I Took The Wrong Physical Therapy Job: What I learned

You’ve successfully aced all your exams, passed your practicals, completed your clinicals, and rocked the NPTE- congratulations! You are now a board-certified physical therapist ready to frame that hard-earned doctorate degree and begin interviewing for jobs to finally enter the workforce as a newly licensed clinician. It’s an exciting, albeit nerve-wracking time, as you want to find the best possible position as a new grad to begin treating independently and autonomously, gain experience, and jumpstart your clinical career

Much like how I navigated the waters of PT school, I delved into job hunting with a carefully calculated plan in mind. I searched job boards regularly, checked for listings on hospital and clinic websites, and reached out to my network of professors, clinical instructors, and friends. Within a few weeks, I completed three interviews and received job offers. One of the employers who offered me a position required a response back in less than a week, so I had to decide quickly which job I wanted to accept.

What I Did

From my interviews, I gathered as much information relating to each job as I could and took notes during the interviews to keep track of it all. Through much contemplation, I thoroughly weighed the pros and cons of each position to help me make the best possible decision. These included things like:

What Happened

The last thing I wanted to do was take a job only to find that I hated it a few weeks or months in. I was excited to begin my professional career and as someone who likes to make careful, well-informed decisions, I wanted to make sure I made the right choice when accepting my first job.

I decided to accept the job as a physical therapist for a subacute rehabilitation facility. Throughout my clinical affiliations, my two outpatient rotations consisted of thirteen-hour days which exhausted me. I enjoyed my subacute rehab rotation (at a different facility) as having consistent eight-hour days allowed me to have a regular schedule and a better work-life balance. I had ample time to study for the NPTE, work part-time, and work out at the gym most days, and enjoyed the flexibility and balance between work and other pursuits.I was also very inspired by some of the patients I worked with during my subacute rotation as it was rewarding to see patients progress from being quite dependent and requiring substantial assistance to making great strides in mobility and functional status upon discharge.

While I had my fair share of lengthy commutes for my rotations, up to an hour and a half away battling rush hour traffic, this job site was no more than fifteen minutes away and required me to take no highways, meaning a very low likelihood of driving delays. Health insurance coverage was good, paid time off and a 401k plan were available, and salary was in the middle range for starting pay for new grads. There was a team of 10-15 physical and occupational therapists that worked together between full time and per diem staff. This was important to me as two of my clinical affiliations were at private practices and the only therapists consisted of my clinical instructor and myself. I learned that I enjoyed having more coworkers to collaborate with and bounce ideas off of, as well as sought a greater diversity of colleagues to learn from as a burgeoning PT. Productivity standards were also on the lower end compared to busier outpatient practices, which was another important aspect to me as I wanted adequate time to provide quality care. Everything seemed to be pointing in the right direction. I accepted the offer and was very excited to start.

Multiple professors and clinical instructors advised me to give myself a time frame of three months to adjust to my new job, and I would agree that this is a fair amount of time to adjust to a new environment, regulate a routine, begin to develop stronger relationships with coworkers, and gain comfort and confidence in your role. But after three months passed and the initial stressors of all the newness dissipated, I found myself stressed and unsatisfied at work and that my first job was anticlimactic compared to what I had envisioned.

Since the focus of subacute rehabilitation is to get patients safe and well enough to go home, my treatment sessions largely consisted of bed mobility, transfers, and gait and stair training. Despite varying diagnoses and conditions, every patient’s treatment session became rather repetitive. I sought variety, wanted to progress interventions, and craved new learning experiences, but every day felt routine, and the way that therapy services operated left little room for creativity. It was discouraging that the company provided no continuing education reimbursement, and there was little recognition for individual workplace contribution.

I was also hopeful, eager, and motivated to help patients get better, but frequently encountered apathy, resistance, and hostility from patients who often refused to be seen for therapy. This not only struck down my personal workplace satisfaction by limiting my ability to be an effective therapist to help patients get better, but also caused further complications for not only myself but for all the other therapists as well. Family members would criticize for lack of meaningful progress when patients refused to participate, and the director of rehabilitation was concerned when we did not meet expected productivity for the week, despite aspects outside of our control. If patients refused to be seen for physical therapy, it was advised that we rearrange our schedules to clock out early to make up for the missed patients.

What I Changed

I wanted to be a good physical therapist that I spent so much time studying and training for, but I felt that my work environment stifled my potential. I was regularly stressed having to fight and plead with patients to be seen for treatment, and despite having extra time to pursue other things outside of work, I felt emotionally and mentally drained that I accomplished very little. This was not the future I imagined.

I began searching for job listings and reaching out to anyone and everyone in my physical therapy network while trying to stay patient and hopeful. Most days were struggling to get through, and job postings were sparse as the winter holidays were approaching. After two months of job searching, I found an opening for an outpatient position that interested me and applied. Luckily, I heard back in a timely manner, progressed throughout a three-step interview process, and was offered a new job! I made sure to avoid talking about my dissatisfaction in the interviewing process and instead focus on my areas of fulfillment that I hoped a new position would satisfy. It was clear that my personality, ambitions, and goals did not align with the work environment I was in, and despite warnings from colleagues that switching jobs so early on was unwise, I knew that a setting change would not only be in my best interest but also in the best interest of the company that I would be working for. I wanted to help, I wanted to learn, and I wanted to make a difference in the lives of those who were willingly and voluntarily seeking treatment. I listened to my gut and changed jobs only six months after taking my first job as a new grad.

On the first day of my new job, I was greeted with a stack of company business cards with my name and license number on it. I immediately felt more respected in my role, and as learning and enhancing my skills were things I emphasized in my interview, the clinic director set aside one hour every week in my beginning months of employment to discuss patient cases, review areas I needed guidance with, and develop plans together to optimize patient care. The company also offers a generous continuing education stipend, and I feel recognized for the work that I do to contribute to a successfully operating clinic and achieve successful patient outcomes.

Advice

My advice to any new grad looking for his or her first job is to carefully consider your options, but even if you fall into a situation like I had, don’t settle or feel bad about changing jobs, especially if you are considering changing settings. Give yourself adequate time to acclimate to taking on the responsibility of being a full time therapist, but if the job isn’t serving you, find some place else that will. It is also important to remember that no one job is the “right” job as I had mistakenly believed. There are multiple options and good fits out there, and knowing that there is more than one good choice will help decrease the stress of making a decision. You may also find that you like a certain setting, but not enough to work there full time. Picking up extra hours per diem outside of full time employment is another way to keep your options open or to get the best of both worlds if you enjoy multiple settings.

No job will be perfect; I made a trade off for a longer commute, larger caseload, and inconsistent hours that ran very early or very late as well as reluctantly agreed to work some thirteen-hour days once again, but my stress levels have decreased significantly and I find myself much more satisfied in the work that I do and the knowledge and skills I am acquiring. It’s important to continually reassess as our needs can change, so the job that might be a good fit for you now may not suit your needs in the future. Every opportunity is a learning experience that helps you define what is important to you and aligns with your goals, so don’t be afraid to try things out and see what does and doesn’t work for you!

Now that we've learned a thing or two, let's take a quiz to find out which PT setting is the best fit! Take the quiz here: