Outpatient clinics across the country are competing for physical therapists in a labor market where demand remains high and qualified candidates often have several choices.
For clinic owners and administrators, the experience can be frustrating. A position is posted, applications arrive slowly, interviews do not lead to accepted offers, and the opening remains on the schedule for months. Meanwhile, patient demand continues, current clinicians absorb additional work, and the clinic may have to delay or decline referrals.
The challenge is larger than any single clinic. The American Physical Therapy Association’s 2024 benchmark survey of outpatient practices reported a 13.5% vacancy rate for PT positions—approximately one open position for every seven positions. In the same survey, 71.1% of responding practices reported at least one PT opening in 2024. The report was based on 330 usable practice responses representing 5,113 clinics, so individual markets will vary, but the results illustrate the scale of the pressure facing employers. Source: APTA Benchmark Report
Understanding why hiring has become difficult can help outpatient facilities adjust their recruiting strategy, protect current operations, and consider flexible staffing options while they continue searching for permanent employees.
1. Demand for physical therapists continues to grow
The need for PT services is expanding across multiple settings. The U.S. Bureau of Labor Statistics projects physical therapist employment to grow 11% from 2024 to 2034, compared with 3% for all occupations. BLS also projects an average of approximately 13,200 PT openings each year over that period, including openings created by growth and the need to replace clinicians who transfer occupations or leave the workforce. Source: U.S. Bureau of Labor Statistics
Outpatient clinics are therefore not competing only with nearby private practices. They may also be competing with hospitals, home health organizations, nursing and residential care facilities, school systems, specialty practices, and other employers seeking the same licensed professionals.
Growing patient demand can create openings even when turnover is stable. APTA’s outpatient survey found that company growth was the most commonly ranked primary reason for PT and PTA openings. In other words, some vacancies exist because practices are expanding faster than they can add clinicians.
2. The qualified candidate pool is limited
Physical therapists must complete a Doctor of Physical Therapy program and meet state licensure requirements. This education and licensing pathway helps ensure clinical preparation, but it also means the workforce cannot expand immediately when employer demand rises.
Clinics cannot simply train an available applicant to become a licensed PT in a few weeks. They must recruit from a defined pool of licensed clinicians and new graduates, many of whom are being contacted by several employers.
The pool becomes even smaller when a position requires specific outpatient experience, specialty knowledge, evening availability, a particular language, or the ability to manage a specialized patient population.
3. Physical therapists have more employment choices
In a candidate-driven market, therapists can compare opportunities across settings, schedules, compensation structures, locations, and patient populations.
A clinician considering an outpatient position may also be evaluating:
- Hospital-based rehabilitation
- Home health
- Skilled nursing or senior care
- School-based therapy
- Sports or specialty practices
- Part-time or PRN work
- Contract assignments
- Nonclinical or hybrid roles
Clinics are not only competing on salary. Candidates may weigh schedule flexibility, documentation expectations, productivity standards, commute, mentorship, benefits, professional development, caseload, workplace culture, and the amount of administrative support provided.
If a position appears rigid or the expectations are unclear, a candidate may choose another opportunity even when the compensation is similar.
4. Compensation pressure is real
Compensation is not the only reason therapists change jobs, but it remains an important part of the decision.
APTA’s 2024 outpatient hiring report found that “better pay elsewhere” was among the most frequently identified reasons for PT and PTA openings. BLS reported a national median annual wage of $101,020 for physical therapists in May 2024, while the median reported for offices of physical, occupational, and speech therapists and audiologists was $94,860. Local wages may differ significantly based on geography, experience, specialty, and other factors. Source: U.S. Bureau of Labor Statistics
An outpatient clinic may have limited room to increase compensation because of reimbursement, overhead, and operating costs. That makes the complete employment experience even more important. A clinic that cannot offer the highest salary may still compete through schedule flexibility, realistic expectations, clinical support, mentorship, manageable onboarding, or a clearly defined role.
5. Work-life balance influences retention and recruiting
Candidates often want to understand what the job will feel like—not just what it will pay.
They may ask:
- How many patients are typically scheduled each day?
- Is documentation time built into the schedule?
- How frequently are therapists expected to work evenings?
- How are cancellations and double bookings handled?
- What support is available when the clinic is short-staffed?
- How difficult is it to request time off?
- Are productivity expectations clearly explained?
APTA’s 2024 report identified work-life balance among the commonly selected reasons for openings when respondents ranked their top three factors. A clinic with a long-standing vacancy may also appear more demanding if candidates believe they will immediately inherit an overloaded schedule.
This creates a difficult cycle: the vacancy increases pressure on the clinic, and that visible pressure can make recruiting harder.
6. Location and commute narrow the market
Outpatient therapy is generally location-dependent. A clinician must usually be present in the clinic during scheduled treatment hours, which makes commute time and geographic convenience important.
A clinic in a rural area, an expensive metropolitan market, or a location far from major residential areas may have a smaller candidate pool. Parking, traffic, public transportation, and the availability of nearby opportunities can all affect the decision.
Regional workforce conditions also vary. APTA’s 2024 outpatient report found different PT vacancy rates across U.S. regions, with the highest reported regional PT vacancy rate in the West. Each clinic should examine its local market rather than relying only on national assumptions.
7. Slow hiring processes cost clinics candidates
When therapists receive interest from several employers, delays matter.
A qualified applicant may be lost when:
- The application is not reviewed promptly
- Initial outreach takes several days
- Interviews require multiple scheduling steps
- Compensation cannot be discussed until late in the process
- Decision-makers are unavailable
- The written offer takes too long
- The candidate receives little communication between steps
Every clinic needs an appropriate hiring and credentialing process, but unnecessary waiting can create a competitive disadvantage.
Assigning one person to manage communication, explaining the interview timeline, and making decisions efficiently can improve the candidate experience without lowering hiring standards.
8. Job postings may not reflect what therapists value
Many PT job postings focus primarily on requirements and responsibilities. They may say little about the actual patient population, team structure, schedule, clinical support, documentation system, or reasons a therapist would want to join the clinic.
A stronger posting answers practical candidate questions:
- What types of patients will the therapist treat?
- What does a typical schedule look like?
- What support staff and equipment are available?
- How is onboarding handled?
- Are mentorship and specialty development available?
- Is the schedule flexible?
- What makes the clinic different from nearby employers?
The posting should be accurate. Promising flexibility, mentorship, or manageable caseloads that the clinic cannot consistently provide will create a retention problem later.
9. Turnover creates additional pressure
Hiring difficulties are not only about adding new positions. Clinics must also replace clinicians who relocate, change settings, reduce their hours, retire, or leave for another opportunity.
APTA’s 2024 outpatient report found that relocation and better pay elsewhere were among the leading reasons identified for openings. Because clinics are recruiting for both growth and replacement, the market can remain tight even as the number of licensed therapists increases.
Retention should therefore be part of the staffing strategy. Protecting current clinicians, communicating expectations, recognizing workload concerns, and providing appropriate support can reduce the chance that one vacancy becomes two.
10. A full-time-only strategy can limit the available options
A clinic may need a full-time PT, but the therapists available in the local market may want part-time, PRN, or contract work. Treating full-time employment as the only acceptable solution can leave patient hours uncovered longer than necessary.
Depending on the clinic’s needs and applicable requirements, flexible options may include:
- Part-time coverage
- PRN support on high-demand days
- Temporary contract coverage
- Coverage focused on evaluations
- Short-term support during recruiting or leave
- Coverage for a particular location or program
A flexible arrangement may not eliminate the need for a permanent hire. It can reduce pressure while the search continues.
What outpatient clinics can do differently
The current hiring environment requires more than reposting the same opening.
Clinic leaders can respond by:
- Reviewing compensation and benefits against the local market
- Clarifying caseload, schedule, documentation, and productivity expectations
- Improving the speed and communication of the hiring process
- Highlighting genuine strengths such as mentorship, flexibility, or specialty opportunities
- Protecting current staff from unsustainable workload increases
- Expanding recruiting channels and professional relationships
- Considering part-time, PRN, or contract coverage
- Maintaining a staffing contingency plan before the next vacancy
The goal is not to lower clinical standards or rush hiring decisions. It is to remove avoidable barriers and create more than one path to coverage.
Flexible staffing can help bridge the gap
Outpatient clinics may not be able to control the size of the local PT workforce, but they can control how they respond to a vacancy.
Flexible staffing can help a clinic maintain patient access, support current therapists, address an evaluation waitlist, or cover specific days while permanent recruiting continues. The right arrangement depends on the clinic’s schedule, patient population, duration of need, and operational priorities.
Distinctive Therapy Services provides physical therapy staffing support for outpatient clinics and other healthcare facilities. As a therapist-owned company, we understand that successful coverage requires more than finding an available clinician. It requires thoughtful matching, clear expectations, responsive communication, and continued support throughout the assignment.
If your outpatient clinic is struggling to hire a physical therapist, contact Distinctive Therapy Services to discuss flexible coverage options that can support your team while you continue recruiting.