In 2006, I was working as a physical therapist in acute care in the Boston area. One day, as I was evaluating a polite, older gentleman after hip replacement surgery, he said, “this is a nice job for you girls.” You girls. He didn’t say it in a “this profession offers so many opportunities for career growth and success” kind of way. Let’s just say that the connotation was … old-fashioned.
After taking a few seconds to resist the urge to rattle off a list of reasons why his comment was so offensive, I simply said, “It better be. It took me 8 years to earn my doctorate.” He looked stunned for a moment, as if he was under the impression that a physical therapist license could be obtained after a weekend of training. For the next two days, we worked very well together, though he did refrain from offering any additional commentary about my career choices.
Our History: Women Only … At First
Upon reflection, I realized that this patient spent his early years, and most of his adult life, in a vastly different world than we live in today. When he was a young boy, his mother, grandmother and aunts probably didn’t have the right to vote or hold public office in the United States, depending on the state they lived in.
The 19th amendment wasn’t ratified by all 50 states until 19201. In fact, Mary McMillan, one of the founders of physical therapy, earned the right to vote just months before becoming the first president of what is now the American Physical Therapy Association.2 The association was founded exclusively by women, because early on, women were the only candidates admitted to programs that trained Reconstruction Aides. It wasn’t until many years later that men could become physical therapists, and they were not members of the association until the 1930s.2
Back then, it was not uncommon for women to have to fight for equal rights and status. Colonel Emma Vogel (Ret.), spent years fighting for equal pay and rank as a physical therapist in the Medical Department of the U.S. Army, finally winning and earning the rank of colonel.3
Physical Therapy Today
These days, women still comprise about 70% of the profession.4,5 While we don’t face all the same issues that our predecessors did, contemporary physical therapy practice is not without challenges for women. For example, like most jobs in the U.S., women in physical therapy earn less than men. The median earned income of a female PT is $80,000 per year, while men earn $92,000.4
In addition, those who tend to make the most in physical therapy, are usually private practice owners; close to a third of private practice owners report making over $100,000 per year. However, men own physical therapy practices at about twice the rate that women do.5 Unfortunately, the disparities don’t end with salary and practice ownership.
Et Tu, APTA?
Only males have filled the role of CEO of APTA for more than 20 years, with the exception of an interim CEO in 2003. The APTA Board of Directors is 63% women, but for the elected executive positions – president, vice president, secretary and treasurer – only 50% of those positions are filled by women.6 There hasn’t been a female president of APTA in over a decade.
According to the APTA bylaws, the president is the official spokesperson for the association.7 It is troubling that an organization that is made up of 70% women, has been officially represented on a national level by a man for more than 10 years.
In physical therapy education, things aren’t much better.8 While only 30% of the profession as a whole is men, 40% of physical therapy program director positions are filled by men.9 Female physical therapy students’ first exposure to a leadership position in physical therapy involves a disproportionate number of male role models.
And while 60% of physical therapist (PT) program directors are women, more than 76% of physical therapist assistant (PTA) program directors are women.9,10 This fact reveals that women are more likely to fill leadership roles at smaller programs, where they are more likely to earn less money, participate in less in research activity, and, due to smaller budgets and staffs, generally have less influence than directors of PT programs.
Trailing in Online Influence
Another area in which women in physical therapy are under-represented is online. In the past few years, the physical therapy community has embraced social media and blogging as a way to connect and communicate.
A quick search on Google for physical therapy blogs reveals that the vast majority are run by men. Of the 17 prominent blogs that are run by physical therapy professionals (excluding those run by students and organizations), only four, including this one, are run by women. The other 13 are run by men. This means that while women make up 70% of the profession, 70% of the blogs are being run by men. Since blogs exist to help us communicate with the world, it is significant that women’s voices are under-represented in this arena.
But Hey, Is This Really Such A Big Deal?
Given the examples above, should we be concerned? Is it really all that bad? After all, there are worse industries. Certainly women in computer science and finance experience significantly more inequality. And there are many positive examples of women in leadership roles in the physical therapy community:
- The Speaker of the APTA House of Delegates is Shawne Soper, PT, DPT, MBA.6
- Mary Jane Harris, PT, MS has been the Director of the Commission on Accreditation in Physical Therapy Education (CAPTE) for 14 years.11
- Selena Horner, PT, MS, GCS, ATC is a leader in social media, running the #solvePT Tweetchat.12
- Ann Wendel, PT, ATC, CMTPT is a prolific blogger and contributor throughout the web.13
There has also been an APTA Task Force on Women’s Initiatives since 2012. In fact, there is a whole page on APTA’s website with the title: Career Considerations for Women in Physical Therapy.14 The thing is, why is there no equivalent page for male physical therapists? Men are the minority and the relative late-comers here. Shouldn’t they be the ones that need more help? It begs the question: why do we need a Task Force on Women’s Initiatives if nothing is wrong?
What’s Wrong, Dear?
The real danger here, is not the present. It is our future that is vulnerable. In female-dominated professions, often the assumption is that parity is a given; i.e., a higher proportion of women naturally means more women in leadership positions. At the very least we should expect to see a balanced leadership that reflects the demographics of the profession, shouldn’t we? We should. But we don’t right now. And it’s possible that it could get worse.
This can be attributed partially to the fact that this may be our elephant in the room. There have been few, if any, articles on the topic in PT in Motion, physical therapy trade magazines, or scholarly journals. Given that both the editor, and the associate editor of PT in Motion are men, it is fair to say that these issues are probably not foremost on their editorial calendars. Or is it, perhaps, a function of PT in Motion’s editorial board, which is 80% men? 15
What Does This Mean?
Raising this issue is not to suggest that men have any less right to pursue as many leadership posts and high paying positions as they care to; or rebuke the notion that the most qualified among us ought to occupy those roles, whether they are male or female.
Nor does simply raising this issue suggest that the challenges surrounding women in society and the workplace are anything other than longstanding, multifaceted and complicated. Indeed, the Task Force for Women’s Initiatives came to the same conclusion.14
It also doesn’t preclude us from accepting the status quo, if we are happy with it. But, just in case there are some physical therapy professionals out there– male or female – that are concerned about this issue, at the very least, an open dialogue is long overdue.
Call To Action
Not everyone wants to pursue a leadership position, and that’s OK. But if 175,000 of us are female, there are surely enough women to guarantee that our leadership is proportionally represented by both genders. So, if you are one of the ones who wants to lead, go for it, because we need you. We need you to run for office on the local and national levels. We need you to start a blog and become a voice of influence. We need you to become a private practice owner. We need you to pursue leadership roles in education and research. We need you to ask for what you need to get it done. We need you, because you know what? In the end, my patient was right. This is a “nice job” for us “girls.” But only because “us girls” made it happen in the first place.
About the Author
Jennifer Bresnick, PT, DPT practices what she preaches as a member of the Connecticut Physical Therapy Association’s Board of Directors, physical therapy blog owner and PTA Program Director. Jennifer lives in Shelton, CT, with her husband and two daughters, ages two and five.
- Wikipedia, Nineteenth Amendment to the United States Constitution, http://en.wikipedia.org/wiki/Nineteenth_Amendment_to_the_United_States_Constitution Accessed March 22, 2014.
- American Physical Therapy Association History, http://www.apta.org/history/. Accessed March 22, 2014.
- U.S. Army Medical Department, Office of Medical History, http://history.amedd.army.mil/corps/medical_spec/chapterIII.html Accessed March 22, 2014.
- American Physical Therapy Association, 2013 Median Income of the Physical Therapist Summary Report. Last updated 2/24/2014.
- Advance Health Network, 2012 Salary Survey Results, http://physical-therapy.advanceweb.com/Archives/Article-Archives/2012-Salary-Survey-Results.aspx. Accessed March 22, 2014.
- American Physical Therapy Association, Board of Directors, http://www.apta.org/BOD/. Accessed March 22, 2014.
- American Physical Therapy Association, Policies and Bylaws, http://www.apta.org/Policies/. Accessed March 22, 2014.
- Sabus C. Engendered Roles in Physical Therapist Education: A Feminist Vision for Scholarship in Clinical Education. J Phys Ther Educ. 2010;24(3):44-49.
- Commission on Accreditation in Physical Therapy Education, 2012-2013 Aggregate Program Data: PT Programs, http://www.capteonline.org/AggregateProgramData/. Accessed March 22, 2014.
- Commission on Accreditation in Physical Therapy Education, 2012-2013 Aggregate Program Data: PTA Programs, http://www.capteonline.org/AggregateProgramData/. Accessed March 22, 2014.
- Commission on Accreditation in Physical Therapy Education Staff. http://www.capteonline.org/WhoWeAre/Staff/. Accessed March 22, 2014.
- #solvePT via SnippetPhysTher. http://snippetphysther.tumblr.com/whatis. Accessed March 22, 2014.
- Prana Physical Therapy Blog. http://prana-pt.com/blog/ Accessed March 22, 2014.
- American Physical Therapy Association, Career Considerations for Women in Physical Therapy. http://www.apta.org/CareerManagement/Women/. Accessed March 22, 2014.
- Masthead. PT in Motion, Mar 2014;6(2):8.
Ann Wendel (@PranaPT) says
Thank you for such a well written, informative article. Wow, you did your homework on this one! You actually answered many of the questions that have been thrown out on Twitter about the numbers and stats involved in this issue. I truly appreciate your hard work and have shared the article in social media. I appreciate the fact that you acknowledged that this is an issue for our entire profession to address. It’s not men vs women, boyz club vs girlz club (I really dislike those terms)…when we all work together we can elevate the profession.
I hope that everyone will join the DPTStudent chat on Twitter tomorrow night at 9pm ET, as we discuss this topic.
Jennifer Bresnick says
Thanks for the kind words Ann! So glad you enjoyed it, and found that I struck a good balance. That was the plan, and I’m happy to hear that it came across that way. You’re right, it has to be team effort!
Nicole Stout says
While I whole heartedly agree with this wonderful post, I need to interject from a different perspective. How do ‘we’ women portray ourselves? How do ‘we’ women step up and ask to take the lead…demand the lead?
Much research suggests that our personalities are vastly different from men. We are not inherently risk takers. We prefer strategy and calculated approaches rather than spontaneous, gregarious leaps. That is OK, however I believe that we, too frequently, fail to portray those attributes as strengths. Slow and steady wins the race, right? Well, you have to be IN the race to start with and that’s a place where ‘we’ don’t step-up. We choose to not play in the sandbox ladies! Maybe we don’t like the adversity, maybe we don’t like the perception of being the woman in the man’s world, maybe we just don’t want to.
Margie Warrell’s post on Forbes.org’s blog earlier this month stated: “(Leading) doesn’t require women to be more like men…Rather it demands that women own and exercise what have long been regarded as their leadership liabilities – sensitivity, perceptiveness, connectedness and compassion – because those feminine leadership attributes, when combined with the strengths of men, measurably improve the outcomes of the decisions being made.
My favorite bit of her advice: “Act as the leader you aspire to be.” Great leaders don’t lead because of the power they have been given, but because of how they’ve used the power that’s always resided in them.
We can’t (nor should we EVER) expect to be given a seat at the table because we are a woman, when we step up and earn that place through strong, sound, decisive actions and successful performance then we deserve to be in that seat. And, I believe, the men around us will see those attributes and not just the “girls’ that we proudly are.
For some very realistic perspectives:
Will Crane says
Your comment articulates very well some of the feelings I’ve had about gender issues for quite some time. To add another “Y” chromosome viewpoint, I concur wholeheartedly that women have innate strengths that can be exercised beautifully in leadership positions. I believe that the world today, including the physical therapy profession, places too much emphasis on male leadership characteristics. I deeply appreciate the perspective that women bring to the table, and I sincerely hope we can all find a place to foster the unique leadership abilities we all have. Great post and comment.
Jennifer Bresnick says
Thanks for your comments, Nicole. The one thing missing from my post is the solution! Your article links offer some practical ones. One general theme is that we can’t force women to simply act like men in order to assume these leadership roles. The consensus is that the culture has to change so that the environment is more suitable to the success of BOTH genders. I think it will, but it will take time.
Matthew J. Taylor, PT, PhD says
Thanks for bringing forward this important issue Jennifer. As a “Y” chromosome carrier, I’d like to offer a couple resources/insights I’ve been fortunate to discover along a 33 yr career.
1.) I had the good fortune to do my doctoral studies here http://www.ciis.edu which is founded on integral philosophy … ie, take it as a whole/ female/male entwined so integral is a nice way to avoid his/her language as we all have the capacity to act as either (loving those women’s power suits at CSM???)… so how do we bring forth a vital/robust balance.
2.) While there I studied with Alfonso Montouri, PhD and someone who has been addressing this issue for years, Riane Eisler, JD, PhD… Her book The Power of Partnership offers great language for looking at this issue from a relationship basis (She uses the polarities of Dominator/Partner) because we’ve probably all run had bosses or colleagues that exhibited the “opposite” gender qualities inappropriately attributed to one’s gender. A great resource is Eisler’s newest book w/ Teddie Potter, RN, PhD Transforming Interprofessional Partnerships: A New Framework for Nursing and Partnership-Based Health Care …which does a great job of describing how our larger professions are woven into the same relationship imbalances and offers action practices that are appropriate for us as PT’s as well…it’s pricey but worth it.
3.) In my upcoming textbook, “Fostering Creativity In Rehabilitation” I’ve invited Ginger Garner, PT, ATC http://www.gingergarner.com to contribute a chapter on how these relationship imbalances thwart creativity on so many systems levels. She’d be a good one to invite into the conversation as she blogs extensively on PT, healing and mother’s. She’s also a student of Riane’s.
OK, my maleness is showing I tend to want/need to take over…so I’ll bow out to lurk, but thanks again for the call for our culture (us) to change to a partnership model. ~ matt
Jennifer Bresnick says
Thanks so much for taking the time to weigh in on this, Matt. It is so important to include all of us in the discussion, so having a male perspective here is definitely appreciated.
I was hoping that once I raised the issue that potential solutions/ways forward would surface. You and Nicole have both offered some of these. Thanks for your contribution!
Nice and very informative post. Very well written and explained. I really wondered to read this blog, this is so much re searchable. Like it. Thanks for sharing a great post with us.
Josh Brett says
Great read. I appreciate the history and insight you have provided. Thank you.
William Richardson PT, DPT, CSCS says
I, like most I presume, can appreciate the intentions of gender parity. After all, who wouldn’t be okay with men and women being proportionally represented in the workplace? It seems obvious that this is in the best interest of all (for many reasons), given the innate differences between women and men and the consequent different skills/strengths each gender can bring to the table. While many argue that men and women are not innately different, that seems to not only contradict psychological research (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149680/), but also the goal of gender parity. For if we truly are the same, there would be no need for equal representation.
With that being said, it doesn’t seem that your premise is in alignment with what we know about the differences between men and women. In other words, there are a lot of assumptions in this piece that imply that we should have an exact (or perhaps, very close, although you don’t specify exactly how close) proportion between men and women in leadership roles, yet that would truly be impossible given the significant differences between men and women.
If gender parity per se is the goal, do you take issue with the fact that women are OVERREPRESENTED in our profession? In other words, are you advocating for women to leave the profession and more men to step up?
That aside, I’d like to address a few of the erroneous claims in your piece that I find misleading to those that are ignorant to the data.
“ The median earned income of a female PT is $80,000 per year, while men earn $92,000.”
As I’m sure you’re aware, this data does not take into account a myriad of factors that explain WHY this is the case. In fact, in the very next few sentences you state “… those who tend to make the most in physical therapy, are usually private practice owners; close to a third of private practice owners report making over $100,000 per year. However, men own physical therapy practices at about twice the rate that women do.” In other words, the math adds up.
If you understand the differences between men and women, it’s easy to appreciate why more men are clinic owners and consequently make more money (males, on average, tend to work longer hours and take greater risk than females- tendencies characteristic of entrepreneurs). This only becomes a problem, in my estimation, if there are definable barriers to women owning practices. Those are the types of worthwhile legislative battles that women fought for in the mid-20th century (and rightfully won), but it seems the differences in practice ownership noted today is largely due to choice- not force or coercion.
“It is troubling that an organization that is made up of 70% women, has been officially represented on a national level by a man for more than 10 years.”
Why is this troubling? Did the men discriminate against women, or do a less than satisfactory job in providing equal OPPORTUNITES for women? If not, why does it matter if it’s a man or a woman?
I don’t buy the assumption that having a woman president is a panacea that will finally move our profession in the right direction. In fact, it’s equally possible that she would be a bad leader as it is that she would be a good leader. If, that is, you believe women, like men, inherently have flaws. Again, based on the preponderance and conclusive literature demonstrating men are more likely to work longer hours, as is required in a leadership position, it seems logical to assume more men would fill this position than women. And it doesn’t seem to be that women are lazy, as you might infer from my position, it simply seems that men tend to “overwork”, as shown by the US Bureau of Labor and Statistics: https://www.bls.gov/cps/cpsaat22.htm
“This means that while women make up 70% of the profession, 70% of the blogs are being run by men.”
This supports the notion that men and women are different, as there are seemingly far fewer barriers to a female starting a (free) blog. Is the implication that more women should step up and do this, or is it that men are unfairly represented in blogs? If it’s the former, I can agree with your assertion, I just don’t know that women care to. If it’s the latter, I’d ask for evidence of unfairness. When it comes to STEM (I’m admittedly hypothesizing that tech-savviness may be partly responsible for the fewer female-run blogs), women are underrepresented, but it seems to be a result of their choice, as noted by Ceci et al (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044353/) and Wang et al (http://www.cds.web.unc.edu/files/2014/10/not_lack_of_ability.pdf).
WOMEN’S TASK FORCE
“It begs the question: why do we need a Task Force on Women’s Initiatives if nothing is wrong?”
I don’t think we do. If we find concrete evidence of sexism, as opposed to differences in outcomes based on free will, I think everyone could get behind that. It’s difficult to support a task force like this otherwise, or simply for the sake of enforcing gender parity (to a degree yet to be defined to my knowledge). So far, I’m not convinced it’s necessary.
“Given that both the editor, and the associate editor of PT in Motion are men, it is fair to say that these issues are probably not foremost on their editorial calendars.”
This seems borderline inappropriate. Are you implying the editor and associate editor are less concerned with the wellbeing of women, simply because they’re men? If they don’t take issue with that, so be it. But I think to assume a man doesn’t care about the prosperity of a woman simply because he is a man, is sexist (if you believe ascribing beliefs to a person based on their sex is sexist, that is).
“It also doesn’t preclude us from accepting the status quo, if we are happy with it.”
I’m in agreement here. Let women decide what’s best for them instead of forcing an arbitrary percentage of outcomes. The choices of women and multifactorial nature of this issue means that a natural disproportion of women in certain roles is, well, natural. Especially given the fact that only women have children, causing increased time out of the workplace- as the APTA mentions in your link. As they state, this explains why many women leave the profession, and on a side note, is likely at least partly responsible for the median wage gap mentioned above (the longer you stay in a profession, the more you tend to make). With that being said, I’d fully support the notion for better maternity benefits to keep more women in the profession- if that’s what they want.
CALL TO ACTION
“But if 175,000 of us are female, there are surely enough women to guarantee that our leadership is proportionally represented by both genders.”
True, there are enough women to be proportionally represented in leadership roles, but there will never be enough women to “guarantee” anything because women are free to choose their roles. In fact, in those countries with the most gender equality, there seems to be the largest gender differences in occupational choice, as demonstrated by Stoet & Geary (http://eprints.leedsbeckett.ac.uk/4753/6/symplectic-version.pdf).
In short, I don’t believe gender parity is a practical or productive goal because of it lacks consideration of biological differences that lead to different CHOICES by men and women. I’m all for extirpating sexist behavior and arbitrary barriers that prevent women from pursuing their interests (I do have a mother and sister :)), but I haven’t seen the evidence that those behaviors and barriers are precluding equal representation in leadership positions.
Happy to discuss further, Jennifer! Thanks for opening the dialogue 🙂