It’s September, which means the weather’s cooling down, pumpkin-flavored everything is now available, and students—including future physical therapists—are heading back to school. If you’re in PT school right now, then this letter goes out to you, because the industry that you’re about to step into isn’t your grandparents’. It’s not even your parents’. A lot has changed over the last two decades—hell, even the last few years. So, as you wrap up your formal education and join us on the frontlines as a full-fledged, licensed, practicing PT, there are a few things you should know—from one PT to another, because really, you joined our ranks the minute you decided to become a therapist. And we are so happy that you did.

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We have entered a new era of care.

And it’s one where data—specifically, outcomes data—is king. The days of receiving payment for services, regardless of how well those services actually perform, are numbered. We’re moving closer and closer to a completely value-based (a.k.a. pay-for-performance) healthcare paradigm—one in which payers will financially incentivize providers based on their patients’ outcomes—not just the volume of services provided to those patients. In other words, by the time you begin practicing, it will no longer be possible to dole out subpar care and still turn a profit. It’ll be difficult to stay in practice without providing valuable, evidence-based treatment and collecting objective data that backs up the effectiveness of that treatment.

This hasn’t been an easy pill for our profession to swallow. As an industry, we’re still in the process of transforming ourselves from “ancillary providers” within the greater healthcare continuum to “primary providers” for the treatment and prevention of neuromusculoskeletal injuries. And being front-and-center is not something many of us practicing therapists are used to, because we’ve gotten comfortable standing in the shadows of physicians. I think part of the reason for that is that a lot of established PTs, despite being doctorate- or master's-level medical providers, aren’t able to articulate and objectively prove the value of their services. They’ve spent years relying on anecdotes and vaguities—and that’s just not enough.

But you all are of a different generation—a different mindset. You understand the power of technology and data, and—from what I’ve seen—you’re eager to use it to help your patients, yourselves, and your profession. You’re eager to embrace new ideas and develop new skills—anything that will help you grow and succeed in your burgeoning career. You are not afraid of change, and because you’re becoming practitioners in today’s evolving landscape, you’re not trained to stand in the shadows, which is why I’m confident you’ll have no problem performing center stage. You’ll settle for nothing less than your rightful place at the healthcare table—as a musculoskeletal expert who’s more than capable and qualified to serve as a primary care provider.

After graduation, you will be in business.

It’ll either be your own (if you start your own clinic) or someone else’s. But it will be a business nonetheless. Many who choose this profession because they want to help people have a hard time accepting that fact; don’t be one of them. You can—and should—help people while being knowledgeable about business. In fact, every one of you should have at least a basic understanding of how a business operates, regardless of where you end up working. That means knowing—and being able to apply—the fundamentals of profitability, profit and loss, salary matrices, and ownership principles. I could go on, but the main idea I want to drive home here is that this knowledge is crucial to our ability to elevate ourselves as professionals. So, whether you get that training in school or in the real world—like I did—make it a point to get it.

Your clinicals are a great opportunity for this. Ask as many questions as you possibly can—and don’t limit those questions to clinical ideology and methodology—dig deeper. Then, be a sponge. Soak up as much knowledge and experience in as many different specialties, niches, and business models as you possibly can. There are so many paths available to you right now—and so much diversity in our profession. In fact, now is the perfect time to get involved with practitioners who have already built successful businesses around cash-pay, direct access, cutting-edge technology, or alternative revenue sources. By doing so, you’ll expand your perspective on what constitutes a viable business model, and that knowledge could prove extremely valuable—whether or not you want to open your own practice. You’ll also have more opportunities to explore your passions, so you can identify your specific interests and tailor your career to match. Trust me, you’ll be so much happier in life if you do.

The point is to be a constant learner—a lifelong sponge—in the classroom and out in the world. Don’t do the bare minimum—ever. Stay up to date on your CEUs. Take it upon yourself to keep tabs on the latest research in your area of practice, and then use it to help your patients—and your practice—achieve the best outcomes possible.

You can help set the standard for our industry.

Once you’ve found your voice as a physical therapist, join it with others, because forming a unified voice is so important—both in terms of maximizing business and clinical performance as well as advocating for the industry at the state and national levels. I urge you—as students—to make a habit of staying informed and getting involved. Our industry is approaching a major inflection point. As a result, we have a unique opportunity right now to get ahead of the large-scale, reform-driven movement that will impact the manner in which we are valued and paid for years to come—to beat the payers to the punch, so to speak—and all it’s going to take is a little forethought and initiative. After all, doesn’t it sound a lot better to establish your own standards and hold yourselves and your peers accountable now, so you set yourselves up for success—and payments—later? Because the alternative is waiting for the standards to be set for you—and there’s nothing more disempowering than that.

Now, once upon a time, I was a PT student, too, so I know many of you barely have time to do your laundry—let alone sit down and write a letter to Congress. And as much as I want to tell you that things will be different when you graduate and start practicing, the truth is that you should probably get used to having a full schedule. Truthfully, there will never be enough hours in the day, but it is so important that you make time to get involved in whatever capacity you can—starting now. That doesn’t mean you have to be in Washington, DC. You have plenty of avenues to make your voice heard from afar and still influence the future of our profession. Here are three that I recommend:

  1. Become an active dues-paying member of the APTA (the APTA is your association, and it’s our industry’s best route to actually instigating change). Then,
    1. Get involved with your section or state chapter.
    2. Research the issues and vote for the APTA leadership candidates you feel are most in tune with your own vision for the future of PT.
    3. Visit the APTA’s legislative action page, where members can do their part by contacting the government officials responsible for seeing pro-PT bills through to enactment.
    4. Download the APTA Action App—which allows you to easily connect with influential congresspeople and view live updates on important initiatives.
  2. Write a letter or pick up the phone and tell your congressional representatives why they absolutely should support—or even better, sponsor or co-sponsor—bills that benefit physical therapists (tell them to think massive healthcare savings and better patient outcomes).
  3. Once you’re out in the professional world, contribute to PT advocacy organizations such as the PT-PAC. They spend as much time as possible on Capitol Hill lobbying on PTs’ behalf—and through their efforts, PTs have made serious headway on numerous issues.

While it may be cliché to tell you that “you are the future of physical therapy,” it’s true. It’s also true that exactly what that future looks like is completely up to you, your classmates, and every other student attending a school like yours across the country. So, what do you want to see happen in our industry? What’s the legacy you want to leave when you’re writing a letter to the next generation of students one day? And most importantly, how hard are you willing to work to bring that future about? Because success doesn’t just happen—and it certainly doesn’t happen overnight. This type of greatness takes hard work, a relentless pursuit of excellence, and constant thirst for knowledge.

Your path to greatness—in practice, business, and advocacy—begins right now. It’s time to shine.

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