The 2023 American Physical Therapy Association (APTA) House of Delegates adopted the position statement Support For Initiatives to Improve Health in Rural Communities which outlines many of the challenges in meeting the need for physical therapists in rural communities. The Academy of Orthopaedic Physical Therapy Scope of Practice work group1 determined that increasing awareness of practice challenges and opportunities in rural health communities could help to increase interest among physical therapists to consider working in the rural setting and potentially improve the access to physical therapy by patients living in rural environments.
The U.S. Census has classified 19.3% of the population (59.5 million people) and 97% of the land area as rural.1 To meet APTA’s vision of transforming society by optimizing movement to improve the human experience2 much work needs to be done. Recently, Felter et al3 in an article on rural health physical therapy described some of the challenges and potential solutions mostly focused on education, cultural awareness, and staffing in rural areas.
The APTA has long had numerous policy initiatives supporting practice and payment in rural communities. The shortage of physical therapists practicing in rural communities was documented decades ago.4 In the ensuing 40+ years little has changed. Meeting the need for physical therapists in rural communities will require profession-wide engagement from individual physical therapists and physical therapist assistants, health care organizations, physical therapy education programs, and policy and payment initiatives.
We invited 5 physical therapists currently practicing in rural health settings to share their perspectives on the challenges, opportunities, and why they chose to practice in a rural community. By sharing these on-the-ground perspectives we aim to increase awareness of the benefits and challenges of practicing in rural communities. We hope these perspectives will spark interest and advocacy for advancing physical therapist practice in these rural communities.
Meet these physical therapists and hear their perspectives on why they choose to practice in rural communities.
Genevieve Correa, DPT, FAAOMPT
Molokai Physical Therapy and Rehabilitation
Molokai, Hawaii
“Really taking the time to listen to their stories, to get them where they need to be. As we learn more, we realize the subjective is kind of the strength of our practice, and then the treatment becomes pretty straightforward, because we're more root cause than anything.”
“I find that when we can just take the time to educate, listen, and share perspectives people start to feel more valued, and it puts more value into of why I went into this field of PT.”
Read, listen, or watch Dr. Correa’s full interview:
Kurt Thompson PT, CAE, CPPS
Director of Rehabilitation
Certified Associate Ergonomist
Certified Professional in Patient Safety
Bourbon Community Hospital
Paris, Kentucky
“[I]t's nice to be able to go out there and say, oh, yeah, I've been to your factory. I know what you've been doing. I walk to your line. I know specifically what you need, as far as we have to get back to that job, so that works out really good. The only downside is to say that having a relationship, I can't get in and out of the grocery store really quickly. There's a very, very good chance if I have to just run in and walk out with milk that may take me 20 minutes because I run into one or two of my previous patients, which is fine, I enjoy that.”
Read, listen, or watch Mr. Thompson’s full interview:
Lori Swanton, PT, DPT, FAAOMPT
Founder of Ability Physical Therapy
Cody, Wyoming
“So that autonomy of practice, of really being able to work [up a patient] in a differential diagnosis [case] and pulling together all our knowledge base, and really being able to do a deep dive with the patient to understand where they're at and what their challenges are being in a rural community. Knowing their mindset and helping to really differentiate their care that it can be different than the traditional path.”
Read, listen, or watch Dr. Swanton’s full interview:
Melinda Montoya, PT, DPT, PRPC
Home based primary care Physical Therapist.
Raymond G. Murphy VA Medical Center
Albuquerque, New Mexico
“You have to have a good toolbox at your disposal in terms of what you're seeing at least on the reservation. I got to see a lot of things that were in your textbook, and they're like, you'll only see this in the textbook…” “But you just have to be a little bit of a Jack or Jill, of all trades within the practice, like identifying neurological changes, orthopedic, addressing pelvic floor dysfunction.”
Read, listen, or watch Dr. Montoya’s full interview:
Rachel Jermann, PT, DPT
Kodiak Area Native Association
Kodiak, Alaska
“The real question is what gets people to stay and usually it's the community when I talk to people who want to live in a close knit community. They like being close to the outdoors. Maybe they like hunting or fishing, or those kinds of things like, I live in a world class location for fishing in particular.”
“[L]ast year, in the month of June, I was supposed to go to 3 different villages, and I made it to none of them. Because we had fog for practically all of June, and we couldn't fly.”
Read, listen, or watch Dr. Jermann’s full interview:
References
- Health Resources and Services Administration. Defining Rural Population. Accessed July 27, 2024. hrsa.gov/rural-health/about-us/what-is-rural
- American Physical Therapy Association. Vision Statement for the Physical Therapy Profession. Accessed July 27, 2024. apta.org/apta-and-you/leadership-and-governance/policies/vision-statement-for-the-physical-therapy-profession
- Felter CE, Zalewski K, Jermann K, Palmer PL, Baier AE, Falvey JR. Rural health: the dirt road less traveled. Phys Ther. 2022;102(11):pzac112. doi:10.1093.ptj/pzac112
- Wisely LD. Physical therapy services in rural hospital settings. Phys Ther. 1981;61(8):1173–1174. doi:10.1093/ptj/61.8.1173
Author Bio
Douglas M. White, DPT, RMSK has been practicing for over 30 years. Four years ago, he relocated to the Big Island of Hawaii in rural North Kohala. He has a small practice in the town of Hawi where he provides rural and primary care physical therapy. North Kohala is a ranching and farming community of ~7000 people. There is a shortage of all types of healthcare practitioners and the nearest hospital 40-50 minutes away over a one lane mountain road. Dr. White is an adjunct faculty at Hawaii Pacific University Doctor of Physical Therapy program he primarily teaches the Diagnostics and Imaging course. Dr. White is credentialed in musculoskeletal sonography and a Board Certified Orthopaedic Clinical Specialist. He is past founding president of the Imaging Special Interest Group of the Academy of Orthopaedic Physical Therapy. He has numerous publications in the areas of orthopaedics and imaging.