Salary, education, and managerial-level differences of physical therapists in Maryland.

Salary, Education, and Managerial-Level Differences of Physical Therapists in Maryland The health care fields in general, and the physical therapy profession in particular, are predominantly female. In an era where women are entering traditionally male-dominated professions such as banking and industry, the question arises as to what is happening in the typically female-dominated careers such as those of the allied health professions. Of particular interest are differences in the representation of men and women in management positions and salary differences. In recent years, men have been assuming more leadership in the predominately female physical therapy profession. [1] A discrepancy appears to exist in the number of women becoming managers and their proportion in the total physical therapy work force. In 1984, women comprised 77% of the physical therapy work force. [2] In a nationwide poll of physical therapists, Kemp et al found that 35.1% of their femal respondents as opposed to 56.4% of their male respondents were chief physical therapists. [3] If it is assumed that all therapists receive the same basic physical therapy training, then women managers are not represented in numbers similar to their proportion in the physical therapy work force.

Another area of discrepancy is in salary differences between male and female physical therapists. Since the late 1960s, the median income of full-time female workers for all occupations remained at about 60% of men's income. [4] For the physical therapy profession, the US Bureau of the Census report for 1980 listed female physical therapists earning, on average, $7,709 less than male physical therapists. [5] Kemp et al found that female chief physical therapists earned 25% less than did male chief physical therapists. [3]

Given the previous findings of salary discrepancies and the relative representation by women in management, factors relating to the attainment of a managerial position may be important. The evolution toward management in physical therapy begins with the basic physical therapy professional preparation, which in most cases has been a baccalaureate degree. To this basic preparation are added three factors: 1) continued education, 2) work experience in physical therapy, and 3) longevity of service with an organization. In this study, continued education refers to short-term courses in management or courses leading to a higher degree, especially in business or management. Work experience includes any practice as a physical therapist, whether at one or several organizations. Such experience could include some supervision of subordinates, such as physical therapist assistants or physical therapy aides. Seniority, in this study, means the length of time that a therapist has been employed in his or her present setting. Seniority may be expecially important if promotions come from within the organization itself. Additional factors that may alter the managerial level of a physical therapist are individual motivation, job stress, part-time employment, or attrition.

The purpose of this study was to examine physical therapists employed in Maryland to identify whether differences existed between men and women in management and staff positions. Managerial position was divided into categories of department manager (held a supervisory position), solo manager (owned and managed own practice), and staff (nonsupervisory physical therapists). Factors studied included whether the actual number of female physical therapy managers differed from the expected number of female managers in physical therapy; whether average annual salaries differed according to sex for managerial and staff levels; and whether male and female physical therapists differed on the factors of courses in management, work experience in the physical therapy profession, and seniority with an organization.

Method

Subjects

The population studied were physical therapists who were licensed to practice in Maryland and also members of the American Physical Therapy Association. A random sample of 400 was chosen from the approximately 800 eligible physical therapists.

Design

Instrumentation. We designed a 29-item questionnaire based on items investigated by Kemp et al, [3] Guccione and Jette, [6] and the APTA membership profile of 1982 as cited by Guccione and Jette. [6] Construct and face validity were examined by a panel of experts.

We conducted a pilot study and determined reliability of the instrument using the test-retest method. After revision, the final reliability value for the instrument using the Pearson product-moment correlation coefficient was .85.

Procedure. Data were collected during the early winter of 1986. A mailed questionnaire and cover letter were sent to 400 physical therapists licensed by the state of Maryland who were also APTA members. The questionnaires included items on salary, managerial position, course work in management, and work experience in physical therapy. They were coded for anonymity and color-coded for sex. Except for report of salaries, nonresponses were coded as missing values. Salary responses were averaged for sex and managerial level. For those not responding to the question on annual gross income, average salary figures were used. Confidentiality was ensured in the cover letter. Questionnaires were returned from 244 persons (61%). Because this return rate was considered excellent for mailed questionnaires and was sufficient for adequate data analysis, [7] we did not conduct a follow-up on nonrespondents.

Data analysis. To examine managerial levels, we tabulated the actual, rather than proportional, responses for solo managers, department managers, and staff-level physical therapists for the total sample, as well as by sex, using the chi-square test for goodness of fit. Differences in average annual salaries of male and female physical therapists at managerial and staff levels were analyzed using a series of t tests for independent samples.

Multiple Mann-Whitney U tests were performed for courses taken in management, sex, and managerial level. No differentiation was made between seminars, college-level courses, or management courses required for a business degree. The number of courses taken was divided into several categories. Zero to 3 courses indicated a casual interest in business or management. Four to 6 courses indicated a more-than-casual interest in business or management. Seven to 10 courses indicated a possible minor in business or management, especially if taken at the college level. Finally, more than 10 courses indicated a possible business major.

We used a critical ratio or z test to investigate the differences between male and female physical therapists on number of years of physical therapy experience and years of seniority in an organization. For all hypotheses tested, a significance level of .05 was used.

Results

Of the 400 subjects sampled, 244 (61%) responded to the mailed questionnaire. The study population was composed of 52 men (21.3%) and 192 women (78.7%). The mean age was 34.9 years, with men averaging 44.9 years and women averaging 35.2 years. All geographical areas of Maryland were represented by the returned questionnaires. The participants represented 57 schools of physical therapy, with 38.5% attending the University of Maryland. The entry level into the physical therapy profession was 85% by bachelor's degree; 78% reported that was the highest degree obtained. The average number of full-time years of experience in physical therapy was 8.5 (s = 7.6).

The respondents included more staff physical therapists than managers. Of the 192 female respondents, 44.8% were in a managerial position and 55.2% were staff therapists. In comparison, of the 52 male respondents, 63.5% were in a managerial position and 36.5% were staff therapists (Tab. 1).

Using the chi-square test for goodness of fit, we found a significant difference (p [is less than] .03) at the .05 alpha level in managerial-level representation by each sex. A chi-square value of 7.11 indicated a significant difference in the observed frequencies of men and women in each managerial level versus the expected frequencies (Tab. 2).

Because of the extreme variability of part-time employment, we decided not to use part-time physical therapists for data anlysis and conclusions. Using only full-time employment, no significant difference was found between the observed and expected frequencies of women in managerial positions in Maryland (X.sup.2 [1, n = 192] = 3.48, p [is greater than] .05, [alpha] = .05).

Table 3 shows the mean annual salaries and standard deviations by managerial level of respondents employed full time. Using the t test, we found that, at the .05 alpha level, a significant difference existed between male and female physical therapists in average annual salaries for the total sample (p [is less than] .001). Among those physical therapists who worked full time, significant salary differences existed, at the .05 alpha level, between the sexes for all managerial level (p [is less than] .001), for department managers only (p [is less than] .001), and for solo and department managers combined (p [is less than] .02). No significant salary differences existed between the sexes of those respondents employed in full-time solo management (p [is greater than] .05) or full-time staff-level positions (p [is greater than] .05). From this analysis, we found the following significant salary differences (p [is less than] .05) between male and female respondents: 1) Women employed full time earned 21% less than men employed full time, regardless of managerial level; 2) female department managers employed full time earned 25% less than did their male counterparts; and 3) all female managers employed full time earned 21% less than men employed full time in a management position.

Multiple Mann-Whitney U tests revealed no significant difference existed at the .05 alpha level between male and female physical therapists on the number of courses taken in management, regardless of managerial level. Our examination of part-time and full-time years of work revealed no significant difference (p [is greater than] .05) between male and female physical therapists practicing in Maryland on the number of years of full-time work experience (z = .19, [alpha] = .05). When examining part-time years for the same group, we found a statistically significant difference (z = 7.09, [alpha] = .001), indicating that women have a significantly higher number of years invested in part-time physical therapy employment (p [is greater than] .05).

Because we chose to specifically investigate full-time employment, only those respondents employed full time were included in further evaluation between male and female physical therapists. No significant differences were found between male and female physical therapists practicing in Maryland on the factor of full time work experience except at the managerial level (z = 2.00, [alpha] = .05).

By using critical ratios, no significant differences were found to exist between men and women for years of seniority in an organization (p [is greater than .05). This finding was true of all levels of management. The mean number of years of seniority was greatest for full-time male department managers and lowest for full-time male staff therapists. For managerial level, the mean years of seniority were greatest for full-time males (X = 6.33) and full-time department managers (X = 6.06).

Discussion and Conclusions

According to APTA membership reports, as cited by Guccione and Jette, [6] 72% of the physical therapy profession was female. This study showed that Maryland is similar in its representation with 78.7% of the physical therapists responding being female.

Based on the results of this study, we concluded that factors other than courses in management and years of seniority in an organization are reasons for attainment of a management position in physical therapy. Total years of physical therapy experience was significantly different between the sexes in only one managerial level, that of department manager. Perhaps factors leading to promotion to the management position should be examined more closely.

The findings from this research reinforce previous studies of physical therapists on managerial levels. Moore et al identified that men were assuming more of the leadership positions than women. [1] Kemp et al found that 35.1% of their female respondents and 56.4% of their male respondents were chief physical therapists. [3] Similar results were found for this study. We found that 44.8% of the female respondents and 63.5% of the male respondents were in management positions, either in an institution or in solo practice. Among full-time practitioners, 47.5% of the women and 62.7% of the men were in management positions. This study also concurred with previous studies on average annual salaries. [2-3,8-10] In this study, women earned an average of 67.5% of men's salaries for all managerial levels, regardless of whether their employment was full time or part time.

The significant difference found between male and female department managers' average salaries could have many causes. It may be the result of upper-level management's views of women in management. Women may be considered to have potential short-term employment because of marriage or pregnancy interruptions. Another reason for the difference in salaries may be that women lack the negotiation skills to demand salaries comparable to those of men. These salary discrepancies and reasons for them warrant further investigation. Berger suggests a third reason for salary inequity: sexual prejudice in job evaluation. [4] She stated that male names were chosen 10% more often than female names in filling teaching vacancies, even though men and women had similar qualifications. With the growth of group practices, it would be interesting to study how many male and female managers are employed in practices owned by each sex.

The other factors studied--courses taken in management, work experience in physical therapy, and seniority in an organization--cannot be directly related to other research findings. Although studies have been conducted and suppositions made in the area of physical therapy management, no concrete indicators have been identified for promotion to leadership positions. [1,3,11,12] We did not address motivating factors in this research. Possibly not every physical therapist wants to be a manager. A written comment on one questionnaire in this study stated exactly that. Yet Kemp et al felt that men, in attempting to legitimize their career in a female-dominated profession, pursued promotions to management roles. [3] This need for autonomy may account for the fact that 23.5% of men in full-time practice were also in solo management positions, whereas only 8.5% of the women occupied the same position.

In the area of work experience, we agreed with Conine who identified pregnancy and marriage as reasons for career interruption. [13] Our research showed that childbearing or childrearing was the primary reason given for career interruption. Three male physical therapists' careers were interrupted, one for education and two for other reasons such as travel. Of the 90 female physical therapists' careers that were interrupted, 71 were for childbearing or childrearing. Such interruptions could influence anniversary dates for annual and merit raises.

We did not find a significant difference between sexes on seniority in an organization. This finding agrees with Harkson et al who noted mobility as a cause for lack of seniority in a physical therapy organization. [14] Another reason may be that women enter and exit the work force for childbearing or childrearing. Also men and women may change employment for career advancement, especially if they are employed in a large facility where internal promotions are slow. More investigation is needed to answer the question of why differences exist between the sexes and to look at possible changing trends in physical therapy practice.

The physical therapy profession has not listened to Moore, who felt that physical therapy management development programs were inadequate. [12] The short-term courses offered to physical therapists continue to be geared predominately toward improving clinical skills. This is not necessarily a bad offering. Typically, however, a skilled therapist, one who has taken clinical skill-improvement courses, will be identified as a leader, promoted to management, and then, because of the management position, be unable to use these same clinical skills. Professional associations should expand management course offerings to the general membership and focus on basic management principles rather than specific managerial skills. Course offerings in the physical therapy curriculum should emphasize management education in the undergraduate and graduate levels to better prepare the future practitioners for leadership roles. In reviewing the curricula of eight physical therapy education programs, no school was found to offer more than two courses in management.

Advancement to management could be considered to be a logical progression of a physical therapist's career. A basic preparation in management, therefore, should be included in the physical therapy curriculum to prepare each student for this future role. A careful examination of the present physical therapy curricula is needed to adequately assess whether the profession is preparing its members for management roles by offering them business or management courses within the basic curriculum. The proposal of the entry-level master's degree physical therapy program, that has been mandated for implementation by 1990 by the APTA, would be the logical place for the inclusion of management courses as an upgrading of the basic professional requirements.

References

[1] Moore P. Conine TA, Laster TE: Sex-role stereotyping in health care: Perceptions of physical therapists. Phys Ther 60:1425-1429, 1980

[2] Bodger C: Sixth annual salary review. Working Woman 10:65-72, 1985

[3] Kemp NI, Scholz CA, Stanford TL, et al: Salary and status differences between male and female physical therapists. Phys Ther 59:1095-1101, 1979

[4] Berger G: Women, Work and Wages. New York, NY, Franklin Watts Inc, 1986

[5] Census of Population Subject Reports: Earnings by Occupation and Education, PC80-2 Series. Washington, DC, US Dept of Commerce, Bureau of the Census, 1980

[6] Guccione AA, Jette AM: Regional differences in physical therapists' incomes. Phys Ther 64:1209-1213, 1984

[7] Nachmias D, Nachmias C: Research Methods in the Social Sciences, ed 3. New York, NY, St Martin's Press Inc, 1981

[8] Barker JT: Women as leaders in the field of rehabilitation. Journal of Rehabilitation 48:9-18, 68-70, 1982

[9] Fortenbaugh J: The fourth annual salary survey. Working Woman 8:65-68, 1983

[10] Rubin DK: Fifth anual salary review. Working Woman 9:59-76, 1984

[11] Gibson D: A guide to women in management. Occupational Therapy in Mental Health 3(1):55-65, 1983

[12] Moore ML: Thirteenth Mary McMillan lecture: Building winning teams. Phys Ther 58:1338-1345, 1978

[13] Conine TA: A survey of the graduates of a professional physical therapy program. Phys Ther 52:855-861, 1972

[14] Harkson DG, Unterreiner AS, Shepard KF: Factors related to job turnover in physical therapy. Phys Ther 62:1465-1470, 1982

C Baker, MS, PT, was Chief Physical Therapist, Burch, Rhoads & Loomis, PA, 6305 York Rd, Baltimore, MD 21212, when this article was written. She is currently in private practice, 30 E Padonia Rd, Suite 204, Timonium, MD 21093.

J McMahon, EdD, is Associate Professor, Department of Health Sciences, Towson State University, Towson, MD 21204 (USA).

This article was submitted November 30, 1987; was with the authors for revision for 22 weeks; and was accepted August 15, 1988.