In what setting do physical therapists make the most money

Deborah C. Escalante

Physical therapists are empathetic by nature. As such, most didn’t get into the PT profession to make bank. That being said, empathy doesn’t pay the bills. Luckily, the impact you make on your patients’ lives actually does. You get paid to treat patients. Now, how much you get paid—i.e., the salary you receive from your place of employment—to treat those patients depends on a lot of factors. Let’s examine:

1. Location, Location, Location

As expected, where you work factors into how much you make. After all, the cost of living is far higher in, say, New York and San Fransisco than El Paso and Des Moines. It isn’t just the cost of living, though, that influences salary rates in a particular location. Supply and demand also play a part. For example, according to this demand map, physical therapists are in higher demand in southern Nevada. Perhaps that’s why Las Vegas has one of the highest average annual salaries for PTs in the country ($124,060), according to a 2013 US News Salary Outlook. Conversely, according to Wanted Analytics, Missoula, Montana, has some of the “best overall conditions and [is] where you are likely to find candidates faster and more easily.” However, the state of Montana has the third lowest average annual salary in the country ($71,880), according to PhysicalTherapySalary.org, and the second lowest ($68,900), according to healthcarewages.org.

Curious as to salary rates by state? Check out this table, which provides hourly, weekly, monthly, and annual breakdowns.

2. Experience vs. Education

As with most professions, a person’s years of experience can influence his or her dollar value in the PT field. “Entry-level physical therapists made an average of $66,545 in 2011, whereas PTs with 16 or more years of experience earned an average salary of $84,656. A therapist who falls somewhere between these two extremes…should expect to earn a salary somewhere near the national median of $79,860,” explains Brooke Andrus in this 2013 blog post. This interactive chart on PayScale.com—which breaks down the median of all compensation (including tips, bonus, and overtime) by years of experience—shows that:

  • Entry-level PTs (0-5 years experience) make a median salary of $65,000
  • Mid-career PTs (5-10 years) make a median salary of $74,000
  • Experienced PTs (10-20 years) make a median salary of $81,000
  • Late-career PTs (>20 years) make a median salary of $83,000

Now, what about education? As detailed in this recent WebPT blog post, physical therapy students must now obtain doctorate-level degrees in order to practice, which essentially levels the playing field for all entry-level clinicians. Thus, education isn’t a significant factor when it comes to salary. But what about practicing therapists who have bachelor’s or master’s degrees? As this article explains, you shouldn’t let the potential for a higher salary be the determining factor as to whether you obtain a transitional DPT: “Insurers don’t adjust reimbursement rates according to the clinician’s educational level, which means PT practices have no concrete financial incentive to offer higher salaries to doctoral degree-holders. In fact, according to TherapyJobs.com, only 25% of therapists with DPTs believe ‘the advanced degree has increased their earnings.’” Moral of the story: Currently, years of experience trumps level of education.

3. Willingness to Travel

Want to get away for a while? Not the type to put down roots? Then traveling PT might be for you, and the pay is certainly tantalizing. According to Onward Healthcare, “travel therapy jobs pay higher salaries to professionals due to the elevated needs of the [hiring] facility.” How much higher? According to this chart, there are some instances where annual salaries for traveling therapists and assistants are nearly double those associated with permanent positions. Of course, PTs interested in travel work must take into account the cost of living in various locations. Furthermore, as this article explains, travel salaries also strongly depend on contract length, the number of contracts in a year, and the specific details of your individual contract. That being said, “Travel PTs that work with agencies enjoy many intangibles, including free private housing, medical, dental, and life insurance, malpractice insurance, travel & licensure reimbursement, a 401(k), and continued employment services,” explains Onward Healthcare.

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4. Practice Setting

Another factor that contributes to salary rates for physical therapists: where you treat. According to PayScale.com, home health, long-term care, home care, and geriatric facilities are the highest paying PT areas. US News confirms this in its 2013 Salary Outlook: “The highest wages go to physical therapists working in schools, home health care or nursing care facilities.” And on average, those annual wages are $96,810, $94,600, and $88,890 respectively, according to the Bureau of Labor Statistics.

Keep in mind that the above list of factors isn’t inclusive. In fact, your salary outlook is a lot like a snowflake: wholly unique. After all, your application, interview skills, clinical style, networking abilities, and professional relationships all can influence whether you land a job and whether that job will pay higher or lower than the medians and averages for your experience level, location, and setting.

Now, if you’re wondering if you’re over- or underpaid in your current position, there are plenty of salary wizards and comparison calculators out there. But, again, all of those calculations are based on industry data and do not account for the snowflake nuances. Still, knowing industry averages for your level of education, experience, location, and setting certainly help during salary negotiations, so do your research and arm yourself with data appropriately. But remember, while money is nice, it isn’t everything. There are a lot of other benefits that can make or break an employment opportunity, so never discount the value of company culture, benefits packages, team fit, management, treatment setting and patient population, schedule flexibility, learning opportunities, and potential for career growth in lieu of dollar symbols.

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Let’s face it: physical therapy school is expensive. REALLY expensive. Even if you get a scholarship, save up money or have generous benefactors, chances are you’re going to be in quite a bit of debt when you finish school. While we all want to practice in the ideal setting and work for the right company, where we feel valued and can make an impact on our patients’ lives, sometimes working in that dream job right after PT school means sacrificing income.

Of course, none of us chose PT for the money, but paying off PT school loans as quickly as possible is a respectable and wise life choice to secure your financial future. Today’s NGPT article aims to help new physical therapists whose priority is to maximize their income.

You can take several paths to high income. One is working your tail off at multiple moderately paying jobs. If you’re dead set on working in outpatient ortho, this may be the solution for you. Another is working in the more high-paying settings, though they may not be as glamorous. Yet another is opting to travel. And still another is to simply live extremely lean. If you’re serious about making some post-PT school dough, this is the article for you!

1. Work for a SNF or Home Health agency

These are the highest paying settings for a therapist. Home health physical therapy pays very well when you can make it work for you and have the right support system. If you’re spending half your day commuting from one end of town to the other, that’s unpaid time that will lead to frustration.

SNF rehab is a popular choice for new grads looking to offset their debt. Because they are not always the best environments to hone PT skills as new grads, you may want to consider that choosing the right setting as a new grad is one of the most important decisions when you first graduate. Make sure you balance financial needs with personal and professional growth.

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2. Work in an environment that offers bonuses/incentives.

Listen, this may not be the most stress-free or patient-focused approach for every PT, but some folks thrive on volume. They simply learn the most when they see the most patients. If you can maintain your integrity and provide quality patient care, read on. There is a plethora of options for you if you thrive on fast-paced and performance-rewarded therapy. Be wary of accepting a position in a private clinic that only rewards productivity, though. This can quickly lead to burnout.

When you receive a job offer, you can ask if you will receive bonuses or pay bumps if you take extra continuing education, work weekend shifts, lead initiatives to expand the clinic or teach seminars.

2. Work in an environment that offers paid overtime

Very rarely will you find a small clinic that is willing to pay overtime; in fact, it’s frequently the opposite problem. Private clinics are notorious for keeping employees after hours to treat additional patients or to do paperwork, without paying them overtime.

On the other hand, larger corporations and hospitals are much more careful with how they treat employees, and typically frown upon unpaid overtime. Some larger hospitals will frequently run on the edge of understaffed. If you work in an environment where the option to stay overtime is on the table, take it! Even better, specialize or become experienced in a way that will put you in higher demand.

3. Work weekends

Continuing from above, the most difficult times to staff are the weekends. When negotiating a wage, you may be able to command more when you accept the times that other therapists balk at working. Don’t be afraid to politely inquire about the possibility of increased pay if you’re accepting a position that involves working every Saturday.  That said, some large hospitals have set new grad wages, and there is little to no room for negotiation. If you are looking to work overtime (as discussed above), weekends are much easier times to have overtime approved, since there’s usually already a paucity of staff on those days and your supervisor may simply want the patients seen, no questions asked.

4. Sign up to do travel therapy

Travel physical therapy has great appeal to new grads. In addition to offering significantly higher pay than pretty much any other gig, you get the opportunity to have paid relocation costs, paid licensing fees and paid housing. If you moved away for school, you’re already far from home, so why not!? To play devil’s advocate, travel PT can be a tough setting for a new grad. On top of getting your feet wet as a treating therapist, you also need to learn new documentation systems and uproot every few months, just as you’re starting to feel comfortable. But if you’re the type that thrives on change, travel PT is undoubtedly the best way to make some dough out of physical therapy school.

5. Move to a rural location

I grew up in a rural part of Texas and, if I had fulfilled my parents’ dreams and returned to practice physical therapy there, I’d be a wealthy woman. It’s not that the salaries are always that much higher (they sometimes are, but no guarantee); the clincher is that the cost of living is quite low. A penny saved is a penny earned, especially when you’re repaying loans and dealing with interest rates. You may not be super enthused about some of the practice locations, but think of life as an adventure; you just may have the time of your life living in the boonies!

6. Avoid salaried/benefited positions

Salaried positions, by definition, are not paid hourly. You receive a set salary for your role as a PT. Hourly positions, on the other hand, pay you for the time you work. Many small clinics offer salaried positions, then load you up with patients so that you’re treating every second of the time you’re at work. Then you’re expected to take your documentation home and work more after clinic hours. Not only is that a recipe for premature burnout, it’s pretty much going to guarantee that you can’t add a second job to the mix if you need the extra income.

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Benefited positions were the way of our parents’ generation. Guaranteed medical and dental was a must for our parents, but they didn’t have the option of the Affordable Care Act. Love it or hate it, Obamacare gives you the option to free yourself from the golden shackles of full-time PT work. If you pay for your own insurance through Obamacare, you can seek per diem positions with the highest hourly rate possible, while allowing yourself the flexibility to explore multiple settings and learn while you earn (<–see how I rhymed that?)

7. Live Lean

Don’t roll your eyes here. I got a little burned out a few years after graduating from PT school. Yes, it was fast, but I had been working in a setting I didn’t realize wasn’t the right fit for me. I decided to switch to per diem for awhile and take more days off for my sanity, while exploring multiple settings. I started cutting costs by limiting dining out, shopping for things I didn’t need (I’m looking at you, TJMaxx), cable, etc. I also moved in with a roommate, which cut down on monthly overhead. Don’t be afraid to give yourself a monthly challenge, such as cutting your grocery bill by 50% or only drinking beer at your home. You’ll be surprised how much you can save. Pack your lunch. It’s almost always the more frugal route.

Enlist the help of a friend to make saving money more fun. Before I went to PT school, I saved aggressively. I didn’t want to be drowning in debt after school, so a friend and I started the dollar meal challenge. Each of us would contribute an item that cost $1 or less. Meals typically consisted of tuna fish on bread with BBQ sauce and an apple. We did this on many nights. It was surprisingly fun and we came up with some really clever meals on nights that it would have been tempting to drop $10 on a quick dinner without batting an eye.  I realize this is extreme, but it’s an option to really cut your costs while you pay down your loans.

Mr. Money Mustache is a fantastic resource for anyone attempting to lead a frugal lifestyle.

8. Move to Alaska

The SHARP program seeks to fill positions in rural Alaska areas with qualified healthcare professionals. There is such a need for these professionals that, after three years, Alaska will pay off your student loans, if you’re in good standing with the program. If you fall in love with your job, you can also opt to extend your contract. Learn more on the website.

9. Open a Cash-based practice

This is a tough one to suggest to new grads. Unless you’re VERY confident in your abilities as a PT and have a guaranteed stream of patients, it can be challenging to jump right into a cash pay practice right out of physical therapy school.

If you’re the type of PT who thrives on being the best of the best, you will likely thrive in a cash pay environment. Without the constraints of decreasing insurance reimbursement and clinic red tape, you can treat patients the way you want, while making a very good living.

12. Get Rich Slowly

One of the best ways to become wealthy is to invest wisely. If your employer offers a 401k/403b or any other retirement savings plan, use it. If your employer matches your contributions, even better. Contribute the maximum amount you can afford to your retirement savings, as that is your way to secure your financial future and avoid the burdens of taxes in the process. NGPT is planning to write more on this topic, so stay tuned!

Some parting words:

Remember to temper your expectations with a dose of reality. While you may have earned a DPT in grad school (and, no doubt, you worked your tush off while earning that degree), the biggest factor in how much you’re paid is your years of experience.  Try to be patient and, in the meantime, enjoy the fact that you get to paid to love your job 🙂

What do you think, new grads? Are you working in a setting where you’re able to meet your financial goals?

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