Why Do Physical Therapy Assistants Get Paid More Than Exercise Physiologists?

Why do physical therapy assistants get paid more than exercise physiologists?

It doesn't make much sense, does it?

To become an exercise physiologist typically involves at least a bachelor's in exercise science, and in many cases grad school as well. Then, at the very end you have to take an incredibly difficult certification exam.

The end result is a job with a great amount of autonomy, where your time is spent helping people who have had heart attacks/open heart surgery/lung transplants/etc. get back on their feet via exercise.

You have to understand EKGs, how medicines affect heart rate, exercise recommendations for a variety of conditions, biomechanics, how to know when your patient is hypoglycemic, gym structure, sales, and often a lot of business-keeping work as well.

The end result? An average salary of $47,000, according to indeed.com, and I've yet to meet an EP that makes that much.

A physical therapist's assistant however, goes to school for two years, typically at a community college setting, before taking a licensure exam. They have very little autonomy whatsoever, basically being at the mercy of the local physical therapist. They too understand some biomechanics, as well as exercise recommendations for a variety of conditions, but not to the extent that an EP is going to.

However, they're average salary is $59,000.

What gives?

How does more schooling, and more knowledge not equal more money?

My theory? Physical therapy leads to more tangible results, and provides a more exclusive service.

If a 44 year old mailman ends up with a frozen shoulder, he's going to be referred to physical therapy. He knows that he's not going to get better without it, and he desperately wants to be able to put his arm above his head again. He goes to PT, they work on the issue, the shoulder's fixed, and he never has another problem with it.

The mailman can vividly see the changes that PT worked for him, and nobody else would have been able to provide him that service.

Contrast that to the 44 year old mailman who has a heart attack. The doctor will refer him to cardiac rehab, but he may not even decide to show up. He knows that he needs to do cardio, so he decides to start riding the bike he's had stored in his basement the past 15 years. He may not know the correct target heart rate, the correct seat height, and how to progress, but he knows how to ride a bike by himself, and that's what he's gonna do.

Why waste money for an EP to tell him the same thing? That tends to be the mindset, anyway, even if it's not the case.

An exercise physiologist's services tend to be viewed as common knowledge, even though that's not the case.

"Oh, exercise more, and eat less. That's all they're gonna tell me."

Somebody with severe joint pain or post-orthopedic surgery is going to do what it takes to get themselves back to being pain-free with a full ROM. Pain is a powerful motivator.

Somebody with a cardiac or pulmonary condition is not necessarily living with pain, however, and they may see their event as a one time thing. You can see the differences in level of pain when PT is helping you out with your low back pain. You can't see the differences in decreasing your risk of future MI via working with an EP. Sure, you may feel healthier, and lose a bit of weight working with an EP, but you may still have a cardiac event anyway, and so what's the use, right?

So it all comes down to the type of patients that a PTA is going to work with compared with the patients that an EP is going to work with.

A PTA is going to work with people in severe amounts of pain, who will do anything to get back to where they were. Nobody else is legally licensed to work with these same customers over these same issues, and so they have an exclusive customer base. (=more money)

An EP is not always working with people in severe pain (CABG being the exception), and a lot of times work with weight loss clients, diabetic clients, and other clients who have similar issues. There's a lot of competition for these people. Local gyms, personal trainers, Weight Watchers, Nutrisystem - all of these people are competing for an EP's customer base.

Nobody says that a personal trainer can't workout with his client that had an MI and stent a month ago. 

He can't provide "cardiac rehab", but who's to say that he can't put his client on a progressive cardio plan starting off slow working on the bike, treadmill, and rower? Nobody.

Does this mean that an EP is going to be less knowledgeable about these issues than all of the other options? By no means. It's typically the opposite. But that's where marketing comes into play, and an EP has to be a good salesman if he wants to keep clients coming his way. A PTA doesn't have to worry about this. The PT takes care of it for them.

And that is why physical therapist's assistants make a significant amount of more money than an exercise physiologist. If you want patients to come specifically to you, you have to figure out a way to provide an exclusive service, and then market it as such.