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.

A New Party Trick to Try

So, we're studying tapeworms in that Infectious Disease class I keep mentioning, and I've just now come to terms with how absolutely terrifying they are.

My professor used to be a physician in Latin America, where tapeworms are prevalent. He tells the story about how one day he had a 30ish year old women come into his clinic. She presented signs of abdominal swelling and pain.

After placing his hand on her abdomen, he felt movement under the skin. His initial thoughts were that the lady was pregnant, but upon further investigation, he found that this wasn't the case.

A stool sample confirmed his suspicions. The woman had tapeworms.

And she was infested.

The type of eggs that were found present in the stool sample were of the Ascaris species. These worms are about the diameter of an earthworm, with the males growing to about 8" long. Females can grow up to 14". (Google image search if you dare)

Fortunately, tapeworms are relatively easy to treat. He gave her the required medicine, and kept her around the clinic.

About half an hour later, she started to vomit, and within the vomit was a worm or two. Then she had diarrhea, and sure enough, a worm or two ended up in the toilet.

Then she vomited again, and about a dozen worms came out. A trip back to the bathroom soon followed with about the same number.

By the end of the half hour the woman was vomiting up worms by the handful. They were trying to escape her system, and were literally crawling up her esophagus to get out, with some exiting through the nose.

When it was all said and done, the lady had expelled over 300 tapeworms. She showed up just in time too. If she had waited any longer the worms could have formed a blockage within her small intestine that would have caused it to rupture, poisoning her system and killing her.

She was cured after that, but I guarantee you she did a much better job with personal and food hygiene from that day on.

Uh, No Thank You

Annnnnnd after spending the past week studying STDs in my "Infectious Diseases" class I now have a better understanding of why God commands monogamy.

Asides from the inability to pee for days yet still manufacturing urine (read "ow"), the development of fibrous growths all over your nether regions, sterility, and some very painful sores, there's also aneurysms, blindness, cardiovascular disease, links to Alzheimer's, and more.

Don't be stupid. God doesn't want his children playing in the street.

Me Punch HARD!!!

That feeling you get after you've spent days collecting research for a paper on anthrax, and have finally come up with enough information for a well-rounded paper, only to find that your professor decided to get creative with the instructions and is making you compare and critique articles instead.

And as a result, most of your research was for nothing.

ZOMBIES!

What I imagine my new class "Prevention and Control of Infectious Disease" is going to be like.

Time To Pick Up Something Heavy

First, the good news.

I passed my CSCS!

After 3 hours of staring at a computer screen, attempting to figure out how those three multiple choices even apply to the question that was asked, I managed to pass!

Sure, maybe I only passed by 5 questions, but it still counts! I'm now a Certified Strength and Conditioning Specialist!

Now, the annoying news.

A few months ago, a buddy of mine informed me that the MPH program had an "exit exam". What did that mean? What did it cover? Why didn't they tell us about this sooner?

These were all some of the questions that instantly spewed out of my mouth.

Apparently, the exit exam is a gigantic essay exam covering everything that I've learned since my first biostatistics night class that if I fail, forces me to retake my entire 16 week practicum (essentially an internship for married people that are already in the workforce and are now forced to juggle multiple jobs. Thanks grad school.).

Oh joy.

Why my school's administration didn't tell anybody about this sooner, I have no idea. I was just officially told about it last month, and told that it was strongly suggested that I take the exam within the next two weeks.

Aside from two week's notice being a bit short for such an exam, especially when I had scheduled a beach vacation one of those weeks a year in advance and had just paid $500 to take my CSCS - which, if I failed, was around a $200 retake fee - I need to have all of my old textbooks to take the exit exam.

THE ONES I SOLD TWO YEARS AGO.

Did anybody ever tell me I should keep those textbooks, just in case I happen to have a gigantic comprehensive exam near graduation? Nope.

"So, what's the big deal? Just go to the library, man."

Yeah, I thought the same thing. Except the library recently decided that it's going to be closed all Saturdays this entire summer, and only be open for five hours on Sundays.

"Well, just go on a different day, man."

That'd be fine, but I've already gotten a phone call from my professor, and multiple emails complaining about how I said I was going to take the exit exam and that I didn't. Did I ever say any of that? Nope, but that doesn't matter, I'm now the lazy, apathetic Southerner in the eyes of my professor.

USE. BETTER. COMMUNICASHUUUUUUUN!!!

Here's To Tomorrow

After six months of saving money/studying, I finally decided to register for my Certified Strength and Conditioning Specialist (CSCS) exam earlier last month. I'm scheduled to take it tomorrow.

I've been doing a good bit of freelance writing lately, and I wanted CSCS after my name to add a little more oomph to what it is I have to say. That, and if I ever want to teach classes at the university level someday, having the CSCS will help.

It's widely regarded as an extremely difficult test, while simultaneously being the gold-standard test to determine whether or not you know what you're talking about when it comes to training. That typically means you devote hours every evening attempting to absorb too much material.

310 questions in 4 hours.

Let's do this.