Spoiler: They don’t teach you everything in physical therapy school. Here’s what I’ve learned my first year in the clinic as a physical therapist.
1. There is So Much I Don’t Know
Coming to terms with this is liberating, daunting, exciting and terrifying all at the same time.
Information accumulates at an outrageously fast rate. It is impossible to know everything… it’s maybe impossible to know most things.
We have the expectation that we complete the course work, get our degree and license and we’re done. If this illusion wasn’t shattered in school it quickly is following graduation, especially during the first year out.
We’ve heard time and time again that to be a great PT we have to commit to a lifetime of learning. The longer I’ve been in the clinic the more I’m realizing that this sentiment is actually true.
Growing stagnant in your learning leads to mediocracy and let me tell ya, I spent way
2. Everyone Truly is Different
There is more to patient treatment than “you have this, do this, now you’re fixed”. People are complex. Pain is complex. Patient care is COMPLEX.
From an anatomical, psychological and just overal human stand point, everyone is different. The key to success with one patient may aggravate someone with a similar impairment.
You have to be aware of what each individual’s goals, limitations and past experiences are in addition to their pathology.
Listen to your patients and treat according to their needs. They’re likely not exactly the same as the patient who came before.
3. I Have to Stay Open-Minded
I’m stubborn and I’ll admit that.
At the very beginning of and into the first year of my career I focused on finding what usually worked and just stuck to that. “If it ain’t broke, don’t fix it” right? Nah, I was just uncomfortable. Familiar is comfortable.
Comfortable isn’t helping me to grow though. Sure, I may look and feel more competent when I do the same thing over and over, but who is that actually helping? My fragile new grad ego?
Referencing back to #1, it is so important to remain open to new approaches, new methods, and new ideas. Build up your toolbox so you’re prepared to help a whole lot more people.
4. I Cannot Fix Everyone
I must have missed this lesson in school, but PT is not going to fix everyone! It hit me like a ton of bricks within my first year out of school.
Little emphasis is placed on determining patient appropriateness for discharge throughout school, and it is a surprisingly sensitive subject with some patients. They can often feel like you’re “giving up” on them if you make the call that PT isn’t their fix.
But at the end of the day, if you truly have tried everything you can think of within your scope and there’s little to no progress being made… it’s time for discharge.
You’re not giving up on your patient. You are helping them to figure out what is and isn’t working so they can find relief faster.
No matter how small the feat, celebrate it. It does wonders for both you and your patients.
One of my favorite patients I’ve ever had was a 72-year-old, post-op total knee arthroplasty As a return to sport-oriented PT, this is not the most exciting diagnosis for me to treat. I’ll tell you what though, I’ve never been more excited about a straight leg raise in my life than when she was able to do it.
She was stoked, I was stoked and that positivity carried me through the rest of the day.
As a physical therapist, I see and hear about a lot of sad things. Making a bigger deal out of the little victories really makes both me and my patients more excited about treatment and optimistic about the future.
Maintaining that mentality really helped me through my first year in the clinic and I don’t plan on changing it moving forward.
6. Everything Works and Nothing Works
It seems like I can’t scroll through Instagram or get through a podcast without someone telling me I’ve been doing everything wrong.
“ALWAYS stretch for this!” – “NEVER stretch that!”
“Manual therapy is all placebo!” – “If you don’t use manual therapy you won’t get optimal outcomes!”
“Foam rolling is a waste of time!” – “Foam rolling changed my life!”
It’s exhausting and confusing. Whether it’s for likes/ shares or to start a conversation, people have become very polarized on different treatment approaches- especially on social media!
With the frequent publication of poorly designed studies and lack of replication, research is kind of all over the place. This makes it easier to cherrypick information to support almost any stance. Information is constantly changing and the human body is still more of a mystery than we would care to admit.
So what’s an overwhelmed young therapist to do? Stay open minded while still critically evaluating your own rationale.
I’m too early on in my career to completely start eliminating treatment options because @JoeThePTBro told me to. At the end of the day, you
7. Home Exercise Programs are Essential
I was super guilty of giving my patients a few exercises to be done at home and maybe changing them once (if ever) throughout the duration of treatment.
Was I really all that concerned about if they were actually getting done? Nah, not really (unless you’re post-op, then best believe imma be on your case). The REAL treatment is getting done when you’re in the clinic anyway, right?
NO NO NOOOOO
What a valuable rehab component to let go to waste!
What do all of us PTs want? Better outcomes faster. One of the best ways to do this? UTILIZE THE HECK OUT OF YOUR HOME EXERCISE PROGRAMS.
Since regularly emphasizing and updating HEPs, not only have my patients been getting better faster but it forces me to look ahead and stay on target. I still keep HEPs manageable (no use in prescribing if no one’s going to do it).
When I put the importance back on home exercise programming I am able to advance patients quicker and catch missing treatment pieces earlier on.
(P.S.- For patients that just aren’t following through with their HEPs, check out my post on the Top 13 Home Exercise Program Excuses Busted)
8. Not Everyone Wants to Get Better
Whaaaat? You’re telling me I can make the perfect diagnosis, accompanied by a perfect treatment plan and this person who is willingly coming to see me isn’t 100% onboard?
It’s true. Some people really enjoy playing the victim. This can be so disappointing and equally frustrating.
Whether the timing in their life just isn’t quit right or they don’t have the motivation to put in the necessary work, there’s no a whole lot we can do to change it.
Once you’ve tried everything you can to set your patient up for success and there’s still no follow through on their end, it is time to call it quits. If things change, they know where to find you.
Save yourself from unnecessary frustration.
9. I Need to Take Care of my Patients AND Myself
Selfcare yo. “You cannot pour from an empty cup”.
This of course includes your physical AND mental well-being.
After graduating, moving to a new state, accepting a leadership role as my first position accompanied by an abundance of other life changes, my anxiety was at an all-time high.
To add to it, I was unhappy with my employer and suffering moral injury from not being able to treat my patients in a way that aligned with my ethics.
It was a rough time, and I know I wasn’t as compassionate and prepared to give to my patients during it. I took days off, picked up some new hobbies and ultimately ended up leaving that job when I realized it didn’t fit with my ethical code.
I did what was best for ME and now my patients and I are reaping the benefits.
Whether it’s taking a vacation, a personal day, talking to a therapist, or straight up just finding a new job, do what you need to do for you.
Do NOT feel guilty about it.
10. Always Follow Your Moral Compass
It’s a bummer that this lesson needed to be included in this list but I would be remised to not touch on it. This was a HUGE lesson for me in my first year as a PT.
We enter the field of healthcare with the goal of helping others. Unfortunately, this is not everyone’s priority.
There’s an ugly side to healthcare that is ruled by profit and greed that should have not have become the norm. Patients and practitioners deserve better.
Stand up for yourself and your patients. If you morally do not agree with something that is going on, say so.
It’s uncomfortable, yes. But, from first hand experience I can tell you that trying to convince yourself you’re okay with something you’re not is a lot more uncomfortable.
What if it all goes south? What if someone is not happy about your readiness to share?
Trust me, there are much better opportunities ahead.
11. Helping People Feels Great
And making a living doing it feels even better.
Do any fellow new physical therapists relate? What lessons did your first year in the clinic bring you?
Tell us about it below!