Easily monthly, sometimes more frequently, I field an inquiry from a yoga teacher or other holistic practitioner asking to pick my brain about becoming a physical therapist. I thought I’d share some some big picture thoughts here as a summary to best serve you.
Know that I love my physical therapy job (20-25 hours a week that I set), but I’ve worked in 10 different clinical settings now (including hard-working clinical experiences as a student) and there are some realities not-obvious to the casual reader of Newsweek articles on job satisfaction.
1) The most important thing is to be ULTRA-CLEAR when making this kind of major life decision: What is your goal? i.e. what do you want to feel that you don’t currently feel? That feeling may be intellectual fulfillment, financial security (first chakra aligned), it may be social status/ego/self-esteem boost (all physical therapy programs in the US, for better or worse, are now doctoral programs), wanting to heal people (still do ask yourself why) or maybe you just want a job that isn’t in a cubicle.
Be exceedingly honest with yourself about your goals. All of them. Then compare them to reality.
2) Second, have you done your homework? Really done it. Do you know which pre-requisites you would need to complete or re-take? Which schools you may hope to attend (and are you willing to move or commute)? Have you looked at the mandatory course listings and professor publications? Perhaps sat through a lecture or toured the (in my case, frozen windowless basement. I wore a down coat to lecture during the summer.) department where you will spend many waking hours of 2.5 years of your life?
Are you ready to dissect a human being for 7 weeks? (Yes’m, it’s true).
Have you started shadowing physical therapists in multiple settings (nursing home, hospital, outpatient clinic) or seeking a part time physical therapy aide/ tech job? (This is hands down THE. BEST. WAY to know what you are getting into. I volunteered then worked on the stroke and traumatic brain injury unit at National Rehabilitation Hospital (NRH) and at least 3 other clinics for 9 months before starting school. Plus, it’s an application requirement for all schools as far as I know, frequently 100-200 hours minimum).
How does your undergrad GPA stack up against the pool of applicants and are you studying for the GRE? (I promise I’m being realistic, not snobby: The year I was accepted into my doctoral program, the department had over 350 applicants for 54 acceptance slots. The following year they fielded 550 applicants.)
Are you willing to give up what you do now? Physical therapy school is a full time endeavor. Yes, as a student I continued to teach yoga 1-2 classes / week and work one weekend a month at NRH, and yes, I know some hyper-organized students who worked up to 20 hours a week (every one of us was overwhelmed). Most students smartly waited until at least the second year to work part-time. Are you ready to dive into your adrenal reserves to make it through?
Are you prepared to go deep in a field of study that is pretty darn conventional in lots of ways, and may not honor your more holistic knowledge and background?
Cash Money Calculations
3) The second part of your homework: Financial considerations: opportunity cost (3 years full time + pre-requisites), actual salary upgrade (if any. In 2011, some of my peers fresh out of PT school were offered starting salaries of $56K). Feel free to calculate actual job benefits, but please don’t include the automatic 30% add-on included by human resource departments. Have you looked at how you will pay for your pre-requisites classes, which activities (including income-generating activities) you will be forced to set aside in the meanwhile, and what your estimated loan repayments will be on a 10 year repayment plan? I happen to know plenty of PTs who pay >$1200 month on their educational loans.
You’d do all of this research before buying a house. Trust me, this is the same as a mortgage, and may be your only “mortgage” for a while!
What Your Day Looks Like
4) Giving a hard look at the numbers, do you see yourself working full-time? In what setting? Doing what? Unlike a medical doctor who may be on call, physical therapists sort-of have the luxury of “turning off” when they leave work. However, I don’t personally know any full time PTs who work less than 9 or 10 hours a day 5 days a week. Many of my peers complete their patient documentation at home on evenings and weekends. A responsible PT keeps learning, and spends 2-4 full on 3 day weekends a year in continuing ed, and reads up on fresh journal articles at least monthly.
In the outpatient segment of the physical therapy world, when not treating patients (usually 7+ hours/day), you are writing notes. If you see only 12 patients a day and each note takes 5 minutes, that’s an hour for quite efficient documentation. Add in pee breaks (which all PTs will tell you are hard to squeeze in. I was reprimanded for taking a bathroom break once as an unpaid student on clinical), phone calls to patients / doctors, administrative tasks (occasionally checking work email), annual mandatory trainings and tests, conversations with peers about how to best treat your patients or pass off care, and other basics of reality…you quickly see that you’ll have to cancel all lunch dates in perpetuity and leave all those personal emails hanging until at least 7pm when you are home and settled. Checking social media? pshaw!
Also, you may not get the vacation dates you want (and need!) since your peers were hired before you or someone else got first dibs 4 months in advance.
Do you know about specialty residencies and fellowships? These are (pretty awesome) specialty trainings that pay very little or actually cost you more educational money and typically tack on 1-2 years to your education. By 2020, they will likely be mandatory for PTs. School itself only prepares you to be a generalist, and probably not the best one at that.
You are the Health Care System
5) Are you familiar with the sometimes-evil monstrosity that is the US Health Care System? How do you feel about being inside of this system? Sure, you could pop out of the school-womb and work for a clinic that accepts only private pay. There doesn’t happen to be a huge amount of job security in that segment, and you are frequently very limited in terms of peer stimulation. Want to start your own business? Do you have an accounting background, MBA or law degree? You might need one to comprehend insurance payments.
Job Searching Myth and Reality
6) Have you asked the hard questions about job searching? We have all heard that it is easy-peasy to get a job as a physical therapist. I agree: it is easy to get a job in rural communities, in acute care, in nursing homes, and part time gigs where you are paid per patient, not even per hour. The awesome-sauce full-time or salaried positions often require at least 3-5 years of experience, and prefer if you can demo some coveted niche skill or certification and self-market in off hours.
As far as I can tell, and it is highly unfortunate, yoga alone doesn’t YET count for much in the PT world.
Tackling OPP – Other Peoples’ Pain
7) Have you spent 7-8 hours a day with people in pain before? Are you ready to treat whomever is in front of you, regardless of how they treat you?
Side note: in the last week, a patient screamed at me (because I reminded her of our attendance policy…I adored her but she missed more appointments than she attended*), was restrained by her own son in the same tiny treatment room that I was in, my boss opened up the door to check on me and my colleagues told me later that — hearing the screams — they feared for my life.
A day later, a patient who hasn’t addressed the stress in her life or sought care for her chronic neck pain (10 years+) tells me “You don’t care about me” after I spent an hour lovingly, tenderly, massaging the muscles of her neck (she barely removed the scarf, and still wore a turtleneck) and discussing parasympathetic nervous system activation in laymans’ terms.
Let’s be real: she is the one who has not shown care for herself; I do care very much about making her better. I just can’t do it all alone in two 30 minute slots a week.
I have many such stories. Fun times. And a very real hazard of the job.
*see above…since I am part of Big Health Care, I have to track my productivity. No show patients knock down my “productivity” substantially so I frequently must cancel patients who show up irregularly, even if for good reason.
If you’ve made it this far, congrats! Being a physical therapist is a true labor of love. For every frustration of working in physical therapy there are at least two joyous positives, not the least of which is watching people return to happy healthy bodies.
I still love my multiple jobs. I balance some of the challenges I mention above by working part time, working in two settings (public and private), keeping my yoga teaching as a major part of what I do, and having kick-ass peers and supervisors whom I love working alongside.
(All this could change, even in the near future as my personal goals evolve. My decent individual health coverage got cancelled because of the American Care Act and it’s been a wild ride applying on the dysfunctional DCHealthLink.org for new coverage that is costing me 30% more to have a $6000 deductible. Yep. I might full-time job search at some point in the future.)
So what to do if you are (still) thinking of becoming a Physical Therapist?
Edit 5/2016 – I am only accepting current students in DPT programs to shadow me in my physical therapy practice.
I invite you to shadow real-life physical therapists. Find diverse settings that treat every walk of life.
But do remember it took me 2 years of working full time AND teaching yoga and having major bags under my eyes to save enough and build up my yoga student community enough to go part time with PT. I presume that’s at least 5 years from where you stand now. Definitely seek out full time PTs to shadow in a variety of settings (school will force you to try all settings anyway) who seem to have fulfilled your specific goals. Especially if one of your goals is to continue teaching yoga or other vocation / avocation on the side on a meaningful scale.
There is always more to say, more details about how to leverage your years in school to prepare you for a satisfying career afterward, but I hope this helps as a start. If you have done the above tasks and want to bounce ideas off me and or for my advice specific to your passions and situation, feel free to set up a formal consult (I regret I am not able to give free consultations) by shooting an email to email@example.com. I’ll give you all the juicy details about how I sustain balance in my many endeavors.
wishing you all the best with your big life decisions,
xo to the max, a
ADDENDUM 2/2017: P.S. Think being a physical therapist is just a slightly fancier yoga teacher? One person did think that and emailed me to tell me so ;). (So if you become a PT you will also field these slightly insulting comments!). Here’s a tiny fraction of why that ain’t the case (and the email transcript below):
and what I responded in the email:
^ Without taking a lick of offense (because…not worth it), I really do think this line of thinking is dangerous and arrogant. If you haven’t watched the video above, you’ll understand more about that when you do. Thanks so much for reading!
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