Physical therapy in school settings focuses on outcomes and is based on meeting the educational needs of the child or student. Despite the expansion in delivery models beyond direct one-to-one intervention, and the use of multiple team members, to achieve outcomes for students in educational environments, there continue to be shortages of physical therapists in many school districts. The supply of physical therapists is, on the whole, slightly less than adequate; however, real personnel shortages continue to exist in rural areas and in populated areas with less desirable schools or workplace environments. An adequate supply of physical therapists does not mean adequate training, and there are ongoing issues regarding what constitutes adequate professional preparation for the delivery of pediatric physical therapy in school-based settings. Licensure requirements are relatively consistent across states with some states requiring additional certification to work in school-based settings. This article takes a look at the economic principle of supply and demand, professional preparation, licensure and certification of the physical therapy profession. In order to increase both the number of available pediatric physical therapists and the quality of the professional skills with which a physical therapist enters employment as a related service provider, the authors suggest some necessary changes to make in personnel preparation and on-the-job training.