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Blog > Should I be a PT or PTA? Part Two: Practice Differences

Jennifer Bresnick 5 Comments

Should I be a PT or PTA? Part Two: Practice Differences

This is the second article in the series “Should I be a PT or PTA?” In the first article, we discussed education requirements. In this article, we review the differences between PTs and PTAs once you graduate and start working.

Patient-Client Management Model in Physical Therapy

One of the first things you will learn about in physical therapy school is how physical therapy practice is structured. The Guide to Physical Therapist Practice calls it the Patient-Client Management Model  and it is arranged in a circle to represent the cycle of care that each patient follows. (There is an updated version of this in the 3rd edition of The Guide, but I find that the explanation below is still valuable.)

patient-client management model for physical therapy

APTA, Guide to Physical Therapist Practice, 2nd edition

When a patient arrives for their first physical therapy appointment, the cycle begins in the Examination box at the lower left corner. The PT does a full work up of the patient, and then goes to the next phase, which is Evaluation. Evaluation is taking all of the information from the Examination, and pairing it with the PT’s knowledge and the current best scientific evidence; this leads to the physical therapy Diagnosis (what’s wrong with the patient?) and the Prognosis (how can we help the patient, and how long it is going to take?). Interventions are the actual things we’ll do with the patient, like exercises, manual therapy and education. Finally, in Outcomes, we do some more testing to see if what we have done is working.

Physical Therapy Practice Areas

Practice Areas of Physical Therapy

The biggest difference between PTs and PTAs in practice has to do with this patient-client management model. PTs are allowed to perform any of the elements listed in this model; PTAs are limited to some of the Interventions and some of the Outcomes. This framework is supported by the American Physical Therapy Association, and it is the law in most states.
 

PTAs Work Under the Direction and Supervision of the PT

This means that the PT will delegate only certain Interventions to the PTA. For example, the PT decides that the PTA should not be providing a particular exercise to the patient because the patient has a special circumstance. Most of the time, however, the PTA is performing the majority of the Interventions listed in the Plan of Care.

It also means that the PTA can’t practice physical therapy unless there is a plan of care in place. I have had many students, who are personal trainers, start my PTA program thinking that they can add physical therapy to the list of services they offer clients once they graduate. However, in order to legally provide physical therapy services and bill insurance companies for them, a PT must first see the patient and set up a plan of care. Without the plan of care in place, the PTA runs the risk of legal action against their license.

Another difference between PTs and PTAs once you graduate, is the salary.

Physical Therapy Salaries

Physical Therapy Salaries

Both have good earning potential, but you will have to decide whether the extra years in school, leading to a higher salary are worth it.

And don’t forget to factor in those loan payments! The following example assumes a public institution education, take-home tax rate of 33%, and 6% loan interest.

Physical Therapy Take Home Pay with Loan Amounts

Physical Therapy Take Home Pay

So, now you have even more information about the differences between PTs and PTAs, to help you decide which path to choose. In the next article, we will discuss career path options for PTs and PTAs.

Did you miss the first article? Find it here.


References

  1. Guide to Physical Therapist Practice, 2nd edition, American Physical Therapy Association
  2. Bureau of Labor Statistics, http://www.bls.gov/oes/current/oes291123.htm, Accessed February 25, 2014
  3. Bureau of Labor Statistics, http://www.bls.gov/oes/2009/may/oes312021.htm, Accessed February 25, 2014.
  4. American Physical Therapy Association, 2010 Median Income of Physical Therapists Summary Report
  5. American Physical Therapy Association, 2009 Median Income of Physical Therapist Assistants Summary Report
  6. http://www.aie.org/paying-for-college/finance-tools/College-Loans-A-Cost-Calculator.cfm.  Accessed February 25, 2014.

Comments

  1. Emily says

    February 12, 2017 at 5:00 pm

    I’m not understanding the take home monthly amount for a PT. Why is it so low? 60,000 divided by twelve, take out taxes. How does it come out to that? Also, what about benefits? I am a teacher with BA in education, thinking about getting into PT. Teaching has a lot of take home work, does PT? Thank you very much for all this info!!!

    Reply
    • Jennifer Bresnick says

      February 14, 2017 at 1:12 pm

      Hi Emily-
      As I explained in the article, I used a take-home tax rate of 33%. $60,000/year divided by 12 months is $5,000/month. 33% of that is $1,650 paid in taxes. Gross pay ($5,000) minus the taxes ($1,650) is $3,300.
      Benefits will vary depending on the facility you work for, whether you are full- or part-time, and other factors.
      PT doesn’t have much take-home work … technically. You see, documentation of each patient encounter should be done during work hours, securely at the facility, where safeguards are in place to keep patient information from winding up in the wrong hands. That being said, I have heard of many PTs that take their documentation home with them in order to complete it on time. This can decrease over time as the PT or PTA becomes more efficient with documentation.
      There is also some time (again, more in the beginning of a PT career), where it is necessary to look up clinical information that is beyond what was taught in the entry-level program. It is just not possible to teach a PT or PTA student everything about physical therapy in two or three years. So, there is a minimum standard which all graduates must meet with the understanding that as they begin working they will be lifelong learners, constantly adding to their knowledge base as they encounter new diagnoses, new research, new technologies, etc.
      Having never been a teacher, I can’t say how the take-home work level compares between the two professions. However, having known plenty of teachers and PTs, I can estimate that the work for teachers is more than the work for PTs.
      I hope this is helpful.
      All the best,
      Jen

      Reply
      • Rachel Forney says

        July 19, 2017 at 12:59 pm

        How difficult and logical would it be to become a PTA but then decide to continue education to become a PT?

        Reply
        • Jennifer Bresnick says

          August 5, 2017 at 12:54 pm

          Hi Rachel,
          I always tell my students that it is an option, but it’s not the only one. There are many other degrees to consider that will further your career.

          I advocate that PTAs pursue degrees and expertise, or otherwise invest time, in a related or complimentary field. For example, business, healthcare finance, innovation of rehabilitation products, computer coding, law, a second language, research, educational technology, political science, etc. Imagine that you spent three years going to law school instead of PT school, and now you’re a lawyer with healthcare expertise … or, like me, you invested time into learning computer coding and educational technology, and now have a web-based business assisting students through their physical therapy programs and licensure exams … or you pursued an idea you had to invent upper extremity slings that stay put on two-year-olds that fracture their clavicles (true story … I’m still trying to figure it out after my daughter fractured hers!). The point is, don’t get stuck thinking a DPT is your only path for advancement. Be creative and you might find success in unexpected places!

          There are a bunch of similar comments and additional answers and advice here: https://theptstudent.com/pt-or-pta-2/#comments

          All the best,
          Jen

          Reply
          • Cal barber says

            December 9, 2017 at 8:04 pm

            If I’m an PTA what other major would be good to support this? Psychology, law, physiology, what else can I do to support my PTA career like you said you have a website and you assist students through Physical Therapy.

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