With demand rising for homecare as the number of older adults and disabled people in need of care increases, it is critical to ensure those entering the medical job force know of the many options for careers in the home health industry and its meaningful impacts. VNS Health is spearheading an initiative to do just that by providing homecare-specific training to physical therapists (PTs) new to the field.
According to the U.S. Bureau of Labor Statistics, jobs for PTs are expected to grow at least 15% in coming years, and VNS Health believes the need for PTs with homecare-focused training has become more vital—especially when there’s little awareness of this branch of the industry.
The Blueprint & a Growing Need
A predecessor of a similar successful program VNS Health had a decade ago, the Student PT Program started this spring and pairs students new to the home health PT industry with VNS Health senior physical therapists. The duos work side by side to learn the skills needed to take care of individuals in their homes.
“We went back to that idea of, ‘OK, we would love to have newly graduated PTs and mentor that,’ but we needed to start a PT student program to create a pipeline,” said Joseph Gallagher, operation services director and a developer of the program.
“We were having difficulty recruiting with the pandemic,” said Allison Simms, rehab services associate director and a developer of the program. “A lot of people made personal decisions about retiring or relocating (which) made it a little difficult with the recruitment process. So just by socializing and advertising what homecare is and what we do, we thought that this program would have a significant influence.”
As a side benefit, they said, training the new generation of PTs has created a new sense of energy among the VNS Health senior physical therapists who were looking for more leadership and responsibility.
“We thought that them orienting a new student would actually brush up their skill set and add more value to their role as a physical therapist,” Simms said.
VNS Health reached out to universities and physical therapy programs around New York City, where it’s headquartered, to renew the interest amongst the organizations and students, as Gallagher said it’s not a common thing to have a student program in homecare. Afterward, the schools send a referral for the prospective student, which is then followed by an interview process. Simms said the program focuses on third-year students as they are preparing to enter the job force.
In Practice
When accepted into the program and placed with a senior physical therapist, the students shadow them on home physical therapy sessions. (Due to regulations, the student is always with their senior physical therapists during home visits and other training.)
“The students are actually practicing, and they’re providing care under the supervision of the physical therapist,” Simms said. “They’re treating these patients in the home environment. We mirror the process as if we are going to hire that individual, and what that training would encompass, because at the end of their training, they’re supposed to be ‘entry-level physical therapists.’”
While training, students treat a variety of patients with different clinical complexities and diagnoses, all while developing a rapport and professional relationship with them. They also learn about what homecare looks like in an urban environment, which brings an added layer of challenges.
“One of the biggest differences—here in New York in particular—is there are areas where you can’t have a car,” said Gallagher. “So, as a therapist, you are on foot, carrying all of your homecare tools with you in a backpack. You really have to organize your day around that. Trying to make sure that you have your patients planned out, you’re walking in the efficient way so you’re not doubling back on yourself, you’re taking care of yourself—especially in extreme weather. That you’re ready for everything that’s going to be thrown at you in that bustling city environment.”
Home health physical therapists in city environments have to think about parking rules, using different modes of public transportation to get to patients’ homes, making multiple stops to get to an area and more.
Students in the VNS Health Student PT Program are also learning what it means to care for diverse communities.
“New York City definitely is a very diverse city, and we have to be culturally aware and sensitive to different customs and beliefs,” Simms said. “We definitely try to hire a diverse pool of clinicians, so we can support our patients in the community that share like customs and preferences.”
Simms said PTs in the city have to consider architectural confines—from small apartments to large homes, settings vary from patient to patient, the opposite of the controlled environment that outpatient physical therapists are used to.
“The therapist has to have the clinical expertise to adapt and provide care and therapeutic treatments for our patients in the confines of their home,” Simms said.
Positive Feedback & Future Growth
The feedback has been positive from the students and senior physical therapists.
“They really developed a great bond, a great relationship,” Simms said. “They learned a lot from each other. The students were able to report on new studies and new clinical procedures and the outcomes. And the senior therapist was able to also teach the students signs and symptoms and what's the best treatment approach and how to get the best outcome for their patients.”
Simms shared an anecdote of a senior therapist who reported that they were lonely when one of the students completed the program, as they had gotten used to having a companion while taking care of patients.
“The student and the senior therapist, by the end, is (a) strong relationship that has to end and both of them are disheartened by the fact that it's over.”
It can be bittersweet by the end, having to say goodbye, a valuable lesson in a field where relationships with patients also come to an end eventually.
As this was the first round of the Student PT Program, the student pool was limited, but Simms said they plan to expand the program and other efforts to make students more aware of home health as at the entry-level, physical therapists are encouraged to go into the hospital setting.
“I think it's safe to say that it was a positive outcome, and we're going to move forward with expanding the program out,” she said. “We actually are in negotiations in the back end (with) other schools so that we can have contracts with them and take on more students.”
Simms and Gallagher also plan to develop a rehab residency program that will hire newly graduated entry-level therapists.
“What that will entail is that we will hire new grads—entry-level therapists—but we are going to label them as rehab residents,” Simms said. “And what that will encompass is that we're going to provide additional resources and education tips for them to help develop their clinical skill set. And this is the type of service they would receive if they were in the hospital setting. We want to develop a rehab resident program so we could support entry-level therapists so that they would be interested in coming in homecare when they finish school.”
