Occupational therapy manpower.

Slephanie Pressel/CT. J'vI.s., OTR, 1:.1 Director, Education Division, 1'101'1'1. Issue Statement In several recent Nalionally Speak­ ing columns the authors have de­ scribed changes the occupational therapy profession is experiencing on a number of different fronts, including practice delivery sys­ tems, regulations governing health care, and so on. The profession is indeed undergoing changes, and nowhere are these changes more visible, and perhaps more impor­ tant, than in the issues that directly and indirectly affect the larger issue of manpower. Between 1970 and 1981 more occupational therapists were certi­ fied than in all previous years. Our growth has been phenomenal. At the same time. the profession has been experiencing an extensive manpower shortage. The most recent available data indicates that occupational therapy services are offered in nearly 40 percent of all hospitals, and in about 30 percent of nursing homes and home health agencies. The implication of these figures is that larg'e numbers of people are not receiv­ ing serv ices th cy need. A federa I gO\ernment study in the mid­ 1970s indicated thaI only 10 per­ cent of the residents of nursing homes who needed occupational therapy services received lhem. Part of the reason for this, unco­ vered in a later study. was that 23 percent of the occupational ther­ apy posilions in nursing homes \\ine vacant. More recently (1980) the American Hospital Associa­ tion (AHA) indicated that 8.5 per­ cent of the occuparional therapist positions in hospitals were vacant. In addition, the Bureau of Labor Statistics at the U.S. Department of Labor predicts a substantial shortfall of occupational therapy personnel through 1990. The overall shortage in numbers of occupational therapy personnel is also reflected rather dramatically in geographic shortages. The numbers of therapists available to serve the U.S. population varies nearly I[>-fold from 1 per 4,000 in New Hampshire to I per 59,000 in Mississippi. Further, the vacancy rates uncovered by the AHA study ranged up to 20 percent in Rhode Island and more than 27 percent in Arkansas. At lhe same lime, it is true that some employment pat­ terns are changing because of recent adverse economic conditions. Of all the changes seen in recent years, two SLand out prominently. In the mid·1970s and continuing through 1981, growth in our pro­ fessional educational system slowed substantially. The output of our programs leveled off at about 1,900 to 2.000 graduates per year: the numbers of faculty stabi­ lized at about 520: and students enrollments grew by only 2.2 per­ cent per year. Similar patterns were seen in our tech n icaJ programs. The second change, occurring at aboutlhe same time, is potentiallv more critical. Th(' numbers of qualified applicants to our educa­ tional program are declining pr('­ cipitously. In 1977, there was a 51 percent excess of qualified appli­ cants to our professional pro­ gra ms. By 1981, the overall excess was only 15 percent, and several programs did not fill all their available paces. In summary, (hen, over the past J5 to 20 years we have seen rapid growth in supply of personnel, with a concurrent rapid expansion of the demand for occupational therapy services, resulting in an