Do you ever think you are in an exclusive club that seems to be getting smaller and smaller? Does it seem there are less and less people you know that have the same job title?
Fallout from COVID years?
There has been many reports of a mass exodus of Healthcare professionals since the beginning of COVID. As the world shut down Healthcare was considered essential workers and continued right on through. Unfortunately all too often with limited personal protective equipment and dealing with the unknown. The hardest part was the constant changes as we learned what was true and what was false.
One of the direct casualties was the decrease in need for therapists as all non essential surgeries were stopped. Without a flow of orthopedic needs, there are less and less patients to be seen which becomes less and less therapists needed.
Just a nursing shortage?
So much of the media attention was based on the nursing shortage that was made worse from the COVID years. There was a big push in the Healthcare world of how to improve the recruitment of nurses.
While this is very true, the shortage is not isolated to nursing only. Many different Healthcare fields have had a decline in ranks.
So how about therapy
The therapy world is also feeling a crunch of less therapists in the workforce. Prior to COVID there had been a small pool of therapists in some geographic areas.
To put this in perspective, the best data I have been able to find for comparison is 2018. This is directly before the onset of COVID as well as the beginning in the skilled nursing world of a large shift in reimbursement from CMS.
For ease of discussion and comparison I will focus on Physical therapy. More specifically as a practicing Physical therapy Assistant, I will first focus on my own license discipline. In 2018 in all of North Carolina there were 2,850 PTAs working. While this sounds like a good amount we need to put that number in perspective. There were 623 Home health care agencies, 422 licensed Skilled nursing facilities, and 111 hospitals in North Carolina. So in total that is 1156 job sites. So without factoring in any outpatient, assistive living or acute rehab facilities, that leaves the capability of about 2.4 therapists per facility.
By looking at PTAs only there is clearly an inadequate supply versus the need. The scariest part is the fact that these numbers were before COVID.
On the Physical therapy license, there were 6520 employed therapists. While this averages out to 5 therapists, it can be very deceiving since there are a huge number working in outpatient clinics and private offices. Often there are more than 1 practice in a geographic region with more than one Physical Therapist at each site.
So what can be done?
There needs to be more of a concerted effort to increase the number of available therapists in our state. With the continual growth of population as well as the increase in the amount of geriatrics in this state, a huge push is needed into skilled nursing settings.
The other side of the coin is for significant intervention by congress to stop bleeding dry therapy companies to allow for proper salaries especially in hard to staff rural areas. We need support from our legislators to decrease burdens of care such as unfair and deceptive practices by Medicare Advantage Organizations, constant denials of payment or services that are overturned anyway after increased labor costs for appeals.
We need increased programs to make college affordable to get the necessary education and degrees to gain entry to the Therapy field. There are plenty of means to grow our ranks.
Colleges and the licensing Boards need to establish easier and more available bridge programs like the ones seen in nursing that allows for a transition from Physical therapy Assistants and Certified Occupational Therapy Assistants to further their careers without needing to start over. Why are there not options for highly experienced therapy assistants in the evenings or weekends to further their degrees?
Definitely not a one size fits all approach
As I have pointed out, there needs to be a multifaceted approach to the establishment of a better and more robust therapy workforce. Without intervention from all avenues ultimately we as a country will feel the effects of a less healthy population and no one to assist with recovery from life changing events. The time for change is now.
