Occupational therapy is facing a turning point. The demand for practitioners continues to rise, yet interest in the profession is declining. According to the U.S. Bureau of Labor Statistics, the need for occupational therapists is expected to increase by 11 percent by 2032. At the same time, OT programs across the country are experiencing a drop in applications, aligning with a national decrease in first-time graduate student enrollment.
This gap is already impacting care delivery. If we want to reverse the trend, we need to help healthcare leaders understand the full value of occupational therapy—and the role they can play in supporting its future.
To understand what’s at stake, we need to first clarify what occupational therapy actually is—and what it isn’t.
What Is Occupational Therapy?
Occupational therapy isn’t just physical recovery or discharge planning. It’s about enabling people to do the things they need and want to do in order to live a full, meaningful life. It’s holistic in nature—OT practitioners consider not just the body, but the mind, environment, culture, and the unique context in which each person lives.
We treat patients across the entire lifespan, beginning in early intervention and continuing through end-of-life care. Our work occurs in a wide range of settings: hospitals, schools, skilled nursing facilities, community organizations, correctional facilities, private homes, and more.
No two treatment plans are the same. One client might need help regaining motor skills to safely cook after a stroke. Another might be a child learning how to carry a lunch tray without dropping it. Someone with low vision might need guidance in adapting their home environment to maintain independence and safety.
Occupational therapy sits at the intersection of science and creativity. We use evidence-based methods, but we also innovate constantly, adapting care to real-life challenges in real time. It’s a human-centered profession that cannot be replaced by automation. In fact, Forbes recently named occupational therapy one of the most “AI-proof” careers of the future—because it relies on clinical judgment, emotional intelligence, and individualized care that machines can’t replicate.
Why the Shortage Exists
Despite its clear value, the field of occupational therapy is experiencing a decline in enrollment—and that decline is rooted in a mix of interconnected challenges.
Awareness is one major issue. Many students—even those pursuing careers in healthcare—aren’t introduced to occupational therapy until late in their academic journey. Some never learn about it at all.
Then there’s the cost. Graduate education is expensive, and for many students, the financial burden of a master’s or doctoral program is too high to justify.
Occupational therapy also lacks visibility. Too often, it’s perceived as a secondary or support role, rather than a core discipline within the care team. Yet we’re essential to recovery, daily functioning, and long-term quality of life.
Meanwhile, the need for occupational therapists is growing faster than the workforce can keep up. OT is increasingly vital in behavioral health, community care, and other nontraditional settings where staffing is already limited.
Even strong research evidence hasn’t been enough to shift perception. A 2016 study from Johns Hopkins found that OT was one of the only hospital services linked to reduced readmissions. Yet this finding hasn’t translated into broader investment in the profession. The impact is proven; what’s missing is recognition and action.
What Healthcare Executives Should Understand
For healthcare leaders looking to strengthen outcomes, improve efficiency, and provide more comprehensive care, occupational therapy is an underleveraged resource.
OT is not an add-on. It is a foundational part of integrated, patient-centered care. Occupational therapists help reduce hospital readmissions, support long-term independence, and guide recovery that extends beyond physical rehabilitation.
Importantly, our work addresses more than mobility or motor function. We also focus on cognition, mental health, sensory integration, and social participation. Whether it’s helping someone rebuild confidence after a traumatic injury or adjusting the environment for someone with autism, OT works at the intersection of function and humanity.
OT’s flexibility is one of its greatest strengths. We’re trained to adapt to a wide variety of settings and populations. That allows us to step into gaps in care—especially in rural or underserved areas—and create solutions that fit both the person and the system.
In short, when healthcare organizations overlook OT, they miss a critical opportunity. When used effectively, occupational therapy leads to better clinical outcomes, more engaged patients, and more efficient teams.
Five Actions Leaders Can Take to Support the OT Workforce
- Invest in mentorship: Too often, new occupational therapists are placed in solo roles—especially in home health or rural environments—without proper support. Creating structured or informal mentorship opportunities can improve retention and reduce early-career burnout.
- Welcome fieldwork students: Many clinical sites decline to accept OT students due to logistical concerns or perceived cost. But fieldwork placements are essential for preparing future practitioners—and they give organizations the chance to identify potential new hires early. Academic partners like the American Occupational Therapy Association can support organizations in setting up these programs.
- Offer fellowships and early-career support: The transition from school to full-time practice can be overwhelming. Fellowship programs provide a structured bridge, resulting in stronger clinical reasoning and increased loyalty from new graduates.
- Make space for evidence-based practice: Occupational therapists need time and access to stay current with research. Supporting journal subscriptions, peer collaboration, and time for reflective practice leads to more effective and aligned care.
- Say yes to innovation and partnership: Too many promising projects stall because no one provides the space or institutional support to get them off the ground. When organizations collaborate with academic programs, they give students real-world experience and deliver tangible community benefits in return.
Building the Pipeline Starts with Awareness
Solving the workforce shortage doesn’t begin in graduate school. It starts much earlier—with awareness.
If we want to attract more students to occupational therapy, we need to reach them sooner and show them the full scope of what this profession offers. That means introducing occupational therapy in high school and undergraduate settings—not just in graduate-level career advising.
It also means shifting the narrative. Occupational therapy isn’t just about hospital discharge plans or handwriting practice. It includes work in maternal health, equine therapy, trauma-informed school programs, gardening interventions, and even comprehensive occupational therapy assessment to help clients reach their full potential across environments.
This is a profession that blends creativity, scientific rigor, empathy, and practical problem-solving. For students who want to make a difference in real people’s lives—and enjoy a flexible, people-first career—occupational therapy offers an incredibly compelling path.
The Human Side of Healthcare
Some of the most impactful OT interventions are also the most deceptively simple. I’ve seen students help older adults find their front door keyholes by outlining them with high-contrast tape. I’ve watched children build coordination by playing cards while standing. I’ve seen clients regain independence and dignity by adapting just one small task they had struggled with for years.
I’ve also seen obstacle courses built from masking tape and laundry baskets become transformative tools for building motor planning, strength, and confidence.
Occupational therapy isn’t flashy. But it’s deeply human. We help people live better—not just longer—through focused attention, thoughtful problem-solving, and a deep respect for the individual. That’s what makes this work worth investing in—and worth protecting.
Dr. Adele Breen-Franklin
Adele Breen-Franklin, Professor and Program Director of Occupational Therapy at Alliant International University.
