Women in Physical Therapy: Can We #solvePT Without a Strong Enough Voice?

In 2006, I was working as a physical therapist in acute care in the Boston area. One day, as I was evaluating a polite, older gentleman after hip replacement surgery, he said, "this is a nice job for you girls." You girls. He didn't say it in a "this profession offers so many opportunities for career growth and success" kind of way. Let's just say that the connotation was … old-fashioned.

After taking a few seconds to resist the urge to rattle off a list of reasons why his comment was so offensive, I simply said, "It better be. It took me 8 years to earn my doctorate." He looked stunned for a moment, as if he was under the impression that a physical therapist license could be obtained after a weekend of training. For the next two days, we worked very well together, though he did refrain from offering any additional commentary about my career choices.

Our History: Women Only … At First

Upon reflection, I realized that this patient spent his early years, and most of his adult life, in a vastly different world than we live in today. When he was a young boy, his mother, grandmother and aunts probably didn't have the right to vote or hold public office in the United States, depending on the state they lived in.

The 19th amendment wasn't ratified by all 50 states until 1920.¹ In fact, Mary McMillan, one of the founders of physical therapy, earned the right to vote just months before becoming the first president of what is now the American Physical Therapy Association.² The association was founded exclusively by women, because early on, women were the only candidates admitted to programs that trained Reconstruction Aides. It wasn't until many years later that men could become physical therapists, and they were not members of the association until the 1930s.²

Back then, it was not uncommon for women to have to fight for equal rights and status. Colonel Emma Vogel (Ret.), spent years fighting for equal pay and rank as a physical therapist in the Medical Department of the U.S. Army, finally winning and earning the rank of colonel.³

Physical Therapy Today

These days, women still comprise about 70% of the profession.^4,5 While we don't face all the same issues that our predecessors did, contemporary physical therapy practice is not without challenges for women. For example, like most jobs in the U.S., women in physical therapy earn less than men. The median earned income of a female PT is $80,000 per year, while men earn $92,000.⁴

In addition, those who tend to make the most in physical therapy, are usually private practice owners; close to a third of private practice owners report making over $100,000 per year. However, men own physical therapy practices at about twice the rate that women do.⁵ Unfortunately, the disparities don't end with salary and practice ownership.

Et Tu, APTA?

Only males have filled the role of CEO of APTA for more than 20 years, with the exception of an interim CEO in 2003. The APTA Board of Directors is 63% women, but for the elected executive positions – president, vice president, secretary and treasurer – only 50% of those positions are filled by women.⁶ There hasn't been a female president of APTA in over a decade.

According to the APTA bylaws, the president is the official spokesperson for the association.⁷ It is troubling that an organization that is made up of 70% women, has been officially represented on a national level by a man for more than 10 years.

In physical therapy education, things aren't much better.⁸ While only 30% of the profession as a whole is men, 40% of physical therapy program director positions are filled by men.⁹ Female physical therapy students' first exposure to a leadership position in physical therapy involves a disproportionate number of male role models.

And while 60% of physical therapist (PT) program directors are women, more than 76% of physical therapist assistant (PTA) program directors are women.^9,10 This fact reveals that women are more likely to fill leadership roles at smaller programs, where they are more likely to earn less money, participate in less in research activity, and, due to smaller budgets and staffs, generally have less influence than directors of PT programs.

Trailing in Online Influence

Another area in which women in physical therapy are under-represented is online. In the past few years, the physical therapy community has embraced social media and blogging as a way to connect and communicate.

A quick search on Google for physical therapy blogs reveals that the vast majority are run by men. Of the 17 prominent blogs that are run by physical therapy professionals (excluding those run by students and organizations), only four, including this one, are run by women. The other 13 are run by men. This means that while women make up 70% of the profession, 70% of the blogs are being run by men. Since blogs exist to help us communicate with the world, it is significant that women's voices are under-represented in this arena.

But Hey, Is This Really Such A Big Deal?

Given the examples above, should we be concerned? Is it really all that bad? After all, there are worse industries. Certainly women in computer science and finance experience significantly more inequality. And there are many positive examples of women in leadership roles in the physical therapy community:

The Speaker of the APTA House of Delegates is Shawne Soper, PT, DPT, MBA.⁶
Mary Jane Harris, PT, MS has been the Director of the Commission on Accreditation in Physical Therapy Education (CAPTE) for 14 years.¹¹
Selena Horner, PT, MS, GCS, ATC is a leader in social media, running the #solvePT Tweetchat.¹²
Ann Wendel, PT, ATC, CMTPT is a prolific blogger and contributor throughout the web.¹³

There has also been an APTA Task Force on Women's Initiatives since 2012. In fact, there is a whole page on APTA's website with the title: Career Considerations for Women in Physical Therapy.¹⁴ The thing is, why is there no equivalent page for male physical therapists? Men are the minority and the relative late-comers here. Shouldn't they be the ones that need more help? It begs the question: why do we need a Task Force on Women's Initiatives if nothing is wrong?

What's Wrong, Dear?

The real danger here, is not the present. It is our future that is vulnerable. In female-dominated professions, often the assumption is that parity is a given; i.e., a higher proportion of women naturally means more women in leadership positions. At the very least we should expect to see a balanced leadership that reflects the demographics of the profession, shouldn't we? We should. But we don't right now. And it's possible that it could get worse.

This can be attributed partially to the fact that this may be our elephant in the room. There have been few, if any, articles on the topic in PT in Motion, physical therapy trade magazines, or scholarly journals. Given that both the editor, and the associate editor of PT in Motion are men, it is fair to say that these issues are probably not foremost on their editorial calendars. Or is it, perhaps, a function of PT in Motion's editorial board, which is 80% men?¹⁵

What Does This Mean?

Raising this issue is not to suggest that men have any less right to pursue as many leadership posts and high paying positions as they care to; or rebuke the notion that the most qualified among us ought to occupy those roles, whether they are male or female.

Nor does simply raising this issue suggest that the challenges surrounding women in society and the workplace are anything other than longstanding, multifaceted and complicated. Indeed, the Task Force for Women's Initiatives came to the same conclusion.¹⁴

It also doesn't preclude us from accepting the status quo, if we are happy with it. But, just in case there are some physical therapy professionals out there – male or female – that are concerned about this issue, at the very least, an open dialogue is long overdue.

Call To Action

Not everyone wants to pursue a leadership position, and that's OK. But if 175,000 of us are female, there are surely enough women to guarantee that our leadership is proportionally represented by both genders. So, if you are one of the ones who wants to lead, go for it, because we need you. We need you to run for office on the local and national levels. We need you to start a blog and become a voice of influence. We need you to become a private practice owner. We need you to pursue leadership roles in education and research. We need you to ask for what you need to get it done. We need you, because you know what? In the end, my patient was right. This is a "nice job" for us "girls." But only because "us girls" made it happen in the first place.

Jennifer Bresnick, PT, DPT was a member of the Connecticut Physical Therapy Association's Board of Directors, physical therapy blog owner and PTA Program Director when she wrote this post in March 2014.

References

Wikipedia, Nineteenth Amendment to the United States Constitution. Accessed March 22, 2014.
American Physical Therapy Association History. Accessed March 22, 2014.
U.S. Army Medical Department, Office of Medical History. Accessed March 22, 2014.
American Physical Therapy Association, 2013 Median Income of the Physical Therapist Summary Report. Last updated 2/24/2014.
Advance Health Network, 2012 Salary Survey Results. Accessed March 22, 2014.
American Physical Therapy Association, Board of Directors. Accessed March 22, 2014.
American Physical Therapy Association, Policies and Bylaws. Accessed March 22, 2014.
Sabus C. Engendered Roles in Physical Therapist Education: A Feminist Vision for Scholarship in Clinical Education. J Phys Ther Educ. 2010;24(3):44-49.
Commission on Accreditation in Physical Therapy Education, 2012-2013 Aggregate Program Data: PT Programs. Accessed March 22, 2014.
Commission on Accreditation in Physical Therapy Education, 2012-2013 Aggregate Program Data: PTA Programs. Accessed March 22, 2014.
Commission on Accreditation in Physical Therapy Education Staff. Accessed March 22, 2014.
#solvePT via SnippetPhysTher. Accessed March 22, 2014.
Prana Physical Therapy Blog. Accessed March 22, 2014.
American Physical Therapy Association, Career Considerations for Women in Physical Therapy. Accessed March 22, 2014.
Masthead. PT in Motion, Mar 2014.