I realized I wanted to be a physical therapist after experiencing—and rehabbing—a knee injury while playing collegiate basketball. But until I actually became a PT, I didn’t understand what it really meant to practice physical therapy. A physical therapist not only treats a patient’s injury; he or she treats the whole person. And if that PT is in private practice, he or she also is trying to run a business while staying on top of changing market conditions and compliance requirements. Put all that together, and it’s like trying to pat your head, rub your stomach, and stand on a soapbox all at the same time. While I doubt anyone could have fully prepared me for the many facets of being a fully engaged PT, there are a few things I wish I’d known before entering the professional world:

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1. You gotta know a thing or two about business.

Simply put, physical therapy is a business. Unfortunately, most PTs—like my younger self—don’t realize this until they enter the workforce, because to date, PT schools have failed to educate students on the practice management side of being a physical therapist. New PTs often are completely in the dark when it comes to things like understanding the cost of health care, developing business plans, marketing their practices, tracking and analyzing metrics, and implementing efficient billing practices. Providers in other healthcare specialties—chiropractors, for example—receive a great deal of business education, while PTs typically enter the private practice field with very little understanding of how to operate a clinic, or how to rise to a leadership position within their professional organization. And that has to change. A strong business and financial acumen can do wonders—both personally and professionally. That’s why I implore all future therapists—regardless of specialty—to seek out business education opportunities, whether or not their schools offer it. And remember, learning is a lifelong endeavor. So, I also encourage all current practitioners to remain steadfast in their professional development and continuing education efforts.

2. Customer service matters—big time.

As a physical therapist, I’m all about making people feel better, but I had to learn early on that the treatment itself isn’t the whole experience. When I got out of PT school, I was so focused on what I’d learned regarding the treatment of specific conditions that I forgot to think about my patients as people. Being a physical therapist isn’t only about treating a patient’s low back pain or arthritis. We’ve got to treat each and every patient as a whole human being—not a condition. Helping patients recover involves more than achieving a desired outcome; studies show that patient satisfaction—which often hinges on things like great first impressions, short wait times, and consistent therapist-patient communication—is a key component of treatment and directly correlates to patient outcomes. With consumers taking charge of their own health care, competition intensifying, and everyone posting reviews online, PTs must understand the value of customer service and patient interaction with respect to the overall outcome of treatment.

3. Physical therapy is a brand.

During PT school, the physical therapy profession seemed like such a big part of the overall healthcare picture. But once I graduated, I realized how insignificant our brand is compared to other medical professions. While the PT field may not be small in physical presence, it certainly doesn’t loom large in the spectrum of health care. I remember folks asking me what I did for a living when I first got out of school. When I told them I was a physical therapist, I’d often hear the reply, “Oh, you must give great massages.” At the time, my naivety allowed me to laugh. But it’s not funny to hear someone minimize your profession. After all, an industry is an industry—no matter how small. Usually, these kinds of comments don’t come from a place of malice, but rather from a lack of understanding of what we do. One way to resolve these misunderstandings? The development of a cohesive brand and vision for our industry.

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4. You must advocate on behalf of the profession.

I’ve always had the gumption to stand up for our profession, but as a student, I didn’t truly realize the importance of advocacy—let alone understand how to go about it. Like many of my fellow DPT students, I became a member of the APTA while I was in school, but I never really took advantage of the opportunity to be heard and get involved. Why? Because I lacked—and failed to seek out—obvious mentors or opportunities to learn how to promote myself and my industry. Once I got into the real world, though, I quickly realized how much our profession is misunderstood, undervalued, and underutilized. And that’s when I finally understood that advocacy is crucial to growing our industry’s voice and staking our claim in the healthcare process. I applaud the next generation of DPT students who consistently advocate for our profession at both the state and federal levels and via social media.

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5. Evidence-based practice trumps your gut feelings.

In our profession, there can be a lot of subjectivity when it comes to diagnosis and treatment. Our level of education and clinical experience as doctors of physical therapy seem to give us the authority to “go with our gut,” but that results in a great deal of variation from one therapist to another. We must keep in mind that objective measures are the foundation of our practice. As such, evidenced-based practice is relevant to not only making clinical decisions, but also proving that what we do actually works—and quickly. Instincts are great, but it’s becoming increasingly important that we support them through the diligent and discerning use of researched evidence. These objective findings inform and affirm the efficacy of our plans of care, and thus, improve the quality of care we provide.

6. It can be tough to get paid for services rendered.

While PT started out as a more loosely regulated field, those days are long gone. Over the last several years, a firestorm of rules, regulations, and policies have been thrown our way. And noncompliance with those programs and initiatives can lead to payment reductions—or even flat-out denials. When I first entered the PT field, I never thought that a bunch of jargony acronyms—MPPR, PQRS, FLR, and the like—would have such a profound impact on my bottom line. But the truth is, PTs have to shoulder a lot of extra administrative burden to prove the efficacy of their treatment and justify the payment they receive. On the surface, this seems to align with the tenets of evidence-based practice, but that doesn’t make it any easier—or less time-consuming. So, I urge you to do your homework and proactively advocate for the PT profession at both the state and national levels. That way, we can have a hand at shaping these types of regulations going forward. As for the rules that are already in the books: make sure you’re not only aware of them, but that you also understand how they work and how they apply to you. Then, implement the processes and tools necessary to contend with the ever-changing payment landscape.  


There you have it: six things I wish someone would have told me about being a PT. What do you wish you had been told about being a PT? Share your experiences and advice below.

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