Perhaps one of my biggest pet peeves in western educational systems is the lack of career guidance and preparation. I feel in professional, graduate programs - there have been more improvements. Nevertheless, it's always helpful to hear from someone who "was just there" - in a manner of speaking.
For the purpose of this post, I will be delivering all content in reference & address to the newly licensed physical therapist with their shiny (and very expensive) Doctor of Physical Therapy degree. In this post, I make some pointed comments regarding some views of the DPT degree, and, want to express that I hold such comments on the VIEWS, not upon those who hold such views. Finally, I want to thank you in advanced for being patient with this post of generous length. I do hope that you find this helpful in your career path.
New Grad Career Strategies for Physical Therapists
In my opinion, there are three basic career strategies for the new graduate #DPTStudent:
- Make Money!
- Go Into Business
- Get REAAAALLY Clinical
1. Make Money!
Face it. You have loans. We ALL have loans. Whether its student loans, loans for a home, car, and/or other - modern economy is a debt/credit based economy.... LOANS are a part of life. The student loans you have sum to a small fortune which in all reality, makes for a physical therapist's license (the right to work) and a little "D-Envy" for your undergraduate peers. Without going into what the "doctor" means in the life of a physical therapist, ECONOMICALLY, you are in a market position where many employers think that:
- You really don't know that much since you are a "new grad"
- They shouldn't pay you all that much since you still learning as a "new grad"
- Since you have zero experience, there is no where else you can go for work to pay off said student loans and they can bully you into accepting a position for terrible pay.
I don't know about you, but THAT... is a sucky deal.
Besides... "they" are WRONG. There are several segments of work that pay VERY well and offer you the exposure & experiences which will raise your market equity as a physical therapist. Home health agencies, contract work for skilled nursing facilities, general registry companies, and, travel agencies (pay the most!) all tend to have pay which is immensely superior to the common 40 hr a week acute care, acute rehab, pediatric, and/or outpatient gig. In fact, the pay grade at such aforementioned companies tend to be comparable to time-and-a-half of the typical entry-level pay for larger health system positions.
Given that in late spring of 2013, rehab therapists in Southern California have earnings ranging from $33/hr to mid $40's/hr with 20+ year clinicians asking for $50/hr, working at as an entry-level-traveler for $45+/hr certainly sounds more worthy of a pay grade for you, doesn't it, doctor?
The reality is, to make money: work for someone who values your labor, NOT your education.
2. Go Into Business
I've had a range of shocking, infuriating, depressing, enlightening, saddening, and encouraging revelations when speaking with healthcare administrators, executives, and leaders in regards to physical therapists contributing at the corporate scale in healthcare. While they fully understand the scope of knowledge, training, and abilities required of a physical therapist, nearly all have communicated that the healthcare market simply does not see physical therapists as healthcare leaders. Why? Because "you're therapists...you're not a nurse... you're not a physician."
The inference is this: a physical therapist's background is insufficient to understand the breadth of human health the way a nurse or physician would. In fact, there are still segments of the market that esteem that physical therapists know muscles and movements but generally know nothing about medicine. Therefore, we would prove poor candidates to serve as a hospital administrator - say for example, the chief operations officer of an acute care hospital.
That's poppycock. POPPYCOCK, I say!
This is a MASSIVE market perception problem that we've carved for ourselves during the various evolutions of our profession. There is a hope, however. To rise in the chain of command in a corporate health system; to get into hospital operations; even to own your own clinic and be held respected by your investors/stakeholders, etc... EVERYONE RESPECTS STRONG BUSINESS SENSE.
Solution: Get Into Business!
If you look at the physical therapists who have risen the ranks to health system leadership, nearly all of them have some type of business background or adjunct degree. Whether it is an MBA, MPH, MHA, etc. - this additional academia positions the individual as one who is "not just a clinician"; this person has business potential! And, business means money - money means leadership.
Unfortunately, it's not that simple. As I mentioned in #1 "Make Money!" - you're a new grad. Say you apply for a job as a new grad DPT, MBA. And, let's be honest here, the respect level for you will still on the shallow end of the dream pool because of cultural barriers in the workplace inclusive of jealousy, insecurity, lack of faith/trust in your freshness... whatever it may be, just remember, it's a "sucky deal" (SEE ABOVE). But, guess what? ALL entry-level-professionals have to pay their dues and climb the totem pole. It is ALWAYS a sucky deal for new-comers. Junior associates for law firms and fellows under training from senior physicians... they all have to pay their dues.
My best advice: Get into a place; get really good; get supremely liked... loved even, by your co-workers & C-level-executives; and... LEAVE.
From what I've seen, it is very difficult for new-hire, new-grads to be seen as anything but a new-grad for the entirety of their tenure at any employment. It's even worse when new-grads have worked as rehab aides as prior employment. Earning your stripes quickly for an employment and leaving is the best way to demonstrate your worth on a CV, with your references, and with the company. The funny thing about human nature: people tend to miss you (and value you) when you are gone.
With that, you are able to better position yourself as an "experienced clinician" to another employer. This is a quick way of rising the chain of command at other ventures. This may also leave an open door at your prior employment to return as a higher ranked employee, maybe even return as a manager. In any case, I would suggest that to take this route, find a really good place to learn from and grow. Once you've reached the ceiling, its time to move on.
Also, if you have any aspirations in business operations or healthcare administration, start looking into online programs. Honestly, its probably the best hope you have of realistically making a difference at the corporate health system level as a physical therapist. Hopefully, over time, this perception of the physical therapist will change. Maybe, we will even see an ending of the in-fighting and intra-professional "D-envy" or even "D-hate" that is sadly still very evident in the workplace today - forcing us to climb the ladder with only one good hand.
3. Get REAAAALLY Clinical
And, I do mean, REALLY clinical and credentialed. I encourage you to get your board certified specialty, get your MDT credentialing, or FMS/SFMA, or additional certification in manual therapy, spinal manipulation, dry needling, NDT, PNF... anything and everything goes!
Go for a residency so you can get that OCS in a year's time. Invest in fellowship training. Even get a Ph.D. if you wish! Regardless of what your perceptions or your colleague's perceptions are of alphabet soup credentials - it still says something to the consumer when a practitioner has a list of credentials for which they could write Shakespearean prose. Many of these credentials represent weeks, months, and years of post-graduate training. And sure, there is no guarantee that a slew of credentials makes you any better of a practitioner - BUT - here's the thing... career = business & marketing position = level of demand. *WE* in the physical therapy world know what most credentials are and mean. The consumer may not. However, consumers can certainly see alphabet soup and can infer for themselves the level of value. Finally, while your first employer may not value (see #2 "Get Into Business) the fact that you are an OCS, Cert. MDT, FMS/SFMA, FAAOMPT within 3 years time & after you LEAVE... let me tell you, your NEXT employer will absolutely care!
When you reach 3-5 years of experience and you come to me with all the above credentials, dry needling background, credentialing in NDT, PNF, DNS, wound care, etc. and more - I WILL HIRE YOU - AND - I will try to find a way to make you a clinical educator; a veritable teacher of teachers.
Now while I've harped on negative view points of the DPT, the same criticism goes for any potential scenarios that would present should the DPT had been a PhD, PhDPT, DPTSC, DScPT, ScD, ... it really doesn't matter what the degree is. What I feel is truly a workplace travesty exists in the disdain, harassment, belittling, and under-valuing of new graduates. In the same vein, I have no tolerance for new graduates, regardless of time/era/degree coming out of school - waving a diploma with a superiority complex. ESPECIALLY in the world of social media, there are colleagues who I consider so highly that I do not feel that it is within my professional lifetime to achieve the levels of expertise that they have achieved. Their years of experience and a legendary era of training have yielded a smooth operator of human function that is likely to become a lost art in the coming years. However, I've also encountered their chronological counter-parts where I've sat in continuing education courses for medical screening by which the term "deer-in-headlights" couldn't begin to encompass how lost they were in current times.
I suppose my angst in this post is truly directed at intra-professional degradation. Physical rehab professionals are the only group in healthcare that I see overtly bash on their new colleagues for graduating with shiny degrees. So many other professions couldn't be happier that their new-grad-colleagues are receiving higher degrees that more accurately reflect where the profession has been, should be, and is going to be. However, our profession seems to have tolerance to those who behave from the view point that "doctor" is giving new-grads far more credit than they deserve.
Now, more likely than not, if you are reading this post, you simply don't hold these negative views in any array or permutation. Therefore, what I do ask of you is to stand up in defense of professional unity; rebuke & restrain those who take negative light to the new-grads who represent our future and the general future of healthcare & society at large.
UNIFORMITY IS THE FACE OF FAVORABLE CONSUMER PERCEPTION.
The profession must advance & we can only advance together. And with that, I leave you until next time in which I have plans on blogging about my first month as a rehab director as well as creating value through content marketing.
With the Most Sincere, Respectful Regards as Yours in Humbly Service,
Great article Ben. Thanks for the career adviceReplyDelete
It's my pleasure! I have a great deal of passion for students and new-grads for which the future relies upon.Delete
I'm glad to be of sound encouragement & of help.
Thank you for the post Dr. Fung. I graduated on May 18th with a DPT from the University of Hartford in CT, and am currently studying for the NPTE and job hunting. I wanted to get our opinion about two topics:ReplyDelete
1. Do you have any advice on salary negotiation?
2. What is the official ruling on placing the "DR" infront of our names after receiving a DPT?
My take is that chiro's go to school for less time than we do and everyone refers to them as doctors, and dentists are doctors of dental medicine or dental science and we all call them doctors. We are doctors of physical therapy so I do not see why we cannot place the "DR" infront of our names. I am just curious if there is a ruling by the APTA or what other practicing DPT's think.
Thank you again for the post, it was very helpful.
Dr. Adams, Let me answer these questions backwards:ReplyDelete
2) I haven't looked into the APTA's stance on the title of "doctor". My understanding is that this is a state-by-state issue. In CA, one can refer to oneself as doctor no problem; so long as that reflects your academic achievement. However, the claim must also clarify that the doctor title is/is not congruent with being a medical doctor if you are not actually a physician.
Personally, I think all health professionals achieving the doctorate level of study should publicly refer to themselves and each other as "doctor" - as they have certainly earned it. The challenge is where/when in our profession's cultural life-cycle to employ such a movement for change.
The largest challenge of this is that most employers that favor the "experienced", tend to hire more non-DPT graduates. These cultures tend to be quite hostile to the DPT itself, just as it was to the MSPT when the masters level clinicians first came out.
Solutions? Simply don't go to such employers for work. You could imagine if an entire generation of DPT new grads entered the market, refusing to work for any place that degraded the education and/or under-valued/behaved hostile to it. This generation would single-handedly change the employment market for physical therapists at large.
That's my "extreme" case - but you get the point on that. In the end, it's all legal which means it's all about the practice act in the state you are licensed in.
1) Salary negotiation is fairly standard for any job market. You high-ball, the employer low-balls, whoever is more desperate will yield to the less desperate.
The key to this is similar to that of #2; don't settle for anything you don't like.
It may be a little naive of an approach but the bottom line is this: clinics/hospitals/facilities/agencies ALL need a certain equilibrium of labor hours found in their therapists.
If an entire wave of therapists refuse to work for companies that don't respect their education and the worth of their labor, these companies will eventually lose market positioning because they cannot fork out the demand placed upon them by patients/insurance companies/the government.
While all the new grads move on to companies that respect the education and honor the person of the new-grad (rather than make cultural assumptions that new-grads-know-nothing), these companies will thrive due to a plentiful flow of labor hours, collaborative organization culture, and the massing of like-minded, forward-thinking practitioners - yielding better outcomes, better workplace environments, and better patient care experiences.
In my humble opinion (and certainly no disrespect to the seasoned clinicians of the R/BS/MSPT era), the best way to advocate for the value, worth, and market perception of the DPT is with your labor hours. When this is done, the DPT's will be given the respect that I, personally, feel it deserves. Additionally, much like in nursing, new employees hired in with advanced degrees will then hopefully be given a hire-in bonus and/or elevated pay-grade to reflect on the level of education/training. Of course, this will all disappear once the population of physical therapists have demographically reached a DPT majority.
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