The PT Education ROI Crisis

Are we Investing in a Future with Limited Returns?

In our conversation with Jonathon Lee, PT, DPT, MBA in Episode 18, we talked about a bunch of topics. One was the concerning return on investment (ROI) of physical therapist education. Let’s explore a little further 👇️ 

Education as an Investment: The Hard Numbers

When we choose a professional education path, we're actually making an investment decision. Here’s a birds eye view of the numbers:

PT Education Cost: $150,000-$225,000 for post-Bachelor's education (DPT)

Starting Salary: Approximately $80,000

Salary Ceiling: Typically $110,000-$120,000  

…and here are some comparisons:

Medical School: Requires an M.D. or D.O., 4 years vs. a DPT’s 3 years. Costs about 25% more than PT school. Physicians’ ceiling is 3-10 times higher than a PT’s.

Nurse Practitioner: Requires an MSN, Costs about 25-40% less than a DPT, starting salary (floor) is between $125,000-135,000, which is higher than a PT’s ceiling.

MBA Programs: Costs about 25% less than a DPT, no real ceiling.

So the DPT has a high entry cost (floor) and a low maximum salary (ceiling).

This compressed financial range makes it increasingly difficult to justify the investment from an economic perspective. How much do you need to want to be a PT to be willing to make these trade-offs vs. other professional degrees and career paths?

The Passion Paradox

Most of us entered physical therapy with a desire to help people. This passion is what drives our profession. The reality is that financial constraints can limit our ability to serve effectively.

Student debt burdens are high for physical therapists—a little less than an M.D. or D.O.—and our ability to pay back those those is exceedingly difficult. Then having the money to start a family, buy a house, save early for retirement? The math doesn’t math, as they say.

The legitimate question becomes: How can we fulfill our mission to serve patients when financial pressures threaten the sustainability of our careers?

Education Limitations: What PT School Can and Cannot Do

Besides low reimbursement rates for PT, our professional education does not prepare us in important ways, so we must acquire additional knowledge on our own.

Our DPT programs excel at teaching clinical skills but often fall short in preparing graduates for the business realities of healthcare. But as Jonathon points out in the podcast, even the best programs can only do so much while meeting their CAPTE requirements.

We think PTs should educate themselves on the following:

Healthcare economics: Understanding payment models, reimbursement structures, and financial incentives

Regulatory knowledge: Learning about the web of healthcare regulations that shape practice and how and why changes do or don’t happen

Business acumen: Developing skills to demonstrate value in financial terms that other stakeholders understand

PTs must bridge their knowledge gaps independently if they hope to maximize their career potential. Power in healthcare careers actually comes from the above knowledge layered on top of our superpower of being a licensed healthcare professional.

The Value-Based Care Opportunity

We think one of the most promising paths to breaking through the compensation ceiling lies in active participation in value-based care models.

Don’t overthink it. VBC sounds more complicated than it is. The bottom line is value-based reimbursement benefits providers whose value has not been realized in healthcare because “value” has been tied to how many codes you can bill in a day.

If your particular profession’s codes are:

1. not time-based

2. have a high reimbursement rate per code (specialist physician codes, especially interventional codes)

Then we get why you wouldn’t care as much about VBC.

But PTs and OTs and others who use time-based codes, as well as those whose codes have been assigned low reimbursement amounts per code? You really must embrace VBC if you want to climb out of the reimbursement floor and ceiling of our professions.

Becoming Change Agents: Individual and Collective Action

Addressing the PT Education ROI crisis requires both individual career optimization and collective action to reshape our profession's future:

Individual Level: Develop business and financial literacy, seek opportunities in value-based models, quantify your impact

Clinic Level: Implement data collection to demonstrate value, engage with local ACOs and value-based care initiatives

Professional Level: Support advocacy efforts for payment reform, participate in professional organizations pushing for change

The path forward requires us to embrace dual identities: clinical experts and healthcare business professionals who understand the financial systems we operate within.

Balancing Mission and Economics

The ROI challenge in physical therapy education is significant, but it’s not insurmountable. By understanding the economic realities, developing business acumen, and strategically positioning ourselves within evolving payment models, we can create more sustainable careers while fulfilling our mission to serve patients.

Our profession's future depends on our collective ability to demonstrate and capture our true value in the healthcare system. We already have the clinical acumen.

The good news? Physical therapists are uniquely positioned to thrive in value-based models that reward precisely what we do best: improve function, reduce costly interventions, and enhance quality of life.

What steps are you taking to optimize your career ROI? Share your strategies and challenges with us.