Both nonwhite and disadvantaged students were also more influenced by exposure to the patienttherapist relationship and by inclusion and diversity than white students. Defining. 'Isn't it all Whites?' Ethnic diversity and the physiotherapy make sense of changing conditions and improve infra-structure in their organizations. Actions You Can Take to Support Diversity in Your PT Practice - WebPT 11. These numbers paint the most objective possible picture of the state of our workforce. Just to be clear, I am not saying that therapists provide lower-quality service to patients who fall into a different racial or ethnic category, nor am I implying that therapists should only treat patients who look like them. Oregon has four statutes, one executive order, and one governing initiative that all compelled the board to examine its diversity. What are the resulting policies, standards, and practices required to address cultural responsiveness, achieve patient outcomes, and protect the public? 4. Unfortunately, across our committees and member boards, we probably are not as well represented as we should be to reflect who we are and the communities we protect. As a physical therapist, Dr. Howard's interest lies within outpatient orthopedic & sports physical therapy. And it does not matter which setting the referral is made to. A workforce that is reflective of the population it serves can have greater cul 10) All students were influenced by career assets and career exploration. She received the Lucy Blair Service Award and was elected a Catherine Worthingham Fellow from National APTA and received an Outstanding Service Award and the President's Award from the FSBPT. Bottlenecks Toward Diversity. Unfortunately, this lack of diversity in physical therapy has not improved with the growth of the profession. 1. Currently there are 43 House and seven Senate cosponsors, but we need more support to get this passed. This was less true for nonwhite students, and disadvantaged students identified factors related to Values and Fit as more influential in their career decision. So do patients experience different outcomes from PT and rehab due to a referral problem? She also served a five-year term on the APTA Ethics and Judicial Committee and the APTA Reference Committee. Diversity, Equity, and Inclusion in Physical Therapy Even if we have state-mandated initiatives, how the board adopts these initiatives can make a huge difference. Minority Applicants to Physical Therapist Education Programs 2010-2012 Heidi Jannenga, PT, DPT, ATC, is the co-founder and Chief Clinical Officer of WebPT, the leading practice management solution for physical, occupational, and speech therapists. There was one theme in our Facebook comments that really stood out to me. Although studies have examined factors predictive of graduation and licensure success of PT students including URMs, these studies have not specifically explored the extent to which diversity factors impact student recruitment.7-14, Three common initiatives to support the successful recruitment of URM students across medicine, dentistry, nursing, and pharmacy include student mentorship, pipelines, and enhancement programs. Recruiting students from underrepresented and disadvantaged backgrounds, especially students of color, should remain a priority to reflect the growing diversity of the United States population. Despite the many challenges to achieving diverse representation, board members need to address this issue now. Why do people of color have worse health outcomes when it comes to PT (and other areas of health care)? Only 6.5 percent of the U.S. physical therapy workforce identifies as Black or Latinx, while both groups account for more than a quarter of the entire nation. Research finds that people of color and whites are referred to rehab at equal rates; Black Americans tend to simply attend PT less. A lack of diversity could prevent patients from feeling wholly comfortable in a medical setting, which could then prevent them from engaging in open dialogue with their providers, thereby preventing them from receiving the best possible care. Mental health matters! Indeed, the strategic plans, visions, and missions of these organizations do not adequately address these issues. Underrepresented minorities; Recruitment; Entry-level education; Workforce diversity. Collapsed across all respondents, the mean age at which students reported deciding to become a PT was 19.6 years (mode 18 years, with a range of 556). What elements of diversity should physical therapy boards be working on? Subscribe today and get a full year of NPQ for just $59. Gain access to our exclusive library of online courses led by thought leaders and educators providing contextualized information to help nonprofit practitioners Modeling a more equitable and inclusive environment creates an environment of empathy, understanding, and justice for our patients. Compared to their white counterparts, Black Americans were significantly less likely to access rehab services, like outpatient PT. Nancy R. Kirsch, PT, DPT, PhD, FAPTA,received her PT degree from Temple University, her Master's in Health Education from Montclair University, Certificate in Health Administration from Seton Hall University, her PhD concentration in ethics from Rutgers University (formerly UMDNJ), and a Doctor of Physical Therapy from MGH Institute of Health Professions. Board members should actively invite those who are not at the table. Andrews A, Johansson C, Chinworth S, Akroyd D. Cognitive, collegiate, and demographic predictors of attrition in professional physical therapist education. Benjamin Rush, often referred to as the "father of American psychiatry" and a signer of the Declaration of Independence, described "Negroes as suffering from an affliction called Negritude .". 15. The U.S. Bureau of Labor Statistics Employment Projections, released in December 2015, stated that job openings for physical therapists due to growth and replacement needs would total 128,300 from 2014-2024. Within the nine closed-choice questions: two questions inquired about race/ethnicity; 1 question probed the extent of underrepresentation and disadvantaged background of each student; five questions targeted support systems and exposure from middle school through college, including advising, health care focused programs and clubs, and STEM programs that might have influenced decisions to pursue application to DPT programs; and 1 question asked what communication and social media tools are used by students. The coding of the third reviewer was then compared to the coding of the two primary reviewers, and a weighted kappa of 0.919 was calculated. While Board Source compiles information about other marginalized identities, the disproportionately low racial and ethnicity data stands out. United States Census Bureau. APTA is committed to increasing diversity, equity, and inclusion in the association, profession, and society. Given this focus and the limitations of the small number of open-ended responses, we broke the data into three nonmutually exclusive groups for qualitative analysis: white (N = 729), nonwhite (N = 142), and disadvantaged (N = 232). Lets start with the objective facts. This article is based on a 2020 Annual Meeting Webinar panel discussion with Anne Wallestad, Ruggie Canizares, Nancy Kirsch, and Adrienne Price. 12 Thus the profound lack of diversity in physical medicine treatment staff is not in alignment with the natural occurrence of racial and ethnic groups in the larger population. Are doctors' referral patterns to PT different based on implicit and internal bias due to race? And to further your point, I continue to be the only person of color at many of the continuing education courses I attend. The Importance of Diversity in Counselling and Therapy So if a referral to PT is made, why would Black Americans not attend therapy? Collaborate with them to help proactively promote inclusion. What is diversity? Boards cannot protect the public if members of the public do not feel comfortable accessing PT services or reporting claims to the board. EIM Community is where you can keep track of your program progress and update your information all in one place. 8. Prioritizing Minority Mental Health | Health Equity Features | CDC As part of the framework, the board developed questions to help guide them: Diversity, equity, and inclusion are essential to work towards actively. Victoria Moerchen is an associate professor of physical therapy, College of Health Sciences at University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413. One study found that after inpatient rehabilitation for hip fracture, Black Americans had a longer length of stay, worse functional scores on the Functional Independence Measure, and were more likely to be discharged home rather than continue their rehab in a sub-acute rehab facility. Racial minorities face obstacles like limited access to care, lower-quality insurance coverage, and less economic and social flexibility than their white counterparts. These themes should be visibly incorporated into recruitment strategies and evident on educational program and/or professional websites. This position paper continues important conversations about supporting URM students into the PT profession. American Council of Academic Physical Therapy. Your email address will not be published. J Racial and Ethnic Health Disparities. As Ive said before, patients should have the option to choose a therapy provider who they feel comfortable with, who they can relate to. Underrepresented minority students reported high use of online resources and lower use of advisors and faculty in obtaining information about the profession and about preparing to apply to professional graduate education programs. That is to say, there is no diversity. Therefore, BIPOC patients are often hesitant to seek the care that they need. Diversity and difference in the therapeutic relationship can create challenges to the therapeutic relationship and may present barriers to relating. Nancy has been active in the American Physical Therapy Association since she was a student. Lack of Diversity in Health Care: A Health Disparity - TED The results of this disparity have been demonstrated in studies, such as the recent rehab therapy industry report that found that more than three-quarters of rehab therapy professionals identify as white, while the 2020 US Census reports just under 60 percent of the population is white. Recruitment strategies should then be tailored specifically to these practices to attract URM applicants for PT education. If thats not enough to sway your opinion, Im going to leave you with one last factual tidbit. The open-ended questions of the survey allowed us to probe the utility of the data collected through PTCAS, and indeed the outcomes are meaningful toward informing recruitment strategies. Commission on Accreditation in Physical Therapy Education. In addition, she is the Director of the Doctor of Physical Therapy Program, and Vice Chair of Rehab and Movement Sciences, at Rutgers, The State University of New Jersey.Nancy has been a member of the New Jersey Board of Physical Therapy Examiners since 1990 and was chairperson of the board for twelve years. Am J Prev Cardiol. Seek learning opportunities on the causes and effects of systemic racism in healthcare and the physical therapy community. American Council of Academic Physical Therapy. According to Anne Wallestad, the CEO ofBoardSource, boards tend to be overwhelmingly white. 00:00. We argue that this may be critical for efforts to increase recruitment and admission of URM students. You may search for similar articles that contain these same keywords or you may Additionally, URM students also identified patientPT relationships and inclusion + diversity as important in their decision-making. Heidi advises on WebPTs product vision, company culture, branding efforts and internal operations, while advocating for the rehab therapy profession on a national and international scale. J Phys Ther Educ. National Association of Black Physical Therapists, Inc. | NABPT 2009;101:836-851. Teaching people how to best access PT and its expected benefits may be key. Two of the authors (V.M. 13. . Racial Disparities in PT and Rehab Outcomes. An overwhelming majority90 percent of patientsof those who could benefit from physical therapy are not receiving it. 2013;77:97. We dont even come remotely close to meeting those numbers. Only 6.5% of our workforce identifies as one or the other, even though the communities cumulatively account for more than a quarter of the countrys population. She served the New Jersey Chapter as Secretary and President, and as a delegate and chief delegate to the House of Delegates. By reviewing PTCAS data (201516) after its adoption of questions that probe underrepresentation and disadvantage and by reporting on a survey of enrolled PT students, a preliminary picture will be described including 1) factors students consider in selecting a PT career and 2) differences in the composite of factors across nonwhite and disadvantaged groups. While numerous studies have investigated the therapeutic effects of ECT and its mechanism, much less research has been conducted regarding the mechanism behind the cognitive side effects . These are our unconscious biases, and theyre notoriously difficult to identify, let alone mitigate. The PT profession has not examined the disadvantaged profile of its applicant pool or student demographic, but this expanded URM definition now supports . Practice Advice in Physical Therapy Regulation, The 2018 FSBPT Membership Survey and the Building Blocks of Success, Leveraging Operational Metrics to Help Justify State Board Regulatory Decisions, Licensing Authorities Contact Information, NPTE Two-Year Ultimate Pass Rates by School, Presentation & Educational Materials for Members, Criminal History Record Information/Criminal Background Checks, Diagnostic and Procedural Imaging in PT Practice, Supervised Clinical Practice Evaluation Tool, Sexual Misconduct and Boundary Violations, 2020 Annual Meeting Webinar panel discussion, the disproportionately low racial and ethnicity data stands out, Physical Therapy Minimum Data Set (PTMDS), 2% identified as African-American or Black, 1% identified as American Indian or Alaskan Native, 1% identified as Pacific Islander or Native Hawaiian, 1% identified as African-American or Black, 0% identified as American Indian or Alaskan Native, 0% identified as Pacific Islander or Native Hawaiian. As an African American female PT with more than 25 years in the field, I couldnt agree more. Some resources include thePhysical Therapy Minimum Data Set (PTMDS)and the Healthcare Regulatory Research Institute (HRRI), an FSBPT-created nonprofit regulatory research organization. It is crucial to be proactive about inclusion. Data is temporarily unavailable. Within this subgroup, students who identified as racial minorities were 34 times more likely than white students to report having received meals at school during primary education and/or being from a family who received some form of public assistance. The State of Diversity in Physical Therapy - Rizing Tide Lets do this! Take a look at this table: It compares data from the US census, our 2019 industry survey, and the APTAs survey of its member demographics. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. We propose that identifying potential differences in how URM students achieve this decision will support the development of recruitment strategies to specifically target URM groups. Teaching doctors and mid-level providers about referral patterns in the Black community may help those who are referring people to PT understand the barriers to attendance to PT. Finally, geographic disadvantaged background was reported by 4.5% of the sample, and Hawaiian or other Pacific Islanders were more than 10 times as likely to report coming from a geographically medically underserved area than whites. This means that every time you visit this website you will need to enable or disable cookies again. In a climate of increasing diversity in the population of patients requiring physical therapy (PT) services, PT educators must prepare students and future clinicians to work competently in culturally diverse environments. Utzman RR, Riddle DL, Jewell DV. This is something we discussed during the 2018 Graham Sessions: the financial cost of obtaining a DPT is out of control, and were preventing lower-income would-be applicants from considering PT as a career path because its just too expensive. Subscribe to NPQ's newsletters to have our top stories delivered directly to your inbox. Recently, the Oregon Board of Physical Therapy sought to increase its diversity. Inter-rater reliability was achieved (kappa, 0.922) for axial coding using a random 25% of the sample before each reviewer engaged in coding the full data set. Educationally disadvantaged background was reported by 34% of the total sample. A total of 2,513 students completed this survey, yielding a response rate of approximately 10%. 2010;24:14-18. And the more students see other physical therapists who look like them and are successful at what they do, the more students will consider this as a career path for themselves. A survey of enrolled DPT students was developed by members of the DTF and APTA and was approved as exempt by the Alabama State University Institutional Review Board. Am J Pharm Educ. Of course, this lack of care may lead to poorer functional outcomes. So what can be done to improve access to PT services and to ensure positive outcomes for people of color? We currently have a bill on the table, The Physical Therapist Workforce and Patient Access Act (H.R. As an industry, we must ask ourselves why. DEI Certificate at the APTA Learning Center. Within this subgroup, over 20% of students identifying as American Indian or Alaska Native, Asian, or Black, and 40% of students identifying as Hawaiian or Pacific Islander, were the first in their families to attend college. Programs and initiatives that encourage more students to consider becoming a PTA or PT are great opportunities for collaboration between APTA and FSBPT. This position paper reports on a survey conducted by the American Council of Academic Physical Therapy's Diversity Task Force designed to examine recruitment into PT education through the lens of the new URM definition, with a focus on how students from underrepresented and disadvantaged backgrounds decide to pursue a PT career. Improving cultural diversity awareness of physical therapy - PubMed Search for Similar Articles In short, are we creating safe and accessible spaces for all patients? The ages at which students from URM backgrounds make their decisions to pursue PT as a career tend to be shifted a bit later relative to non-URM students, which may reflect that URM students take longer to complete their undergraduate degrees and/or are less aware of careers or engaged with career mentoring at earlier academic stages. Phys Ther. Zipp G, Ruscingno G, Olson V. Admission variables and academic success in the first year of the professional phase in a doctor of physical therapy program. Ruggie practiced in various clinical settings including acute care, in-patient rehabilitation, nursing home and long-term care, and in-school pediatrics. The distribution of enrolled students in PT education programs categorized by race and ethnicity has not changed significantly in at least a decade.2 During the 20162017 academic year, only 9.7% of students were from underrepresented racial/ethnic groups (Asian students are not considered underrepresented minority [URM] in PT education); an additional 2.7% of students were designated by programs in the two or more races category for a combined total of 12.4% of admitted students.2 Notably, the percentage of African-American students enrolled in PT education programs declined from 4.8% in 20042005 to 3.1% in 20142015 and held constant at 3.0% during 2016-2017.2 Demographic data on applications and admissions to PT programs participating in the PT centralized application service (PTCAS) support that numbers of students from underrepresented racial/ethnic groups (19.4% of applicants in 20152016 and 11.8% of accepted applicants in 20162017) remain insufficient to meet the current and projected US demographic.3,4, In response to the stagnant diversity in professional PT education, the American Council of Academic Physical Therapy (ACAPT) established the Diversity Task Force (DTF) in January 2013 and charged it with defining URM in PT education and affirming a rationale for promoting a diverse PT student population and workforce in physical therapy.2(p.1) After reviewing similar academic organizations for other health-related professions, the DTF proposed a definition for URM, as follows: Underrepresented in physical therapy means those racial and ethnic populations that are underrepresented in the physical therapy profession relative to their numbers in the general population, as well as individuals from geographically underrepresented areas, lower economic strata, and educationally disadvantaged backgrounds. Diversity characteristics of the 20082009 pharmacy college application service applicant pool. We wanted a discussion, and boy, did we get a discussion. What is the health regulatory role in addressing culturally responsive healthcare? There are many initiatives and programs with the centrality on diversity in physical therapy programs, however there still remains a paucity of . I would even argue that one of the biggest diversity barriers in rehab therapy, and part of the reason why our talent pool is so limited, is our professions high barrier of entry. According to CAPTE, in 2019, the majority of graduates from PT programs were White, and, at 77%, it is a more significant share than the 71% for PTA graduates: Additionally, forPTs in practice from 2016-2017, there is still little diversity: While the PTA workforce has seen growing diversity, the PT workforce compared to graduates actually shows a slight increase in White PTs. At the basic, fundamental level, we are talking about human interactions and relationships. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. What do we gain with diversity? These challenges may include organizational intent and leadership. Salome Brooks is an associate professor of physical therapy, Department of Physical Therapy, School of Health Sciences at Springfield College. Legislation Introduced to Promote Workforce Diversity in Allied Health Ruggie served as Board Vice-chair from 2014 to 2018, and as Board Chair from 2018 to 2019. These are the top 7 challenges that are affecting PT's, as well as some suggestions on what you can do to overcome them: 1. We further examined this relationship using the relative frequencies of the axial codes per selective code across the three groups (Figure 2). Over the years, Ive seen my white counterparts not understand, or misinterpret communication from AAs and other minorities because of a lack of cultural understandings. Race/ethnicity and outcomes following inpatient rehabilitation for hip fracture. However, students of color (alone and in combination with Hispanic or other races) represented the greatest percentage of disadvantaged backgrounds (Table 2). In 2018, 50% of Black and African Americans with a serious mental illness did not receive mental health treatment. Regressive Therapy. This warrants further investigation. This approach involved reviewing each response thoroughly for open coding of the responses. Is Physical Therapy Covered By Insurance? Following the adoption of the URM definition, the DTF undertook the second part of its charge: to affirm a rationale for promoting a diverse PT student population. When this occurs, the true benefit of the PT profession can be realized and enjoyed equally by all. "In our community, there is a longstanding belief that [seeking] therapy automatically means . Supplemental digital content is available for this article. There are tons of patients who are lacking trust in their providers because they don't feel that their providers really care. Additionally, nonwhite and disadvantaged students did not report career path decisions after age 30. The historical roots of racial disparities in the mental health system Anne Wallestad serves as president and CEO of BoardSource, a globally-recognized nonprofit focused on strengthening nonprofit leadership at the highest level the board of directors. Studies addressing these issues report that racial and ethnic disparities persist even when demographic factors, such as socioeconomic status, level of insurance, and comorbidity conditions are controlled. Unfortunately, this is not the case with PTs. Members receive unlimited access to our archived and upcoming digital content. The authors wish to acknowledge staff at ACAPT and APTA in assisting with their work. Im going to say this outright: diversifying the therapist pool and making an active effort to combat our biases will not hurt us. Ruggie continues his active role in regulation and public protection by serving as a public member on the Oregon Mortuary and Cemetery Board. Read our, Racial Differences in Physical Therapy Outcomes. Position and Rationale. Another part of the issue is the woeful lack of racial diversity within the physical therapy provider workforce. The education community should go beyond just being intentional with recruitment and also provide additional services to students with different needs. There is an obvious lack of diversity in the profession, but I believe the problem starts in the lack of diversity in physical therapy program applicants. They specifically valued the patienttherapist relationship and inclusion + diversity. Please try again soon. Racial diversity in the rehab therapy industry. Wall AL, Aljets A, Ellis SC, et al. Abstract. However, the orchestra still hired men, overwhelmingly so. The quest for diversity in the classroom. A good starting point would be greater understanding the factors and causes of the lack of diversity within the profession. Once the orchestra began asking auditioners to take off their shoes, the number of women hired increased dramatically. Most high school studentsand especially BIPOC studentsare not introduced to the profession unless they or a family member have received treatment. Thank you, {{form.email}}, for signing up. While this may have been a function of the small sample captured with the survey, this finding warrants further investigation and lends itself to the question of whether second career or returning adults from URM backgrounds may be an untapped population in the effort to increase the diversity of the work force. You do not know what you do not know. Please address all correspondence to Victoria Moerchen. To achieve this objective, qualifiers based on the URM definition were used in a survey to identify similarities and differences in factors influencing student decisions for and pathways to a career as a PT. 7. Physical Therapy & Sexual Misconduct: What You Need to Know, Caring for a Loved One After Total Joint Replacement Surgery, Breast Cancer Treatment Barriers for Black Women, Mastectomy and Breast Reconstruction: Considerations for Black Patients, Benefits and Considerations for In-Home Physical Therapy, Breast Cancer Risk: Disparities That Affect Black Women, Physical Therapy for a Pectoralis Major Tear, Racial and Ethnic Health Disparities Exist in Every State, Report Finds, The Intergenerational Impact of Racism on Health, Type 2 Diabetes Management Barriers in People of Color, Physical Therapy for Post-Intensive Care Syndrome, Key facts on health and healthcare by race and ethnicity, Disparities in the COVID-19 pandemic: A clarion call for preventive cardiology, Rehabilitation services use and patient-reported outcomes among older adults in the United States, Race/ethnicity and outcomes following inpatient rehabilitation for hip fracture, Follow-up disparities after trauma: A real problem for outcomes research, Institutional racism in the health care system, Racism, inequality, and health care for African Americans, Disparities in access to outpatient rehabilitation therapy for African Americans with arthritis, CDC COVID-19 response health equity strategy: Accelerating progress towards reducing COVID-19 disparities and achieving health equity, Lack of availability of outpatient physical therapists who can meet the needs of Black Americans, Location of PT offices may affect accessibility for Black Americans, Hours of operation and ease of scheduling office visits for PT may not fit the needs of Black Americans, Family responsibilities, lack of time, or lack of child care, Federal government intervention to collect and analyze data and to ensure health and social programs address the needs of the Black community, The use of public health officials to connect providers, educators, transportation, and service organizations to help improve health access and outcomes in the Black community, The use of community organizations to connect people of color to appropriate medical services and to help remove barriers to those services, Education of healthcare providers to the specific needs of Black Americans and to create collaborative models of care across the healthcare spectrum.