PTJ: New Workforce Forecast Projects PT Shortages Through 2037

Projected shortages in physical therapist supply over the next 12 years or more could jeopardize patient access to timely or sufficient care unless strategic steps are taken to increase the supply of PTs to meet demand.

This was one conclusion of a new APTA report, “APTA Supply and Demand Forecast 2022-2037,” released as a companion to supply and demand forecasts just published in PTJ: Physical Therapy & Rehabilitation Journal, APTA’s scientific journal.

The PTJ article, “Current and Projected Future Supply and Demand for Physical Therapists from 2022 to 2037: A New Approach Using Microsimulation” projects a fluctuating shortfall in the supply of physical therapists relative to projected demand through 2037. APTA engaged leading health care workforce researchers to generate the supply and demand estimates and forecasts outlined in the paper.

The journal article and companion report offer insights into the current supply and demand situation, the projections through 2037.

To help inform the analysis behind the PTJ forecast, APTA collected crucial survey data — not otherwise available — on PTs’ workload, hours, and capacity to meet current demand. Having an accurate estimated starting point, rather than building a forecast based on the assumption that the current supply of providers equals demand, sets the PTJ study apart from many other workforce projections.

Key findings of the PTJ forecast include:

There were approximately 233,890 FTE physical therapist FTEs in the United States in 2022.
There was a national shortfall of 12,070 physical therapist FTEs in 2022 — about 5.2% fewer physical therapists than needed to meet the estimated demand.
Demand is forecasted to grow faster than the population growth rate by 2037 — with a 14.7% growth in demand for physical therapist services compared with an 8% growth in population.
This shortage is forecast to fluctuate over time, reaching 8.2% in 2027 and shrinking to 3.3% in 2037.
Because uncertainty surrounds any forecast's assumptions about the future, alternative forecasts using different key assumptions were central to the project, including more or fewer entrants to the workforce, earlier or later departures from the profession, and a policy environment that would increase demand for services.
Among responses to survey questions about capacity, about 72% of respondents reported either a shortage in capacity to meet local demand (57%) or being at the limit of their capacity (24.1%).
About 5% of survey participants reported plans to retire or leave the profession in the next year. Work settings where respondents were most likely to report plans to retire or leave the profession were the patient’s homes/home care (9%) and skilled nursing facilities/long-term care (8.9%) settings.

Forecast Scenarios and Findings

At the core of the forecast published in PTJ is a microsimulation approach supplemented with an original survey of APTA members in 2024. According to the model’s baseline scenario, there were 233,890 FTE physical therapy providers in 2022, while the estimated demand required 245,960 FTEs. In short, the nation lacked about 12,070 FTEs’ worth of physical therapist services in the baseline year of 2022. And for every subsequent year up to 2037, the shortfall is expected to continue to varying extents.

The projected 14.7% increase in demand reflects 36,250 FTEs’ worth of physical therapist services. The FTE supply is expected to increase around 16.7% by 2037, slightly higher than the 14.7% increase in demand. However, given the baseline 5.2% shortfall in 2022, a 3.3% shortfall is forecasted for 2037, approximately 9,160 FTEs.

Given the uncertainty that accompanies all projections of this type, alternative scenarios reflecting higher demand as well as higher or lower supply assumptions were also included in the forecast.

Alternative Supply Scenarios

On the supply side, multiple scenarios were developed based on more or fewer entrants to the profession and earlier or later departures:

In the More Entrants Scenario, in which a higher number of FTE entrants was projected, the analysis forecasts a supply greater than demand of 7,290 FTEs (2.5%) by 2037.
The Fewer Entrants Scenario, in which a lower number of entrants was projected, shows a shortfall of 25,620 FTEs (-10%) by 2037.
In the Earlier Exists Scenario, in which PTs retire or leave the profession two years earlier than baseline, the 2037 FTE shortfall is 17,470 (-6.6%).
In the Later Exits Scenario, in which PTs leave the profession two years later than baseline, the 2037 shortfall is reduced to 970 (-0.3%).

Reduced Barriers Scenario

To explore the implications for demand from increasing access to care, the Reduced Barriers Scenario models what would happen if historically underserved populations used physical therapist services to the same extent as populations with greater access to health care. This scenario results in the largest shortfall of FTEs, at 42,312 (-15.5%) in 2037.

Capacity Concerns

Due to the national shortfall of FTEs, there are concerns about the capacity to provide adequate care to all who seek physical therapy treatment.

The APTA 2024 Physical Therapist Workforce Survey indicates that about 72% of respondents reported either a shortage in capacity to meet local demand (57%) or being at the limit of their capacity (24.1%).
Another 31.5% could meet local demand but only by extending hours to their work week.
Among respondents who are “able to provide care to everyone but had to extend hours,” the average number of days new clients wait to be seen is 9.3; among respondents who are “unable to provide care to everyone,” the average wait time nearly triples to 27 days.

Looming Exits

Another contributing factor to the forecasted shortage is the probability of PTs retiring or otherwise leaving the workforce.

Nearly one-fourth of the PT workforce will reach age 65 in the next decade.
Overall, about 5% of respondents in APTA’s survey reported plans to retire or leave the profession in the next year.
That rate rises to 20.4% in the 61-70 age group.

Potential Policy and Advocacy Solutions

APTA’s companion report not only summarizes the PTJ forecast, it also provides context from the association on the forecast’s policy implications.

APTA’s research finds that action is necessary to decrease the shortfall of FTEs. According to the report, “Without strategic interventions to increase the number of physical therapist graduates or retain more of those in the profession, shortages of physical therapists and geographic imbalances suggest that patients may face challenges in accessing timely or sufficient care.”

Policy and advocacy solutions include the following:

Reducng the administrative burden facing physical therapy providers.
Increasing payment rates, particularly from Medicare.
Giving providers more autonomy.
Decreasing student debt to entice more potential students to enter the profession.

Future Workforce Research Needs

Further research and improvements in workforce data will be critical to ensuring that the growing demand for physical therapist services is met, particularly as conditions requiring physical therapy increase with the growing and aging population. APTA’s companion report states that “Research into rural shortages, geographic imbalances, policy and technology changes, the role of PTAs in meeting demand, and other topics is also needed, as is research into interventions to address shortages — what helps attract and retain workers.”