
biology, chemistry, physics, art, health, and the social sciences. Experience
in a health care setting, either as a volunteer or summer worker, is
particularly advantageous when applying to occupational therapy programs.
Educators then know the applicant has had at least some exposure to the field
and is aware of the level of commitment required of health care professionals.
Employment Outlook:
Approximately 37,500 people were
employed as occupational therapists from 1992 through '93. Assistants accounted
for approximately 9,000 jobs in rehabilitative services. Most positions were
found in hospitals, including rehabilitation and psychiatric clinics and
hospitals. Schools systems comprised the second largest employer of
occupational therapists, followed by nursing homes, adult day care centers,
residential care facilities and outpatient clinics. A still small but growing
number of occupational therapists are in private practice and may contract
their services out to hospitals and rehabilitation facilities.
Like
most careers in the health care industry, employment of occupational therapists
and assistants is expected to increase much faster than the average for all
occupations through the turn of the century and beyond. Experts anticipate a
steady growth in demand for rehabilitative services due to advances in medical
technology and an expanding elderly population.
In addition to hospital
care, a growing number of people will rely on out-patient services and home
health care in the future. The area of private practice will continue to grow
as more occupational therapists provide services to individual clients, and
follow-up and long-term services to patients recently released from
institutionalized care. To further encourage the expansion of private practice
is a recent legislative change permitting OT's to bill Medicare directly for
services provided. Previously, Medicare billing was only submitted through a
Medicare-approved facility or home health agency.
Earnings:
In 1992, the average yearly salary for a
registered occupational therapist employed by hospitals or medical schools was
approximately $32,000. The minimum pay for an OT hovered around $26,500 and the
maximum topped off at about $40,000. Those involved in private practice could
potentially make much more. Occupational therapists employed by school
districts in some states were paid the same wage as teachers, averaging around
$33,500 during the 1992-93 school year. Occupational therapy assistants earned
an average of $15,000 to $18,000 and more, depending on type of facility and
location.
If you would like more information on a career in occupational
therapy contact one of the following organizations:
American Occupational Therapy Association
P.O. Box 1725
1383 Piccard Dr.
Bethesda, MD 20850
Department of
Occupational Therapy
School of Allied Health Professionals
Loma Linda
University
Loma Linda, CA 92354
Accrediting Bureau of Health
Education Schools
Highway 20
Elkhart, IN 4651
A career in
rehabilitative services is about as recession-proof as possible. As health care
coverage improves, so do the numbers of people who will require rehabilitation.
In the future, people will spend less time laying in hospital rooms and more
time learning to return to normal activities with the aide of rehabilitative
therapy. Do a little research and you will discover that there is a wealth of
opportunity for financial and personal fulfillment in the fields of both
physical and occupational therapy.
Olicia Vargas, an aide studying to
be a physical therapist believes that nothing beats watching a patient stand on
their own again after a stroke or debilitating accident. "You have to love what
you do, however," reminds Vargas. "You must follow your heart and then success
will naturally come." But if you are interested in and truly concerned with the
health and welfare of others; then a career in rehabilitative services may be
right for you.
Internet Therapy Job Resources:
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