Nothing has yet to rock the modern world quite like the COVID-19 pandemic. Life as we all knew it changed both during and after. It didn’t matter where you were from, how old you were, what job you had. COVID affected everyone. Many of us would say there was a world before COVID and another one after COVID. And if you were to ask someone, “what changed?”. The answer would probably be well…everything.
But perhaps this is most true for the healthcare system and the workers within it. The COVID epidemic all but brought the US healthcare system to its knees. Between over-run hospitals, staffing shortages, clinic closures, regulation and procedure changes, PPE shortages, and integration of increased tech there was not a single healthcare provider that didn’t struggle or wasn’t forced to adapt in some way. Physical therapy was no exception. COVID changed how PT was both practiced and perceived. It also changed the PTs themselves. 5 years and counting we’re still dealing with the effects of COVID. . . for worse and for better.
PTs of the COVID Epidemic
I’ll first start by sharing my own experience. COVID blew up in my last semester of PT school. My classmates and I were all supposed to be on clinicals. However, many of them were cancelled which led to a lot of confusion and anxiety about graduation. Once we knew we’d graduate (ceremony was cancelled, but hey as long as we were still done on time) we thought our problems were over. We were so wrong. Then came is what I’m gonna call a cluster fuck of trying to take boards.
I was lucky in the fact that I didn’t take boards till late Summer, so by then most of the testing sites had their shit figured out. My friends who took boards in the Spring had to fight for testing dates and had testing dates get cancelled more than once. Basically it was every third year PT student’s own personal hell. Well finally we all passed boards and then the next problem was one we’d never thought we’d have – getting hired.
To be frank, when it came to jobs, there were none. I actually had several classmates get their job offers rescinded due to the fact that places were just trying to bring their current employees back to full schedules. My now husband and I had planned to do travel PT. However positions were few and far between. Finding close sites who were down to take one new grad much less two was proving to be impossible, especially with plenty of more experienced PTs out there vying for jobs as well.
We finally saw the writing on the wall (and our bank accounts) and decided we’d need to take perm positions instead. This proved to be easier than finding travel positions but still not THAT easy. There weren’t many options, and as new grads during that time, we didn’t have much room to negotiate. There were lots of experienced PTs out in the job market and some places really weren’t hurting that bad for new help. Many of my classmates and I look back now and admit we accepted positions and salaries we never would have if times had been normal. Now most of us feel we’ve caught up in salary or changed to more desirable positions, but COVID definitely didn’t give us a cushy start.
Current PTs didn’t have it much better. The one thing many of us were told when choosing PT as a profession was that we’d have great job security. Well, with COVID that went out the window for a lot of people. Clinic closures, lay-offs, or reduced hours significantly impacted many PTs.
Between student loans, long hours, and high patient caseloads job security was the ONE thing we really had going for us. Poof. Gone. PTs who’d been in their positions for years lost their jobs and were thrust into a job market where pickings were slim but the competition wasn’t. PTs who had built their business from the ground up couldn’t keep their doors open. Business owners faced impossible decisions. They had to choose between staff lay-offs (which still may not be enough) or close their clinics.
Some PTs were VERY VERY busy. Inpatient PTs in hospitals, SNFs, and AMRs dealt with a constant influx of very sick and/or debilitated patients. Not to mention treating patients for a virus we knew relatively little about at the time. These PTs continued treating during the pandemic through PPE shortages, staffing shortages and overall a failure of the healthcare system to keep up.
Many of these PTs were also traumatized by the amount of death they saw. If you’ve ever lost a patient you know it’s not easy. I can’t imagine dealing with that every single day. Not to mention doing it in the same N95 you’ve been wearing for a week. That type of stress and anxiety with no end in sight would weigh on anyone after a while. During COVID those working in hospitals were rightfully referred to as Healthcare Heroes. To the PTs that worked tirelessly in full PPE day in and day out, proning patients and motivating patients at their lowest, loneliest points, just know you deserve that title just as much as any doctor or nurse who worked in the pandemic.
Finally, the vaccine came out, COVID cases dropped, and things gradually returned to what we now call “the new normal”. Part of that new normal was crippling, debilitating burnout of healthcare workers. After all that craziness, every healthcare worker was exhausted and it led to a lot of people in general, but especially healthcare workers, to rethink some things. After COVID, people put a lot more emphasis on self care, work-life balance, and workplace flexibility. PTs were no exception.
COVID left a jaded after-taste for many. The pandemic showed we didn’t have as much security and happiness in the profession as we thought. PT’s began to rethink their careers. They looked to expand their skills and seek other opportunities – either for better work-life balance or to diversify revenue streams. The brokenness of the healthcare system was on full display during the pandemic. This pushed PTs to start experimenting with new business models that may better serve both patients and therapists.
A Post-Covid Population
I could obviously go on and on about how COVID affected us PTs, but we can’t forget about the patients. COVID resulted in some challenges and benefits for healthcare providers and patients.
I’ll start with the good. One of the ways PTs and other healthcare providers adapted to COVID was the use of telehealth. While it’s true telehealth has some limitations it doesn’t outweigh the benefits. If we’re being honest, it’s something that should have been used more pre-covid. Sometimes patients have trouble getting to appointments due to where they live or the inability to drive. This makes healthcare harder to access for the physically impaired who can’t drive, older people, and rural patients. These are usually populations who need healthcare!
Many patients were skeptical about telehealth at first. Now, some even prefer it or request telehealth if the visit doesn’t require a physical exam. Pre-COVID telehealth visits were often not covered by Insurance. Some things changed for the better with COVID and telehealth was definitely one of them. COVID made telehealth accessible which made healthcare more accessible. And that was good because people REALLY needed it.
Delayed care was a major consequence of the pandemic. Many outpatient and specialty clinics were forced to reduce patient appointments to comply with social distancing. I know my clinic pretty much kept it to post-op patients only. Which meant anyone who wasn’t a post-op patient had to wait a long time before they could be seen. We all know that often the longer someone waits, the worse things can get. So when patients were able to get into a PT, their pain was likely worse and chronic at this point.
So patients were dealing with their prolonged nagging pains, but many were also left sick and debilitated. Many vulnerable populations needed PT due to debility after contracting COVID. Long COVID is another issue that patients and providers had to – and still have to – navigate. Long-COVID is a syndrome that goes beyond just debility with many varying symptoms and severities. Much is still not well known or understood about it. What we do know is many people were not physically the same as they were before COVID.
More than one of my co-workers who were at our clinic before and after COVID have said they feel like we are busier and patients are sicker now versus before. I’m not sure if this is a result of always playing catch up from the delayed care during the pandemic or the after effects of the virus itself.
No Going Back
Thankfully not everything stuck around after COVID (wearing masks everywhere, social distancing, the elbow high-five). But some things, both good and bad, are here to stay. One great thing that’s likely to stick around is telehealth! It’s good for both healthcare providers and patients. It’s not every day we get that win-win scenario. Honestly, patients now come to expect it as an option. Thanks to legislation many of the once temporary telehealth allowances have become permanent.
While I think telehealth is very hard to do as a PT, I do think it can be done and be done well. Many PTs have used this as part of building their businesses and an extra source of income.
The change in the PT career path is another thing that’s never going to be the same. COVID-19 showed just how much the healthcare system can fail the patients and the workers. We PTs decided it was time for some better options. Some decided to pursue non-clinical roles and leave the profession altogether. A large PT population turned, and continues to turn to, self-employment and cash pay.
I think this was needed for PTs to market themselves more and demand more than the status quo. At the same time so many PTs are doing this now that the competition is HIGH. So only the best are gonna rise to the top. Cash-pay models aren’t feasible for everyone. I think there’s still the unsolved issue of finding models that use insurance but where quality PT can be given.
However, I can’t say I’m not happy about the increased opportunities a post-covid world has opened up for us. It’s true what I said before about a large part of the US population being very sick and/or unhealthy. There’s also a large population out there who after COVID began to take their health a lot more seriously. The entire country saw those suffering from diabetes, cardiac, and pulmonary diseases get ravaged by covid. For many it was a wake-up call and they began making more investments in their health.
Take this interest and couple it with all the confusing crap about health and wellness on social media, people began looking for a trusted guide. Unfortunately the US healthcare system doesn’t make primary care the most efficient place for this. I’ve explained that in a previous blog post that you can read here. PTs stepped up to the plate have begun positioning themselves as the bridge between health and healthcare. Many PTs have made services related to general wellness part of their business model and treatment. I’ve written a previous article on why we as PTs are the perfect profession for this role.
There’s no doubt that COVID disrupted, but also advanced the physical therapy field. What was your experience as a PT during COVID? After COVID did you become part of “the great migration” and switch positions or careers? In your opinion what changes happened as a result of covid that were ultimately good for PTs? Or what do you miss about pre-covid times? I’m so interested to hear your thoughts so please drop them in the comments section! I’ll also be posting some opportunities to share on Instagram @the_pt_page so make sure you’re following there as well. Don’t forget to hit that subscribe button below to get new posts directly to your inbox and stay up to date on things PT.
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