The physical-therapy profession is starting to recover from the effects of a 1997 federal law that came close to killing the demand in the field, hiring experts say.
“I think we’ve already seen a pendulum shift,” said Marcy Maines, the outpatient physical therapist in charge of the comprehensive pain-rehab program at Medical City Dallas Hospital.
The 1997 law, called the Balanced Budget Act, capped Medicare reimbursements for physical therapy at $1,500 a year.
Because so many physical-therapy patients are elderly and depend on Medicare, the law staggered the profession.
“In 1997 and 1998 when this first happened, the bottom fell out, basically, and everybody kind of panicked,” Maines said.
“Now, it’s kind of trying to level off. The job market now is much better than it was even one year ago. There was nothing out there.”
Nursing homes were hit hardest, and many of them had to lay off their physical therapists because they could no longer afford to pay them.
The law also killed a decade of gains in which the demand for physical therapists grew every year, said Jennifer Hunt, associate director of public relations for the American Physical Therapy Association.
“It’s now [at] the point where we’re going to be having a surplus of physical therapists,” she said. “The surplus is going to be continuing through the year 2005. . . . we project.”
Congress has suspended the $1,500 reimbursement cap for two years and ordered a study of its effects.
Some congressional leaders are calling for more generous reimbursement standards–a move that Hunt and others say has already stimulated demand for physical therapists.
Congress has “received reports that have linked staff shortages now at nursing homes to increased bedsores, malnutrition and dehydration,” Maines said.
“With physical therapists there in the facility, we had [the patients] up walking, getting out of bed.
“We were preventing those types of bedsores, malnutrition, dehydration, decreased energy, all that comes with some sort of demobilization.”
A secondary effect of the Balanced Budget Act was to drive many nursing-home physical therapists into private practice, increasing the already-stiff competition for a limited number of jobs.
“We were bombarded with new grads’ resumes, and there were no jobs,” said Brenda White, a human-resources manager for Dallas-based MATRIX Rehabilitation, which provides outpatient care. “They were taking whatever, whenever they could get a position.”
White said the job situation has improved a little because some physical therapists who had never been in a depressed job market decided to leave the field.
“That’s created new opportunities for some of the new grads coming out, whereas a few years ago that just wasn’t available to the extent it is now,” she said.
A recent survey by the American Physical Therapy Association, which lobbied aggressively for suspension of the Medicare cap, confirms that the job market for physical therapists is getting stronger.
The association says the unemployment rate for physical therapists is now about 1.8 percent, down from 2.9 percent in the spring of 2000 and 3.2 percent at this time a year ago.
Maines and other professionals say that prospective physical therapists should not let the recent rough patch discourage them from entering the field.
“[For] anybody that likes to help people, this is still a great profession and there are going to be jobs out there,” Maines said.
“You just have to make yourself marketable.”
