How Much Do Pelvic Health OTs Make? What the Salary Data Says
OTs in Pelvic Health Podcast · 21 min listen
Nobody asks their colleagues what they make. Which means most of us are negotiating in the dark, with no idea whether an offer is generous, fair, or insulting.
So we ran a survey. Around 275 OTs in pelvic health told us what they earn, and the results broke down into three groups: salaried employees, hourly employees, and practice owners. What came back surprised us both.
"The more transparent we are around pay for OTs in pelvic health, the more negotiating power they have."
— Doug Vestal
In this conversation with Doug Vestal — my husband, the owner of Freedom of Practice, where he helps OTs start and grow thriving private pay practices, and the person who helped me start my own practice in 2014 — we walk through what the data actually says about earning potential in this field, and the four things you can do about it. Before working with OTs he spent fifteen years on Wall Street, rising to managing director, and he holds a PhD in statistics and applied probability.
These figures come from the first annual OTs in Pelvic Health Salary Survey, based on roughly 275 responses. Pay data changes, so treat these as a benchmark rather than a current quote.
$43/hr
Median pay, employee
What the typical pelvic health OT earns working for someone else
$150/hr
Median rate charged, practice owner
What owners bill per hour — before expenses, not take-home pay
64%
Practice owners with under two years of experience
Most didn't wait a decade before starting
$0
Added by an OTD over a master's
No measurable pay difference in the responses we received
In this episode:
- Why pay transparency gives you negotiating power, and why money is as taboo as pelvic health
- The gap between employee and practice-owner income, and why it's bigger than most people assume
- Why salaries for employees flatten out after only a few years
- What an OTD actually adds to your earning potential
- Four concrete ways to increase your income, starting with the one you can do this week
Why we did this at all
Lindsey: Tell me what this is. Why is it groundbreaking?
Doug: A lot of transparency. Pay is one of those things where you typically don't ask your friends or colleagues how much they make, or what's even possible in this specialization. The more transparent we are around pay for OTs in pelvic health, the more negotiating power they have. The better they're able to discern: is this a good job offer, or a bad one? They get more power and more autonomy to seek out settings that pay better. It lifts up the profession.
Lindsey: I completely agree. Money, along with pelvic health, is another taboo topic. We're already talking with our clients about peeing and intimacy. Let's go ahead and talk about money too.
Doug: Exactly. And what I hope is that it inspires people to see what's possible. Without data, with only anecdotal evidence, it's easy to think your existing worldview — whatever is right in front of you — is the only thing available. There are insights in here that I hope give some of us pause and prompt that reflective question: maybe there is more out there than I realized.
The number that stopped us both
Lindsey: Reflecting on all of it, what surprised you most?
Doug: The biggest thing is the gap between being an employee and owning a practice. The median for an employee working in pelvic health is $43 an hour. The median rate a practice owner charges is $150.
Lindsey: Whoa. That's a big gap.
Doug: We knew going in it would be significant, but seeing it in the data was really something.
The other thing that stood out: 64% of the people who own their own pelvic health practice have less than two years of experience. This isn't something where you work in pelvic health for ten or fifteen years and finally decide you're ready. It's people saying, if there's an opportunity in my community, I'm going to make that opportunity for myself and start seeing clients. They're not waiting.
One important clarification on those two numbers, because they aren't measuring the same thing. The $43 is what an employee is paid. The $150 is what an owner charges a client — it's revenue, not take-home. Out of it come rent or space rental, insurance, taxes, software, marketing, and all the unpaid hours that go into running a business. Owners also don't bill forty hours a week.
So the honest version isn't "owners make four times more." It's that owning your practice gives you pricing power and control over your rate, where being an employee doesn't. What you actually keep depends entirely on how you run it.
Why experience barely moves the needle for employees
Lindsey: What does the data show about someone just getting started versus someone who's been working a decade?
Doug: If you're an employee, there's some variation with years of experience, but not what you'd expect. It's all clustered tightly around that $43 median.
The takeaway for new grads is actually pretty great. The average salary outside pelvic health is $37 to $42 an hour, so they can come in and make as much as someone who's been working five years.
The downside is that they're capped pretty soon. They won't see the kind of increases you'd expect as they take continuing education, refine their skills, move settings. It's almost a flat line.
When I started thinking about it, it makes sense. There are so many downward cost pressures in healthcare. If you're working for someone else, you're always at the mercy of reimbursement rates — and those are going down while costs go up. So your salary flattens.
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Sign up for freeDoes an OTD increase your pay?
Lindsey: What else surprised you?
Doug: I looked at bachelor's, master's and OTD. I was really curious about the difference between a master's and an OTD. In the responses we received, the results were exactly the same. No disparity at all. That can obviously change.
Lindsey: You have a bachelor's, a master's and a PhD. You're someone who values higher education. So what do you take from this?
Doug: That you should pursue an OTD program for reasons other than money. I'll see posts from people who are stuck at a certain level and are considering an OTD because they hope it'll propel their salary. That just isn't the case.
I'm all for doing an OTD if you want to go into research, or pursue other things. But I wouldn't do it motivated by money. If you're looking to upskill and reach the next level, you're better off taking that $30,000 or $40,000 of tuition and investing it in yourself — in specialty training, in expert continuing education, in learning how to start your own practice, in getting good at communication and marketing. Those are the investments that actually give you the skills to increase your income.
Go in with your eyes open, and make sure it's actually the solution to the problem you have.
If that's the direction you're leaning, I've written separately about which CEU courses actually build toward a pelvic health career — including why specialty courses assume foundational knowledge you may not have yet, and what that means for the order you take them in.
Four ways to increase your income
Lindsey: How do you imagine people using this report?
Doug: There are four things.
Show the data to your employer.
If you love the job but not the pay, first check yourself against the numbers — sometimes we perceive ourselves as underpaid when we're right in line. Compare yourself to peers in your situation. If you genuinely are underpaid, print it out and hand it to your employer with the median for your setting and your state.
Consider where you live.
Nationally, salaries don't change dramatically from state to state. But after adjusting for cost of living, the disparity is significant. You are much better off as an OT in Oklahoma than in Hawaii, purely in terms of how far your money goes. Not an option for everyone, but if you're a new grad, or you like to travel, or you have flexibility, it's worth considering.
Change your practice setting.
There's a wide gap in income across settings. Many times it was much better to work in a private practice owned by someone else than in a SNF or acute care rehab. If you don't want to own a business and you can't move, this is where to look — and it often reduces your frustration as well as raising your pay.
Start seeing clients privately.
You can do it mobile, in clients' homes. You can rent space hourly so you only pay when you see someone. Moving in this direction means more control over your career, more autonomy, more pricing power, and the benefits of a private-pay model.
Get the full report
What's above is the headline. The full guide runs more than 30 pages and breaks the data down three ways — salaried employees, hourly employees, and practice owners — across years of experience, level of education, practice setting, and income by state adjusted for cost of living.
It also includes the detail behind the four strategies above: which settings pay the most and the least, and where your money actually goes furthest.
The OTs in Pelvic Health Salary Survey
Over 30 pages of data on what pelvic health OTs earn, broken down by setting, state, experience and practice model. Free.
Get the guide