Dream Job, Take One


Thinking about Your first physical therapy career move? My advice for recent physical therapy graduates.

By Dan Rootenberg, PT, DPT, CSCS

Back when I was graduating physical therapy school in 1997, the prevailing wisdom was to start out at a hospital, learn as much as you could, and then later go into private practice if that was your goal, as it was mine. So that is exactly what I did.

I was initially rejected from my dream job working for a global leader in orthopedics based in New York City. Feeling disappointed, I continued the interview process at other hospitals.

A few weeks later, I came across another physical therapy job posting at that same leading hospital that had previously rejected me. While in the process of interviewing for this position, I was simultaneously offered a staff therapy spot at a competitor, a leading and respected private hospital. After years of graduate school, I was excited to get my first physical therapy job—even if it was not my first choice. So, I accepted the job at the private hospital and began working there immediately.

I remember how great it felt to actually have a real full-time job. I also remember how exhausting it was standing on my feet all day when I was not used to that as a student. But that was really the only negative. Other than that, I loved it. The private hospital was an extremely fun and energetic place to work. I was even fortunate enough to work with a good friend of mine from physical therapy school. The two of us laughed a lot on the job, which created an enjoyable, environment that was personally and professionally rewarding. Who could ask for anything more?

Dream Job, Take Two

After about only one month on the job, when I was really getting into a groove and starting to enjoy myself, that large orthopedic leader—my dream employer—came back in the picture. This time, they called me directly to tell me I had been accepted as a staff therapist.

I was shocked and excited, but I had a huge decision to make. I really liked where I was, but I knew ultimately I wanted to practice in orthopedics. I felt like there was no better place to start that dream than at this leading organization.

So I decided to tell my manager that I would finish out the rotation, and I accepted the other offer.

Turning a Mistake into a Learning Experience

Looking back, I now realize that this was not an ideal path. In fact, it was an inexperienced and immature move. I later came to understand just how important culture truly is in a practice setting, and how little time I gave myself to really absorb the lessons I could have learned at the private hospital.

It was a very different feel at this major institution. Professionally, it was a tremendous place to work with talented staff, superior clinical learning opportunities. However, it was more rigid and hierarchical than the hospital I had left, and there could not have been a starker cultural difference in the day-to-day atmosphere.

When I think back to my first two jobs, some important lessons come to mind that be beneficial to graduates today. I have realized that fit and culture are more important to today’s physical therapists than ever before.

Keeping that in mind, here is some advice I would give you when making your first—or next—physical therapy career move.

Size up a Practice’s Culture

1. Plan to Stay and Commit
Now that I am on the other side, I realize how disruptive it can be to a practice when someone commits to a job, and then changes their mind the moment something else comes along—just like I did 20 years ago.

It has happened to me once or twice as a practice owner. Training a physical therapist takes resources, time, and effort. It is a huge commitment from the practice itself and should be appreciated by the therapist. I still believe you have to do what you feel is best for your career but a deeper understanding of the impact of your decision and how it affects others is vital.

Additionally, from the new therapist’s personal perspective, if he or she jumps ship too quickly, they probably have not had the chance to fully absorb the lessons to be learned from the position. And they most certainly have not given themselves a fair chance to see what the culture of the organization is like, both in terms of relationships with patients and colleagues, as well as managers. So make sure you give the culture a chance to grow on you. If you quickly leave one opportunity to test out another, have you really learned what either company is about? Have you truly given your initial position a chance to become a part of your life?

The lesson is clear: Do your due diligence to ensure you are fully able to see if the culture is a fit for you before starting a new position.

2. Embed Yourself In Their Culture—Shadow Before Committing
You must understand the culture you are about to join. Culture may at times be unspoken, but it is deeply ingrained in any institution, public or private. Spending time at the potential clinic or hospital even before accepting a position is of the utmost importance. I did not even know this was an option when I was first starting out. If the practice does not allow you to shadow with them, I would question why. Shadowing allows you the chance to see if a clinic is the right fit for you and if you are the right fit for the clinic—in real-life situations with real patients and in conversations with the current team.

3. Ask Yourself Specific Culture Questions
To me, this is the most important thing you can do. It will reveal to you how your coworkers will be, and how they will treat you. Make sure to ask yourself the following questions about the company’s culture:

  • Does the culture feel right on a gut level?
  • Can you see yourself working there day in and day out?
  • Does the company seem like a fun place to work?
  • Do patients seem to be getting better and enjoying themselves at the same time?
  • Does the atmosphere fit your personality, or does it feel like fitting a square peg into a round hole?

4. Ensure the Company Is Proud of Its Culture
Do some basic, initial research on their culture. Take special note of the company’s website, for instance. Does it list their vision, their values, and their mission? If so, do they connect to who you are as a person?

More Tactical Tips for Assessing a Potential First Job

5. Read Their Online Reviews
What type of online reputation does the practice have? Do they seem to have an established community with their patients? Read the good and the bad reviews, and pay attention to how the company and its therapists respond to all of them. Is it their therapists and directors who are responding? Or is it a template response from a public relations agency? How they respond to a bad review reveals just as much as how they respond to a good one. Do their patients seem to be loyal? What else can you glean about the relationships they have built?

6. Assess Their Mentoring Opportunity
A mentoring program is crucial for a new graduate. Are you being thrown into the fire? In and of itself this is not bad—but not all practice settings offer adequate support. At our practice use the equation of Development = Challenge + Support to outline our mentoring philosophy.

7. Question Their “Clinical Ladder”
Is there a way for you to develop internally, from a new graduate to a seasoned therapist? Is there an opportunity to learn from more experienced therapists? Is that a practice value? If this is important to you, then you should seek out a program that is developed and formalized so that you can grow into a top clinician.

8. Ask If They Have a Leadership Training Program
A practice should have a way of training and developing not only your clinical skills, but also your leadership skills. These are skills that will enhance your success—both as a clinician, a leader, and more importantly as a human being. At our practice, we have created and implemented a yearlong leadership program which has been a huge success; each of our clinical directors has risen up the ranks after formally completing it.

Through this homegrown, focused platform, we develop newer team members to become the future leaders in our company. Other companies have their own version of a leadership training program as well. If it is your goal to learn the skill sets that are inherent in leadership and management, then a clear pathway to that goal is immeasurably valuable.

Are You Starting a Career, Or Just Getting a Job?

It is important to differentiate between job growth and career growth. A “job” is a short-term approach to paying bills and getting by.

A career, however, is a foundation for growth and enjoyment that lasts a lifetime. It becomes a part of your reputation in your community and how you make a name for yourself through the great work you are doing. To find that career you are proud of, you may consider the following steps before accidentally jumping into “just a job.”

9. Ensure the Practice Hires from Within
Are leaders and directors hired from within the company, or does the company consistently hire from the outside? When a company heavily emphasizes internal development and hiring as positions become available, that is a clear indication of its commitment to its team—and that will be you. If the company has training programs as mentioned previously, and its staff tenure is long and growing, then you can feel more comfortable that the company and its managers will treat you with respect and support you toward personal and career growth.

10. Learn About Your Future Coworkers
Besides the cultural fit that we mentioned previously, what else do you know about your future coworkers? Does the employer have the right number of coworkers for your comfort? Are they all spread out, working in a large environment, or is it an intimate setting where you can easily learn from the more experienced therapists? Whether a practice has the right type of team members who can help your career is something only you can answer.

Lessons Learned

As you can see there are many different factors that go into finding the right fit. Do not just automatically assume your dream job is actually your dream job—or better yet, your dream career—until you have observed and researched as much as you possibly can about the potential fit. If you take my advice and ask the right questions, I am hopeful that you will not end up working somewhere for two months before jumping ship, like I did.

Best of luck to you on your search!

Dan Rootenberg, PT, DPT, CSCS, is the president of SPEAR Physical Therapy in New York. He can be reached at dan@spearcenter.com.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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