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Not a Perfect Clinician? That's OK.

by Savannah Smith, PT, DPT

I was recently reading the article “I Failed a Physical Therapy Practical. It made me a better PT.” by Julie McGee. The article resonated with me as a new grad physical therapist. I have been tempted by the desire to be a perfect student and a perfect clinician.

I will totally agree that PT school is like drinking from a firehose, and you are trying to just keep your head above water the entire time - you feel like you’re never really catching up. I will also agree that physical therapy school is tough and challenging, but not in a calculus question kind of way.

I know that for me, a "B" is NOT for “balance.” A "B" is for “breakdown,” meaning I’m going to have a nervous breakdown because I didn’t get that A. Eric Cressey just wrote a blog piece, “The Success is in the Struggle,” and it made me think about the parallels of life during PT school and life as a practicing clinician in the workforce.

Provide empathy for patients, and demonstrate the hands-on skills that we were taught just weeks before. We are graded by our professors on our performance. Afterward, our professors express what we could have done differently and what could be improved upon.

Will we sometimes get unsatisfactory ratings by our patients? Maybe – But that’s life. As much as we want to please all of our patients and help them get back to 100% of their previous level of function, in reality that's an unrealistic expectation that will ultimately lead to disappointment.

Did you get a 100% on every single practical or test in PT school? No. And as Eric put it, the “success is in the struggle.” Julie may have failed a PT practical, but she learned valuable lessons after it that prepared her for where she is now. Failure is a part of life, and is not an end-all-be-all. In fact, failure is an opportunity to look at your mistakes and learn from them.

If I get an unsatisfactory rating from a patient, I will take that feedback and try to find ways to improve.

  • Did I give them enough of my time?
  • Did I help relieve their pain to the best of my ability?
  • Did I listen carefully and express that I was present during our treatments?
  • Did I refer out if/when appropriate?

During our careers, we will be subject to performance reviews, where we will need to be open to constructive criticism. My advice to you is don’t think of this kind of feedback as failure. Take it from someone who hated feedback in the beginning of school and thought I would fail if I didn’t do something 100% correctly.

I now believe this type of criticism is a way to show the “blind spots” that you yourself can’t see. Take these blind spots and improve yourself! We all have weaknesses and may be struggling in certain areas, but take these weaknesses and make them strengths. You will be a better physical therapist because of it.

At my current job, I am surrounded by fellows or fellows-in-training. As a new graduate, I often feel like a fish out of water, or in my earlier analogy, like I’m drinking from a firehouse.

  • Why don’t I know this manual technique that this PT is doing?
  • How do the fellows know so much?
  • Uh oh...a patient has numbness and tingling down both legs?

The PT student in me 3 years ago would have run from these issues, but now I ask for guidance.

I can’t even count on my hands how many times I have asked my colleagues for advice about certain patients or asked them how to do a certain manual therapy technique. I know my weaknesses, and I put them fully on the table to my clinic manager before I started. However, my strengths outweighed my weakness and here I am today.

As Julie said, “Just like asking a professor for help, it is best to be clear what your needs are.” Know your needs, know you are human and you are not a failure, and know you are a great PT. It is vital that we all recognize that the learning process never ends.

This message is not just for the new graduates and PT students out there either. This is for the seasoned vets, as well. Our profession is constantly changing, and I would make sure you keep up with the latest research and literature, as it is transforming what we as physical therapists do.

Some experienced PTs become stuck in their ways and are not willing to change, or they don’t ask for feedback at all. I had a conversation with my clinic manager just yesterday about this topic.

I also had this exact conversation with the Pittsburgh Pirates physical therapist as well. I asked him, “So what does a Major League Baseball team look for when hiring a new PT?” He said it is often hard to bring in a person with 10+ years’ experience because they are so used to doing things a certain way, and in the world of baseball, this is a huge turn off.

Some teams have started to add new graduates or post-residency trained physical therapists onto their staff for this exact reason. I don’t want to speak for all new graduates, but generally speaking we are willing to jump right in and be a “sponge”. We are hungry to learn, and are willing to change the status quo.

My advice whether you have been practicing for a long time or whether you have just graduated – Be willing to change and ask for feedback from your coworkers, mentors, professors, or even your classmates.

So to wrap up, don’t be complacent in where you are at right now. It's OK if you're not a perfect clinician, but you should always be improving your skills. If you are in a clinic where they are still treating people with modalities and hot packs – RUN. Run as fast as you can because you are not using the skills that you spent 3+ years learning. And lastly, seek constructive criticism. Seek failure. It gives you a look at your weaknesses, and you will grow to become stronger because of it.

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