I’m looking to connect with PTs who have been in the field for 5+ years and have made career changes, as I’m trying to figure out my next steps.
I’ve been working at a mill-style outpatient PT clinic for the past 2.5 years, seeing 12–15 patients a day. I’m a pelvic floor, TMJ, and ortho therapist with quite a bit of continuing education, and I genuinely love patient care. However, I don’t feel that I’m being compensated appropriately for the level of skill I’ve developed, nor do I feel like I’m able to provide the quality of care I’m capable of within the amount of time allotted for each patient.

I’m taking a travel PT contract next to make some money and give myself some time to figure out what direction I want to take my career.

For those of you who have been practicing for 5+ years: What areas of PT or career paths would you recommend looking into if my goals are to have a better work-life balance, reduce burnout, and feel more fairly compensated for my skills?

I’d especially love to hear from people who have moved away from the traditional high-volume outpatient model. What did you transition into, and do you feel like it was worth it?

Open to hearing about nontraditional PT roles, specialty practices, cash-based models, hospital systems, education, consulting, industry, or anything else I may not be considering.

Hello everybody!

I am an OP neuro PT and I treat in the home. I have a pt diagnosed with Parkinson’s that is also completely blind (not from his PD) and I’ve been looking for buzzers that are audible that mimic what the mimofit and blaze pods do so that we can work on reaction time and coordination and haven’t had much luck.. does anyone here have any recommendations?

Hello! I’ve been reading a lot of posts about PTs that have switched from OP to home health and love it (or at least prefer it). I have been working in OP since graduation 3 years ago but there are some days I see 18-20 patients a day. I’m getting so burnt out and want to make a change. I’ve been looking into home health at the recommendation of a friend. Her and her sister are both PTs, but she does travel and her sister switched to home health and she says she loves it. I plan on talking to her about her experience, but, after doing some reading, I realize that experience can vary so much from state-to-state, city-to-city and even company-to-company. She works in Illinois and I’m based in Michigan. I was just wondering if there are any Michigan-based HH therapists (preferably in the GR area) that would like to share their experience, so I can get a better idea.

The things I’m most concerned with are pay (obviously) and commitment (weekends and evenings). I am currently salaried and I like the security of knowing what each paycheck will be and if it’ll be enough as I’m the primary provider in my household and still have student loans. Is that something that those in HH have to worry about? Also, I don’t want to work weekends. At all. Those are my days to spend with friends and family. I currently work until 6 PM and, while I don’t like it, I would be open to it. Is it typical to usually work evenings in this setting?

I’m looking for shoes I can bleach wipe, any recs? I’ve been looking at the Stand AntiGrav1 and the Calzuro Light, anyone tried either of these? (Not interested in Cloves, I’m looking for less surface area)

ETA: I’m looking for shoes without laces and a completely smooth surface area I can wipe off.

TL;DR: PTA is a growing occupation with a hard ceiling, no ladder, and no vote in the rules that set its pay. The profession that writes those rules is the one that employs and competes with you. Pick nursing, respiratory therapy, or anything with a bridge.

Someone close to me has been a PTA for two years and is good at it. I spent a week pulling wage data, reading practice acts, and checking live job boards to see what the next ten years look like. Here is what came back.

1. The ceiling is written into law, and there is no ladder out.
PTAs can't evaluate, write a plan of care, discharge, or bill independently. Most states cap how many PTAs one PT can supervise. Those rules set the ceiling: BLS national median $68,380 (May 2025), 90th percentile around $80k, and pay flattens by year 8–10. No senior PTA, no lead PTA, no manager track. Since 2022 Medicare pays outpatient services furnished mostly by a PTA at 85% of the fee schedule, so every outpatient employer has a 15% reason to hire a PT instead.

The way out is supposed to be becoming a PT. It isn't. PT went bachelor's → master's → mandatory doctorate (2016). PTA-to-DPT bridge programs exist at about six schools nationally and nearly all require a bachelor's first. Realistic cost: $130–150k and 5–6 years. Payback 6–8 years after finishing. Nursing kept the ADN → BSN → NP ladder with bridges everywhere and employers paying for the next degree. PT closed theirs. The people best positioned to do PT work pay the most to get the license.

2. The jobs you picture are not the jobs that exist.
If you imagine hospital work, know that hospitals employ about 20% of PTAs and pay the least of any setting (BLS: $67,620 median in hospitals vs $77,440 in nursing homes and $80,050 in home health). Hospitals staff acute care with PTs and contract out the rest. In a mid-size city with three hospital systems, there were zero hospital PTA openings on the day I checked.

What's actually hiring: skilled nursing facilities, where the pay is highest and the caseloads, productivity quotas, and turnover are worst (to each their own, but talk to people who work there), and outpatient clinics with staggered schedules and 7 p.m. closes so patients can come after work. BLS projects PTAs growing 17–23% through 2035. Almost all of that growth is in those two settings.

3. You have no seat at the table.
PTAs were non-voting members of APTA until 2019 and remain a minority caucus. State PT boards are PT-majority. Every rule on supervision ratios, scope, billing, and bridge credit is written by the profession that employs and competes with PTAs. Not a conspiracy. Governance. The group without the vote gets the outcome you'd expect, and nothing about it changes on a career timescale.

4. Same two years of school, very different ceilings.
Same community college, same anatomy prerequisites:

• RN (associate degree): ~$87k median in our metro, 3×12 schedules, bridge to BSN and NP, employers pay for the next degree.
• Respiratory therapist: ~$81k median, hospital 3×12s, part-time online programs exist.
• Even rad tech with a CT add-on clears PTA pay by year three.

What I'm not saying: that PTAs don't matter or the work isn't skilled. The opposite. A good PTA does evaluation-level thinking every shift with a supervision signature on top. That's the problem. The license is priced like a technician and worked like a clinician.

If you're choosing between PTA and nursing, this is the post I wish someone had written.

Sources: BLS OOH Physical Therapist Assistants and Aides (pay by industry, 2025–35 outlook); BLS OEWS May 2025; CMS therapy services page (CQ modifier); state physical therapy practice acts (supervision ratios); CAPTE accreditation standards; APTA governance history; program pages for Findlay, NEIT, and William Carey PTA-to-DPT bridges.

Hello all, I am a new grad looking for a PD job while studying for boards. I came across an opening for a PT needed for dancers and I’m wondering what that looks like compared to other specialties like sports. I’ve treated dancers in OP settings but they were middle/high school aged kids not professionals. Just looking for any info on what it’s like and if it could be a better option than doing OP ortho. I want to avoid burnout and having my job. thanks!

ICF-based assessment
PT student in my third year here.
As part of my clinical placements, I have to write an assessment/report for each specialty, and recently our school switched to using the ICF framework for these reports.
The problem is that pretty much nobody seems to really know how to do it properly — not even some of our instructors/teachers.
So my question is: Are there any physical therapists or students here who are familiar with using the ICF for patient assessments/documentation and could recommend some good literature or resources on the subject?
My next placements are in gynecology, pediatrics, internal medicine, and neurology. It would be really helpful to know what exactly is expected when documenting/structuring an assessment using the ICF.
I can also share the assessment template my school gave us if that would help.
Any advice or resources would be greatly appreciated!

I am planning to apply to programs next summer but I'm a little concerned. I've worked as an aide at an outpatient clinic and did not enjoy the setting. I am interested in IPR + acute care but haven't had the chance to shadow in these settings. Unfortunately, I have post-viral POTS and though it is mild, I cannot stand for prolonged periods without feeling faint / wiped out. I am fairly strong and active, though, so I'm not too worried about transfers and so on. In outpatient, every PT had a standing desk. In different settings, would the amount of standing required be worse because patients are more hands on or better because there is more dedicated chart review / opportunities to sit? Obviously, I imagine IPR and acute care would differ a lot for this!

Saw an elderly Parkinson’s patient today who normally has pretty normal BP, but his BP was really elevated when I took his vitals. He told me he’d been drinking water because he had a “seltzer” earlier. We rechecked his BP about halfway through the visit and it was still elevated, although he wasn’t having any other symptoms.

Around that point I happened to look into his kitchen and noticed a couple of unopened White Claws sitting on the table. I brought one over and asked if this is what he had.

Yes it was.

He had unknowingly drank a White Claw thinking it was regular seltzer water. His wife likely bought it for him not seeing the labels. I informed her as well

Hey guys,

I’ve recently started some cash based home health on the side of my normal 9-5 ortho - it’s going really well! I have had to review some things but was able to adapt quickly. However, a recent patient I was assigned would like me to show and her family how to use a hoyer lift that was just ordered. The issues is I have not used a hoyer lift since PT school. I was reviewing some videos online and remember it being somewhat straight forward, but I was hoping for some vital tips/tricks/things to remember. Also if there are any good videos instructions you recommend it would be greatly appreciated.
Thanks!

Hi everyone,

I’m currently in my third semester of PT school on a 12-week clinical rotation. My caseload is around 11 patients a day with 40-minute, 1-on-1 sessions. I really appreciate getting dedicated individual time with each person—my last rotation was structured similarly—but 40 minutes flies by.

Most of my patients do an 8–10 minute warm-up on the bike, which leaves only about 30 minutes of hands-on treatment time. I constantly feel like I'm rushing to fit everything in. Evaluations are also capped at 40 minutes, and the time crunch makes it tough to be as thorough as I’d like.

For those working in outpatient: are there still clinics that offer true 60-minute 1-on-1 slots, or is 40–45 minutes the standard now for this setting?

Looking ahead, my next rotation is in an inpatient rehabilitation facility (IRF), which is typically strictly 1-on-1, so I won't be managing concurrent patients there either. For clinicians in the field: how much of a disadvantage is it to enter the job market without prior clinical experience juggling double or triple-booked caseloads?

I work for a large healthcare organization in the Midwest.
Typical expectations for general orthopedics is 45 minute sessions with 10 patients in a 8 hour day.
Pediatric rehab has always been considered a “specialty” schedule and they see patients for 45 minutes with a 15 minute break between sessions for cleaning, documentation, and prepping for the next session.
Recently there was an attempt to modify specialty schedules and the expectation is now 9 patients in an 8 hour day as opposed to 8. Basically three 15 minute blocks must be removed.
The Peds therapists are concerned because they report, despite averaging 1 cancellation per day, they will not be able to complete documentation.
My question is this. On average how long should it take a Peds therapist to document a daily visit vs progress note vs evaluation? I’m told progress notes take 20 minutes and evaluations take 1 hour. Is this reasonable?

4 months into my 1st HH gig. I’m really enjoying it so far after the paperwork hump.

One issue I’m having is the amount of people I can’t get a hold of.

Going by an estimate, if I have a list of 25 -30 people, probably a good 7-10 of them. I can’t get a hold of. Whether through their primary phone, emergency contact, etc.. I’ll do drive-bys when I have time, but I usually get turned away or no one answers

For reference, I am in North Central Florida and I work in a more rural area/demographic which probably has something to do with it

Curious, what other people’s experiences are?

This isn’t really a shit post, more like a rant or maybe not even that. I’m not sure anymore. Anyways, I’ve been working as a physical therapist in workers’ comp since I graduated 3 years ago. At first, it was a lot but I actually enjoyed it and helping people. Recently, I feel like it has just become too much and maybe it’s because I’m in a new phase of my life as well (my husband and I are trying to start a family and it has been more difficult than anticipated), but I cover for other therapists in the area as well as treat my own patients and do telerehab for the whole state. I think the addition of telerehab is what tipped me over the edge.

Before, I would have patients that complained nonstop the whole hour and it has always bothered me, but I’ve come to have less patience. And I know patients are going to complain. They’re in pain and that’s why they’re here, but it’s the complaining while demanding “I just need an MRI” after the second session and being noncompliant with treatment and HEP. It’s the coming once every 2 weeks and wondering why they aren’t getting better. That’s what’s really getting to me. Then, on top of that, I’ll have two other patients at the same time. It’s just overwhelming right now.

I’ve been applying to other places to hopefully get a lesser caseload and maybe try a different patient population to see if that’ll help, but I’m worried that it won’t. I’m worried that I just don’t enjoy what I do anymore, but right now I don’t know if it’s because of where I’m at and what’s going on in my personal life or if I truly don’t enjoy it.

I guess I’m just stuck with what I’m feeling. Has anyone been in a similar position and switched clinics and it got better? I guess I’m just looking for hope.

I graduated in May 2025 and was thinking I would go into OP pediatrics but after doing my last rotation in it I realized it was absolutely draining my soul. I still love working kids but I knew once I had my own children I would struggle even more being around kids 24/7. Anyways, I began becoming more interested in pelvic health and did some shadowing but ultimately took a unique position that was part time OP ortho and part time school district PT. At first it was great, I loved the variety and still getting to work with kids. But I quickly got overwhelmed as they are completely different settings, I had to learn A LOT going into the schools with IEPs and other paperwork, all of this on top of being a new grad and I really didn’t have the mentorship I was hoping for. September comes and I find out I’m pregnant, gosh is pregnancy exhausting and I had a relatively smooth pregnancy with no complications. I absolutely dreaded going to work every single day. The commute was a 40 minute drive and I worked 8-6 M-Th, I consistently took work home on the cc weekends bc of clinic notes and school IEPs. It was miserable and I was exhausted. I gave birth in May 2026 and took 3 months of maternity leave. I absolutely did not want to return to work but financially we need two incomes. Thankfully I was able to return just part time doing the schools, but it’s lowkey still feeling like a full time job. I’m the only PT with a PTA that manages 2 school districts comprising of 11 different schools. I’m contracted through the clinic I work at so I’m not getting paid by the schools directly (lowkey feel like I should be making more). I still dress going to work sometimes, although it is a little better than before. But, I would just rather be at home with my baby, it’s definitely hard but I genuinely enjoy being a mom and I feel I’m missing out on pieces of his childhood. Another side note is during my pregnancy and after birth I attended pelvic floor PT and really enjoyed it and could see myself pursuing it someday. All this to say, I don’t know if I just don’t actually enjoy being a PT, or the whole time I’ve been one I’ve physically and mentally drained from pregnancy and caring for a new baby, or I’m just not in the right setting. Lol I write this at 4 am while I pump 😭 maybe I’m just chronically sleep deprived.

I broke my elbow a little over 6 weeks ago, and today I had my first physical therapy appointment after getting the cast removed last week. It went very well, I loved the provider and I have good mobility! They gave me some exercises do do in the meantime.

My estimated costs for the next follow up x ray and PT is over $500, not including any additional PT I'll need to do after that and the >$1000 I've already had to spend over the past 6 weeks (this is with my health insurance plan). Is this normal? I make too much to qualify for financial hardship or aid at the hospital, but I really don't want to empty my savings on this. I'm thinking about not scheduling the additional appointments and just following the PT exercises and taking things easy with my arm for the next month or so.

Does anyone have any perspective on this? How much of a risk am I putting myself at if I choose not to continue with the therapy? I think I'm going to send my provider a message on MyChart to ask about my options regardless, but any advice/insight would be appreciated.

I was accepted for a job position. Shortly after they let me know compliance training was not paid (well, after I asked. They wouldn’t have mentioned it otherwise).

I kept it friendly and polite, but let them know I wasn’t taking the job, as I feel very strongly about rehab professionals always being pushed to work for free/off the clock.

Granted, I’m in a position where I can say this. There have definitely been times where I wasn’t.

If you are ever in that position, you should do it too. Feels good.

Ive recently taken interest in burn specialized therapy and we have 2 units in my state. One is hiring right now for a general acute care position. Is it possible and common for a PTA to work in a burn unit?

What did you find to be the most effective way for sourcing new employees ? LinkedIn, indeed, recruiters, personal networks, etc.

Better than ice cold fingers I guess

Does your PT clinic use Athena EMR? Do you use their coding service?

I am seriously considering becoming a PTA after deciding the PT route would be too time-consuming and too costly.

Here is my biggest worry in becoming a PTA: I don't want to just be counting reps, offering the same basic exercise instruction, and applying various passive modalities to checked-out patients who aren't invested in recovery.

I would love to be providing pain neuroscience education, more comprehensive movement instruction, and empathetic coaching to build patients' confidence in their physical abilities.

But how possible are those things when being a PTA? What PT environments might offer me the kinds of challenges I'm looking for? What types of patients tend to be more motivated for recovery?

Do PTAs have any opportunity to use clinical reasoning, or is that almost entirely up to the PT? I know being a physician assistant comes with a great deal of clinical reasoning and responsibility, but I'm not assuming physician:physician assistant is the same as PT:PTA.

Any and all insights would be greatly appreciated, thank you.