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New grad physical therapy tips

Congratulations! You did it! You finally made it through school. You passed the boards! No more long lectures to sit through! No more papers to write! You finally know it all and are ready to venture out into the world of clinical practice and fix everyone!…..Or are you?….. This article will provide tips for new graduated physical therapists to help get you started in your career.

The Beginning of your Physical Therapy Career as a New Graduate

The reality is that school gives you a good broad knowledge base on a large breadth of information and allows you to succeed in hopefully not killing anyone. You will have a fair chance of figuring out what may be causing a patient

You were likely taught a variety of evaluation techniques that the newest research shows to be outdated or have very poor clinical utilization. In addition, you were likely taught a variety of treatment interventions that have poor reasoning behind them (METs to correct innominate torsion, cross friction massage to stimulate healing, mobilizations to relocate a fibro-adipose meniscoid in the cervical facet joints, etc, etc) or lack of any research to support their effectiveness (ultrasound, laser, spray and stretch, etc, etc).

Nonetheless, you have graduated and you are a freshly minted Doctor of Physical Therapy. You enter the next phase of you career feeling confident and hungry to fix the world. You get in the clinic and begin to treat patients for a few weeks and all the sudden you start to have the sinking realization that you feel a little lost and maybe aren’t as good of a clinician as you thought (we’ve all been there…. all of us).

Patients are so much more complex in the real world. They have a presentation that doesn’t seem to follow a pattern. They have several comorbid conditions that didn’t come up in class. All 17 special tests you are doing seem to be positive; or even worse they are all negative. You begin to miss school and how much simpler the days and patients were.

The common path new physical therapists’ take (and the mistakes they make)

You will have the tendency to treat physical therapy as a PRODUCT and not as a PROCESS; attempting to do something to “fix” people’s dysfunctions. The next step new grads usually take is to find the first continuing education course they can register for in order to teach them the magic trick to fix all the patients they have been struggling with. I’m sorry to let you know the new functional needlecupstymio taping course (note- needlecupstymio taping is now a common language word)  isn’t going to be quite what its marketer’s claim. This is the step that leads me to where I wanted to go with this post. I want to stress the importance of understanding that physical therapy and treatment should be a PROCESS not a PRODUCT.

There is no magic bullet that will be the secret ingredient you’ve been missing in treatment. Manual therapy (of any sort) can be helpful and a good adjunct to treatment as part of the entire process. However, it’s the confidence with which the practitioner applies the treatment and the patient’s perception of the treatment that makes it valuable as opposed to the inherent power of the super-secret tool box treatment itself. Interactions will always carry more power than specific techniques.

There isn’t a fancy movement screen that can pick up on the risk of injuries and dysfunctions in all of your patients. Again, a movement screen could possibly be a helpful addition to a comprehensive evaluation PROCESS for the purposes of giving the clinician a standardized way to look at global movement capacity of the patient and the presence of pain with certain movements. As a stand-alone our screens tend to fall short when tested for injury prediction in controlled trials. In fact, the founders of the FMS openly state this here on their website, but that doesn’t keep people from bastardizing their approach and claiming to be able to predict all sorts of injuries in virtually everyone they can get to complete the screen.

So at this point I’ve basically shot down approximately 96.54% of continuing education classes and you’re wondering what you’re supposed to do. I want to strongly encourage you to develop a plan for self-growth and education that revolves around building your critical thinking skills, gives you well-rounded and thorough examination skills, and improves your PROCESS. Seek an approach that helps you to coach patients through their rehabilitation by leading them down the path of the best evidence, providing realistic expectations, building relationships, and encourages patients.

Tips for new grad physical therapists – The 3 Biggest things you can do to succeed

Mentorship: Find a GOOD mentor. However, by mentor I don’t mean someone that can hold your hand through treating patients daily. Instead, a mentor should be a clinician that you can go to with your more difficult patients and someone that poses questions to you that encourage clinical thinking and growth. Mentors can be in person, on the phone, on skype, or even through Facebook. There are a plethora of outstanding clinicians that are putting out top notch content free for consumption. I consume loads of information from several different people and try to pick what makes the most sense from each one to build my own unique approach and identity as a clinician.

Read…as much as you can: Read both physical therapy and personal growth materials. Plug yourself into as much easy access info as possible. groups and people who post good solid info on a daily basis. Find these people and follow them like a fly on the wall for a little while. Then jump in and ask questions. Get into discussions about why they do what they do and what caused them to say what they said. Read about leadership, interpersonal relationships, what makes someone successful. Self-reflect on what you’ve read. Are you blowing through information but not applying it?

Consuming new information without reflection is like breathing air when you’re thirsty. Just because it has hydrogen and oxygen in it doesn’t mean it is going to quench the thirst you had. You need to convert the ingredients into a viable product before it will become useful and nourish the deficiency you had.

Finally, remember that you are human: You aren’t going to be the best clinician in your clinic, company, town, county, state, or region over night. Don’t get discouraged. Learning and becoming a master at your craft takes time and consistency; reading a little regularly; talking with people smarter than you regularly; going outside your comfort zone regularly. In fact, you will likely end up with far more questions than you started your journey with.

Trust the Process

Enter into the PROCESS of growing yourself. There is no PRODUCT you can buy to make yourself successful and no PRODUCT you can throw at your patients to fix them. Become comfortable with the processes and stay consistent. Develop critical thinking and a knowledge base in place of a “tool belt”. Grow your user manual not your list of tools.

Thanks for reading,

Jarod Hall, PT, DPT, CSCS

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4 Things I Wish I’d Known as a New PT Grad

New PT Grad Tip #1: Advocate for Yourself

You’ve got to advocate for yourself in the workplace. As new grads, so many PTs feel that they are on the lowest rung of the professional ladder, and they don’t deserve to ask for more. I certainly fell victim to this mindset, and looking back, I see how it led me into situations where I was asked to do more and more for less.

Don’t forget that you probably have more marketable skills than you realize:

  • Can you treat patients in another language?
  • Do you have business experience that you can use to help improve your company’s marketing and bottom line?
  • Are you a certified yoga teacher or strength coach who can offer group wellness classes as a continuum of care for discharged patients?

You can leverage this type of expertise to help you feel more confident asking prospective employers for more than the bare minimum.

Remember that “asking for more” isn’t necessarily just referencing a wage increase.

Many potential employers, particularly in small private practices, have limited ability to significantly raise salaries. But! They may be able to improve compensation in other ways, such as allowing more schedule flexibility or setting up profit-sharing for additional income you bring in (think: Teaching a weekly Pilates class in the clinic, performing cash-pay home or worksite visits to help patients with ergonomics, etc.).

You’ll never know if you don’t ask!

New PT Grad Tip #2: Admit You Don’t Know

It’s okay to say “I don’t know.”

This was one of the hardest things for me to learn in the early days of my career.

After all, when we walk into clinic for the first time with that shiny new DPT after our names, we all want to look as confident as the title “Doctor” implies we ought to be.

Unfortunately, despite all the studying and fact-cramming we do as DPT students, none of us know everything when we graduate.

And, I’ll let you in on a little secret: Ask any experienced clinician worth their salt, and they’ll tell you that they still don’t know the right answer to every clinical situation, no matter many years of experience they have.

To this day, I distinctly remember one of my clinical instructors telling me that the ability to respond to a patient’s questions with “I don’t know” is a marker of a seasoned, thoughtful clinician. The key to confidently admitting to a patient that you don’t know the answer is how you qualify that statement.

Here are a few of my favorite follow-ups:

  • “I don’t know, but I’m going to do some research and find out.”
  • “I don’t know for sure, but let’s find the answer together.”
  • “I don’t know, but I have a co-worker/colleague/other provider I trust who can help us.”

New PT Grad Tip #3: Change is OK

As the popularity of residency and fellowship programs rises, and as more and more PTs dive into niche areas of practice (1), there seems to be a growing sense among new grads that one has to know exactly the specialty they want to pursue even before they cross the stage at graduation.

If this sounds like you, I have some news: It’s okay to change your mind, to branch out and try a variety of settings.

While many PTs settle into one specialty area, there’s no law saying you have to stay in that specialty forever.

I’m a great example! I rolled right into an orthopedic residency after graduation and went on to earn my OCS. When I finished my residency, I started working at another outpatient orthopedic clinic, but I made my dual interest in pelvic health clear from the beginning. Thankfully, my clinic supported me in the development of a pelvic health caseload.

About a year ago, I began feeling that I was in a professional rut. So, I made the decision to transition to telehealth PT with a new company.

Though I’m still using my orthopedic brain in this setting, there are a whole lot of new processes to learn and differences to embrace in my new setting. In some ways, I’m starting fresh!

New PT Grad Tip #4: Branch Beyond Clinical Care

Earning your doctorate in physical therapy doesn’t mean that treating patients is the only thing you can do in your professional life. In fact, for many of us, grinding out months of back-to-back patient care days with no disruption or variety is a recipe for burnout. (2) The last thing most of us want is to find ourselves exhausted and jaded just a year or two into clinical practice, questioning why we spent all that time and money getting our degrees in the first place.

As it turns out, the old adage “variety is the spice of life” has more than a little truth to it. The options for adding some diversity to your professional duties are more numerous than you might imagine, even as a new grad.

Here are just a few ideas to get the wheels turning:

  • Rather than taking one full-time job, consider two part-time gigs in different clinical settings. This will diversify your resume, let you experiment to learn which settings you enjoy most, and help you build a wide knowledge base.
  • Gain some business experience (or leverage a business background you already have): Some knowledge of marketing, finance, or other basic business skills can go a long way in the world of healthcare, since most DPT programs include only the bare minimum of business or practice management content. (3) Plus, taking off your therapist hat and putting on the business one is a great chance to challenge your brain in a different way.
  • If you enjoy teaching, partner with other providers and/or wellness professionals in your area to offer community classes on topics that interest you. From fall prevention to workplace ergonomics to common causes of low back pain in recreational athletes – the possibilities are endless!

While the first years in any career are filled with successes and challenges, the process of learning and exploring in that time can be fun and rewarding. With any luck, these ideas will help you enjoy the ride!