The United States is facing a growing gap between the demand for physical therapy and the number of therapists available to provide it. The Bureau of Labor Statistics projects 14.2% employment growth for physical therapists between 2023 and 2033, translating to roughly 36,800 new positions that need to be filled. Meanwhile, the pipeline of new graduates, burnout-driven attrition, and shrinking reimbursement rates are all working against that demand.
How Big the Demand Is
The 14.2% projected growth rate for physical therapists is significantly faster than the average for all occupations. An aging population drives much of this: as baby boomers move deeper into their 70s and 80s, the need for rehabilitation after joint replacements, strokes, falls, and other age-related conditions accelerates. At the same time, younger adults are increasingly referred to physical therapy for chronic pain management as an alternative to opioids, and sports medicine continues to expand.
That 36,800-job increase represents net new positions, not replacements for therapists who retire or leave the field. When you factor in normal workforce turnover, the actual number of openings over the next decade will be considerably higher.
The Graduate Pipeline
In 2024, U.S. Doctor of Physical Therapy programs graduated 12,149 new therapists. Programs currently average a planned class size of about 48 students, with public institutions averaging 44 and private institutions averaging 51. These numbers have remained relatively stable in recent years, meaning the pipeline isn’t expanding at a pace that matches demand projections.
Simple math highlights the challenge. If roughly 12,000 new graduates enter the workforce each year and the profession needs to fill 36,800 new positions over a decade (plus replace those who leave), the supply stays tight. And not every graduate stays in clinical practice long-term, which narrows the effective supply further.
Burnout Is Pushing Therapists Out
One of the less visible drivers of the shortage is how many physical therapists are burning out and considering leaving. A study published in the Internet Journal of Allied Health Sciences and Practice found a 70% prevalence of burnout among DPT faculty respondents. More than half, 54%, said they had considered leaving their role because of it. Nine percent had already taken a leave of absence, and 24% had sought professional help for burnout-related issues.
While that study focused on faculty rather than clinical therapists, the implications ripple through the entire profession. When faculty burn out, programs lose experienced educators, which constrains the ability to train new therapists. Clinical therapists face their own version of the same pressures: high caseloads, documentation demands, and the feeling of running on a treadmill that speeds up every year. The statistical link between burnout and intent to leave was strong in the data, suggesting the profession is losing people it can’t easily replace.
Reimbursement Cuts Squeeze Clinics
Even when clinics want to hire more therapists, the economics don’t always cooperate. Medicare reimbursement for physical therapy services has been declining year after year due to the fee schedule’s budget-neutral structure. For 2025, the Centers for Medicare and Medicaid Services proposed a 2.8% decrease in the conversion factor used to calculate payment amounts, dropping it from $33.75 to $32.36.
That might sound small, but these cuts are cumulative. Each year’s reduction builds on the last, and clinics that treat a high proportion of Medicare patients feel the squeeze most. When revenue per patient visit drops, clinics respond by increasing patient volume per therapist, reducing support staff, or freezing hiring altogether. This creates a cycle: remaining therapists see more patients, burn out faster, and some eventually leave, which worsens the shortage in their area.
The budget-neutral structure means that whenever Medicare adds new services or adjusts payments upward in one area, it must cut elsewhere to stay under a $20 million spending threshold. Physical therapy reimbursement has been on the losing end of that equation repeatedly.
Where the Shortage Hits Hardest
The shortage isn’t evenly distributed. Rural areas and underserved communities have the hardest time attracting and retaining physical therapists. New graduates tend to cluster in metropolitan areas where salaries are higher, lifestyle amenities are better, and career advancement opportunities are more visible. If you live in a rural county, you may face wait times of several weeks for an initial evaluation, or you may need to drive an hour or more to reach a clinic.
Specialty areas feel the pinch too. Pediatric physical therapy, geriatric home health, and neurological rehabilitation all require additional training and tend to offer lower reimbursement than orthopedic outpatient care. Therapists who specialize in these fields are particularly scarce.
What This Means if You Need Treatment
If you’re trying to get a physical therapy appointment and finding long wait times, the shortage is likely part of the reason. A few practical realities worth knowing: many states allow direct access to physical therapy, meaning you can schedule an appointment without a physician referral, which can save days or weeks in the process. Telehealth physical therapy has also expanded since 2020, and for certain conditions (especially exercise program progression and movement coaching), virtual visits can bridge the gap while you wait for in-person availability.
You may also encounter shorter treatment sessions or higher caseloads at busy clinics, where your therapist is juggling multiple patients simultaneously. This model, sometimes called “concurrent care,” is partly a response to reimbursement pressures. Asking a clinic upfront whether your therapist will be one-on-one or managing multiple patients at once can help you set expectations and choose the right fit.