Best Careers 2009: Physical Therapist

Overview. Next to the clergy, physical therapy ranked highest in job satisfaction, according to a survey conducted by the National Opinion Research Center at the University of Chicago. More than three quarters of physical therapists reported being "very satisfied" with their occupation. In a similar survey by the Wall Street Journal's Career Journal, physical therapy rated one of the eight best careers.

And it's easy to understand why:

• You're a one-on-one coach, a role that many people enjoy. It's a bit like a fitness coach but with more skills and you're helping people with more acute problems.

• You usually see real progress. For example, it's touching to see a patient, who came in on a stretcher or in a wheelchair, walk out at the end of treatment.

• Unlike physicians, who often are restricted to 12-minute appointments, you typically see a patient for an hour.

• You have considerable autonomy in how to solve problems, yet, unlike in self-employment, you can get a steady and pretty good paycheck.

• There's variety: Most physical therapists are generalists. You might treat, for example, a brain-injured child, a football player who broke his arm, an Iraq War veteran amputee, and an aged stroke patient.

• You can choose from a wide range of work settings, notably hospitals, physical therapy clinics, schools, physicians' offices, and patients' homes.

• Unlike many other health professionals who must work nights and weekends, you usually have normal work hours.

• Despite increased use of lower-cost physical therapy assistants, the job market for physical therapists is projected to remain strong as the baby boomers are reaching the age where they get more weekend-warrior athlete injuries and more serious problems.

Like all careers, physical therapy has downsides:

• This career is physically demanding. All day, you're moving patients around, demonstrating exercises, and so on. That's a plus for some people and a minus for others who might prefer a desk job. It's not uncommon to leave work with sore muscles.

• Burnout risk. Many of your patients will be newly disabled, in pain, progressing slowly, and/or frustrated by the painful exercises you prescribe. That can take a toll on you.

• Training requirements have been ratcheted up. Not long ago, a bachelor's degree would do. Now, a master's is the minimum, with a three-year doctor of physical therapy increasingly the norm.

Nevertheless, if you're a science- and helping-oriented person, fascinated with the human body, and have an optimistic personality, a physical therapy career may heal your career pains.

A Day in the Life. You arrive at the hospital and head to the physical therapy room, with its weights, mats, and treadmills. You discuss the day's cases with your physical therapy assistant, who will do much of the routine work.

Your first patient had arthroscopic knee surgery and is back for his third session. You review his chart, interview and examine him, and see that since his last visit, he has improved his range of motion to 90 percent. You teach him a new exercise that should get him back to 100 percent, and you give him the good news that he doesn't need to come back. He walks out with a smile.

Alas, that was your easiest patient of the day. Your next patient, who had a stroke, arrives in a wheelchair. He has been seeing you for months, and he still can't walk well. He's frustrated not only by his lack of progress but with the reality of his likely limitations for the rest of his life. And like some patients, he can't help but take his frustration out on you. "For all that money I'm paying, can't you help me more than to tell me to keep trying these torturous exercises?" You help him with his exercises; because of his poor mobility, you have to help lift him and move his legs. He is making enough progress that you're able to start weaning him from his wheelchair and teaching him how to best use a walker.

By the time he leaves, you're ready for a break, but first, you E-mail his occupational therapist and social worker, requesting a meeting to discuss his case.

Next, you have a new case, a cancer patient who is wheeled into your clinic on a gurney. She has had abdominal surgery and can't sit up. After reviewing the physician's reports and taking a medical history, you reassure her that she will get better. After examining her, you develop a treatment plan, which, yes, includes painful exercises but also pain-relieving ultrasound, massage, and other palliative measures. This is another one of those cases that make you glad you have an upbeat, cheerful personality. She really appreciates it, promises to do the exercises you've assigned, and you schedule her for another appointment tomorrow.