Continuing education (CE) is part and parcel of a therapist’s clinical and professional development. Many states mandate completion of 20 to 40 CEUs every 2 years to qualify for license renewal. Finding a course that is clinically and professionally relevant has become challenging due to decreased employer reimbursement for tuition, travel expenses, and time off. Decreased employer support combined with ongoing family demands has shifted therapists’ CE buying decisions. Continuing-education providers across the country have had to adapt their business models in response to the factors affecting these decisions.

For Andrew J. Schrodt, president, Therapy Network Seminars, Clyde, NC, the key to success is simple: “Value and service. I can’t emphasize that enough for any business. Those seem to be the primary driving forces for most consumers, whether they are purchasing clinical education or a new car. While familial obligations, CEU reimbursement, and ability to travel are important to all clinicians, we have witnessed first hand the willingness of many to view their continuing education as an investment and not a hardship. We have thousands of regular customers who travel nationally to attend our seminars at their own expense and time commitment. That no doubt speaks for itself as to the benefits of providing consistently good seminars at a fair price.”

Stacey A. Lyon, executive director of The McKenzie Institute USA, Syracuse, NY, agrees, “Even before the recent economic collapse, budget cutbacks were afoot in the rehab marketplace, forcing therapists to pay out-of-pocket for CE. Furthermore, with a growing number of states requiring CEUs to maintain licensure, PTs are now obligated. With a plethora of quicker, cheaper options out there, it speaks to the ethical integrity for the majority of PTs who opt for education with a strong evidence base at its core and not simply the quickest, cheapest prospect available. Creating accessibility to programs is important; however, it is also imperative to not lose the quality of programming in the process.”

One of the most important factors affecting PTs’ decisions on continuing education is simply finding the time. According to Vikki Dibble, vice president of business development, Care2Learn, Bradenton, Fla, “Therapists are under tremendous pressure to maximize productivity, often spending 80% or more of their day on providing patient care. Unfortunately, this leaves very little time for nonclinical—yet essential—activities, like continuing education and professional development. Our staff understands the time constraints of therapists, which is why we have expanded our live help desk support to 11 pm EST, 365 days per year, to answer any continuing education questions that the therapists may have.”

The Academy of Lymphatic Studies, Sebastian, Fla, decided to shorten its course offering. “When we first started to offer the European model of lymphedema management education in the United States,” says Joe Zuther, PT, founder and director, “we offered our courses in a 4-week format to conform with the European model. We learned over the years that due to employer demands, individual family situations, restrictions on time off for continuing education, etc, we had to shorten the course considerably. After 14 years, we now have a 2-week, 135-hour model of our certification courses in lymphedema management, which works great for all parties involved, ie, course participants, employers, and the course provider. Our 2-week format provides an optimal learning environment for course participants, ensuring best possible course outcomes.”

If the time is available, plan early. On average, therapists register 6 weeks before the date of their seminar, giving them plenty of time to make travel and lodging arrangements. Six weeks is not always timely enough to get an early bird discount, however, so it’s best to start shopping at least 8 weeks before the target date.

On the one hand, decreasing reimbursement has made it more difficult for therapists to find high-quality CE; on the other, increasing state requirements make it imperative that they do just that. Ryan Sparks, vice president of operations, Care2Learn, notes, “A trend that predominantly affects physical therapy is the growing number of states that are creating their own approval boards for continuing education. This complicates the purchasing decision for physical therapists, who need to find CE courses that are specifically approved for the states in which they are licensed. To help simplify the evaluation and ultimate purchase selection process, we have redesigned our online course search feature to allow the physical therapist to browse only the online courses that have been approved for their specific profession and state.”

Such innovation can be the key to maintaining your CE business in a difficult reimbursement and economic environment. According to Lyon, “The McKenzie Institute® sponsors a Program of Certification in Mechanical Diagnosis and Therapy® (MDT) for the spine and extremities and recently had the MDT Fellowship approved with APTA and AAOMPT. We encourage ongoing research in MDT, and we are also avidly exploring the various technology advancements for appropriate portions of our curriculum to extend into distance learning opportunities. The challenges to attain quality, evidence-based continuing education are many, yet it is ultimately the best investment to improve patient care and outcomes. Our business model, as I believe is the therapeutic model, is to remain committed at all costs to provide the best possible service—superior education and an effective process to assess, classify, and treat patients.”

Some providers, however, have found that online innovation is not always the answer. Jane Boston, MEd, BSW, president of Motivations Inc, Fort Mill, SC, says, “We have seen a shift in learners’ desire to travel less over the past 8 years. Fewer therapists find traveling to training fun, though all seem to still prefer hands-on learning rather than alternative and distance learning. We have shifted our approach to offer more courses in more cities, making it easier to find a course in their area. We also are bringing in more private courses since employers appreciate less clinic downtime when travel is not warranted.”

Zuther says in regard to his shortened lymphedema management course, “We learned that all additional cutbacks in live (face-to-face) instruction, for example, providing part of the theoretical instruction in an online format, had negative effects on the outcome.”

In addition to educational skills, both on- and off-line, the savvy CE provider always keeps in mind some of the basics of marketing. Schrodt says of a common problem he has encountered, “Many of our repeat customers return to us having attended another sponsor’s event, only to have had a less than stellar experience or simply have the event canceled all together. That in my mind is a terrible business model and one that will bankrupt any business, large or small, in a very short time.”

“Learning from others’ mistakes in this business has been as valuable as learning from our own,” he says. “The best adaptation we have made to the current industry standards is to not cancel our events based on turnout. We try very hard to keep the big picture in mind. Close to 25% of all CE events are canceled due to low turnout. As a therapist-owned company, we are familiar with just how small the therapy community truly is and how important it is to earn your customers and not take them for granted. Clinicians who have their CE event canceled are often placed in very compromising positions and routinely lose valuable time and monies as a result. The biggest failure in that service model falls onto the sponsor who then has 10 or 20 unhappy customers who most likely will not attend another event by that sponsor for years to come but, still worse, will return to their facility and share their negative experiences with 10 or 20 colleagues. That is negative advertising, something we aim to avoid.”

Our company, which offers more than 1,000 live and home-study CE opportunities for therapists, provides “Host-Match” services to assist rehab managers who are seeking to bring specific skill sets to their clinics. It matches them with CE providers that can offer quality content as well as “raving fan” customer service, all for the right price. As a result, well-planned, hosted seminars are arranged perhaps months in advance and are often tied into recruiting and marketing efforts.

At the opposite end of the time spectrum are the desperate therapists who need 10 CEUs by the end of the week to keep their license. With the improvement in online courses over the past 5 years, therapists are pleasantly surprised by the vast selection of good-quality, state-approved home-study courses.

It is evident that continuing-education providers have adopted a variety of strategies to align their companies to the current market. However, quality, value, service, and convenience are seen by all as significant factors in therapist purchasing decisions. Each of these providers may weigh these factors differently, thereby creating a wider spectrum of choices for therapists and rehab managers, who in turn can make their decisions based on their particular environment and professional values.

David Adamczyk, MS, PT, is president of, which offers live and home-study CE opportunities for therapists. Its searchable online course catalog contains all of the seminar offerings provided by more than 30 nationally recognized CE companies.