15 Jun Why I Walked Away From My Career As A Physical Therapist

You should probably know that this article is potentially the most painful article I’ve ever written.

Painful because I’m openly sharing why I chose to walk away from a great profession.

As a matter of fact, this one is going to take some courage to hit the “publish” button.

It’s been several years now since I walked away from my role as a clinician.

I was an orthopedic physical therapist (hopefully, a damn good one too).

I still get a lot of questions about why I left the clinic?

Until now, I’ve never shared the full story, but because I’m asked about this so often, it’s time. 

(*Special “thank you” to Tami and Luis for your recent questions. It was your questions that formed the basis for this article).

Keep in mind that there are lessons in this article for every reader.

Do I regret leaving PT?

I’ll explain soon.

Things happen for a reason and it’s the choices we make that shape our lives.

I believe that.

I’ll tell you why I left and also answer some of the most commonly asked questions about my job as a PT.

Before I get started and answer these questions, it’s important to know that being a physical therapist was an incredibly rewarding and satisfying profession for me.

I loved it.

I wouldn’t trade that experience for anything.

My experience shaped me and made me better today as a person – and certainly as a strength coach and teacher of movement.

I worked in amazing clinics and I gained extremely valuable experiences through my years as a clinician.

And, frankly “I worked my ass off” for my education (but that’s another story and article, folks).

Something that no one will ever be able to take away from you is your education.

While I don’t practice in the clinic anymore, the education and experience I gained in that role will always influence how I approach training, performance, injury prevention and rehabilitation.

When I say rehabilitation now, I mean primarily my own.

I don’t “rehab” patients anymore, but I admit to having some minor injuries “here and there” through the years, even though I do everything humanly possible to prevent them. It happens.

Because of my background, I am an expert in rehabilitating myself when I need to.

I know exactly how to restore myself to full functional capacity and I know how to do it very quickly.

I guess that’s one of the perks of having the PT education and being able to put it into practice.

You see, injury-free and pain-free training is a primary long-term training goal for me.

Anyway, let’s talk about the common questions I’ve been asked about.

I’ll start from the top with the burning question everyone wants to know.

Why did I leave?

1-WHY DID I LEAVE PHYSICAL THERAPY? WHY AM I A “FORMER” PT?

This is really the big question, isn’t it?

Why did I leave the field of physical therapy when I actually loved my role as a clinician?

There are a couple of reasons why I left physical therapy.

The #1 reason was – burn out.

I was simply “burned out” in the clinic. I was fried.

In the final months, weeks and days, I was running on empty.

You might be thinking why was I so burned out? 

For almost the last 3 years that I spent in the clinic, I was slowly running myself into the ground.

While the clinic was great, it was largely about the numbers (meaning that I was required to treat a certain number of patients each day).

The clinic I worked in was a very high-volume orthopedic sports medicine clinic.

High-volume is the keyword here and I saw a lot of patients during the course of a typical day.

As time wore on, treating so many patients each day eventually lead to burnout as a clinician.

I’ll give you a more specific example of what I mean and the chaos I faced at times.

There were days when I would be doing a new patient evaluation and I’d also have multiple other patients that I was treating at the same time.

Now, keep in mind that a new patient evaluation requires your focus and full attention.

An “eval” is when you see the patient for the first time and do a comprehensive assessment and plan.

Trying to do this while working with potentially several other patients at the same time was tough, as you can probably imagine.

It was hectic and it was stressful.

This article doesn’t do justice to what it was really like in the clinic – you’d have to experience the situation to really understand the insanity.

Honestly, there were situations where it was challenging for me to give the high-quality standard of care that I demanded of myself. I always felt I provided high-quality care, but it was certainly challenging at times under the demands I faced.

That left me frustrated and disenchanted about what I was doing sometimes in the clinic.

It became a “numbers game” and I didn’t like it.

As with the lessons I teach here – quality is so much more important that quantity.

Funny how that rule applies to many things in life.

That’s the big reason why I left physical therapy, I was simply burned out.

This is not to say that this was the only reason, but it was a big one.

2-WHAT DID MY “TYPICAL” DAY LOOK LIKE?

As I just mentioned, the average day for me was treating several patients during the course of an 8 hour workday.  

16 to 20 patients per day was about average, sometimes more and sometimes less.

If you’re a clinician, then you know that’s a large number of patients to evaluate and treat on a daily basis.

You also have to factor in the number of new patient evaluations I did, which took much more time and more brain power, of course.

There were days that I had 5 to 6 patients (or more), in addition to my other returning patients. It could get crazy.

This doesn’t tell the whole story though.

There were always times during any given day where it was totally hectic and chaotic due to patient scheduling.

For example, I can remember many times when I was working with two, three, or more patients trying to give them my full attention and keep them moving along in their rehabilitation program.

Then suddenly, I’d hear my name called over the intercom system announcing that my new patient evaluation had just arrived (for your background: this new patient was supposed to be at the clinic some 2 hours earlier and now finally show’s up for their initial evaluation – this was not fun).

Again, a new patient evaluation is critically important because it was my opportunity to assess them as a patient and design a critical plan of care.

I was proud of my ability to provide a thorough patient evaluation and set an appropriate and individualized plan of care.

After all, that’s what make an effective PT – dare I say a great PT.

The “typical day” always kept me thinking and challenging myself to advance and progress treatment algorithms for the benefit of the patient.

Each and every day was dynamic and fluid with new patients and also advancing treatments with my patient caseloads.

Being in the environment I was in, I came to accept what the day had to bring – and then “roll with the punches” as best I could. 

One of the best things about the “typical day” was what I just described.

It was fluid and dynamic and always kept me thinking.

Essentially, there was no “typical day” because each day was so different.

3-WHAT ABOUT THE PROFESSION WAS NOT TAUGHT IN SCHOOL THAT YOU HAD TO LEARN ON THE JOB?

This is a very interesting question because my first job out of graduate school, I was basically running an outpatient clinic.

When I graduated PT school, I started out at a small private practice.

A few weeks in, I became “the” primary physical therapist at that clinic.

I had a physical therapy assistant (PTA) and an athletic trainer (ATC) working with me. I did all the “evals” and they helped me carry the load with the treatment plans and follow-ups.

It was great actually and it forced me to get up to speed very quickly.

But, if it hadn’t been for having outstanding mentors prior to this role, there’s no way in hell I could have ever done this (more in a minute).

PT school teaches you the basics.

PT school teaches you how to be a generalist. It really doesn’t prepare you for “real-world” experiences like this.

What really made a huge difference for me was the clinical internships during my 3 year graduate school education – having phenomenal experiences and incredible mentors throughout my internship process.

This was probably the first time that I realized the real significance of having great mentors in my life.

That’s because I never had mentors as an young trainer when I started out. I didn’t have a “guru” coach that I learned form.

But as a PT, I had a few mentors that were exceptional.

I also had a few that were not. The exceptional ones made the difference and made up for the few who were ‘subpar.’

Looking back, I would say that this was the most important thing to prepare me for coming out of school and facing the “real-world” as a practicing physical therapist.

They taught me how to think and critically evaluate, among so many other things.

A mentor can accelerate your learning faster than anything else.

4-WHAT MADE YOU HATE THE JOB AND EVENTUALLY LEAVE? COULD THAT HAVE BEEN PREVENTED?

I never hated the job.

I loved my job for the most part, but it burned me out.

Just like any job, there are good days and “not so good” days.

There were days I dreaded.

There were days that stressed me out and beat me down.

Those were the “not so good” days.

There were also some other things that could drive me a little nuts, as well.

Let’s face it, there were the good patients and there were the bad patients.

I definitely had a few bad patients through the years that I knew were going through physical therapy because they had to, not because they wanted to actually get better.

They were working the system. I won’t go there.

Let’s just say that the less motivated patient had a way of wearing on me.

Now, most of my memories of patients were great.

I had many outstanding and motivated people that I worked with.

There was nothing really that I hated about the job, but like any job there were things that I disliked at times. 

I’ve already talked about the stress and the chaos that I was dealing with in the clinic.

Could this have been prevented?

Well, if I had found another clinic to work in that didn’t operate in the high-volume capacity as the one I was working in, maybe that would have helped.

It’s a trade-off though.

The clinic I worked at, while it had some negative things,  it was also a state-of-the-art beautiful clinic.

It offered many opportunities to work with a great variety of orthopedic and post-operative patients.

I got to work with high school, college, semi-pro and professional athletes as well as a very diverse caseload of orthopedic conditions from the general population.

Overall, it was a great experience, but it sure wasn’t perfect.

5-WHY DID I DECIDE NOT TO MAINTAIN MY PT LICENSE?

This is a great question and I’m glad that it was asked.

I have NOT maintained my physical therapy license.

This was a mistake.

We cannot go back though.

However, I would certainly have kept my license active if I had a “do-over.”

I have debated this and looked into sitting for the board exam again – although it would be a ton of extra study time that I’m not sure how I’d manage at the moment.

I have not completely ruled out sitting for the boards again to earn my license back, but I would say it’s very unlikely (I say that now, but this could change tomorrow).

Never say never.

I haven’t been able to answer the question – “How would this help me accomplish my goals? How would it allow me to better serve?” 

Yes, it would be great to have my license and treat patients again in the clinical setting.

But, how I work with people now is what I had always envisioned as a physical therapist.

What do I mean by that?

When it comes down to it – I am a movement teacher, plain and simple.

I teach people how to move better so that they get stronger and improve performance – as safely as possible.

My goal is to empower people.

I’ve become much more of a movement teacher than I ever was as a practicing clinician, but a big part of that is the acquisition of knowledge through the years and the clarity of my philosophy.

I’ve learned a helluva lot since my days in practice.

One of the most rewarding things I did when I was in the clinic was teach the “Back School Clinic” for small groups.

I taught, I educated, and hopefully, I inspired those who attended to make changes and take control of their rehabilitative process.

I stood up in front of a group every so often and I discussed how to prevent back injuries. This was easy because I’m a back patient myself and I’m passionate about the topic (always will be).

What I’m trying to say is that being a teacher and being a coach is the greatest role that makes a difference in people’s lives.

At the moment, I don’t need my PT license to do that and my background and education will never fade away.

I will always look at things through the eye of a rehab professional. It’s a part of who I have become.

6-WHAT DO I MISS THE MOST?

I miss the great patients that I was fortunate to work with.

I miss “making a difference” in the rehabilitation process on an individual level.

I remember Linda, one of my “post-op” rotator cuff repair patients, who came to see me and couldn’t move her arm after surgery. When she was discharged from therapy with full active range of motion, normalized strength and nearly full return to function, it was rewarding beyond words.

There was Patrick (my “post-op” ACL patient and a football player) who lost range of motion in his knee joint and had his quads completely shut down following surgery. To know that I was a part in his return to sport the following season with full strength, mobility and function was incredibly fulfilling.

ACL rehab, in particular, is a long process and a long road to recovery. You spend quite a bit of time with your patients and get to know them very well.

There was Steve who came to see me with low back pain as a result of a suspected disc herniation and couldn’t move very well. After a few sessions, his pain resolved, he was moving significantly better and he much better understood the importance of body mechanics and positioning, as well as exercise, to prevent injury and restore his function.

Hopefully, I had empowered Steve for the rest of his life.

The interactions and treatment sessions made a difference for these individuals.

Improved strength, improved range of motion and return to function – that is impact and truly making objective and significant improvement in people’s lives.

I could go on, but it’s the individual impact (specific to rehab) that I miss the most.

The impact I have today is different.

Is it better?

It’s different.

CLOSING THOUGHTS

Do I regret leaving PT?

No.

Honestly, I do not.

The education and experience is truly what makes me different as a strength coach and movement teacher.

I will forever use that background, education and knowledge that I worked so hard to acquire.

One thing is certain, there’s a lot I would do differently if I were a clinician today – knowing what I have learned about strength, movement and human performance.

I think about that sometimes and what it would look like if I were still in the clinic.

I don’t think a lot has changed in the field since I left many years ago (the sad truth).

So, I think my approach would be considered very “contrarian” and unconventional from a PT perspective.

Would I recommend a career as a PT?

Yes, I absolutely would – if you’re willing to keep learning, keep growing and challenge the conventional wisdom that seems to put most clinicians on “cruise control” in their roles as physical therapists.

You must always learn, if you really care about what you’re doing.

I don’t care how much of an expert a person is – there is always something to learn and no individual knows it all.

Great coaches keep their ego in check.

The best coaches I know are student first. They are lifelong learners.

When you’re green, you’re growing and when you’re ripe, you rot.Click To Tweet

In my opinion, once you stop learning – your life is really over.

SIMPLE ADVICE FOR ASPIRING CLINICIANS

1-GET IN THE CLINIC

Volunteer your time and get in the clinic to see what it’s really like.

Observe.

Ask yourself – “Can I see myself doing this job? What do I love about it? What do I see that I may not like? What could I do different – and better? Am I willing to invest significantly in my education? Will this help me accomplish my professional goals?”

A lot to consider, I know.

To be a game-changer, you have to be willing to change the game. - Scott IardellaClick To Tweet

Talk to clinicians and find out their approach.

I told you how mentors make the difference, right?

Also, check out different settings (outpatient, inpatient, sports med, neuro, peds) to get different perspectives. You may know the area your interested in (orthopedics, for example), but I do believe it’s valuable to experience the different settings.

See different styles of treatment and always ask this question:

Why???

2-CONTINUE TO LEARN ABOUT MOVEMENT AND STRENGTH 

I recently wrote a major article about “the gap” in physical therapy and today’s game-changers – the hybrid coach in today’s rehab world.

They are few, but they are growing as this “new movement” gains momentum.

I think the one big thing what will separate future clinicians is their ability to integrate rehab with performance – to bridge these gaps.

This means doing more and learning more than what is expected of you in the PT curriculum.

To be a game-changer, you have to be willing to change the game.

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