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The Pros and Cons of Being an Independently Contracted Physical Therapist

Working as an independent contractor won't suit everyone—but it may hold serious appeal for some staff therapists.

Melissa Hughes
5 min read
May 18, 2021
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Maybe you’ve already heard: the gig economy is booming. The number of freelancers and contract workers in the US has been on the rise for more than half a decade, and the 57 million Americans who engaged in “some type of gig work” in 2020 contributed more than $1 trillion to the US economy. While we don’t yet understand the full impact that COVID-19 will have on these ultra-flexible workers, experts believe that gig work isn’t going anywhere—and the author of the above-linked Forbes article believes that a call for increased work flexibility will drive up the number of independent workers across the country.  

Not surprisingly, gig work has made its way into the PT field. A number of clinics are looking to hire contract PTs for a variety of reasons, and therapists are engaging in spirited debate over the merits of contract work. Here’s the lowdown. 


The pay is better. 

Contract roles vary in a lot of ways, but one of their undeniable (and fairly across-the-board) pros is that they pay better than your standard nine-to-five. The average annual salary for a PT in the US is $90,170; per diem workers (who form a subset of contract workers), on the other hand, pull in an average of $108,479 per year.

Why such a glaring disparity? Because when employers hire salaried workers, they have to cover a whole heap of other expenses—like employment tax and employee benefits. As a result, employers are often willing to pay contract workers higher base rates than salaried employees.



You can choose your hours—and you’re not tied down. 

Contract work is extremely flexible. You can choose when to enter a contract—and for how long. You can even negotiate for specific hours. If you aren’t happy with your experience working at a particular clinic, you can up and leave when your contract expires. Or, if you want to change your workload (but ultimately stick around at a clinic you’re familiar with), you can renegotiate the terms of an expiring contract to better suit your preferences. Just be prepared to sharpen your negotiation skills come contract renewal season. 

You can easily test out different settings and specialties.

As a contract worker, you can channel your inner nomad—moving from clinic to clinic and even specialty to specialty. And if you’re not sure which type of patients you’d like to treat, this gives you a wonderful opportunity to move around and find a setting or specialty that makes your heart sing. 

You can set the terms of your contract—and you can renegotiate them when it’s time to renew. 

Speaking of contracts: When setting your employment terms, you can also negotiate your responsibilities and duties. For instance, consider some of the tasks that may fall to a contract physical therapist (per this article from The Non-Clinical PT): 

“In an inpatient rehab facility, on top of seeing a full caseload, an additional job duty at the end of the workday might be creating the team schedule for the next day...In a private outpatient setting, there may be a requirement (or at least an expectation) that you assist the company in marketing activities either during or outside your regular hours.” 

If, as a contract worker, you have a hardline opinion about these sorts of tasks (e.g., you refuse to perform them), you can account for that in your contract. However, be aware that there are some tasks you can’t offload (e.g., documentation), and refusing to perform too many mission-critical tasks (or too many tasks altogether) may make you a less desirable hire. Furthermore, it’s best to be upfront about these contract stipulations, as this type of open and honest communication will strengthen the relationship between you and their employers. 


Your paychecks may not be consistent. 

Contract workers are typically hired on an as-needed basis, helping clinics manage seasonal swells in patients volume or cover scheduling or employment gaps. Unfortunately, this means you’re beholden to market conditions and the business needs of clinics in your area. At times, contract workers can score seasonal (or even annual) contracts. Other times—like during the COVID-19 pandemic—those same workers can experience employment dry spells. 

Your career pathing may be limited. 

Unlike salaried employees, contract workers are not typically seen as a long-term investment. They are usually hired to meet a specific need—and that’s it. If you take a contract gig, the organization’s leaders likely will not take the time to mentor you or give you opportunities to grow other skill sets like business management or marketing. This means that you may struggle to develop your career outside of being a staff PT. And to be fair, that’s not a con for everyone—but it’s worth keeping in mind.

You’re in charge of your own healthcare coverage. 

If you’re a contracted worker, then employers will not (and legally cannot) offer you full-time employee benefits. That means your healthcare costs land squarely on your shoulders—unless you’re already on someone else’s plan. But those aren’t the only benefits you’ll miss out on. You won’t get PTO or paid sick, parental, or bereavement leave. You’ll have to pay for your own CEUs, and you won’t be able to enjoy the benefits of employer 401k matching. And remember, there are other benefits clinics may offer a salaried employee—but those listed above are the ones that come at the greatest expense to you. 

Tax season comes with a whole new host of difficulties. 

If you think filing your taxes is already complicated enough, thank you very much, then you may want to reconsider becoming an independent contractor. When you’re self-employed—as contractors tend to be—you’re in charge of your own income taxes. That means you need to set aside your own income withholdings so you have enough money to pay your social security and Medicare taxes come springtime. You’re also in charge of finding your own write-offs (if you have any). If you decide to establish an LLC (with or without other contractors) in an effort to limit your liability, you’ll have to figure out how to correctly complete your taxes as a business. And while that’s not an insurmountable challenge, it’s something to keep in mind if the thought of a more stressful tax season is too much to bear. 

Contract work may be the perfect professional lifestyle for some—but it’s not ideal for everyone. It’s important to know where your proclivities lie and what you want out of your work life. So, what do you think? Is becoming an independently contracted PT the right move for you?

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