Health
As physical therapist practices in America face staffing shortages, kids are ‘suffering,’ say experts
The physical therapist will not see you now.
Outpatient physical therapist (PT) practices are experiencing severe staff shortages, with the highest vacancy rates at 17%, according to a recent report by the American Physical Therapy Association (APTA), a nonprofit group based in Virginia.
The report is based on survey responses from 133 outpatient physical therapy practices across the U.S., which include 2,615 clinics and some 11,000 full-time employees, ranging from support staff to PTs. The survey was conducted between May 25 and June 16.
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The pandemic may have accelerated the staffing shortage, but only 1.7% of owners of physical therapy practices cited COVID-19 as the primary reason for leaving, per the press release.
Here is more detail about the survey results — and what they mean.
Outpatient physical therapist practices are experiencing severe staff shortages, per a recent report by the American Physical Therapy Association. (iStock)
Factors driving PTs to leave
Most survey respondents said the big drivers of employee loss were salary, relocation and work-life balance issues.
Among the business owners, 37.3% cited relocation, 25.4% blamed salary and 22.9% said issues with work-life balance were the reason that employees left practices.
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“There is certainly a shortage of physical therapists, especially here in New York, and the pediatric population is suffering,” Dr. Susan Taddonio, assistant professor at Long Island University and a practicing pediatric physical therapist based in New York, told Fox News Digital.
Physical therapists are also retiring, changing careers or selling their practices to corporate entities, added Taddonio, who was not involved in the survey.
Most survey respondents said the big drivers of the loss of physical therapists were salary, relocation and work-life balance issues. (iStock)
“The sad fact is that we go into physical therapy with a major desire to improve the lives of the people we serve … and the rewards at the end make meeting the costs of living and paying off student debt difficult at best,” Dr. Marilyn Moffat, professor of physical therapy at New York University in New York, New York, told Fox News Digital.
Sizable student debts
It’s tough for many potential students to rationalize investing in a physical therapy education that may not yield a return on their investment, added Moffat, who was not part of the survey.
Students typically spend four years earning a bachelor’s degree before embarking on a three-year program to graduate as a doctor of physical therapy.
“To become a licensed PT, you need to earn a doctorate degree,” Taddonio emphasized.
“We go into physical therapy with a major desire to improve the lives of the people we serve … and the rewards at the end make meeting the costs of living and paying off student debt difficult at best.”
“This can lead to a large amount of student debt, and when compared to other fields, the earning potential is not as great — especially with [high] burnout rates and the burden the job places on one’s body.”
Meanwhile, she noted, nurses and physician assistants can graduate sooner with less debt and earn more pay.
“There is a shortage of physical therapists, especially here in New York, and the pediatric population is suffering,” said a physical therapist. (iStock)
The median annual wage of physical therapists ranges from $88,000 to $101,500, but this income only met or fell behind the inflation rate in most areas of the country between 2016 and 2021, according to the APTA’s most recent published data.
At least 80% of recent physical therapy graduates have an average debt of $142,000, per a 2020 report.
Lower Medicare reimbursements
The Centers for Medicare & Medicaid Services (CMS) is planning an additional reduction in reimbursement that will affect physical therapists in 2024, which would bring the cuts to a total of 9% over four years, according to APTA.
(Medicare reimbursements are payments that Medicare sends to hospitals and physicians for medical services they provide.)
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“On Nov. 2, 2023, CMS issued a final rule that finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues, effective on or after Jan. 1, 2024,” a CMS spokesperson told Fox News Digital.
The policy changes “reflect a broader Biden-Harris administration-wide strategy to create a more equitable health care system that results in better access to care, quality, affordability and innovation,” according to the CMS.
Medicare patients make up a large percentage of the people that physical therapists treat, which means new graduates are finding it increasingly challenging to establish small private practices that will be sustainable. (iStock)
Although finalized payment amounts under the PFS will be reduced by 1.25% overall next year compared to the 2023 calendar year, CMS is finalizing increases in payments for many services, such as primary care visits and longitudinal care visits.
“Overall, the finalized [calendar year] 2024 PFS conversion factor is $32.74, a decrease of $1.15, or 3.4%, from [calendar year] 2023,” the CMS spokesperson said.
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Medicare patients make up a large percentage of the people that physical therapists treat, which means new graduates are finding it increasingly challenging to establish small private practices that will be sustainable.
“In the past, we could … actually establish a nice private practice and even have that grow into several practices,” Moffat said.
“However, because the publicly held and private equity-backed major firms have and continue to buy up small practices where the bottom line is the major consideration, it is now extremely difficult — if not impossible — to think about being entrepreneurial and starting that small practice.”
Regulatory changes for remote services
Several recent regulatory changes should give physical therapists and occupational therapists more flexibility in providing services to patients, the CMS spokesperson told Fox News Digital.
Several recent regulatory changes should give physical therapists and occupational therapists more flexibility in providing services to patients. (iStock)
Since 2005, CMS has required physical therapists in private practices to provide direct supervision of their therapy assistants.
“CMS is finalizing a regulatory change to allow for general supervision of therapy assistants by PTPPs (physical therapists in private practice) and OTPPs (occupational therapists in private practice) for remote therapeutic monitoring (RTM) services,” the CMS spokesperson said.
“Practically, this means that physical therapists and occupational therapists will not need to be physically present to supervise RTM services.”
Long wait times for children
A particular population of patients is adversely affected by the shortage of physical therapists, Taddonio noted.
“We have seen children in the early intervention system waiting months to get a therapist,” she said.
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Early intervention services help address the developmental needs of eligible infants and toddlers with disabilities up to 3 years old and their families, Taddonio said.
They are authorized by Part C of the Individuals with Disabilities Education Act (IDEA).
“We have seen children in the early intervention system waiting months to get a therapist,” a PT said. (iStock)
“The data from early intervention reported a 33% drop [in] children being identified and serviced each year since COVID in 2019,” said Taddonio.
She has not seen pay increases for the preschool population in years — a trend she attributes largely to budget and Medicaid cuts.
“In the past 30 years that I’ve been practicing, early intervention has made two reductions in the pay rate,” the physical therapist said.
Fox News Digital reached out to the American Physical Therapy Association for additional comment.
For more Health articles, visit www.foxnews.com/health.
Taking time to sit in a sauna can be a great way to decompress after a grueling workout or even a stressful day.
While in a sauna, you can add to the relaxation by reading your favorite book, listening to a motivational podcast or just by closing your eyes, taking deep breaths and sweating the stress away.
Saunas are commonly found at gyms and spas, but you can buy one for your home.
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A sauna offers health benefits, but it’s also important to be mindful of risks.
- What are the different types of saunas?
- What are the health benefits that come from sauna use?
- How long is it safe to go in the sauna?
- Are there any risks of sauna use I should be aware of?
A sauna is full of health benefits, but it also poses risk if not used properly or if used with certain underlying health conditions. (iStock)
1. What are the different types of saunas?
A sauna is “a specific room heated to about 150 to 195 (F) degrees, and where the temperature and humidity of the room can be controlled with sprinkling water on the rocks in the heater/stove,” according to the North American Sauna Society’s website.
Some of the most commonly found saunas are wood-burning saunas, electrically heated saunas, manufactured sauna rooms, smoke saunas, steam rooms and infrared rooms.
For the most part, many of the health benefits are consistent no matter what type of sauna you use.
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“While many benefits overlap, steam may be better for respiratory issues, far infrared for weight loss and recovery,” Dr. Brooke Jeffy, a board-certified dermatologist from Scottsdale, Arizona, and founder of youth skin care brand BTWN, told Fox News Digital via email.
2. What are the health benefits that come from sauna use?
There are several different health benefits that come along with sauna use.
“Both steam and dry saunas can have beneficial effects on respiratory conditions, cardiovascular disease and dementia,” Jeffy said.
“They also help stiff muscles and joints and increase circulation to the skin. Both steam and infrared saunas have beneficial effects on blood pressure. Infrared saunas may improve weight loss when combined with exercise and improve muscle recovery.”
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The time at which you use a sauna doesn’t matter, according to Jeffy. Either a morning sweat or a relaxing sit in the sauna before bed can boast health benefits.
Many people also choose to hop in a sauna after a workout.
“Post-workout sessions help improve weight control and muscle recovery,” Jeffy said.
It’s common to sit in a sauna after completing a workout. (iStock)
3. How long is it safe to go in the sauna?
When in a sauna, make sure you keep track of how long you’ve been inside.
Many gym saunas have a clock, so you don’t have to take your phone inside, potentially causing it to overheat.
If there isn’t a timer or clock available, make sure to bring one with you or set an alarm to sound so you know when it’s time to exit.
For more Lifestyle articles, visit www.foxnews.com/lifestyle
“The maximum time to spend in the dry sauna or steam room is about 15-20 minutes,” Jeffy said. “Infrared sauna can be used longer, anywhere from 20-40 minutes.”
4. Are there any risks of sauna use I should be aware of?
While sauna use does include benefits, there are also risks you should be aware of if you decide to add it to your routine.
The risks include dehydration, heat exhaustion and stroke, according to Jeffy.
Make sure to drink water to keep yourself hydrated while in a sauna. (iStock)
To avoid potential dehydration, bring a bottle of water into the sauna with you.
If you aren’t a regular sauna user already, consider a slow progression to allow your body to adjust and slowly begin increasing the time you sit inside.
Lastly, if you are pregnant, sick, intoxicated or prone to dizziness, you should not use a sauna, according to Jeffy.
“Saunas should not be used if you have had a recent heart attack, or history of angina, aortic stenosis or congestive heart failure,” Jeffy added.
You’ve likely heard the old adage that breakfast is the most important meal of the day, but what if you’re just not hungry in the morning?
Is it OK to consistently skip the morning meal and hold off until lunch?
Fox News Digital asked some nutritionists about the potential ramifications of bypassing breakfast on a regular basis and their recommendations for optimizing metabolism with a healthy morning routine.
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While most experts agree it’s OK to skip breakfast once in a while, it’s generally beneficial to eat something within an hour or two of waking up.
While most experts agree it’s OK to skip breakfast once in a while, it’s generally beneficial to eat something within an hour or two of waking up. (iStock)
“Skipping breakfast regularly could lead to some unwanted side effects,” Shelley Balls, registered dietitian and owner at Fueling Your Lifestyle in Smoot, Wyoming, told Fox News Digital.
“It can lead to an overconsumption of foods in the following meals throughout the day. You may think you’re eating fewer calories, but you might actually be binging at lunch or dinner,” she said.
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Never eating breakfast can also affect energy levels, she warned, as the body isn’t getting the carbohydrates and nutrients it needs to perform optimally.
There could also be a long-term effect of slowing down the metabolism, the expert said.
“Breakfast is meant to break the overnight fast, and can help jump-start your metabolism. So, over time, not eating breakfast could decrease your metabolism, as your body becomes more efficient with fewer calories,” Balls said.
Protein in the morning usually leads to a higher calorie burn and helps to reduce hunger later in the day, experts say. (iStock)
Breakfast has been associated with a bevy of benefits, including better weight management, better cognitive function, increased metabolism, improved energy and reduced hunger, according to Vanessa King, registered dietitian nutritionist and media spokesperson for the Academy of Nutrition and Dietetics in Oahu, Hawaii.
“Breakfast gives you an energy boost to power-start your day,” King told Fox News Digital.
“Not eating breakfast could decrease your metabolism, as your body becomes more efficient on fewer calories.”
“Breaking an overnight fast with a balanced breakfast significantly impacts well-being and overall health,” she added. “It’s important for everyone. And for children and teens, eating breakfast has been associated with better behavior and academic performance.”
If you’re not hungry within an hour or two of waking up, King suggests looking at your eating pattern.
“Are you snacking at night and it’s leaving you full in the morning? Try lighter snacks and allow more time between your last meal and sleep,” she advised.
The fasting factor
For people who are following a plan of intermittent fasting or time-restricted feeding, eliminating breakfast is a common way to maintain a shorter eating window and a longer fasting stretch, according to Dr. Jennie Stanford, an obesity medicine physician in Pennsylvania and medical contributor for Drugwatch.
“One main determinant here is how someone feels later in the day,” she told Fox News Digital.
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If skipping breakfast makes you feel ravenous later in the day, ultimately causing you to overconsume at other meals, this is not recommended, the doctor said.
“However, if not eating breakfast doesn’t impact the calories and other macronutrients they consume as the day progresses, it may represent an opportunity to decrease overall calorie intake,” Stanford added.
Lighter options for when you’re not hungry
“If you’re not ready for a full meal, begin with something small within 30 to 60 minutes of waking,” recommends Chloë Ward, a functional diagnostic nutrition practitioner and certified integrative nutrition health coach in Santa Barbara, California.
“Even a light snack can help signal to your body that it’s time to start burning energy.”
“Breakfast gives you an energy boost to power-start your day,” an expert told Fox News Digital. (iStock)
Ward offers the following breakfast suggestions for someone who’s not generally hungry in the morning but wants to kick-start metabolism.
- Smoothies: A nutrient-dense smoothie with ingredients like spinach, a small amount of fruit, protein powder and healthy fats (like avocado or nut butter) can be a light yet satisfying option.
- Greek yogurt with berries: Greek yogurt is rich in protein and can be paired with a handful of berries and a sprinkle of nuts or seeds for added fiber and healthy fats.
- Overnight Oats: Preparing oats the night before with milk, chia seeds and a dash of cinnamon can create a light and easy-to-digest breakfast that’s ready when you wake up.
- Protein-rich snack: A hard-boiled egg, a piece of turkey or chicken, or a small serving of cottage cheese can be a quick and light protein boost.
- A piece of fruit with nut butter: Slices of apple or banana with a spoonful of almond or peanut butter offer a balance of carbs, protein and healthy fats without being too heavy.
Greek yogurt is rich in protein and can be paired with a handful of berries and a sprinkle of nuts or seeds for added fiber and healthy fats, a nutritionist said. (iStock)
Overall, experts agree that healthy options like fruits, whole grains, dairy, protein and vegetables provide the biggest benefit.
“Protein has a higher thermogenic effect than other macronutrients, meaning it requires more energy (heat) to break it down than either fats or carbohydrates,” Stanford told Fox News Digital.
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“As such, having protein in the morning usually leads to a higher calorie burn, at least temporarily.”
Protein also helps to reduce hunger later in the day, Stanford said.
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“Protein doesn’t have to mean meat, if it sounds too heavy in the morning,” she noted.
“Other good protein sources include low-sugar Greek yogurt, eggs, low-carb breakfast wraps, cheese, protein oats, protein shakes or clean protein bars.”
“Even a light snack can help signal to your body that it’s time to start burning energy.”
If you really can’t tolerate food in the morning, Ward suggests starting the day with a glass of warm water, possibly with lemon.
“Warm water helps wake up your digestive system, aids in hydration and can boost your metabolism after a night of fasting,” she said.
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