Physical therapy profession expands role

Experts estimate that 80 percent of Americans will face back pain at some time in their lives, and it will cost $50 billion each year to care for them. A report from the Agency for Health Care Policy and Research says this figure does not include lost wages for the pain-sufferer nor lost productivity in the workplace — the staggering amount is only for medical bills, workers compensation payments, and time lost from work.

The flip side is that there is money to be made in caring for all those people. Many people turn to chiropractors, pain killers, massage, and other alternative therapies, but they often forget about another important resource: physical therapy.

“I think most people have the image of it being for athletes only,” said physical therapist Ryan Loughmiller, who works for the Mt. Carmel Regional Medical Center’s Rehabilitation Services department. “We do wound care, ostomy care, sports medicine, but we also do a lot of geriatric care and we do a lot of backs. At least 50 percent of our business is neck and back pain.”

Another common stereotype is that physical therapists provide care for back pain sufferers only after surgery or a severe injury, but in fact anyone in pain can benefit from their care. We may envision someone suffering back pain from heavy or improper lifting, but it turns out that desk jobs are just about as deadly for the back. The more office workers are confined to their desks, the weaker their backs become, and the more pain they suffer.

Patients range in age from under a year to “easily into the 100s,” Loughmiller said. The youngest cases tend to be suffering from developmental delays or severe rheumatoid arthritis. Another big category is people on workers’ compensation, recovering from a workplace injury, and a third is athletes of all ages. Surgery is another large category as well.

“I think our population is getting younger,” Loughmiller said, explaining that people in their 40s, 50s, and 60s are used to being active and don’t want pain to slow them down.

The surprise, Loughmiller said, is that those people can come in for preventative care. Patients can even come in to the rehab center’s wellness center to work on their own under medically trained supervision. Many patients move to the wellness center once they are released from the physical therapist’s care. Of course, Loughmiller said, many patients backslide, slumping back into their desk chairs and forgetting to do their exercises.

“If everybody followed their treatment plan, I’d be out of a job,” he jokes. But it’s not likely to happen anytime soon.

Loughmiller said he works with almost every patient to strengthen the core muscles that support the body. He also works on balance, which is often a major consideration in geriatric care. Proper therapy can sometimes even prevent the need for surgery, and it can help prevent falls. That means aging patients can stay independent longer. “That’s the big goal, independence, to keep our elderly population independent as long as possible and as safely as possible.”

That’s also his favorite part of the job. Loughmiller has worked as a lab technician, in the emergency room, and as a drug rep, but he returned to P.T. because he missed the interaction with patients. “I like the patient care,” he said. “I really, really missed the patient contact. I really like working with the patient and seeing people get better. They get back to a lifestyle.”

He explained that when he sees someone come in for therapy in a wheelchair and end by walking, “it’s kind of a nice feeling, a little less gloomy than the ER work.”

In short, Loughmiller likes the happy ending.

“I think everybody who goes into the medical field should see the dirty side of things,” he said. “You learn read quick whether you like patient care or not. If you don’t, go into research.”

In addition, the field is growing and it’s a good way to make a living. The starting salary for the Mt. Carmel rehab center is about $55,000. With an advanced degree, it can go up dramatically, and physical therapists in private practice or in long-term care facilities can easily make six-figure salaries.

“Not bad for 40 hours a week,” Loughmiller said.

The median salary for this region, he said, is about $65,000. Salaries have gone up over the past five or six years as demand has grown and supply of trained physical therapists has dropped.

Private practice is a growing field for physical therapists, and it allows practitioners to offer different services. In exchange for freedom, however, they give up the support of a hospital, but it can be more lucrative, Loughmiller said. In all cases, physical therapists use only evidence-based, peer-reviewed treatments.

Loughmiller holds a master of science degree in physical therapy and is working toward a doctor’s degree in physical therapy. He said that those who graduated in the past five or six years can spend a little over a year to complete the doctor of physical therapy, which is similar to a doctor of pharmacology or doctor of optometry. With a doctor’s degree, a physical therapist can move into research and development of new equipment and new treatments.

But Loughmiller plans to stay in the gym. “In high school I had a shoulder injury and hand some physical therapy work done prior to surgery,” he said. That experience inspired him to go into the field, and he says that’s not uncommon. Each of the six therapists he works with has a sports background of some kind, from college football to recreational tennis.

In addition to the six physical therapists, the center staff includes a physical therapy assistant, two occupational therapists, and two speech therapists. The wellness center is staffed by certified physical trainers with degrees in sports medicine.