Wow, you look like me! - The Need To Increase Diversity In The Field of Physical Therapy

While interning at a rehabilitation center in a predominantly Black-populated city, I observed a scarcity of Black physical therapists. Every week at the center, numerous patients approached me, expressing that they had never encountered a Black physical therapist before. They also have emphasized the significance of having medical professionals who mirror their community. This experience prompted me to reflect on the importance of enhancing diversity in the field and how it could positively influence the well-being of its patients.

The field of physical therapy plays a crucial role in restoring and maintaining the health and well-being of individuals. Despite its significance, one glaring issue persists—the lack of diversity within the physical therapy profession. According to the APTA 2021/2022 demographics of the profession, Black physical therapists make up 4.22% of the practicing PTs in the US (1). This underrepresentation raises concerns about the profession's ability to provide culturally competent care and meet the diverse needs of the population it serves. To effectively address the diverse needs of patients within the physical therapy profession, initiatives must start within educational institutions.

According to Greene and Karavatas (2018), African Americans are underrepresented as students in the health professions (2). According to the 2021/2022 Physical Therapy Centralized Application Services Applicant Data Report, Black/African Americans represented 8.5% of all applicants but only 6.2% of those applicants were accepted into Physical Therapy schools (3). This presents a challenge as the limited participation of Black students in applying to physical therapy school, coupled with potential difficulties in acceptance, raises concerns about how we can effectively enhance diversity within the profession when the initial pool is already limited. Another factor that limits the amount of Black students from pursuing a career in physical therapy is the cost of education. The financial burden of a doctorate degree can deter students from applying, especially students from low socioeconomic backgrounds and other personal responsibilities. Factoring low application pools for Black students along with the cost of attendance for a Doctor of Physical Therapy (DPT) program, many programs are figuring out ways to increase diversity and decrease the cost of attendance with scholarships.

With a DPT program being the pipeline to the career field of physical therapy, DPT programs' admission process are beginning to adopt a holistic review approach to enhance diversity in programs. In a study done by Canham (2021) from the University of Colorado DPT program, the holistic approach they followed focused on looking at applicants with community engagement and leadership, personal experience with diversity/health disparities, positive personal qualities, scholarly aptitude and intellectual curiosity and commitment to the physical therapy profession and interdisciplinary approach to healthcare (4). In addition, they looked at cognitive factors such as GRE and GPA along with non-cognitive factors such as socioeconomic status, race and ethnicity. With this holistic approach, they were able to increase the diversity of their physical therapy program by 30%, including a 3.4% increase in Black students from the previous year (4). According to the American Association of Colleges of Nursing (2021), increased ethnic diversity within health professional student cohorts, faculty, professional associations, and research has the potential to improve quality of education, create policy change, and enhance societal engagement (5). With many DPT programs adopting a holistic review approach, we hope to see an increase in diversity and an increase in Black physical therapists over the next few years.

The cost of attendance to many graduate programs deter many students of color from applying and attending due to the increased school debt that will continue to accrue over the course of their schooling. According to the National Center of Educational Statistics, a significant disparity exists as Black students bear the highest burden of student loan debt stemming from their bachelor's degrees. The current cumulative student loan debt has reached a staggering $1.77 trillion dollars. (6). Physical therapy programs and their associated associations have taken the initiative to establish diversity scholarships, aiming to ease the financial burden of attending a DPT program. However, it's worth noting that the majority of these scholarships offer limited assistance in offsetting the overall costs. The overall expense of completing a typical physical therapy program, ranging from $40,000 to $120,000, can impose significant financial stress on students who may have already incurred debt during their undergraduate studies.Reducing the cost of attendance and enhancing the availability of diversity scholarships are essential steps to boost the enrollment of Black students in DPT programs.

Diversifying the students entering DPT programs will lead to an increase in diversity in physical therapy. According to Kachingwe (2003), providers from underrepresented ethnic groups are more likely to treat patients from their own ethnic group or provide care in settings where patients may be underserved (7). This can lead to higher patient satisfaction, reducing health disparities, improved trust and communication, increased adherence to medical suggestions and an overall impact on patient care.

References

(1) Report: A physical therapy profile: Demographics of the profession, 2021-22. APTA.

(2023, July 18).

https://www.apta.org/apta-and-you/news-publications/reports/2023/physical-therapy-prof

ile-demographics-profession-2021-22

(2) Greene, R., & Karavatas, S. (2018). Increasing Diversity in the Physical Therapy

Profession by Addressing Deficiencies in the Performance of African Americans on the

National Physical Therapy Examination. Journal of Best Practices in Health Professions

Diversity, 11(1), 51–59. https://www.jstor.org/stable/26554291

(3) Physical Therapist Centralized Application Service 2021-2022 applicant ... (n.d.).

https://www.apta.org/siteassets/pdfs/2021_22_ptcas_applicant_data_report.pdf

(4) Canham, L. E., Mañago, M. M., Dannemiller, L., & Rapport, M. J. (2021). Holistic

Review in doctor of physical therapy admissions can lead to enhanced diversity in

admitted students. Journal of Physical Therapy Education, 35(3), 195–202.

https://doi.org/10.1097/jte.0000000000000192

(5) American Association of Colleges of Nursing. Diversity, Inclusion, & Equity in Academic Nursing.

AACN Position Statement.

https://aacnnursing.org/Portals/42/News/Position-Statements/Diversity-Inclusion.pdf. Accessed

January 22, 2021.

(6) The NCES Fast Facts Tool provides quick answers to many education questions (National Center for

Education Statistics). National Center for Education Statistics (NCES) Home Page, a part of the U.S.

Department of Education. (n.d.). https://nces.ed.gov/fastfacts/display.asp?id=900

(7) Kachingwe, A. F. (2003). A grounded theory investigation of diversity and multiculturalism in the

physical therapy profession. Journal of Physical Therapy Education, 17(1), 5–17.

https://doi.org/10.1097/00001416-200301000-00003

Author: Kierra Washington, SPT

 APTA x NABPT PH1 Scholarship Recipient

Author Bio: I am Kierra Washington and I am a 3rd year DPT student at Grand Valley State University. I received my Bachelors of Science from GVSU in athletic training and masters of public health from Chamberlain University. I am passionate about diversifying the field of physical therapy and I am excited to observe the changes and developments in the PT profession in the coming years. In my down time, I like to read, enjoy trying new restaurants with friends and spending time with my family.