Dear Cindy – No More PTAs?

I'm attending college for surgical technology. I was thinking about switching majors and transferring to a school that has a physical therapist assistant program. I've done a little research online, and found all the info on the career. There's just one thing that bothers me though – I'm hearing that due to a law passed that they have cut back or laid off a lot of physical therapist assistants. And I was reading somewhere that insurance companies didn't want to cover physical therapy, and this was leading to a decrease in demand for PTs and PTAs. I wouldn't want to spend all that time and have a problem getting work. Should I just stick with the surgical tech program?

Sincerely,

M

You've touched on a few issues here.

Regarding the law, I believe you mean that regarding caps on rehab services for Medicare patients. On December 29, the president signed on legislation temporarily relieving patients from arbitrary caps on rehab services, which was to begin on January 1, and which extends the relief to June 30, 2008. (For information about advocating to have the therapy caps repealed altogether, see the American Physical Therapy Association's Therapy Cap page.) I have not found information about job cuts being made in anticipation of this legislation coming into effect.

In general, one could argue that insurance companies – since they're in the business to make money – want to cover as little as possible. Most people are insured through work, and often employers offer different plans, but usually these plans reflect what their employees find attractive, so some plans may focus on the typically "expected" healthcare need areas of drugs, hospitalization, and dental, while others may include physical therapy or other rehabilitative therapies. Some cap benefits or restrict based on preexisting conditions. So yes, some people, though insured, may have little or no rehab coverage. But those lacking rehab coverage may be willing/able to pay out-of-pocket.

However, the other reality is that the population is aging, and as a result, the Bureau of Labor Statistics forecasts that jobs for PTAs will "grow much faster than average" to 2016. The BLS addresses the legislation, saying, "The impact of Federal limits on Medicare and Medicaid reimbursement for therapy services may adversely affect the short-term job outlook for physical therapist assistants and aides. However, long-term demand for physical therapist assistants and aides will continue to rise, as the number of individuals with disabilities or limited function grows."

You may want to contact your state physical therapy board or the APTA to ask about their views on the situation and the impact it will have on their membership.

Another thing to keep in mind is that one possible way to deal with cutbacks when care is still needed would put PTAs at an advantage. That is, an employer may begin to hire as few "expensive" staff and as many "inexpensive" staff as possible, thus hire fewer "expensive" PTs to supervise and direct care, and a greater number of "inexpensive" PTAs to provide care.

Finally, if you have found that you aren't interested in the field of surgical technology, it's a very good idea to investigate other options, as you are doing.

Good luck.