What Are the Different Settings Where PT’s Practice?

If you’re filling out PTCAS observation hours, you’ll have to indicate which setting you were in. While some settings might be obvious, the level of detail PTCAS asks for can be confusing. What is the difference between subacute and acute? What is a SNF?

Since PT’s can work in dozens of places, I’ll stick to the categories identified by PTCAS, which include the most common areas (as well as some more unusual settings). Read on to find out some common places where physical therapists work. It’s hard to find official definitions of each setting, so I’ve linked to the source for each.

The biggest divider between settings is inpatient vs outpatient. As PTCAS so helpfully tells us, inpatient settings are facilities that “generally admits patients overnight,” while outpatient settings have “no overnight patients.”

But let’s break it down further:

Inpatient settings:

1. Acute Care Hospital – Acute care is intensive rehabilitation for people who have suffered from a debilitating injury or illness or recently had acute care surgery. They usually have over 3 hours of therapy a day.
2. Nursing Home/Skilled Nursing Facility/Extended Care Facility – A nursing home is a “permanent residence for people in need of 24/7 care,” while a skilled nursing facility (SNF) is a “temporary residence for patients undergoing medically necessary rehab.” These settings may often be combined. For example, I had a clinical in a facility that had some floors for permanent residents and some floors for SNF patients who only stayed for a few days or weeks.
3. Other Inpatient Facility – Any inpatient setting that doesn’t fall into one of the other three categories listed.
4. Rehabilitation/Sub-acute Rehabilitation – Patients in subacute settings can’t withstand sessions as long as those in acute care can. It can come after someone has already had acute care and typically involves therapy for less than 2 hours a day.

Outpatient settings:

1. Freestanding PT or Hospital Clinic – This can include private practices and many orthopedic clinics we typically think of when we first think of PT.
2. Home Health – Home health PTs and PTAs work one-on-one with patients in their own environment, making services completely relevant to the patient’s needs and goals.
3. Industrial/Occupational Health – Industrial rehabilitation combines occupational therapy and physical therapy to help employees return to work safely after an injury or illness. 
4. School/Pre-school – Physical therapists are integral members of school-based teams that ensure a free and appropriate education for students with disabilities and prepare them for further education, employment, and independent living in many cases.
5. Wellness/Prevention/Fitness – PT’s in this role help people “improve overall health and avoid preventable conditions.”

PTCAS also includes a category for “Patient Diagnoses/Patient Observed” because, for example, while I work in outpatient orthopedics for a hospital, I have a colleague who only treats children. If you shadowed her, you would be in outpatient orthopedics, but the population you’d be seeing would be “Pediatrics,” whereas if you shadowed me, it would include, “General Orthopedic,” “Geriatrics,” and “Sports.”

When in doubt, ask the therapist who supervised you.

Physical therapists also work in a variety of other areas, including the emergency room, with performing artists, in the military, with athletes on professional sports teams, with animals, via telehealth, as traveling physical therapists in many settings, as professors, and in a multitude of non-clinical roles.

According to the US Bureau of Labor Statistics, 36% of physical therapists work in physical therapy offices, 29% for hospitals, 11% in home health, 5% for nursing and residential care facilities, and 3% are self-employed.

There are also 10 areas in which PT’s can officially specialize while working in many of these settings, including Cardiovascular and Pulmonary, Clinical Electrophysiology, Geriatrics, Neurology, Oncology, Orthopaedics, Pediatrics, Sports, Women’s Health, and Wound Management.

So, as you can see, there are so many diverse settings in which you can work as a physical therapist!

Interested in purchasing my PTCAS-compliant observation hour log? Email me and submit payment to buy yours today for just $5!

To purchase, simply submit payment via  Venmo (@jasmine-marcus), Cash App (@jmarcusdpt), PayPal (jmarcusdpt@gmail), Apple Pay or Zelle (email me for username). I will then email you the PDF ASAP.