"It seems like just yesterday that schools had hundreds of applicants vying for their coveted 50 or so physical therapy seats," writes Bob Feldman, MS, MA, PT, in Advance for Directors in Rehabilitation, online edition, February 18. "Now, for many institutions, the tides have reversed, and they find themselves with unfilled seats." Feldman, who is an assistant professor of physical therapy at the University of the Sciences in Philadelphia, Pennsylvania, mentions several theories to explain the drop in applicants. He lists the extended curriculum to accommodate the masters degree in physical therapy (MPT), the tightened job market, and the chance to make a better salary in fields that require less training than physical therapy. Sound familiar? Many educators say that these are some of the same challenges confronting the O&P profession. Will a decrease in applicants result in a "lower-quality" applicant? This question too has been an issue in O&P education. "There is a strong possibility that this might occur, and it will be up to individual schools to ensure that future graduates are of the same high caliber as those who graduated within the past ten years," Feldman acknowledges. "Should a school bow to financial pressures to keep their classes full, allowing less qualified applicants who may not have been previously considered to be admitted?" Feldman notes that some of these academically weaker students might shine in certain areas, such as in clinical or humanitarian work.Schools essentially have three choices, Feldman says. These are: Maintain a wait-and-see approach , keeping outlays similar to past years. A school adopting this approach could, if a faculty member leaves, opt to not replace him with another full-time instructor. Instead, the school could hire a part-time professor or consider adjuncts. Invest more in the program in order to attract more students, such as adding new facilities, increasing scholarship money, or developing a larger ad campaign. Close the program . Developing a unique program can bolster a school. "Schools that have faculty who can think outside the box and who can develop unique programs that excite students will be one up in the game of one-upmanship," Feldman says. "Administration needs to recognize these programs and promote them as strongly as possible, because not being unique can doom an institution to 'we-have-a-PT-school-just-like-everyone-else' standing." The Bureau of Labor Statistics, however, has an encouraging statement about physical therapy employment, which can apply also to the prosthetic and orthotic profession: "Employment is expected to increase faster than the average, as rapid growth in the number of middle-aged and elderly individuals increases the demand for therapeutic services." The challenge for educational institutions will be to recruit and train enough new professionals to meet this growing demand. Direct Access to Medicare Patients?Will physical therapists be able to provide services to Medicare beneficiaries without a physician's referral? This could happen in the near future. Legislation to allow Medicare patients direct access to physical therapists was introduced on Capitol Hill November 28, 2001, by Representative Phil Crane (R-IL) and Representative Earl Pomeroy (D-ND). The bill (H.R. 3363), known as the Patient Access to Physical Therapists Act (PAPTA), includes these provisions, according to the American Physical Therapy Association (APTA): Eliminating required physician referral. The bill amends Medicare law to eliminate the requirement that a Medicare beneficiary obtain a referral from a physician to receive outpatient physical therapy under Medicare Part B. It addresses services provided by a physical therapist in the following settings: private practice, rehabilitation agency, public health clinic, Part B services in skilled nursing facilities, comprehensive outpatient rehabilitation facilities, and outpatient hospital departments. Defining a qualified physical therapist. The bill amends Medicare law to add a definition for "qualified physical therapist." No statutory definition currently exists in Medicare law for a qualified physical therapist. For more information, contact the American Physical Therapy Association, 1111 North Fairfax Street, Alexandria, Virginia 22314; 703.684.2782; 800.999.APTA; fax: 703.684.7343; www.apta.org .
