Recently my grad alma mater blasted an email requesting alumni to provide “words of wisdom” to clinical-bound first year students for their Clinical Practice Ceremony. A few years prior my (true) alma mater connected me to a graduating senior interested in learning more about the field of physical therapy through the Career Center. You know, a little forced self-reflection. Hmmm, what would I tell a bright-eyed, ambitious young person at crossroads like these? 13 years into my career, if I could go back to my young-to-mid 20’s self, what would I say?
So I’ve thought of a few ideas. Some are optimistic messages. The ones that would inspire a young-20-something to really feel it. And others are practical anecdotes, the ones you sort of wish you knew in your 20’s to tuck away for a later date, when your sight is the long-game and your priorities typically make the shift (that one, when your plans extend beyond the weekend and even beyond yourself).
1. In this profession, more than many others, you truly have the capacity to positively impact another person’s quality of life. Don’t take that for granted. YOU will learn the skills to do this and become an expert at analyzing movement and its impact on function. This can be as elite as working with professional athletes to perfect core control and torque production with their throwing arm; to helping a new mother learn strategies to hold and feed her newborn baby while protecting her healing body; to getting a weekend warrior back on the hiking trail; or reducing fall risk in an older patient. The issues for which your patients come to see you are a big deal to them; and so you must take that into relative context and make it a priority to achieve. And more often than not, you will help them do that. Sometimes they even bake a plate of cookies in gratitude.
2. Pay attention to your foundations. You may learn fancy techniques like the Chicago Roll, the shotgun, a Mulligan MWM, ART, Graston, McKenzie, Maitland…but pay attention to your foundational classes. The best therapists are masters of critical thinking; and that is steeped in expert knowledge in the basics of anatomy, kinesiology, physiology, neurology. Only with years of practical clinical experience will you confidently be able to develop shortcuts. Don’t be enamored with fancy titles and techniques – if you know the fundamentals, you will be able to develop a treatment plan and truly build an arsenal of sound clinical practice guidelines. I’m grateful for the sometimes painful exercises of critical thinking we were subjected to in my program. I never recognized until after the fact just how valuable that was.
3. Don’t burn bridges. This is probably a good rule of thumb regardless of profession, but I can only speak from personal experience. The therapy world is small. Much smaller than you might think. Be a professional. Be courteous. Be respectful. You never know if you’ll cross paths again.
4. Your options are endless. Stay open-minded. Most people enter this field to help people. There are so many ways to do that. Clinically there are subspecialty fields in which to practice, the breadth of which is huge, and you will graduate with the basic knowledge to embark on any path. You can work with kids in the school systems. You can work with amputees to learn to use their extremity again. You can work with patients post-stroke, leveraging the concepts of neuroplasticity to reorganize movement patterns. You can rehab people post-op from ACL reconstruction to rotator cuff repair to total hip replacements. You can do this in people’s homes, rehab facilities, hospitals, private clinics. You can change your mind mid-profession and turn in a different direction. You can move up the management ladder and focus on business operations.
5. Recognize burn out. Recalibrate and plan. It’s easy to burn out in this profession. Walk into any private therapy clinic and chances are you’ll see lots of young faces working. Why? Outpatient therapy is fast-paced and hours are long. In other settings sometimes the emotional toll is too much to bear day to day. Other places, the work feels monotonous. Insurance and payer pressures force high productivity expectations with increasingly higher demands to improve efficiency while remaining uncompromised on outcomes. There are times when it might feel like you can’t do it anymore. Now reference #4 above. Is it time to consider a new option? Have the circumstances in your life altered your priorities to the point that it might be time to make a shift?
6. Know healthcare is a business. PT’s are by and large inherently altruistic. The bottom line matters less than a successful outcome and happy patient. The older I get in my field, the more I want to believe that, but the more I realize it’s naive and ultimately unfair to ignore that the responsibility to be a good practitioner also means respecting the business. This isn’t to suggest that decision should be driven by the dollar; only that to pretend the dollar doesn’t matter is actually irresponsible. Be part of the solution – provide high quality care at every opportunity. Don’t be lazy or complacent, which only lends to wasteful healthcare dollars. Know when you’ve hit the plateau, and if that happens, be comfortable cutting the cord. Learn how to communicate that effectively to your patient.
7. Work-life balance is a dynamic concept. Ah the utopian space called work-life balance. It’s a very popular thing to talk about. Here’s the thing I’ve learned – it’s not an end goal. It’s a dynamic, nebulous and oft elusive amoeba that you can sometimes hold and just as quickly lose. Reminds me of this toy from the 80’s:
PT’s love to talk about finding the right work-life balance. You know the main reason I think it’s so elusive? Because PT’s at their core mostly want to do what’s right for the patient. Jeez, we get so attached to these patients, we really do. Which often means not settling. Which often means working hard. Which pushes us into the “work” side of the tipping scale. So work-life balance is hard for the inherent workaholic in us. Embrace it. Your workaholic attitude is why you care about your patients. Just remember to take some time for yourself in there because you’ll make yourself nuts if you don’t. If you don’t think you want to spend extra time outside of your clocked hours, this probably won’t be the right profession for you. Because people who truly care about people sometimes put in more than 40 hrs/week.
8. Physical Therapists are FUN! Well, most of us are. Seriously though, therapy environments are social and collaborative. If you think PT’s are making therapy fun to keep you distracted, you are partly right. But I also think if you get a group of happy, positive, energetic people in a big room working with and helping people all day, you are bound to have a few laughs. I’ve had more memories than I can remember – the job is active and unpredictable day to day. You get the opportunity to meet so many different personalities, some you will never, never forget.
So there you have it. A somewhat spontaneous reflection on my career, these last 13 years.
little eggi 