Talking PT with Dr. E

Dr. Erson Religioso and I had an awesome Google Hangout yesterday. Check out the blog entry at: The Manual Therapist!

And, of course, the video below:

New Grad Career Strategies

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:

1. Make Money!
2. Go Into Business
3. 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,

-Ben Fung

Competition vs. Collaboration

Greetings!

Please consider the following tweets:

@mjcdpt @jerry_durhampt Much agreed! PT needs to function in concert to raise demand; in fighting will weaken our market position.
— Dr. Ben Fung (@DrBenFung) May 19, 2013

And now, please consider this most intriguing inspiration

Other versions of the same clip:
http://www.youtube.com/watch?v=uAJDD1_Oexo

http://www.youtube.com/watch?v=2d_dtTZQyUM

HMMMMMMMMMM!!!!!

Competition in a perfectly competitive market is one where firms would need to "worry" about gaining, maintaining, and fighting for a competitive edge. A perfectly competitive market has two main characteristics:

• The goods offered for sale are all the same.
• The buyers and sellers are so numerous that no one buyer or seller can influence the price.

Physical therapy is NOT a perfectly competitive market.... not by ANY means. Therefore, we need a lesson from microeconomics. In this particular case, the Nash Equilibrium. Most commonly portrayed in the Prisoner's Dilemma (as seen below) or popularized by the movie, "A Beautiful Mind" (as was seen above) - the principle states that if all individual parties in a group does whats best for the individual AND the group, THAT point will be the most advantageous for all parties involved.

The Prisoner's Dilemma: Best Choice is staying silent - cooperating.

For the physical rehabilitation & wellness business, we NEED to learn from this economic principle. The level of demand for our service and expertise is far below where it could be. Competing amongst ourselves will only be damaging to our market position in comparison to referral-for-profit models, alternatives to our services, or the very simple choice - NOT GOING to the physical therapist (or allied rehab professional).

In healthcare, related scopes and similar disciplines gain from collaborating, cooperating, strengthening in concert, and marketing in unison. Sure. Not all *insert professional service here* is made equal. But, just as I've been saying since the New Year's posts aka. the Mickey Mouse Moment series - unity is the only thing that will elevate our profession as a whole. When the entire profession is better positioned, all of our individual firms will be that much stronger in the marketplace.

My suggestions are these:

• See another rehab therapy professional that is doing something similar? Make a business alliance; share ideas; cross-market; and, refer to each other.
• See another hospital that is doing excellent work? Request for their expertise and wisdom gained from stumbling across the wrong paths of choice so you avoid the same mistakes.
• Conversely, see a facility that is struggling? Share your success stories. Help them avoid the pitfalls you've already conquered.
• Notice someone on social media who is positioned in a similar vein of expertise? Make for a combined and expanded presence. One of the earliest expressions of this concept that I've noticed is with Dr. Erson Religioso's Physio Answers and Physio Pics. As you can see, each participant is made better for their collaboration.
• Are you already involved in a larger group, association, club, or fellowship? How about create a physical therapy marketing combine? Use your strength in numbers and associated financial power to create a marketing campaign to identify, position, and advocate physical therapists as the practitioner of choice for all things related to health, pain, movement, performance, sports, and graceful aging. A health specialist that serves as an ever supportive friend who can give guidance for finding a live-worth-living; one of longevity, fulfillment, and well-being.

Competition? PLEASE... not with one another. We're a team; a unit of professionals. The "enemy" isn't each other. There are far more dangerous foes that we must face. The best thing we can do is to strengthen each other such that we as a whole are then stronger.

Just like this scene from "The Gladiator"

"LOCK YOUR SHIELDS. STAY AS ONE!" - Maximus, The Gladiator.