Founder Letter: This Mother’s Day, Give Working Moms Support—Not Just Lip Service

May is a big month for celebrations from Star Wars and Cinco de Mayo to Memorial Day.  In addition to cheering on DPT graduates as they join us in the workforce or go on to residency, we also set aside a weekend to honor and give gratitude to all the moms out there. Granted, we should celebrate our mothers more often than once a year, but it’s still wonderful to be treated to a nice brunch surrounded by family. Although being a parent is a key part of a mother’s identity, it’s only one of the many roles that women play, with nearly half of US workers being women and 57% of women participating in the workforce (which is still not back to pre-pandemic numbers). 

It’s no secret that women—particularly mothers—were the most impacted in terms of occupational security and happiness by the COVID pandemic, and only recently have we seen progress toward a return to pre-pandemic levels of participation in the workforce. While we must applaud the consistent progress made over the years in educational attainment, business ownership by women, and wage growth,  there is still much to do in support of the unique challenges that working mothers face.  We’ve come a long way, baby—but work remains in areas like pay disparity, schedule flexibility, and public opinion on which parent should bear household and caregiver responsibilities. We feel these disparities acutely in rehab therapy and healthcare due to two-thirds of the workforce being women.     

So, on this Mother’s Day, let's take a hard look at some of the experiences women and working mothers have faced trying to walk that tightrope of work-life balance and their contribution to the workforce shortage.

Not all working mothers came back after COVID.

The early days of the pandemic saw a lot of women taken out of the workforce, and even as the world has returned to normal, not all women have returned to the workforce or done so at their previous level. As this Washington Post article notes, 90% of women who lost their jobs during the pandemic left the workforce completely in 2020, compared to just 70% of men. 

Women also bore much of the brunt of pandemic-related layoffs without benefiting as much as men when rehiring began. A study found that men outpaced women in returning to work until mid-2022, when we saw marked increases in women (especially mothers) re-enter the workforce. As many mothers who left clinical work can attest, a desire for remote work and a push for greater flexibility—paired with our longstanding burnout issues—led many clinicians to leave clinical care altogether, further exacerbating an already aching PT pipeline.

There is some good news for women returning to the workforce post-COVID; according to APTA data, the gender pay gap is narrowing. The data shows that, from first entering the workforce through the first ten years of their career, women now earn $0.95 for every dollar a male PT earns. The data also shows that the wage disparity has dissipated at other levels of experience —  except for therapists with between 11-15 and 31-35 years of experience, although those gaps seem to be narrowing each year. Granted, this data may not be the most complete, as it only compares APTA members; many other sources state the gender pay gap remains closer to $0.87 on the dollar. 

Gender norms remain entrenched. 

In the long arc of history, women have made monumental strides in recent decades—but when you're talking about entrenched cultural norms, small incremental gains can be big wins overall. 

Significant changes have occurred in the U.S. in terms of having women in the workforce—especially married women—since the PT profession started in the early 20th century. According to the Census Bureau, only 20% of women worked outside the home at that time, and of those 20%, only 5% were married. By 1970, 50% of single women were working, as were 40% of married women. The participation rate of “prime-aged women" (age 25-54) in the workforce hit its peak of growth in the mid-1990s, took a big dip in the COVID years, and is now recovering with the latest 2023 statistics showing 77% participation.  However, despite this progress, the employment gender gap between mothers and fathers during the child’s early years remains wide.

In addition, recent research has shown that although women now enter professional schools in numbers nearly equal to men, they are still substantially less likely to reach the C-suite of their professions. McKinsey has found that 75% of women are in entry-level healthcare positions compared with only 32% in C-suite and suffer high attrition once at the executive level. We see this in the PT industry with men's disproportional roles in PT clinic ownership and leadership roles compared to their presence in the profession.  As such, we cannot rule out gender-related impediments that hold back women, including blatant discrimination, attitudes that reduce women’s success in the workplace, and an absence of mentors and role models.

Working moms are having to look outside full-time clinical care.

While it’s starting to shift somewhat, there’s still an assumption that, in heterosexual couples, the woman will be the one to stay home and care for the child in those early years. This can present significant financial stress to the family unit with minimal support for stay at home parents.

There are many women who have combatted this over the years by supplementing their home primary caregiving roles with PRN and part-time work. And I think many working mothers are doing just that today, as women represent a larger proportion of “part-time, temporary and informal work.” Kelly Giebel, PT, DPT, shares that “for many years, I felt as though my ability to work and have a career had to revolve around the lives of my husband and children first. Then, once their schedules were set, I was finally able to fulfill my desire to have some semblance of a career.”

Kristen Severson PT, DPT, ATC-R, COMT, SDN, owner of In It Together PT, goes further to point out that when she began her life as a working mother, there was a constant juggle between the kids’ needs and that of her employer. “Eventually what happens is moms start cutting their hours in the clinic to accommodate the responsibilities of parenthood. These reduced hours have a lot of implications on a person's ability to meet their financial needs, but it also affects who will hire them, ” Severson says. This paradox is not singular to Dr. Severson or Dr. Giebel. It was a significant reason that Dr. Severson decided to break from the traditional mold and start her own mobile PT practice. In doing so, she is able to balance her love for kids with her love for being a PT.

Not every rehab therapy working mom is able to start a mobile practice or supplement their hours around a sampling of PRN and part-time gigs, and there is a segment of working mothers who DO want to work less and are able to swing that financially. Unfortunately, regardless of the mother’s aim, the burden often rests on her shoulders to figure out what’s best for her and the family. With our current workforce shortages,  the opportunity for improvement of the work environment and policies providing more flexibility and benefits so women don’t have to leave the workforce completely,—or at all—can significantly benefit not only women, but society as a whole.

We still lag behind in parental leave and care.

Parental leave policies are one area where we lag behind the rest of the world. Shockingly, the U.S. is one of the only countries in the world that does not offer paid maternity leave. Most other rich countries have also embraced paternity leave as an included benefit. And per the World Policy Analysis Center, the global average, in 2019, for paid maternity leave is 29 weeks, and the average paid paternity leave is 16 weeks.

Thinking back to the pandemic, Jodi Rickfelder, PT, DPT, now a Sales Development Representative at WebPT, recalls some of the hardships she faced when, while working as a clinician,  her second child had medical issues, requiring her to take additional time off beyond the Families with Medical Leave Act (FMLA) time she had already exhausted. Luckily, Dr. Rickfelder had a strong support network at work and home to help her through this trying time, but she still was placed in a tug-of-war position between her family and patients. She states, “Looking back at those four years working in the field as a mother, I can't help but recognize not only how strong I was for enduring all the challenges and unknowns, but how incredibly grateful I am/was for supportive, understanding coworkers. If it wasn't for them, I am not sure I could have been a successful PT and mom!”

I suppose we should be thankful that at least FMLA exists, but it’s hardly the gold standard of parental leave. In fact, the US ranks last out of 40 developed countries in terms of providing maternal care. For a country that is as wealthy and productive as ours—and one where most people aren’t taking much vacation time anyway—we must find ways to manage and support these new mothers, especially in a time of workforce shortage.

Changes are happening to provide more support for pregnant women—which could benefit the PT industry. The EEOC (Equal Employment Opportunity Commission) recently published its federal rule on the Pregnant Worker Fairness Act (PWFA) in April 2024, which should go into effect in June 2024. The PWFA aims to protect against discrimination and requires employers to provide reasonable accommodations for "pregnancy, childbirth, or related medical conditions." The federal rule supplements other EEOC protections—such as pregnancy discrimination under Title VII of the Civil Rights Act of 1964 and access to reasonable accommodations under the Americans with Disabilities Act. Furthermore, the PWFA builds upon Department of Labor regulations, like the PUMP Act for breastfeeding employees and FMLA—which provides 12 weeks of unpaid, job-protected leave for the arrival of a child or certain medical conditions.

These are great steps forward, and we must continue to press our elected representatives and industry leaders to recognize the importance of these issues to our profession and embrace our ability to lead by example in the healthcare field. 

We must create a safe space for women everywhere.

With falling birth rates, the U.S. population is rapidly aging and steadily declining which is leading to social and economic pressures caused by labor shortages. The rise of educated women in the workforce correlates with declining fertility trends. In the U.S., despite our freedoms of choice and improving support for working mothers, guilt and conflict plague many women as they return to the workplace following FMLA leave—PTs included as shown in this study done by Katherine Franklin, PT, DPT, PhD(c) and Gail Zitterkopf PT, DPT, CLT.

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In our female-dominated workforce, clinic leaders and owners must be intentional in creating a space where women can feel safe in their decision to start a family or not, as bias remains on both sides of that decision. 

How can you be more intentional as managers or clinic owners? Start by being transparent about the career pathing, parental benefits and mentorship opportunities in your practice. In our recent podcast with Dr. Keaton Ray, PT, DPT, Co-Founder and COO at MovementX, she emphasized the need for financial literacy in private practices. That need is true of any employee, as well. By being transparent with your staff on how they function in the financial picture, you can have more meaningful conversations about personal and professional goals.

With a transparent and safe workplace, your employees—mothers included—will feel less stress and need to hide aspects of their lives that could impact your practice. Even better, they will feel empowered knowing that you value them as integral members of the rehab therapy community.

Adopt benefits that embrace the working mother.

I should start by saying that I empathize with the plight of small practice owners when it comes to the prospect of losing a clinician to maternity leave. As much as you truly want to be supportive,  long-term attrition to care for new family members means possible headaches in revenue and scheduling that impact the entire practice. However, intentional investments in working mothers canl yield downstream benefits that far outweigh the short term. 

While new graduates are the ones grabbing headlines for reexamining the classic 40-hour work week, they’re not the only ones looking for flexibility. Many working moms are looking for ways to keep their careers going while they’re caring for kids, however,  the ongoing requirement for a traditional 9am to 5pm, 40-hour week in the clinic (which never matches up with school hours) and the subsequent expense for childcare is a big reason many mothers decide to leave the workforce. Options for more flexible work schedules can often work to fit both the individual and the employer and demonstrate to current and future employees that you are invested in them—not to mention creating a powerful recruiting and retention tool in the process.

Some examples of benefits that might appeal to working mothers include:

• Paid maternity leave,
• Child care assistance (i.e., stipends or reimbursements for child care expenses),
• Onsite childcare or related partnerships,
• Flexible work schedules,
• Dependent care flexible spending accounts (FSAs),
• Digital forums for parents at your company to chat with each other,
• Programs for new parents, and
• Paid sick leave.

Mentorships provide limitless benefits for working mothers.

As it stands today, our rehab therapy workforce is composed largely of working mothers. Women who have been practicing for one year to more than twenty-five years are all part of a greater PT, OT and SLP community that provides free lifetime membership. With that in mind, I cannot stress enough how important mentorship is in clinical practice. This type of mentorship requires what current working mothers can do for new and future mothers as they enter the profession or the clinic respectively. 

Mentorship in rehab therapy has its own set of benefits—one of which helps to strengthen a workforce that is already tight-knit—but if we focus on new moms, it can create a lasting relationship that stands to benefit all parties involved. Furthermore, as an American Medical Association article points out, “more women than men are encouraged to pursue an ‘easier’ subspecialty because they are a parent.” Providing mentorship can assuage some of the gender norms that impact women negatively and strengthen our pipeline for a brighter future in the long term. 

This is exactly what Dr. Stephanie Weyrauch, Dr. Keaton Ray and myself will be doing as we tackle the subject of “Balancing Act: Nurturing the Well-Being of Working Mothers in the PT Workforce” in a presentation at the 2024 Private Practice Section Conference this October in Maryland. 

Let’s take a moment to reflect on and thank our working moms.

As a working mother myself, I have learned that balance is elusive, but it's not impossible. We are adept at finding creative solutions to manage our time effectively—whether it's through flexible work arrangements, supportive partners, or reliable childcare. I have had my moments of self-doubt, stress, and guilt, but finding happiness in the struggle requires constant adaptation and a willingness to prioritize what truly matters.​​ I look forward to celebrating with my 91-year-old mother and my daughter on this special day, reflecting on the resilience and love needed to be the best mother possible one day at a time.

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With the wealth of knowledge we, as working moms, carry into the clinic, I feel strongly that we have a level of empathy that is unparalleled for our patients and our co-workers. The work-life tightrope we have been balancing on provides a unique perspective that we must share and use to help guide the next generation of rehab therapists—and mothers.  Happy Mother’s Day!