On "Storm Clouds on the Horizon: The 3 Perils of Unconstrained Academic Growth in Physical Therapist Education." Deusinger SS, Landers MR. Phys Ther. 2022;102:pzac046. https://doi.org/10.1093/ptj/pzac046.

Abstract

We wholeheartedly agree with Deusinger and Landers1 that the current proliferation of new doctor of physical therapy (DPT) programs will likely lead to damaging consequences for the collective enterprise of academic physical therapy as well as for the students and patients it exists to serve. We do, however, believe that their forecast of “storm clouds on the horizon” is insufficiently severe. Instead, we would argue that, to borrow a phrase from Game of Thrones,2 “Winter is coming.” The unsustainable proliferation of new DPT programs in a marketplace in which demand cannot possibly keep up with supply is a classic example of an economic bubble. Eventually and inevitably, bubbles burst. Indeed, we have seen this occur before in physical therapist professional education. From 1989 to 2002, the number of physical therapist education programs in the United States increased by 75% (from 118 to 205).3 That bubble burst in the late 1990s, partly as the result of the passage of the ``Balanced Budget Amendment'' by the Republican-controlled US Congress in 1997, which led to drastic reimbursement cutbacks and reductions in jobs for physical therapists.4 The results were not pretty. The applicant pool plummeted by 74%, from an average of 342 applicants per program in 1995 to 88 in 2002.3 Total enrollment in US physical therapist education programs dropped by 30% from 1997 to 2003.3 Many programs were unable to fill their classes. Total enrollment did not recover until 2009; average applications per program, not until 2011.3 Those were hard years for physical therapy academic programs – for faculty, for students, and, most of all, for graduates.