Founder Letter: The Best Physical Therapy Career Advice I Ever Got

May is a month of beginnings—at least, it is for students. Graduation season marks the end of an era for them, but it also serves as the starting line for most students’ professional journey. Students and new grads have their whole future splayed out before them; all they have to do is start running. But there are obstacles that crop up in front of every young professional—which is why I wanted to share some advice that helped me navigate the field when I was a fresh-faced PT. 

Learn the business side of physical therapy—and health care in general.

For all the knowledge PTs soak up in school, there’s still one area that very few programs cover in depth: business. There has been a lot of progress over the last three years, but the problem persists: PTs are experts at treating patients and helping them return to optimal function, but many of those same PTs have a hard time wrapping their heads around the business side of running a clinic—shying away from metrics and strategic plans like there’s no tomorrow and failing to truly understand the relationship between clinic revenue and individual paychecks. But learning the business side of physical therapy can open countless doors for PTs. 

When I was a young therapist, I was recruited by Keith Kocher, a regional director at Physiotherapy Associates, to help establish clinics on college campuses. I had started a clinic inside of Phoenix College (with good success), and he wanted me to do the same thing at Arizona State University, because he saw the potential to grow Physiotherapy Associates through that new line of business. 

During my training at the University of St. Augustine, I received a general introduction to business metrics. That foundation boosted my confidence, enabling me to take on a clinic director role only two years post-graduation and create the business plan to start the campus clinic. Through that experience (and Keith’s mentorship), I further honed my skills and knowledge. Keith helped me develop a deeper understanding of metrics and dashboards, so I knew which dials I could turn to improve outcomes and meet goals. That knowledge has been invaluable, even as I transitioned out of a clinical role and into a tech company leadership position. 

Command respect, but check your ego at the door.

I want to share a story from my final clinical internship in PT school. It happened more than 20 years ago (wow!), but it had a tremendous impact on my career post-graduation. My clinical instructor (CI), Grace Johnson, was the clinic director at the Iowa Methodist Hospital outpatient clinic and the team physical therapist for the Iowa Barnstormers—a professional indoor football team. The year I interned there, the Barnstormers (with Kurt Warner as the quarterback) played in the Arena Football League’s championship game. It was an amazing experience, and a big part of it was seeing a female therapist confidently work with a team of male professional athletes. My CI commanded their respect—not from barking orders, but rather from her confident, strong, and decisive demeanor in the training room and clinic. Her clinical knowledge, direct approach, and caring attitude allowed her to build positive rapport with the players and coaches. Her motto was, “I show them respect; they show me respect.”

Trust and respect are at the heart of what every PT must establish with, and earn from, their patients. I was a quick study in understanding that the best outcomes and satisfaction scores come from patients who feel that connection with their therapists.

Educate your patients.

That same CI also showed me the value and importance of explaining the clinical reasoning (a.k.a. the “why”) behind my treatments in layman’s terms. Patients are more likely to buy into their treatment plan (and adhere to their HEP) when they understand your clinical design and the goals of the plan. So, invest time in educating your patients and helping them understand the purpose behind your care plan. Throw out the PT jargon and complicated terminology you learned in school, and pretend you are talking to a grandparent. Use anatomical models or review the patient’s MRI scans if you have that information on-hand. The object is for your patients to know exactly what they need to do to recover and get back “in the game.” This is a very natural way to not only connect with your patients, but also demonstrate your clinical expertise, empathy, and compassion. 

Listen before you problem-solve.

Speaking of connecting with patients, one of the best ways you can build trust with them is to simply let them talk. I challenge you to hold off on your full diagnostic process until your patients are truly finished explaining what is wrong. You’d be amazed what you can discover by listening first and problem-solving second. This was a lesson I learned during my DPT education through Evidence in Motion. Larry Benz has since written a book titled Called to Care explaining the importance of humanizing health care.

PTs are so eager to jump in and start fixing a patient’s problem—but in doing so, we may miss the opportunity to get a crucial piece of the puzzle. So, take a breath. Let the patient have the floor. Paint a full picture of the problem before you start brewing up a solution.

Mentor others outside of your immediate peer group.

It’s easy to surround yourself with—and only with—your regular coworkers. And often, if you do choose to mentor someone, it’s one of those peers with whom you work day in and day out. I challenge you to expand your mentorship efforts beyond the four walls of your clinic—or even your company. 

I’m speaking from experience here. As I developed my leadership skills, I looked outside of the PT world to learn more about:

• company culture,
• the dichotomy between employee rewards and motivation, and
• marketing.

This opened my eyes to a plethora of new ideas that I then paid forward to my clinic team. I made a point to offer monthly and quarterly educational sessions to everyone in the clinic, sometimes with guest speakers from other medical specialties and professions. I wanted to inspire people and give them an opportunity to grow by hearing first-hand stories from folks who tackled similar issues or introduced a critical business concept to their team. It was very well received, and it helped everyone become more engaged in solving clinic problems. It also gave the team a better understanding of how their actions contributed to the overall success of the practice. So, I encourage you to give those who follow you the opportunities and mentorship you perhaps didn’t receive at their level. You have heard me reference Daniel Pink many times, and I’ll do it once more: autonomy, mastery, and purpose are the three keys to keeping employees motivated. Mentor relationships contribute to all three of those areas whether you’re a mentor or a mentee—but at the end of the day, it's about making the profession better for those who come after you.

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Develop a passion for your profession.

I strongly believe that the best way to cultivate long-term success in your career is to nurture your passion for it. Think of it this way: the PT industry is the soil in which you are growing your career. And, like when growing a garden, it’s important to keep the soil fertile, nurture the garden’s growth, and enjoy the final product. That means caring about the industry as a whole—not just within private practice or your particular specialty. If we want our profession to remain relevant and become the go-to treatment discipline for neuromusculoskeletal issues, we must advocate for, and have pride in, what we collectively do for society. It’s the only way we’ll begin to make a dent in the 90% problem.

Pay attention to what is happening in PT at the state and national legislative levels, and become an active member of your state and national professional association. Step up to advocate every single time the call arises—and trust me, it will. 

I’ll be honest: I didn’t understand the detrimental effects of the widespread apathy PTs feel toward our profession until I became involved in the PT-PAC. There, I learned that only 3% of American Physical Therapy Association (APTA) members fund our advocacy. It’s no wonder we’re overlooked time and time again by regulators and constantly given the short end of the reimbursement stick. I saw how much sway physician lobbying groups held (and still hold) compared to PT groups—and frankly, they have that power because they have more numbers and more financial support. Our advocacy efforts are definitely improving as we partner with other organizations to create PACs that amplify PT voices on Capitol Hill. But we can do better. If every PT became an advocate for the profession, physical therapists would have exponentially more legislative influence—and that could make a big positive difference in the industry. 

So, here’s to new beginnings. Here’s to a better future for the therapists who come after us. Together we can elevate our community and become more well-rounded clinicians. I’m ready for tomorrow—are you?