Monday Memo 01/20/2020

The Monday Memo

January 20, 2020                                                                       PITT DPT STUDENTS

The PT Diversity Gap

“Diversity and Inclusion, which are the real grounds for creativity, must remain at the center of what we do” – Marco Bizzarri

For this Monday Memo, I was inspired by Dr. Gregory Hicks, Chair of the University of Delaware Physical Therapy Department.  On October 15th, 2019, Dr. Hicks visited the University of Pittsburgh to give the 2019 Endowed Scully Lecture entitled “Who Do We Want to Be? Responsible Stewardship of our Profession”.  Dr. Hicks spoke of the diversity of the Physical Therapy profession… or should I begin by noting, a current and persistent lack-thereof diversity in both practicing physical therapists and the present student body.  To premise, I am writing this as a Caucasian Female, the most prevalent statistic according to the APTA member demographics profile.  To some readers, this may be viewed as a “taboo” subject but increasing the diversity of the PT student body and workforce plays an integral role in the future direction of our profession, and our patient outcomes alike.  The intention of this Memo is to educate about the underlying issues regarding a lack of diversity and pose suggestions for what we, as students, can do!

First, we’ll begin with some statistics.  According to the WebPT Industry Survey of 2019, 79.4% of PTs are White, 4% are Hispanic or Latino, 2.2% are Black or African American, 5.7% are Asian, 0.7% are American Indian or Native Alaskan, 0.4% are Native Hawaiian or Pacific Islander, 1.6% are “Other”, and the remaining 6% preferred not to report their race or ethnicity.  From this statistic alone, it is clear to see that there is an apparent lack of diversity across the Physical Therapy profession.  Based off of APTA Membership in 2015, only 15.5% of members reported being of a minority race or ethnicity, whereas at that time, the US population of minority races and ethnicities was 33%.  Regarding diversity in PT academics, the disparities are also clear.  According to the American Counsel of Academic Physical Therapy, the following populations are currently underrepresented in PT programs as compared to the US population: Hispanic/Latino, African American/Black, American Indian/Alaskan Native, and Hawaiian/Pacific Islander.  From this information, it is clear to see that there is an apparent lack of diversity in both the current PT workforce, and within the student-body.

So, why is diversifying the profession so important?  According to Cohen et al, it is argued that achieving greater diversity will lead to a more culturally competent workforce, improve access to high-quality care for the medically underserved/underrepresented, increase the scope and depth of the United States’ health-related research agenda, and diversify the population of medically trained executives and policymakers taking on leadership positions in the health care system in future years.  One frequently cited consequence of inadequate minority representation within the healthcare professions is reduced utilization of preventative care and increased utilization of emergency services.  Increasing utilization of preventative services is particularly important for our profession, as upwards of 90% of patients with musculoskeletal injuries choose NOT to seek formal care from a physical therapist.  It is important to note that it is widely accepted that health care outcomes are improved, especially for minority patients, when the healthcare providers and staff in a hospital or clinic resemble the patient populations they seek to serve. To add to this, in 2013, Yeowell conducted a qualitative research study investigating physical therapists’ perceptions, views, and experiences of ethnic diversity in relation to the profession. Yeowell, too, argues that it is important for the workforce to reflect the patient population it serves, so they are better equipped to understand and respond to individual patient’s needs.  This is NOT to say that a therapist with a differing background from a patient is incompetent and unable to treat them effectively.  According to Dave Kietrys, PT, PhD, “We live in a diverse world, and our clients and patients come from diverse communities.  We should be mirroring that. We also should be welcoming people from all backgrounds into our profession. The greater our diversity, the deeper and richer our understanding will be of the needs of a varied population. We’ll naturally be more sensitive to underrepresented communities—what they’re going through and how they might have been marginalized, stigmatized, or treated with bias.”

There are many speculations to why a lack-of diversity is persistent in the field of PT, such as the astronomical cost of higher education, implicit biases of interviewers/directors, lack-of exposure to the Physical Therapy profession, and several other potential reasons.  As a physical therapy student, it may seem like we do not have control over this aspect of our future profession at this point in our careers. Luckily, the APTA does have some suggestions of what can be done to aid this pertinent issue while we are still students!

  1. Talk to our chapter delegates! Discussing these pertinent issues while we are still students gives us an opportunity to become “responsible for the stewardship” of our future profession! 
  2. Talk to faculty and staff in the program that you are attending.  Determine if there are any programs/policies that are currently enacted, or work diligently to establish a program to support future students.  For example, at the University of Delaware, there is a mentorship program in place for minority undergraduate students interested in the field of Physical Therapy.  Qualifying students have the opportunity to take classes alongside of PT students, meet with advisors directly in the program, and receive access to study resources.  This assures that these students are receiving support to function academically at their highest potential and remain solid, competitive candidates for Physical Therapy school programs nation-wide.
  3. Educate children in underrepresented minority, gender, and socioeconomic groups about what physical therapy is and how they can be part of our profession. A program that was enacted once within Pitt Physical Therapy with this goal in mind was referred to as the “Homestead Community Sports Medicine Exposure”.  Pitt PT students met with athletes from the Homestead area of Pittsburgh and showed them various exercises, as well as educated them about the field of physical therapy!  These are the fun, rewarding experiences that students will remember when they are choosing a career path.  This shows that having physical therapy exposure is not limited to patients walking into your clinic alone.  Exposure to the profession was identified as a more influential factor in career choice among minority students compared to white non-Hispanic students. However, Caucasian students are five times more likely to have had direct (being a patient) or indirect (family member/friend being a PT or being seen by a PT) personal experience with a physical therapist than their minority counterparts. 

I am hopeful that, as time progresses, diversity in the field of Physical Therapy will increase.  The future of our profession, student-body, and patients are counting on us to do so.

A special Thank You to Dr. Gregory Hicks for bringing this pertinent information to the University of Pittsburgh.

-Mariah Callas, SPT