I am often asked by patients, friends, and parents if I would speak to their son or daughter about the field of physical therapy. Usually their child has expressed an interest in the field of physical therapy and want to get some information on what it's like to be a physical therapist, how much money they can make and what type of jobs are available. They also usually want to know how difficult it is to get in school and stay in school.

It is always very interesting when I meet with these young adults. I'm sometimes tempted to discourage them from the field of physical therapy. I have been practicing physical therapy for 24 years and have seen many changes. When I began practicing the educational level and training was different, clinical practices were different and the amount of care that was able to be provided was very different than today.

When I reflect on the way physical therapists practice today, it is very different. The amount of paperwork to get authorization to see a patient and documentation necessary for reimbursement continues to grow. The educational level for physical therapists has gone from a Bachelor of Science degree or certificate program to a Masters degree and soon to be a Doctorate degree. Finally, the length of care per patient case is greatly decreased and continually monitored by the insurance companies. This challenges the skills of the physical therapist to progress the patient to the highest functional outcome in the shortest period of time.

To those of us who have practiced for many years, these changes are sometimes challenging and disheartening, especially when dealing with patients who are unable to get care that the physical therapist feels is necessary because of insurance limitations.

Physical therapists also practice in many different settings. These include inpatient settings such as community hospitals, rehabilitation hospitals and nursing homes. Outpatient settings are also very common and include private practice clinics, hospital outpatient clinics and satellites. Finally, physical therapists also provide home care to patients who are home bound and are in need of rehabilitation but unable to travel to outpatient centers. No matter what the setting, the challenges are very similar for the physical therapist even though the type of diagnoses and case mix can vary dramatically depending on where a physical therapist practices.

When I actually meet with these young adults and see all the enthusiasm in their eyes, my perspective changes and instead of the negatives I remember how rewarding it is to work with patients and see their progress. In addition to helping patients improve physically, you also meet so many nice people and you have an opportunity to make an impact on their lives.

In addition to the rewards of patient care, the changes in the level of education and the practice of physical therapy provides for a very challenging professional career. Physical therapists are expected to evaluate and treat patients as appropriate, make recommendations on discharge and provide information through evaluative techniques as to the functional levels of patients. The profession has progressed significantly in the last 20 years to become increasingly respected and I would recommend it to anyone who is willing to work hard, genuinely cares for others and enjoys being around people all day. As all healthcare professions, physical therapy is very challenging as you strive to help others improve their health and well being, but it also remains very rewarding and fun.

Dale J. Cordial, PT is President of THE pt GROUP Physical Therapy based in Greensburg with twenty offices in Southwestern Pennsylvania.