Monday, December 14, 2015

University of St. Augustine: Questions Asked

Recently I asked some students entering physical therapy school at the University of St. Augustine if they had any questions prior to coming to school. Here are some of the questions asked: 
  • Would you go to St. Augustine again knowing what you know now? I mean as far as cost of school and living in that area.
My experience at the University of St. Augustine overall has been good. I am incredibly grateful for the opportunity to go to PT school. That being said, you should look at the price of tuition. I did not fully comprehend how much 13,000 dollars a trimester in tuition really is. The bill adds up quickly. You also have to factor in living costs: rent, food, transportation, internship costs, etc. I can't speak for the Florida or California campuses but Austin a pretty expensive city. 
  • Do you feel well prepared to take on a career in PT?
With most of my classes over with I feel like I am ready to be a PT. All I have left are a couple more internships and then the manual therapy certification courses. As far as regular class, I am pretty much done. The school focuses heavily on orthopedics and manual therapy so in these areas I feel extremely ready. Some other areas, such as pediatrics and neuromuscular, I feel ready but not to the same extent as orthopedics.
  • Does the accelerated program make you feel less prepared or leave out things you wish you had experience in?
Keep the accelerated aspect of the school in mind when deciding to come or not. I underestimated how hard an accelerated PT program was going to be. If you are good at managing your time and you want to get in and get out then you are good. If you need to have a social life I would say you need to find another school. I am not sure what it is like to go to a regular program but I have not felt like the program here is lacking. To ensure you learn what you need to learn takes a lot of time and sacrifice. ___________________________________________________________________________________

I hope this helps. Let me know if you have any more questions; I'll do my best to help.

Twitter: @dpt_usa 

Saturday, November 21, 2015

Interview: Good Luck

Reflecting on the interview process brings back a rush of memories of applying for PT school. The application process, waiting, interviewing, and more waiting is such an awful process. After I received the acceptance letter I thought I had it made. Then I had to start the next process, which goes as follows: new semester, study, study, study, study, take a bunch of tests and practical exams, study more, then rinse and repeat.

All in all, the purpose of this short post is to say... Good Luck as you interview! It doesn't matter where you go to school! If it is USC or NYU who cares... Nobody! Apply and go to any physical therapy school that will take you. Because in the wise words of Dr. Kunal Bhanot "Nobody cares as long as you graduate and passed the boards." Could not agree more! Just get into a program, put your head down and work your tail off, graduate, and pass the boards. No one is going to ask what was your grade in cadaver lab, TherEx, or any other class. Just do what you gotta do to get into PT school. Get in and get out. Nothing else matters.

I would love to connect with you if you have any questions or concerns about anything physical therapy. Find me via:

Twitter: @DPT_USA
Facebook: Dalin Hansen 

Friday, November 20, 2015

Chicago: Changing the Healthcare

I recently attended a workshop in Chicago about making a successful practice and business. Having the opportunity to learn from @Jerry_DurhamPT in Chicago was a privilege. I was able to take way some great info to apply to my future/current situation. 

If you don't follow Jerry on twitter... You should. He has an awesome fresh look at physical therapy and healthcare in general. He is passionate about making a change and the coolest part about it is, he is making a change! Just want to share a few key take aways from Jerry:

- Healthcare has set the customer service bar very low 
- When you are taken care of by a business or person you want to go back 
- People are willing to pay more if you make it worth their money
- Word spreads when you are good (managing time will make you good combined with a good PT makes you great)
- Why do we call it discharge... What other profession "discharges" their customers
- Make follow up calls; not to talk them into coming back but to get their honest opinion of their expereince
- Be passionate and share that passion
- Why would you learn business from PT's? Learn business from business people and apply it to PT
- Promise big and deliver big

All in all treat people well. Respect others time. Be caring and compassionate. Change your practice style to meet the needs of those you serve. Disrupt healthcare by being not only an effective but an efficient physical therapist. When you tell someone you are going to do something... do it (this includes scheduling).

For questions or comment feel free to contact me on twitter at @dpt_usa or via email at


Friday, October 23, 2015

PT School: Schedule

Prior to getting into physical therapy school I just wanted to get accepted anywhere. Being eager to start down the path to becoming a physical therapist I had no thought of what it would actually take. This past couple of years has been so rewarding but so difficult. After getting accepted to the University of Saint Augustine's physical therapy program I thought the tough part was over... getting accepted. I had no idea how trying it would be to make it through the program. Not to say it is impossible by any means but it is no cake walk. With just a couple semesters left I can see the light at the end of the tunnel but my daily schedule has been brutal this semester.
A typical Tuesday:

7:00    Wake up
7:30    Leave for school
8:00    Musculoskeletal IV (four hours of lecture)
12:00  Lunch (warm something up in the microwave and review class notes)
1:00    Musculoskeletal III (three to four more hours of lecture)
5:00    Study (after all that lecture its important to try to actually absorb some of the material)
9:00    Head home
10:30  In bed

The overarching message is... It can be done! but it takes a lot of work and sacrifice. You have to give up much of your personal and social life. In ten months time I will finish this crazy thing they call PT school. Cannot wait until that day but in the mean time back to the books.

Questions? You can reach me at
Click here to check out some of the words and advice of some awesome PTs

Monday, August 31, 2015

Experiences: Clay Case PT, DPT, CSCS

Clay Case PT, DPT, CSCS is a graduate of Daemen College and currently works outpatient orthopedics in New York. Presently he is applying for an orthopedic residency and pursuing a certification in Mechanical Diagnosis. For more info about Dr. Case check out his website

  • How was the transition/learning curve coming out of school and starting your first job?
Personally, I got lucky in that I was hired on at a previous clinical affiliation site. For academics requirements, students at my school needed to complete 4 separate affiliations. My 3rd affiliation was an outpatient orthopedic clinic in my hometown that was a perfect fit for me and apparently for them. After I graduated, I started working there under a limited permit and have since transitioned to a staff physical therapist.

One of the biggest obstacles coming out I think is realizing the balance of how much you actually learned and how little you truly know. The therapists at this clinic have provided good mentorship throughout any troubling cases or general weak spots in my knowledge which is invaluable to me. Because of that mentorship, I think my transition has been much easier than if I were taking a position in a different clinic or setting.
  • What is your work load like and what is typical day is like for you?
Typically, I will see 1-2 patients every half an hour and an initial evaluation for 1 hour each day. Currently, I am still building up a caseload and, accordingly, I am working a part-time schedule. A typical day will begin at 7:30am and 1-2 patients will arrive for their appointments on each half an hour. An initial evaluation will be scheduled somewhere throughout the day according to the patient's preference with an hour allotment of time for that evaluation. Depending on the day, I will work until 2:30pm or work through to 7:00pm. Notes are completed whenever time allows for it, and I try to finish them off during my patient's session so I don't have a huge stack of work at the end of the day.
  • What do you wish you would have known/been prepared for after graduating?
So far, I feel like any knowledge I could have gained on insurance companies and their policies would have been beneficial. Although we did receive some of that education during the didactic portion of our DPT program, the topic is certainly immense and requires continued learning. Clinically, I felt very prepared in knowing who I can help, who I can't help, and who I might need a little assistance in helping. While that comfort may have come from the clinic I chose to work with, I think active searching for a nurturing work environment directly out will improve a new grad's ability to grow. I'm sure a handful of situations will come about in the future that will inspire other answers to this questions, but currently I'm pretty satisfied with my preparation for new grad life.
  • Coming out of school what was compensation is like/managing student loans, etc?
I graduated in May 2015, so I am currently still figuring out the student loan management! Although I'm still currently in my grace period for my loans, I have been steadily building reserves from my income to pay off my loans prior to my interest capitalizing. I have decided to maintain my minimalist college budget for as long as I can in order to pay off my loans in the quickest time frame that I can. That's a personal choice, and I certainly don't claim it to be the best route! However, it just fits my lifestyle best and the thought of being debt-free as soon as possible really appeals to me. If that means I have to give up a few big purchases for a couple years still, I will be putting off that short term satisfaction for the long term gain.
  • Additional advice.
Never, ever, ever, stop being hungry. This profession is one of the best in the world because of the amazing results we can get with relatively low cost and low risk to the patient. Every time a person experiences success, you should be proud of yourself and celebrate that victory; however, don't forget how you got to that victory. A whole lot of work went into that, and I think one of the biggest pieces is continuing to advance your knowledge and skills. Regardless of your situation, you should always strive to become the best you that you can. Just because you're still in school, just because you're a new grad and have loans, just because you have 5 million things to do other than learn....Those ideas shouldn't hold you back from seeking out any topics you want to learn. Want to learn more about Mechanical Diagnosis and Therapy? Take some MDT courses, student membership is discounted. Want to learn more about training athletes through strengthening and conditioning? The NSCA offers a student membership which receives discounts for study material for the Certified Strengthening and Conditioning Specialist track. Many organizations offer these discounts, and many PTs offer mentorship!

We got in this profession to help people. Do it the best you can.

Huge thanks to Dr. Case for his inspiring word. For more physical therapist's experiences click HERE

Saturday, August 15, 2015

Experiences: By Dalin Hansen, SPT

  • What do you like about physical therapy/why did you choose physical therapy?
I chose physical therapy because I want to help people. I looked at other healthcare professions and they just did not offer what I was interested in. I like fitness and wellness. I felt like as I shadowed PTs they treated the whole person not just an illness/disease/problem. As I have been on my internship it has been a testament that I have picked the right career. I have been able to help people get a better overall wellness. Sometime a listening ear while exercising seems to make a world of difference in peoples lives. I love spending time with people everyday. Most other healthcare professionals just do not get one on one like PTs do.
  • What type of facility were you in, where was it located, and a brief background?
My internship was located in South Austin, Texas. Being in a Skilled Nursing Facility (SNF) sounded like such a drag at first but I was surprised how much I enjoyed it. Essentially, I was able to work with long-term (people who can no longer care for themselves and need 24 hour help) and short-term (knee/hip replacements, fractures, spinal surgery, etc. but just not quite ready to go home from the hospital) residents.
  • What was your biggest surprise/learning curve at your internship?
Having confidence in what I know. I feel I have learned so much in school thus far but sometimes it was hard to talk with patients and be sure of what I was saying. With simple cases I felt I could walk in confident but with more complex cases or agitated patients I felt a little more timid.

Something else that took me off guard was when patients seemed angry or agitated. I can understand why they might be upset; many of the patients just went through a traumatic event or surgery. When I did my first evaluation the patient was screaming and yelling. Honestly it freaked me out but I made it through and felt so accomplished afterward.
  • What was your case/work load like during your internship?
I covered between 70% and 90% of my CI’s caseload on any given day depending on who we were supposed to see. My CI slowly worked me into more and more patients as well as note taking. It is tricky to manage time wisely to see all the patients and get all the notes done but it was not crazy; it was definitely do-able. Of course my least favorite part of the workload was the note taking but again totally do-able.
  • Additional thoughts.
Just want to add be confident but not cocky. If your CI is any thing like mine take careful note of their advice. Listen to your CI, they have great insight and advice they have been a PT longer than you. Also, go into your internship open minded, I did not think an “old folks home” would be any fun but it was a blast. I don’t know if it is what I want to do for a career but I am not opposed to it.

Wednesday, July 1, 2015

Experiences: By Dr. Brett Kestenbaum, PT, DPT

A huge thanks the Dr. Meredith Victor, Dr. Brett Kestenbaum, and the gang. Your contributions to Creating a PT have been fantastic. Thanks to Dr. Kestenbaum for this posts. His experiences are very insightful!

      • How was the transition/learning curve coming out of school and starting your first job?
        I took my first job out of school at the hospital where I had my final clinical rotation. Although I was familiar with the staff and the documentation system, I still remember being quite nervous. My first day following orientation was on a Sunday: a day where there was very little PT staff support available to bounce ideas/questions off of. I remember gaining momentum throughout the day. I started the day out slowly and methodically, over-reading charts and over-cautious with my treatments. Towards the end of the day, however, I was able to hit a groove. This pattern continued for quite a while. I made it a goal of mine to learn at least one thing new every day. It took me about 1 month to get somewhat comfortable, 3 months to get pretty comfortable, and 6 months to get comfortable enough where 90% of patient encounters did not make me nervous - rather excited instead.
        • What is your work load like and what is typical day is like for you?
        I work in an acute care hospital where we have a lot of scheduling freedom. I see an average of 8 patients in an 8 hour day. When you are in a hospital, your ability to review charts and understand what is going on with your patient can mean the difference between a positive outcome and something going very wrong. A typical day for me looks like this:

        Arrive at work and settle in

        Check my schedule and determine which OTs have the same patients as I do so we can coordinate treatment

        Review patient information on the EMR (electronic medical records)

        Head up to the floors and begin seeing patients

        Depending on the day I will either see a patient and chart or I may see a few patients and then chart on all of them

        Finish my day, complete my charting, turn in my billing sheet, organize my scheduling board and then head home to work on

        What do you wish you would have known/been prepared for after graduating?

        I feel like I was very prepared coming out of school. I read a lot of books, blogs, etc on subjects I was curious about while still a student (and I have to admit I may have done a lot of this reading during class lectures). I made sure I was knowledgeable about finance, the implications of student loans, and how to make sure I could live the life I desired - growing as a person and as a PT.

        That being said, I would have liked to be more prepared for the simple things, such as how to apply for the NPTE. I feel I would have also benefitted from having a mentor - someone to tell me that PT is a journey that is not defined by this moment. We are professionals who evolve. Every day we have the opportunity to grow and learn something new. I feel this is very important to understand at a deep level. Many decisions are driven from the perspective that life is stagnant. The reality life is a process of personal (and in this case professional) evolution. Understand that you can always change and grow, and you can do great things as a physical therapist.

        • Coming out of school, what was compensation is like/managing student loans, etc?
        Following graduation I picked up a book I had read many years ago. Think and Grow Rich By Napoleon Hill. I followed the principles in the book and thought a lot about what was important to me. I came up with this.

        Freedom to work in the geographical location I desire

        Work somewhere that would allow me to grow as a professional

        Make the most money possible without sacrificing #’s 1 and 2

        From there I created a spreadsheet that helped me discover the minimum amount of money I would need to live the life I wanted. I considered both pay rate and time as variables so that I could either work more (or less) or get paid more.

        I figured out early that working per-diem in an acute care hospital would afford me the freedoms, education, and compensation I desired.

        In Think and Grow Rich, Napoleon Hill describes the process of focusing on what you desire, and stating out loud daily what you hope to achieve. Well, after doing all my budget calculations I came up with a specific number, focused on that number and strangely enough… I got offered the EXACT pay that I wanted to the penny.

        Food for thought.

        • Additional thoughts
        Always remember to be yourself and be true to yourself. Yes, you graduated from school as a physical therapist but letting that title define you can be a mistake. You are still a person - an individual. Do what makes you HAPPY, forget the rest, and you will have an exciting and VERY successful career.

        Monday, June 15, 2015

        Experiences: By Dr. Jasmine Marcus, PT, DPT

        I would like to thank Dr. Jasmine Marcus, PT, DPT who is a recent graduate of Columbia University’s program in physical therapy and is currently working as a Physical Therapist in Upstate New York. You can follow her on Twitter @JasDPT15 and check out her PT blog:
        • What do you like about physical therapy/why did you choose physical therapy?
        I actually focused on journalism until the year after I graduated college. I love reading, writing and reporting, but I wanted a more stable career where I could help people more directly. I had physical therapy in the back of my mind ever since seeing one for a high school cross-country injury, so eventually I decided to take the plunge and go back to school. Now I am so glad I made the switch. I love getting to know all of my patients, trying to solve the mystery of what’s bothering them, and helping them get back to living their lives.
        • What type of facility were you in, where was it located, and a brief background?
        Since I knew I wanted to work in an outpatient orthopedics facility, I had three clinical affiliations in this setting and one in a skilled nursing facility since I enjoy seeing geriatric patients. Two of my internships were in New Jersey, near where I’m from, at places recommended by my school, and two were in upstate New York, where I have moved since graduating, and which I set up myself. I was lucky that Columbia let us pick our own internships and was very helpful in helping us set up our own.
        • What was your biggest surprise/learning curve at your internship?
        I think the biggest learning curve was figuring out how to apply all the things I learned in school to real people. A classmate can pretend to have had a stroke during a practical, but transferring someone who has actually had a CVA is a different story. And no patient presents as simply as a case history from class. However, I was able to learn so much from applying my skills to real patients, and working alongside four great clinical instructors.
        • What was your case/work load like during your internship?
        During my first internship, I worked up to treating about half of my CI’s caseload. In my second and third, I’d see almost all of the caseload, except I would have assistance for dealing with more “complicated” cases. By my last internship, I was flying solo. My CI would be around to chat with patients and answer my questions, but mostly I tried to pretend that he wasn’t there because I knew in a few weeks I’d be on my own. Instead, after I had already formed a plan, I would use him as a resource from which to get suggestions.
        • Additional thoughts.
        Treat each internship like a it is a long job interview. If you make a good impression, you can be a great asset for any company. You will already know their philosophy, policies, staff members and other details, and they will know whether you would make a good fit. All four of my internships ended up discussing hiring me, and I am lucky to be starting a job (June 15th) at the site of my third internship!
        Again a huge thanks to Dr. Jasmine Marcus for sharing her experiences and words of wisdom. She has an awesome blog; check it out at:

        If you are a PT and are interested in sharing your experiences/wisdom please contact me at Check out the Experience Series where therapists have shared their experiences and advice for pre-PTs, SPT, and PTs.

        Sunday, May 31, 2015

        Experiences: By Dr. Seth Watson, PT, DPT, Cert. DN, CSCS

        Huge thanks to Dr. Seth Watson, PT, DPT, Cert. DN, CSCS who is a UT Southwestern Orthopedic Physical Therapy Resident. His advice and experience is remarkable. Fine him on twitter @texagswat12.
        • How was the transition/learning curve coming out of school and starting your first job? 
        This is a great question and something that I think is huge with many entry-level physical therapists. Obviously, how steep the learning curve is unique, personal, and greatly dependent on the quality of your rotations as a student and the quality of education you receive. Luckily, I was fortunate enough to have clinical rotations with 3 clinical instructors that were either former residents or current residents finishing up their residency. I also received an exceptional education at UT Southwestern, which effectively prepared me for many of the difficult transitions that entry-level PTs face.

        However, no matter how well you are didactically prepared, there are certainly areas where you are not going to be ready. One that certainly sticks out to me is learning the intricate details behind billing & coding, especially when each insurance company is different and there are daily changes occurring. This can be quite the headache early on and the intensity of the headache is largely dependent on the helpfulness of the front-office staff and the electronic medical record documentation system used. (PS This is something to consider when contemplating taking a job, ask about what EMR is used!)

        Another aspect of beginning clinical practice as an entry level PT that is certainly a transition is developing your own critical thinking skills without the input of a clinical instructor. I am fortunate to have a mentor with me for 1 half day/week, but really beginning to synthesize all of the information you have gathered from school, continuing education courses, and research is something that takes practice and is very dependent on experience and your personal drive to be better each and every day.
        • What is your work load like and what is typical day is like for you?
        As a resident in an academic setting, my schedule is quite a bit different than most entry-level physical therapists. I treat patients 28 hours/week (4 hours in collaboration with a mentor), have 4-8 hours of teaching/research/office hours, and 4 hours seeing patients with an orthopedic surgeon in his office. I also attend weekly Orthopedic Surgery Ground Rounds, attend/present at weekly Brown Bag journal clubs, help 1st and 2nd year students at a supplemental lab hosted by residents on a weekly basis, attend/present at monthly collaborative journal clubs, and have other optional, outside opportunities that I typically try to attend. The residency also includes a 5 weekend series of courses that cover just about everything orthopedics in order to advance clinical practice and prepare attendees for the Orthopaedic Clinical Specialty examination in March.

        I see patients in 30 minute slots and try to keep most of my care one-on-one. I will have our technician take a patient through one or two more exercises dependent on the patient’s stage of rehabilitation, insurance requirement, level of independence, etc. I am a big believer in one-on-one care, so while I often times get behind on notes, I am right there with the patient the majority of the time. The long-winded point of this is to give the fact that I can treat up to 16 patients on a full day with no initial exams. I get 1 hour for most initial examinations, which is usually more than enough.
        • What do you wish you would have known/been prepared for after graduating? 
        As I mentioned before, I do feel I was prepared didactically from UT Southwestern and my clinical rotations. I also felt prepared to manage a heavy caseload due to my managing this many patients as a student on my clinical rotations.

        One thing I do wish I had done better as a student is be more organized with the course and supplemental materials I received during the courses I took in PT school. Often times, when something comes up that I have not seen in a while, I find my self-digging through computer files or paper documents mad at myself because I should have been more organized. I have taken that to heart since I started the residency so that I don’t deal with this issue again in the future.

        Like I said, another thing that takes some getting used to is handling the different aspects of billing/coding that comes up and is frequently changing. Learning how to get out of making notes a performance like it was in school/rotations takes some time. You must get the critical details in the note to protect you and make sure the patient is being progressed each treatment, but cutting down on the “fat” per say and only writing what is crucial will save you from many headaches down the road.
        • Coming out of school what was compensation is like/managing student loans, etc? 
        This is an important question that needs to be understood as one finishes up school and contemplates the next step. I was fortunate enough to have the opportunity to begin an academic based residency as my first job, which meant taking a “pay-cut” relative to many of my classmates’ starting salaries. UT Southwestern actually pays their residents approximately $50,000/year, which is probably in the upper 10% of residency salaries. When applying/interviewing for other programs, many offered anywhere from $25,000/year to $37,000/year, dependent on the setting and geographic location. In my opinion, making less for 1-1.5 years is totally worth the benefit I will receive from advancing my clinical practice during that time. I wouldn’t hesitate to do this again if I were to have the same choice in front of me.

        In terms of loans, I was fortunate in that I was blessed to have supportive parents that helped me through school. However, I am also fortunate to have married my beautiful wife a week before we graduated from school, who has student loans. We are approaching her loans utilizing the Dave Ramsey motto “Live like no one else, so later you can give like no one else.” We are trying to use my salary for each month’s loan payment so that we are paying around 6x the required monthly payment. Luckily, most loans give you approximately 6 months after you finish school to begin paying, so we had time to get our feet under us after graduating. However, the first few months were definitely tough between graduation and passing boards, so we lived on wedding gifts, gift cards, peanut butter, and extremely helpful family for a few months.
        • Additional Thoughts  
        Being a Physical Therapist is not just about prescribing exercise and doing notes. Physical Therapists are in an integral role where we are able to change our client’s health status in a positive manner. We spend more time with our patients than any other healthcare provider. We have an expansive (& expensive) amount of knowledge, not just about that patient’s specific injury/diagnosis, but nutrition, strength/conditioning, etc. Spending the entire patient visit talking about yours or your patient’s weekend is a waste of that patient’s time and valuable health care resources. Take these opportunities to introduce health and wellness concepts to these patients with the mindset that if you change even one aspect of their lifestyle in a positive manner, you can significantly impact their quality of life many years down the road. If we are truly to be a patient centered profession, we need to leave our most of our personal lives out of patient care and place value in each of our patient interactions through patient education.

        Just a final thought, when you come out of school, you will be rightfully motivated to become as excellent of a physical therapist as possible. My best advice to any entry-level PT is to get really good at what you “know” before trying to dive to deep into continuing education courses or the literature. By no means am I saying avoid these resources/opportunities; just remember that you are coming out of school with what should be the latest, greater knowledge. Solidify this knowledge base and then build on to this foundation as you become more experienced. Just my two cents!

        Thanks again to Dr. Seth Watson, PT, DPT, Cert. DN, CSCS. Grateful for his words of wisdom!

        If you are a PT/SPT and you are interested in sharing your experiences please email me at

        Click HERE to read about other PT's experiences.

        Thursday, May 14, 2015

        Experiences: By Dr. Meredith Victor, PT, DPT, CSCS

        I would like to give a huge thanks to Dr. Meredith Victor for sharing such great advice and experiences. Also please take the chance to check out, its a fantastic resource.

        Bio:  Meredith graduated from University of St. Augustine in San Diego in 2010. She has worked in multiple settings and strived to experience as many environments as possible. She currently works as a rehab intake liaison at South Bay Rehab Center in San Diego, and runs
        • How was the transition/learning curve coming out of school and starting your first job?
        My first job was pretty interesting, actually. In many ways, I had a pretty nice situation at a hospital-based outpatient clinic. We had charting time included both before lunch and at the end of the day, so I almost never had to stay late or work through lunch. That was awesome!  

        The patients' diagnoses ranged from fibromyalgia and chronic pain to the occasional total knee replacement or orthopedic condition. We even saw some TMJ patients and had a pool to offer aquatic therapy to our spine and arthritis patients.

        The toughest part for me was feeling like I was losing some of my ortho skills, since I really didn't get to use them that often. We had an HMO, so our patients were subject to capitation spread throughout all the HMO patients. That meant our clinic had chosen to provide 5 visits per patient, unless they were post-op or special circumstances. That could be frustrating, since new grads like to see patients for longer than 5 visits to gauge whether their treatments are effective.

        Another challenge was the language barrier. We had quite a few patients who either didn't speak English, or came from cultural backgrounds where treating pain with exercise was unheard of. It was pretty difficult to convince them of the efficacy of PT if we only had 5 visits to do so, and most of our 30 minute treatment was spent fumbling with an awkward translation phone. It was very frustrating, and the combination of those factors is what ultimately led me to seek employment elsewhere.

        I do really miss my coworkers, and the patients were quite sweet. 
        •  What is your work load like and what is typical day is like for you?
        I have two really unique jobs right now, and I love them!!! I work as a rehab intake liaison for South Bay Rehabilitation Center (at Paradise Valley Hospital). The job involves no direct patient care, but there is quite a bit of interaction with patients and their families, as well as collaboration with other disciplines in the hospital.

        My role is to market and promote our fantastic sub-acute inpatient rehab program. We spend a lot of time educating doctors, case managers, patients and their families about the intake criteria for admission to our facility. It is a perfect match for my personality, so I feel incredibly blessed to have the job!

        A typical day involves a combination of speaking with case managers and physicians, filling out intake paperwork, brainstorming with the team about marketing efforts, going to various hospitals around town to meet with potential candidates (and their families) and working on our social media and web strategies. Before I was a PT, I was a web and graphic designer, so I've absolutely loved being able to merge my two careers this way.

        My other "job" is running, which is a website devoted to helping new PTs with the transition from student to professional. I love the opportunity to help new PTs carve their own paths and provide resources that to help them tackle the mundane tasks that take away from the joy of being a physical therapist.

        While those two gigs keep me pretty busy, I don't want to leave patient care entirely. I do some per diem PT work to keep my skills sharp :)
        • What do you wish you would have known/been prepared for after graduating?
        I wish I had known that acute care was out there. I never had a clinical in acute, and rushed into outpatient when I graduated. I found that having a set schedule of solo treatments was not for me. I didn't hate it, but I felt very drained by the end of the week. I was also pretty sore from doing manual therapy.  

        A PT school classmate suggested I apply to an acute care job at his facility, and it was such a great move! I much preferred the flowiness of acute care, and I loved the interaction with OTs, nurses, MDs, pharmacists, etc. I do much better in a collaborative environment, and I find that acute was my favorite setting. I loved being able to help people take their first steps after surgery, and the fact that my patient load was always changing kept things interesting and fun.  

        However, once I was out of school for about 5 years, I really found myself missing the creativity of design work, so it was time for a real change, which led me to my current positions with South Bay Rehab Center and I'm extremely happy, so I also wish someone had told me that you don't HAVE to do patient care to use your DPT to the fullest.
        •  Coming out of school what was compensation is like/managing student loans, etc?
        Because I work in a large city with two PT schools, compensation is not, shall we say, "competitive." I didn't go into physical therapy for the money, but rather for the flexibility. I am lucky in that my husband has a stable job with benefits, which has enabled me to create a work schedule for myself that fits my personality. I am also able to work at a higher per diem rate, since I opt out of benefits. I strongly urge therapists to check out per diem work, if they're feeling burned out. With the Affordable Care Act as an option for health insurance, you can choose to work at several positions at a higher hourly rate, with more flexibility. Of course you don't get paid time off with per diem, so make sure to consider that when you make your decision! 
        •  Additional thoughts.
        PT is an excellent career for anyone who can be creative about carving a path for themselves. It is not unusual to get burned out at some point in your career. Some therapists work 40 years and never feel burned out. Others are ready to leave patient care after a year of treating. Don't judge yourself for where you land on the spectrum. Just take stock of your strengths and your passions and life will present opportunities to move in the right direction. Good luck, everyone! 

        Thanks again to Dr. Meredith Victor for her contributions to 

        Feel free to write any questions or comments in the comments section. If you feel you have something pertinent to share on send me an email at

        Click HERE to read about other PT's experiences. 

        Tuesday, April 28, 2015

        PT School: One Year Down

        Being a PT student has been an incredible adventure. I have been stretched thin at times in all aspects of life: funds, time, mental capacity, sanity, etc. I would not change this for anything. Looking at the past 12 months which has been jam packed with exams, assignments, and projects; not to mention 61 credit hours. As I learn new things it helps me realize how little I really know. Being hungry for more knowledge fuels my drive to continue despite the difficulty I have faced thus far. The one take away I wish to share as I reflect on the last year: I will be creating a pt for the rest of my life because as soon as you think you have arrived, I can assure you; you have not. Becoming the best physical therapist is a life long journey and at this point I'm barely taking baby steps. Always strive to be better. Don't stop until your the best.

        Tuesday, April 14, 2015

        Experiences: By Cinema

        Very grateful to Cinema for sharing his insights as a clinician. Cinema has been an inspiration to me with his blog and twitter presents. Please take the chance to read some of his blog posts/interviews. He is an advocate to PTs and PT students alike. _________________________________________________________________________________________
        • Bio:
        I graduated less than a decade ago from University of Saint Augustine FL. Back then our classrooms were basically mobile homes that looked like classrooms on the inside. Rainy days felt like scenes out of “Jurassic Park” - noisy downpours on our double-wides amidst lush vegetation while I peered out the window expecting a velociraptor or two… Since graduation I’ve been lucky enough to work with fantastic PT’s while adding to my out-of-the-box knowledge & skills. I love learning from other PT’s who walked the paths before me, as well as getting a better understanding of my philosophy of treatment and approach to our incredible profession. Connect with me on twitter (@Cinema_Air); also check out my blog for interviews, opinion pieces, & more.
        • How was the transition/learning curve coming out of school and starting your first job?
        At first, the learning curve wasn’t so steep...until I realized I wasn’t sure if patients were getting better on their own or if I was adding any benefit. Some patients were improving, but others weren’t. Textbook cases suddenly became less & less textbook. I wondered about the modalities I was using - “was this ultrasound actually doing anything?” The answer came to me one day when - after using applying US for about 8-10 min - the patient said he felt better. Then I went to turn off the machine and… I NEVER TURNED IT ON! I got more curious, so I decided to use US for some TKA (Total Knee Arthroscopy) cases and skip it with other TKA cases. I didn’t notice difference; both progressed just as well. The 3 things we did consistently was Manual Therapy, Therapeutic Exercises, and Ice. That’s when it hit the fan - I started taking as many continuing education courses as possible; and my learning curve steepened very quickly.

        While I was ready for most situations I faced in the clinic as soon as I graduated, I’m better today than I was before; and I hope I’m better tomorrow than I am today. I was also fortunate to work for & with someone I really admired. Do what I did - work for someone you really admire. And, make yourself indispensable.

          • What is your work load like and what is typical day is like for you?
            I worked previously at an outpatient clinic where I attempted to juggle 3-4 patients per hour. While many patients seemed to progress, it didn’t provide enough time for me to slow down & reflect on individual patient cases. There wasn’t enough time allocated to analysis and reflection.

            Today I see 1 patient per hour; adding up to about 8-10 patients per day. We tend to share patients between 2 physical therapists - I like this set-up because I can bounce ideas off the other therapist and get their input on what I’m thinking since both of us have direct contact/experience with that particular patient. I really enjoy the mix of chronic pain and neurological cases we see. The environment at our clinic is geared toward progression as clinicians - something I was looking for and am glad I found. About once a week (or more) we chat about patient cases over lunch meetings and exchange ideas on treatment approaches or management of patients.

            What do you wish you would have known/been prepared for after graduating?

            I wish I had a better grasp of Strength & Conditioning. My opinion is that PT school does not adequately prepare you for real-world strength & conditioning applications. I would strongly encourage you to dig into this after graduation - take as many continuing education courses as you can handle. Additionally, I don’t believe I had enough neuro exposure thru my clinicals. Retrospectively, I should have signed up for a pure neurological setting in one of my clinicals. Every orthopedic case you will see in the clinic has a neurological component - I wish I learned that sooner. It would be to your benefit to explore as many paradigms of treatment as possible until you find the one(s) that yield the best results for your patients.

            As mentioned earlier, in a prior location I worked at a stereotypical outpatient clinic where I juggled 3-4 patient per hour. ONe big benefit of that experience was I gained significant exposure to the business facet of running a clinic. Managing a clinic requires a stronger and broader skill-set than I had imagined - I knew it would be challenging, but didn’t grasp just how challenging it can be for an owner-operator. I wish I had a strong understanding of the business aspects of Physical Therapy, but unfortunately PT school didn’t prepare me for this, and I didn’t take the time to learn it on my own prior to graduation.

            • Additional Thoughts
            1. I really don’t know that much - there’s always more to explore. I think we think we know more than we really know. Believing that I know everything - on any subject/topic - immediately closes the opportunity to step into the sunshine of something I could love/enjoy more than I can imagine to day. Connecting the knowledge I accumulate can open avenues of thought and perspective that can surprise me - and they have! Rather than believing or pretending that I know all there is to know about a particular subject or topic, I find it much more interesting when I’m given new perspective on generally accepted ideas/truths. Read broadly, connect the dots for yourself, and stop pretending you’re smarter than the person next to you. Choose Intellectual Promiscuity over Intellectual Vanity.

            2. The occasional lone wolf may outperform, but a collaborative effort elevates the tide that lifts everyone. Contribute to the larger ecosystem that you’re engaged with. Engagement today is significantly more viral than ever before; why not use this virality for the greater good? What you (Dalin) are doing by sharing these quick interviews is a benefit for all readers. I’ve learned quite a bit from some of the individuals you’ve interviewed before me. I’ve even extended “collaboration” into the workplace by viewing myself as “working with”, not “working for” somebody. Start by collaborating locally while gradually growing your sphere of positive influence. And, collaborate with your colleagues across the country via the APTA to create the change you want to see. A rising tide lifts all boats.

            3.The proof is in the pudding - in our case, the pudding is the patient. Our process should be based on how our patients respond to our care & interactions. Does it consistently improve your outcomes? If so, then it might be worth pursuing. This is the guiding star for my clinical progress, and I use it as a ruthless filter. This also comes with the added benefits of preventing me from getting too attached to the latest professional & academic zeitgeists. Physio fads, academic themes...all these come & go; but my North Star remains Consistent Patient Outcomes. You’ll never be 100% consistent, but it’s definitely worth the effort.

            4. Finally, find a mentor. There’s significant value in seeking and being mentored by someone of experience that you truly admire and with whom you have shared goals/visions. One mentor will (very) rarely fill your needs in more than 1 or 2 of your interests. Find different mentors for your different interests. Leverage their experience, proficiencies, and skills to fast-forward your progress. Then, become a mentor yourself. As a mentor, you realize how much you really don't know! (back to point #1)
            Special thanks to Cinema for his willingness to share his insights. For more information about Cinema find him on twitter @Cinema_Air or on his blog at

            Click HERE to read about other PT's experiences.

            Tuesday, March 31, 2015

            Experiences: By Dr. Ben Fung

            Getting to know Dr. Ben Fung through his blog as well as twitter has given me great respect for him. His ideas are fresh and innovative. I highly suggest you visit his blog for great new insights on physical therapy. 
            • Bio
            Ben Fung, PT, DPT serves as a consultant in the space of physical therapy and healthcare. He is based out of San Diego, California and graduated in 2009 with a Doctor of Physical Therapy degree from Azusa Pacific University. He is finishing a Master’s in Business Administration with a concentration in Marketing from the University of Michigan-Dearborn this April, and, aspires to self-publish his first book in early summer.

            • How was the transition coming out of school and starting your first job?
            The transition coming out of school was quite smooth. I felt I was very well prepared at a clinical level, and, my program’s faculty continually stressed professionalism in the strictest fashions. If anything, I had the fear put into me that should I do anything remotely unprofessional at any time, I’d fail my rotations and get kicked out of the program. As work began, there were certainly random things here and there that I just didn’t know, or, knew academically but haven’t seen in real life. Nevertheless, I felt that I responded to each situation with poise when paired with a healthy dose of asking when I needed clarity or guidance – after all, nobody knows everything. In any case, the majority of quandaries weren’t too difficult to solve. It was the politics that I had difficulty with… more on that later.

            The learning curve was also quite seamless. Being that I’ve worked in every major healthcare setting from acute hospitals to rural home health, I felt that what I needed to be fully functional in each setting was a short time of exposure to the work environment. After that, I was running on all cylinders. Where I felt that I was weakest was my understanding of healthcare politics and my ill-preparedness for effect business solutions within physical therapy and healthcare at large. This was one of the reasons for my pursuits of an MBA.

            •  What is your work load like and what is typical day is like for you?
             Well, how about I go through a range of my past experiences since my current days are quite anomalous to what the newly graduated professional experience is like.

            In Acute Care, I worked both 5x 8s and 4x 10s. I loved 4 x 10s, but, I was spent after the day’s work. Typically, I would arrive on the hospital campus around 715am and clock in at 730am. My shift went from 730 to 6pm. Productivity at this hospital was 75% so I needed to put in 30 units or 7.5 hours of direct patient care. I recall I got an extra unit for evaluations so evals were a nice thing to boost that productivity measure. Usually, I would try to slam out 4 or 5 evals in the morning until about 1230pm. I’d take a quick 30 min lunch then scramble to get the rest of my evals or treatments as quick as I could. I also loved picking up new evals and swapping treatments with PTAs. It helped everyone as it boosted productivity for all. Some clinicians didn’t like having more patients because it meant more documentation… this is where I feel Acute Care standards for productivity could improve across our industry.

            It remains an lazy measure of hospital “productivity” for rehab clinicians to take their time with patients, get 45 to 60 minute treatments (which may not be necessary) and get a bunch of slow easy units in that fashion. I’m just not like that. I rather get my butt moving and see as many patients as I could to help alleviate the supply chain. Anyway… enough of that soapbox.

            As a Rehab Director, I was in charge of inpatient SNF rehab, outpatient, and community home health. This was a hard life. I worked 10-12 hour days, typically 5 but sometimes 6 days a week. I had to do all sorts of ad lib scheduling and staffing duties that spilled over at home and anywhere else when I was mobile. My son was born in this time frame as well, so, my wife had to take a brunt of the parenting. It quickly led to my resignation due to poor work-life-balance. But in any case, I would arrive at 630-7am almost every day. I would fine tune the schedule as best as I could. I’m not necessarily a perfectionist; however, I do believe optimization. I feel passionately about optimal operations. It actually served me quite well on the job, leading my region in profit margins and raising a sinking ship in less time than upper management ever expected. Well, from 830-900am I’d be in meetings. Then from 930-1030am I’d be in more meetings. Several times a week I’d have 11-1230pm meetings with occasional 1pm meetings. Sooooo many meetings. There would also be meetings which lasted from 1030am until 3:30pm. What time I had left was left to optimizing the next couple days in terms of operations and revenue streams followed by seeing my own patients. Since most of my team didn’t like doing outpatient or community home health, I helped alleviate that by taking it on myself which led to lots of walking back and forth between offices and throughout the community itself. It took less than 3 months to completely destroy a pair of dress shoes.

            In Home Health, I found myself driving more than I was actually seeing patients on most days. I’d leave the home around 630am or 7am to get to where I needed to be by 730-8am. I averaged 25-40 minutes treatments with OASIS starts of care to be around 1.75 – 2.5 hours. If I was lucky and the patient didn’t have many medications, I could get done in 1.5 hours. Regular evals would just be the normal hour. The most annoying thing was that many times, I’d have to drive PAST my patients to get to the next one. It is a funny thing about home health, all the patients that you have clustered together never seem to want to be seen in the same breadth of time. You always find yourself driving to and from, back and forth… just to keep up your visit quotas. So close, but, so far…

            See, in home health, most companies require you to meet a certain quota or productivity equivalent of patients within a time frame. This could be something like 28 weighted units in a week; in such cases, you may be working 3 hours one day, 10 hours the next, picking up a quick eval over the weekend summing to 6 days a week but random hours. This is the case because in home health, you get paid for what you do, not how long it takes. A 20 minute treatment makes as much as a 45 minute treatment. The faster you work, the more money the company makes and the more of a cut you get. Does this lead to some shoddy treatments in the midst of a large company? You bet! But, that’s life in the home health industry. Home health is just a different animal compared to the rest.

            •  What do you wish you would have known/been prepared for after graduating?

            I wish I knew more about business in PT school, and, even more about the very complex lattice that is healthcare politics. PTs are in a bad place when it comes to healthcare politics. Anything except outpatient and you’ll find that we really lack a strong stance. The problem is that most healthcare corporations see PTs as an add-on in the medical continuum rather than a pillar in the healthcare environment. As such, physicians and nurses tend to be the political powerhouses. All decisions, budgets, and executive positions are held by either of the two. PTs need to find ways into roles such as COO of a hospital, regional director of operations, and even CFO for health systems – another reason I went to get my MBA. I was told that without this stamp of business approval, larger organizations wouldn’t really consider us. I found this advice to be true.

            If we don’t shine out in business, we won’t truly shine in the scheme of things because we won’t have any control of our own fates. It just doesn’t work the way our current internal culture says it does where: tip-top clinical skills + years of experience = influence. Truth be told, clinical savvy means very little in the spectrum of healthcare politics. Positions hold the power. Until we get into those positions, we will remain with very little power.

            • What is it like/managing student loans on a physical therapist salary?

            Coming out of school, I was offered $30/hr. No flexibility, no bargaining, non-negotiable. I was offered a sign-on bonus which was nice. It was what it was. By the time I was working in home health, I was getting paid a six-figure rate.

            Managing loans is a personal story for everyone. The best I can say is that a tool such as can really help with structuring your financial lifestyle to keep up with your goals while having a reasonable life of enjoyment. Find the best balance for you.

            Personally, I’ve always been very disciplined about living within my means. I do my very best not to spend more than I have (or will reliably have). I can still recall some college and grad school days when I’d eat the same meal, 3x a day to make it buy both financially and nutritionally. I carried the same work ethic coming out of school. Discipline and hard work are beacons of fiscal solvency at any level. If you get financially lost, look to those lighthouses… you will find your way back.

            Discipline and hard work.

            • Additional thoughts.

            There are five things I really want to encourage students and new graduates to pursue:
            1)      Get as many students into advocacy as possible. Laws can either confine us or empower us. If we don’t advocate our own laws, then we will be confined, contained, and extinguished by competitors. If we define them, we can in turn empower our practice and truly work at the top of our credentialing. Start early and don’t stop caring.
            2)      Get into social media. A profession has a brand and it is represented by every member that it boasts of. The more presence we have, especially the more positive presence we have without infighting, the more the public will recognize us. That is the first step to cultivating a strong, positive, favorable brand in the public eye. Also, there have been enormous opportunities made available to me because of social media; I can see the same will be the case for students and new graduates when it comes to employment in the coming future. Get involved and invest early in your personal brand.
            3)      Realize the life cycle of a new grad: Start working. Quit your first job early to shed your “new-grad-ness” (I have a whole post about this in my blog). Rise to management. And, empower the generation under you. Management is the first barrier to making sure PTs get competitive pay. Too often, companies which employ PTs (PT owned or not) are managed by stagnant and disengaged individuals. They don’t want change. They want status quo. In our current healthcare environment, that just isn’t good enough. Get in. Rise up. Change our world from within. Again, those key positioning within the healthcare political matrix is where things start. We need to get there fast as a culture and as a profession. THEN changes will happen as a tidal wave of improvement across our industry.
            4)      Don’t settle in working for bad companies, for bad pay, and for circumstances that demean if not insult what you’ve worked for. Once you’ve graduated, you’re doctors. Make sure your lives reflect it in every dimension. Live healthy. Stay fit. Represent yourselves and your colleagues well. Also, by not settling, you will set up a momentum that will deny bad business patterns the oxygen they need to perpetuate. Shoddy SNF programs that pay amazing for terrible practices will lose the human resources they need. Seasoned PTs won’t go near it because it typically means a big change in their lives, those that have work currently aren’t interested in any change, and thus only new grads and travelers will get sucked in and burnt out. Deny them this and you deny them bad brand perpetuation of YOUR legacy. Deny companies that want to rob you because you are new and fresh out of school and you will deny them that “cheap labor” idea of new grads. Work for places that respect you, not for those that wish to take advantage of you. I know it is tough coming out of school being picky about jobs, but honestly, if we don’t start becoming picky, they will always pick on us.
            5)      The title doesn’t mean good pay. Hard work means good pay. DPTs are generally the lowest paid doctoral professional in any industry in present times. This sucks, isn’t equitable, and needs to change. That said, ANYONE regardless of profession, working 60 hours a week will make more money than someone working 40 hours a week. There ARE ways to make 6 figures as a PT and pay off all sorts of student debt right out of school. The challenge is finding work-life-balance when you’re grinding away so many work hours. As your career matures, you’ll be mystically valued more in the job market – then you can work fewer hours to make the same. It’ll take time. But, if you get into management (again, with this politics and business thing), you can help change this and have it that people earn according to their level of performance. Imagine that?! Being paid for the worth of work you do. Advocate, learn the business, navigate the politics, rise to leadership and key positions, and such will be your reality. It’s yours to capture!

            A huge thank you to Dr. Ben Fung for his awesome insights. For more about him check out his blog or find him on twitter. I want to reiterate Dr. Fung's advice to get involved in advocating as well as getting on social media. Both of which are powerful tools that will help you connect with like minded professionals and help you find mentors.

            Twitter: @DrBenFung

            Click HERE to read about other PT's experiences.