There are several current factors that sometimes make being in the PT profession a bit painful – low recognition, poor debt-to-income ratio, working conditions that lead to intense burnout, you name it. One of the more triggering frustrations I hear and see discussed is the dissatisfaction with our national organization.
Due to this dissatisfaction, most PTs I know are not members of the APTA. Full transparency, I do hold an APTA membership and belong to the Missouri chapter. My decision to join APTA was driven by several factors. For one, I knew I wanted to start this blog. Full access to APTA’s content would help me stay up-to-date on recent events and developments in our field. Second, I wanted to contribute financially as I know the money does have a purpose within the APTA. Lastly, I didn’t think it fair of me to write about change in the profession if I myself don’t support our national organization in even the most basic way.
If you’re reading this and are not a member of the APTA, I don’t blame you one bit. Two out of my three reasons for being a member are highly tied to this blog. Without those, I’m pretty sure I’d be in the same boat as you. I have those extra motivators and sometimes still wonder if it’s worth it.
Member or non-member, the fact remains there’s a huge disconnect between the APTA and the majority of PTs. This divide creates a giant road block in the advancement of our profession. I want to explore how we got here, how we get out, and maybe how the PT workforce and the APTA find common ground again. At the end of the day, we’re on the same team. Whether or not we act like it is up to all of us.
The Cycle of the APTA, the Cycle of Pain
To look at where we’re going we’ve got to take a look at where we’re at. Honestly, where we’re at is a never-ending cycle of frustration.
Insurance companies aren’t shelling out the money we’re worth and find any reason they can to deny claims. Low reimbursement drives low salaries compared to the debt we carry. The burden of this debt deters us from contributing money to the APTA and leads to low membership overall. Low membership means the APTA doesn’t have the financial resources to support lobbying and representation. This means nothing really changes and the cycle repeats itself over and over and over again.
You look at this and funny enough it’s pretty comparable to the pain cycle. Patient has pain, the patient stops moving, the patient gets more pain and around and around it goes. A cycle with no beginning or end. You could jump in just about anywhere and one thing still leads to another.
We help patients off the merry-go-round of pain, but we need to find a way to get off our own messed up ride. Nothing changes if nothing changes. Physical therapy breaks through the gaps in the pain cycle. It’s time we start finding gaps in the cycle of the disconnect between our profession and its national organization.
Getting off the Merry Go Round
So how do we get off the merry-go-round? One of the biggest qualms I hear about the APTA is the imbalance of cost/benefit of yearly memberships. A current APTA membership cost varies depending on the individual state dues. The APTA membership itself is $295. Chapter memberships then cost an average of $120 dollars for a total of around $415 a year.
Now let’s compare APTA membership cost to the American Medical Association which is a common guild among MDs across the US. A yearly American Medical Association fee is $420.
So both memberships cost about the same. Except according to the Bureau of Labor Statistics, one profession makes a mean annual salary of about $97,000 and the other makes a mean of about $281,000 as a family med physician or $347,000 as a surgeon.
I’ll be honest, when I figured out APTA membership costs were the same as what MDs pay for their national organization… I was pissed. In terms of salary, it’s a frustrating comparison. I mean they earn more than twice as much as we do!
On a PT salary that amount of money could easily go towards other things. That’s a monthly student loan payment, a monthly car payment, saving for a down payment on a house, a plane ticket to escape from our job that’s burning us out …the list is endless. From a PT perspective we see this and say “Why put my hard earned money towards the APTA who isn’t going to do anything that will help me or the profession when I have so many other things I need to pay/save for?”. For an MD, they can fork over the membership fees and still be able to pay on a car, loans, house, etc.
But what if that price was a little more reasonable? More doable? And comparable to our wages?
Hypothetically, let’s say the APTA reduced the membership to half the cost it is now. According to the APTA, the current membership number of PTs alone is about 57,350. Some of these members get discounted rates for being early in their career, but for comparison we’ll say they’re all paying the current $415
$415 x 57,350 = $23,800,250
This would be the current total PT contribution to the APTA yearly. What if the APTA reduced the cost to about $210 annually (APTA and state fees), but in return gained double the membership or even more? What if membership was around 50% of PTs in the US?
The Federation of State Boards of Physical Therapy reports 238,256 licensed PTs in 2022. 50% would be 119,128.
$210 x 119,128 = $25,016,880,
So if membership dues were reduced to half and membership increased to 50%, that would actually result in a GAIN of about 2 million dollars. That’s not even accounting for changes to PTA or student numbers. More money is certainly a good thing. What about the benefits of having more PTs involved in the national organization? There would be new ideas, more collaboration, increased awareness, more man-power for committees and specific movements, and more PTs advocating at their state levels. All good things and all things we need to help both ourselves and our patients.
This all sounds super great, but it wouldn’t be fair to ignore the gravity of what we’d be asking the APTA to do here. This would be a MASSIVE risk for the APTA. If they decreased fees and didn’t see a necessary jump in membership they may wind up with catastrophic losses to funding. Losses to funding mean they’d have an even harder time pushing agendas and be even less productive than before. Then cue more PTs pissed off at their national organization than there already were and we all know we’d be the first to tell them how bad they messed up.
What I’m trying to get at is solutions to this problem cannot be one-sided. Whether it’s this solution or something else, PTs and APTA will have to meet each other at the table. If APTA would be willing to make changes, then we would have to be willing to put in the effort to support them in order to advance the profession and find solutions to the issues we anguish over at home, in our offices, and on social media.
Sometimes that support will be financially – which I know is a big ask given that in order to buy just about anything these days you have to sell a kidney and your first born child. Again, the cost deters a lot of us, but I do think there is a number that’s more doable, fair, and that will appeal to a larger base of the PT profession.
What would you pay? I’ll go first. I’d like to see membership dues down to $250 a year. To me this is enough to keep funds without having to basically double the membership numbers.
I’m going to be posting a survey on Instagram and on the website asking what YOU would be willing to pay for an APTA membership. I’m telling you now because I want you to think about it. When you come up with a number I want you to think about how you came to that number because I’m going to ask you that too.
This is the part where I beg you PLEASE don’t be that person that says “$5” and the reason being “because they suck”. 1.) don’t waste my time and 2.) if you’re not going to positively contribute to the dialogue at least be funny . . . that’s not funny. (**UPDATE** Survey now available click here to take the survey!)
I know APTA earning our support is not all cost based, but this is an opportunity to get a productive and honest conversation going about a major issue in our profession. If the APTA doesn’t consider reducing membership fees as a viable option, they do have other ways of increasing support.
What would it take?
On that survey some of you may still answer $0 and have some very legitimate reasons. Again it is unlikely membership fees will decrease due to the associated risks. There are other issues within the APTA I would like to see addressed before devoting more of my time or money. I think it’s important we start asking ourselves what would it take for us to start supporting the APTA? Each of us will have our own “big ticket” items, but there’s likely some common themes. Here’s mine:
Cost
I already went in depth on this one, but in summary it seems ridiculous to ask for the same amount in fees that MDs pay for their organizations who make 2-3 times as much as us. I couldn’t find their membership numbers. In theory though, if we have similar numbers and pay just as much, our professional organization should be just as proficient which doesn’t seem to be the case.
Better Advocacy on Reimbursement
Low salaries are largely driven by decreased reimbursement. Until this last year I did not see an effort from the APTA regarding reimbursement that seemed to be working. They did get some brownie points from me on this one when they published The Economic Value of Physical Therapy in The United States last September. The report took eight common conditions and broke down how PT helps patients through recovery while saving the healthcare system money. You can read the full report HERE. It actually touched on a lot of the same sentiments that will be a topic for the blog next month. To me, they finally articulated the benefit and skill of PT while speaking a language insurance and government would respond to – money. So I like to think we’ll be seeing more of that in the near future.
Cease support of corporations that perpetuate barriers to the advancement of the profession
I remember going to CSM in Denver in my last year of PT school. After having a few years as a working PT I’m glad I went when I was a student because now there’s a few booths I might spit on if given the chance. The corporations represented at these booths are also in APTA’s magazines, social media posts, and website ads.
They are also the ones that create environments that burn out PTs. They offer poor wages and encourage questionable billing practices, making it impossible to give quality care to patients. Ultimately they make us look like less skilled professionals which perpetuate barriers to our advancement. Basically they stand for everything our national organization shouldn’t stand for. If APTA isn’t going to condemn them, they should at least not give them any semblance of a platform or representation.
These are my “big three”. What would yours be? Share in the comments section and let’s all discuss. What are some other ways, through initiation on our end or the APTA’s, that we can start mending a bridge between us? Some of you might be thinking, what’s the point? The APTA never gets it right and won’t change anything.
But I want you to think about it this way. If someone important in your life – a significant other, family member, or friend came to you and said “I’m not happy with our relationship. I don’t feel like you support me enough or in the ways I need you to.” You’d probably ask, “Well, what would you like me to do?”. Imagine if they said “Well I can’t give you specific examples, just do better. . .” You’d probably be a bit frustrated.
When we’re just out here saying “APTA doesn’t do shit” or “I’ll never support the APTA” without giving context … I’m sorry but we are that annoying loved one.
If the APTA doesn’t feel the level of membership is where it needs to be to get the results we’re ALL wanting, then they need to be asking what it will take to get that support. In turn, we need to be prepared to give an answer they can work with. It’s going to take both us and the APTA being open-minded to change the status quo and get out of our own painful cycle. Nothing changes if nothing changes. I’ll be posting the survey I mentioned earlier on Instagram and the main page of the site later this week. So make sure to follow @the_pt_page on Instagram to look for that. Think about those responses! I plan to compile the results and share recurring themes.
If you’re a return reader from last week, thank you so much for coming to round two. It means so much to me and I hope you enjoyed it as much as the first. If this is your first time at The PT Page, welcome! If you want to catch up on what you missed in the first post you can read it here. Regardless if it’s your first or second time, I hope you found something in this post that resonated with you and will add your thoughts in the comments section. Share this post with your friends so they can do the same. Lastly, don’t forget to hit “subscribe” to get new content from The PT Page directly to your inbox!
**UPDATE** Survey now up click here to take the survey!
Sources:
APTA PT membership
https://www.apta.org/contentassets/d6ed0d57dada44e48de5dfb63b7c0e05/apta-annual-report-2022.pdf
Salary
https://www.bls.gov/oes/current/oes291123.htm
https://www.bls.gov/oes/current/oes291215.htm
https://www.bls.gov/oes/current/oes291249.htm
AMA Dues
https://www.ama-assn.org/member-benefits/member-eligibility-dues/ama-membership-dues
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