The public health emergency may have ended in May 2023, but that doesn't mean vacancy challenges faced by outpatient physical therapy clinics ended with it: According to a new benchmark report issued by APTA and APTA Private Practice, clinics were experiencing a lower, but still significant, overall vacancy rate by mid-2023 compared with summer 2022. The reasons for continued openings, according to the results of the survey-based report, included clinic growth as well as employees seeking better pay and being relocated.

"APTA Benchmark Report: Hiring Challenges Continue in Outpatient Physical Therapy Practices" is based on results of a survey representing 3,843 clinics with 20,443.2 full-time equivalent positions. Conducted during the summer of 2023, the new benchmark statistics update findings of a similar survey conducted in 2022, which identified an overall vacancy rate of 17%. The new report, which reports a drop to 10%, is available for free to APTA members.

The earlier report was conducted partially as a way to assess the effect of the COVID-19 pandemic on vacancy rates and attrition among private practices. That report revealed that while the pandemic ramped up an already-existing shortage of personnel in outpatient clinics, relocation and pay — rather than concerns about the pandemic — were the main factors driving employees' decisions to leave a clinic. The latest report identifies the same two reasons as the main drivers behind PTs and PTAs leaving a position, but it also reveals that the most-cited reason for staffing shortages is related to the growth of the clinics themselves.

Overall, the 2023 report paints a picture of continued staffing challenges among private practice clinics, but with some notable variations across the country and between small and large facilities. Among the findings:

• The total vacancy rate reported by practices averaged 10%. Vacancy rates were highest for PTAs, at 12%, followed by 11% for PTs and 8% for support personnel. Similar to the 2022 survey, nearly 80% of respondents reported at least a 5% vacancy rate across all positions.
• At the clinic level, one in every three clinics reported having an opening for a PT, compared with one in every 11 clinics for PTAs and one in every 5.5 clinics for support personnel.
• Small practices with fewer than five full-time equivalent, or FTE, positions tended to be less challenged by vacancies, with 50%, 75%, and 80% reporting no openings for PTs, PTAs, and support staff, respectively. In contrast, 100% of large practices with 50 or more FTEs reported openings for all three job types.
• Clinics in the West reported the largest vacancy rates, at 16.7%, followed by clinics in the South at 15.2%, the Northeast at 11.1%, and the Midwest at 7.6%. In terms of the severity of vacancies, the South led the regions, with 40% of clinics reporting vacancy rates of 20% or more, followed by the West (40% with a vacancy rate of 20% or more), the Midwest (31.4%), and the Northeast 29.2%).
• In terms of job openings, 39.3% of clinics reported the same number of staff openings compared with the 2022 survey. A nearly equal number of clinics surveyed — 39.9% — reported more openings than the year prior, with 46.2% of those reporting an increase in openings of 50% or more.
• Among respondents, company growth topped the reasons for increased vacancies, with 51.5% citing growth as the primary reason, and 69.7% placing it the top three reasons.
• When it came to employees leaving clinics, most respondents (72%) cited leaving for better pay among the top three reasons, along with better work-life balance (72%) and employee or significant other relocation (46%).

While APTA and APTA Private Practice characterize the report as primarily a tool for practice owners to compare what they're experiencing with national and regional trends, both groups point to the resources as part of a larger commitment to gathering and sharing relevant data that could inform payment and policy. That commitment is centered around four "action steps" that include working to develop a minimum dataset on the physical therapy workforce, continued collection of the datapoints included in the most recent report (and possible expansion to other settings), exploration of workforce models, and expansion of the range of reports offered by APTA.