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Don't Accept Your First Physical Therapy Job Without Reading This

by Steve Thompson, MPT


Over the past 15+ years of running a PT clinic, I have seen my fair share of young PT students and new graduates looking for their first physical therapy jobs.

Some have accepted our offers, while others have graciously declined, instead taking jobs that seemed sexier, with higher pay and better benefits.

When a new graduate begins the search for their first job, often they come in and ask very standard questions, such as “what kind of benefits do you offer?” or “what is a typical day like for a treating therapist?”

Understandably, if this is their first foray into the workplace, they are often inexperienced in how to act in an interview and what kind of questions to ask. In this article, I hope to open the eyes of many new prospects to learn to ask the tough, but important questions. This is a big decision for you and you should make sure you are making the best decision for your future.

Know what you want from your first physical therapy job

I understand that most students may have a very limited background of experiences in the field of physical therapy. Those experiences may be solely based on the 3-4 clinical internships provided by their PT school. Some graduates know what type of field in which they want to practice, and many are not sure. Not having clarity on what you want to do can lead you to make a reactive, bad decision.

The field of physical therapy offers a wide variety of choices and paths to follow once a student graduates. One can choose orthopedics, acute care, rehab, or pediatrics, along with many other iterations of these paths. To complicate matters, the PT schools are may only offer a limited scope of experiences in these areas, because of the limited number of sites available, and the highly competitive space for schools to fight for placements of their students.

But not everyone knows what they want when they graduate, much less before they begin school.

Here are some thought-provoking questions to help you get clarity and to know what you want:

  1. “What type of patients did I really enjoy working with during my physical therapy clinical affiliations?”
    Did you enjoy athletes? Were the elderly more fun to work with? Did you really enjoy the challenge of a neuro rehab setting? Be very clear about the patients because if you are energized by your patients, you will want to work with them day in and day out. If you didn’t like working with work comp patients, then ask that question of the interviewer – how many work comp patients do you work with?
  2. “Do I want to be surrounded by experienced PTs, or am I ok working by myself?”
    If you don’t want to work alone, I recommend not falling for the lure of the money in home health or skilled nursing, or in a solo practitioner orthopedic practice. Ask the question of your interviewer – does the staff regularly interact with each other, both inside and outside of work?
  3. “What is one thing that I will not sacrifice or compromise on when deciding where I want to work?”
    Maybe you want mentoring. Maybe you want benefits. Maybe you want education benefits. Maybe you want healthy work-life balance. Think about what is THE most important thing you want above all other offers, including money.

By becoming more aware of what motivated you, excited you, frustrated you, and stunted your learning during your clinicals, you can get clear on the type of facility you want to work in. Also, as you embark on your career, by being clear and knowing what type of place you want to work will help you realize right away where you want to work. And the questions you ask of your prospective employer could be shaped by these experiences.

The lure of the almighty dollar - money isn't everything in your first physical therapy job

I have seen my fair share of students tell me that our clinic was everything they were looking for in a job, but they elected to take a job that was nowhere close to where their passions lie. Often these students get lured into higher paying, impressive benefit offers in a SNF or home health role, not knowing that they have just crossed the point of no return in their career.

I recently had a father reach out to me inquiring if PT school was worth the investment (note the word investment, not cost) for his daughter who was considering PT as a career. My response to him was, “it depends.”

If a student is passionate about helping other people recover from injuries, restoring function and mobility to someone injured and being able to give that patient their life back, then yes, it is worth the investment and more.

There were several people in my PT school class (ages ago) that left the profession to venture into new professions. Remember, that loan payment follows you, regardless of whether you practice as a PT or not.

So, back to the topic of the almighty dollar. My suggestion to all new grads is to ask yourself what are you passionate about. Also, are you willing to put your passion and desire to work in a profession that you absolutely love, and may have to continue the life of a student (eating Top Ramen) a bit longer in exchange for the true reward of doing what you love ahead of the lure of the higher pay? Some of the most successful PTs that I know initially took a lesser paying first job but worked in a clinic that provided mentorship, growth, and opportunity in the future, trading hard work and desire for the comfort of money to become amazing PTs.

Whereas the most disgruntled, miserable PTs I know started out taking a higher salary, better benefits, and were “sold” on opportunities as a prospective for their employment, choosing pay over passion. These PTs most likely are the ones that will ask me right off the bat in an interview, “how much does the job pay?” and their resume speaks volumes of multiple jobs with short tenures.

I won’t touch these PTs with a 10 foot pole!

Ask the tough questions

When you are presented with an array of job offers with varying salaries, you must ask yourself, “why are these salaries so different?” Really think about this, especially if the jobs are in the same practice setting/industry, such as outpatient orthopedics.

Most likely, that clinic has a high turnover rate of therapists, so they HAVE to offer a better salary because their working conditions are so poor.

When you are considering a clinic to start your career, here are some questions to ask of your prospective employer:

  1. “What are the demands and expectations of this position?”
    Will you be required to see 16-20 patients a day, without aide or tech support, and no time dedicated to documentation? Will you be required to market to doctors yourself? Will vacation time increase with longevity, and will you be able to take longer than 1 week at a time? The answer to these questions will depend on your willingness to work hard and maybe sacrifice work-life balance.
  2. “Why are you hiring at this time?”
    The answer to this question will tell you if a site is growing or struggling. If an owner or clinic director tells you that business has increased x% in the last 3 months and everyone is working at 100% capacity, you can deduce that the clinic is hiring due to growth demands. If the answer is because 3 PTs have left in the 3 months, there might be a problem.
  3. “How would your staff describe the culture and atmosphere here?”
    Be aware of canned responses such as, “we have a great working environment here! Lots of autonomy! Lots of opportunity to grow!” Ask for specific examples of each and then if you have the opportunity to talk to staff, ask them the same question. If you get different responses and there is any pause before responding, think twice. Yet, if the clinic director or owner uses a lot of emotive descriptors, and offers for you to ask the staff the same question, he/she has nothing to hide.
  4. “How many physical therapists have you hired in the last year and how many have left?”
    Again, look for the pause in the response or discomfort in stating the answer. This is a sure sign of either a mass exodus that has occurred or this may not be a good fit. If the clinic or owner smiles and freely shares that “yes, two PTs have left”, ask why. If the PTs left and moved out of the area, or they had major life changes, such as having children and wishing to be stay-at-home parents, there may be a legit reason for hiring.
  5. “What growth opportunities do you offer, and who may I speak to here that has taken advantage of these opportunities?”
    I like this question because if digs into what your future might be like. If the clinic or owner cannot supply an answer, more than likely you will always be a staff PT. If some of the staff have taken on new roles or become clinic directors, then there is an upward growth track.
  6. “Will I have the opportunity to meet with the staff and interview them?”
    I always shake my head when candidates tell me that other interviews lasted about 15 minutes and they only met with the owner. Now if this is a solo practitioner office, then that makes sense, but at least ask to speak to the receptionist or office manager, aides, etc. Remember, when you are applying for your next job, you will have to work with other people, so you have to know what working with them will be like.

Hopefully, this article shed some light on how to pull back the curtain on your prospective employer to really know what is behind an offer. Don’t be shy when seeking clarification on the offer. Don’t worry that you might offend your next potential employer by digging into the offer. Realize that you are just seeking clarity on what type of job you will be accepting, and if you get shortness or hostility or demand of an answer, you might have a clue that this potential boss does not like to be challenged and does not respect you for what you are – a potentially amazing PT!

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