As much as we didn’t want it to happen, it looks like the US has entered a recession. For those of us in the rehab space, it’s an especially challenging time. While rehab has weathered other economic downturns fairly well in the past, the coronavirus pandemic (coupled with fallout from PDPM and PDGM) has caused some serious foundational cracks in the physical therapy profession.

But, those who remember the late-’90s fallout from the Balanced Budget Act and the introduction of the Prospective Payment System (PPS) would probably remind us that this, too, shall pass. Necessity is the mother of invention, as they say. We could rattle off some more platitudes here and call it a day, but that’s not very practical. Instead, we’ve created this brief guide to navigating the PT world during a recession—whether you’re a student, recent grad, therapist, or business owner.

Students

The Challenge

While physical therapy school can be stressful, the in-person experience of learning manual techniques, studying at each others’ apartments, and having late-night cram sessions together over pints of ice cream is pretty priceless. Moving everything online changes things quite a bit. Plus, it’s scary to not know what the job market will hold for you upon graduation.

The Opportunity

You can build new skills.

The simple act of using remote educational platforms and digital document-sharing systems looks great on a resume. If you ever plan to pursue a non-clinical role—specifically in education—these skills will be invaluable. If you really want to lean into the niche of remote education, you can even volunteer to assist your professors with their needs as everything moves online.

You have more downtime.

You’re not commuting to and from campus, so you’ve likely found a bit more time on your hands. You can use this time in so many productive ways—from setting up your LinkedIn account and building your brand online, to volunteering time with your local PT association chapter. Plus, you get more time to study for the NPTE if you don’t have a job lined up and waiting for you!

You can minimize your debt.

It’s so tempting to rack up more debt than you have to during PT school. Studying over beers is way more expensive at the bar than at home—but now that you’re only studying at home, you can save a lot of money, which translates to less debt when you graduate.

The Bottom Line 

All things considered, the situation for PT students could be worse. After all, you won’t have to explain a gap in your resume, and this gives you lots of opportunities to take extra time to study, build skills, work on your interview abilities and job application materials, and rein in your spending before you rack up extra debt.

Recent Grads

The Challenge

New and recent grads are foundering a bit. With many clinics fighting just to keep their doors open, mentorship and other resources to help kickstart your career may not be as readily available. Whether you have a job that’s not panning out to be what you hoped—or you haven’t been able to land one because of the competitive market—this is a stressful time. You have loans to pay back, and you need consistent hours to do so!

The Opportunity

While you may not be able to find the hours you need with direct patient care, this is a great time to step back and think ahead to how alternative income options might fit into your career.

You can take time to reflect and research.

When you’re a student, you are so excited! You have big dreams of becoming a rockstar clinician, teaching, opening a clinic, completing a residency or even a fellowship, opening a canine PT clinic, volunteering on medical missions—the possibilities seem endless. But once you get into the real world, it can be easy to let those dreams languish. There’s nothing like a global pandemic and resulting recession to help you look in the mirror and ask yourself what you really want. Depending on the answer, you can create a career path that truly works for you.

You can leverage your tech skills.

Take advantage of your natural inclination toward tech. Coming out of school means you’re comfortable with cutting-edge technology and clinical practices, and you can use that knowledge to your advantage. Whether you help establish a telehealth model at your clinic, start your own PT side hustle as a teletherapist, or join a rehab tech startup, your familiarity with all things tech-related can serve you well.

You’re primed to network.

Losing touch with your classmates means losing out on 30-plus connections down the road in your career. As a newer grad, you have time on your side. Keep up those relationships—as well as your relationships with professors and CIs—before so much time passes that it would be awkward to reach out.

The Bottom Line

You’ve gotten a taste of real clinical life (at the very least, from rotations you completed before everything shut down), and now you have the opportunity to reassess what you truly want out of your career. In which settings do you feel you’ll make the most difference? What types of hours do you want to work, and what schedule suits you? The answers can help you make smart career moves when things stabilize.

Staff Therapists/Assistants

The Challenge 

The tough part about being a seasoned therapist or assistant right now is that you’re not the cheapest labor around. So, when clinics make cost-cutting moves like furloughing and reducing hours, you might be on the hot seat. This might also coincide with increased life responsibilities, such as homeschooling your kids—and all the while, your bills aren’t going anywhere. 

The Opportunity

You’re perfect for telehealth.

Luckily, your experience makes you a very appealing pick for the growing number of telehealth physical therapy companies that are expanding. If you’ve thought about trying telehealth PT, this is a great time to use your skills in a new way.

You’re ripe for non-clinical roles.

Most companies hiring for non-clinical physical therapy roles want candidates to have some solid clinical experience under their belts. Whether you opt to pursue rehab liaison work, utilization review roles, or any number of non-clinical jobs at physical therapy startups, you have the experience; now, you just need to tailor your resume accordingly! (Note: WebPT often looks for folks with rehab therapy industry experience when hiring for certain positions, so keep an eye on the careers page!)

The Bottom Line

Things will eventually bounce back for staff therapists in the clinical space, but it might not happen right away. If you’ve been toying with the idea of leaving the clinic, keep in mind that you have a great amount of experience under your belt to help make that happen. And, if you do opt to stay in patient care, having a gap on your resume is more understandable during a recession than in normal times!

Clinic/Business Owners

The Challenge

While certain businesses—such as online physical therapy publications and telehealth companies—are expanding or seeing increased interest, brick-and-mortar clinics are struggling. Patients aren’t keen to attend appointments in person, and there’s a lot of expense involved with buying personal protective equipment (PPE) for staff members and patients. It’s also challenging to cover PTO when staff members are mandated to self-quarantine—and when you must implement cost-saving measures simply to stay afloat, it can be extra tough to keep employees feeling happy and invested.

The Opportunity

You have a chance to look at the big picture.

Chances are, things haven’t always been sunshine and rainbows in your organization—even before the pandemic. Whether you have processes ripe for improvement, billing practices that need refining, or employees who could benefit from additional training, this is a perfect time to create a strategy that addresses all of your clinic’s issues—not just those spurred by recent events.

You can talk to your staff openly.

If you ask your staff members what they truly want, their answers may surprise you. Some may want to help you pore over infection control protocols and set up compliance programs—even on their own time—simply to have that type of work on their resumes. Others may wish to voluntarily flex off if their personal circumstances allow. If you ask your staff members what they want and need—with the mutual understanding that you can’t realistically fix everything—it could open up many mutually beneficial arrangements.

The Bottom Line

You can weather this storm by soliciting feedback from staff members, developing creative policies to solve problems, and simply being open to change. You can take this opportunity to improve your culture, invite innovation, and make major changes to your business model that you might otherwise never be able to try.


At the end of the day, a tough economy requires a (reasonably) good attitude, willingness to adapt, and patience. We PTs excel at all of these, and our ability to stay rock solid in the face of adversity will make our profession stronger and more resilient in the future.

Meredith Castin, PT, DPT, is the founder of The Non-Clinical PT, a career development resource designed to help physical, occupational, and speech therapy professionals leverage their degrees in non-clinical ways.