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Presidents Perspective

The Importance of Understanding the Physical Therapy Workforce

David Relling, PT, PhD

I am very honored for this incredible opportunity to serve as FSBPT President. It is a tremendous privilege to serve this organization and work with so many individuals dedicated to protecting the public on a daily basis. I greatly appreciate your support and hope to measure up to the leadership of Nancy Kirsch and the many outstanding past Presidents of the organization.

The past few years have been extremely challenging due to the SARS-CoV-2 pandemic. During the early phases, there were shortages of critical items such as personal protective equipment and ventilators. Healthcare professionals rose to the challenge of providing high-quality care during a pandemic, even though resources were limited. The healthcare workforce was a prime example of a critical resource that had limited information about types of providers, clinical expertise, and areas of practice Governors and healthcare facilities were often heard requesting healthcare providers show up to help, come out of retirement, or relocate from a less affected region of the country. At the same time, the extended workload and challenging circumstances facing healthcare providers resulted in overwhelming fatigue and burnout of professionals in a variety of settings. Physical therapy, medicine, nursing, and many other healthcare professions were strained by the pandemic resulting in some healthcare providers reducing their hours or even choosing to leave their professions.

One of the missing factors that came to light during the pandemic was knowledge of the healthcare workforce. The pandemic demonstrated the importance of knowing where healthcare providers are located and what types of clinical practice they can provide to the public. This information is necessary to address the maldistribution of healthcare providers compared to the public's need for care. Healthcare workforce data is sparsely collected and variably reported in most jurisdictions. When workforce data is collected, the process typically includes data related to the workforce conduit feeding into the profession, distribution of the practitioners throughout the region, and identification of those preparing to exit through retirement or a career transition. The physical therapy profession is no different, although a consistent data collection and reporting process for the workforce does not exist.

There are a few resources that have attempted to understand the physical therapy workforce. The US Bureau of Labor Statistics (BLS) develops projections for both physical therapists and physical therapist assistants. The American Physical Therapy Association (APTA) has also developed a workforce model used for reports in 2016 and again in 2020. Both the BLS and APTA projections have been scrutinized based on various factors such as the impact of new education program development, study methodology, and unknown future needs from an aging population or sequelae related to COVID-19 infection (e.g., long COVID).

One of the critical factors in studying any workforce is defining a minimum data set (MDS) for the profession. A minimum data set is a consistent set of data elements that are collected on all licensees at regular times to better understand workforce needs related to access to healthcare. The optimal MDS provides key information about the current level of practice and can be used to compare across various settings and help project for the future. FSBPT and APTA worked collaboratively with the Health Resources and Services Administration (HRSA) between 2012 and 2015 to develop an MDS for physical therapy (PTMDS). Some jurisdictions have incorporated components of the PTMDS into their licensure renewal cycles, while other states require completion of the entire twenty-two-question survey. More recently, the healthcare regulatory CEO’s workgroup engaged Hannah Maxey, Associate Professor and Director of the Bowen Center for Health Workforce Research & Policy at Indiana University School of Medicine, to guide the development of a multi-profession workforce MDS. Hannah introduced the draft “Cross-Profession Minimum Data Set Tool (CPMDS)” to the FSBPT membership at the Annual Education Meeting in October.

While the CPMDS is in its approval stages, FSBPT has moved forward with multiple activities related to supporting the physical therapy workforce. There have been many presentations helping to raise awareness of physical therapy burnout and moral injury. You can access the FSBPT Webinar Series replays using the FSBPT event platform on Cadence. At the Annual Education Meeting, members of the FSBPT re-entry task force shared additional details about their work on the loss of competence and time for recovery of critical work activities. The task force will next study the demographics of individuals returning after a substantial pause from the practice of physical therapy. Jurisdictions will benefit from identifying efficient and effective methods to assure safe and effective practitioners wanting to re-enter the physical therapy workforce and provide care in areas with limited access to physical therapy or maldistribution of physical therapy practitioners. FSBPT continues to support the Physical Therapy Licensure Compact (PTLC) and its ability to enhance licensure portability for PTs and PTAs. The PTLC legislation has passed in thirty-four member jurisdictions, with twenty-seven of them now actively providing compact privileges. The PTLC facilitates access to physical therapy services across jurisdictional lines to support access to care, continuity of care, and opportunities for telehealth where allowed and appropriate. These are just a few of the many initiatives from FSBPT that support access to safe and effective physical therapy to meet our combined mission of protecting the public. I hope that you will begin conversations about workforce data in your jurisdictions and work toward finding solutions at the jurisdictional level for this important initiative.


David Relling, PT, PhD, is Associate Dean for Health Sciences and Professor in the Department of Physical Therapy at the University of North Dakota in Grand Forks, North Dakota. He chaired the UND department of physical therapy from 2014-2021 and has practiced in a variety of settings including acute care, orthopedics, and long-term care. Dave was appointed to the North Dakota Board of Physical Therapy in 2010 and completed his second term on the board in 2020. He served as President of the ND Board from 2014 to 2016. Dave is a member of the state association and the American Physical Therapy Association.

Dave began his involvement with FSBPT in 2005 as an item writer and has served as a member and then co-chair of the NPTE Exam Development Committee for physical therapists. He was inducted into the Academy of Advanced Item Writers in 2010.