Therapists as Leaders

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Translating clinical skills to corporate success

By Fred Gilbert, PT, DPT

Today’s leadership landscape is rapidly transforming. Gone are the days when “hard skills” such as work experience and financial mastery are the determining factor for entry into C-Suite positions. The torch is now being passed to leaders armed with “human” skills — attributes that pivot around people management.

Consider these four key skill sets described in the Harvard Business Review’s 2017 article “What Sets Successful CEOs Apart”1:

1. Deciding with Speed & Conviction

They’re decisive, realizing they can’t wait for perfect information and that a wrong decision is often better than no decision.

2. Engaging for Impact

They engage for impact, working to understand the priorities of stakeholders and then aligning them around a goal of value creation.

3. Adapting Proactively

They adapt proactively, keeping an eye on the long term and treating mistakes as learning opportunities.

4. Delivering Reliably

They deliver results in a reliable fashion, steadily following through on commitments.

Sounds familiar, yes? Let’s break those same qualities down inside the day-to-day operations of a physical therapy clinic:

1. Deciding with Speed & Conviction

You have 30 minutes to do a full evaluation. Within that time, you need to create a therapeutic alliance, map out the journey ahead, and make a meaningful impact on their primary goal today. Within minutes, you evaluate all the data points and choose the most important place to start.

2. Engaging for Impact

You find the goal within the goals. You know that climbing stairs pain-free is more than it seems — you tie that goal to future freedom and independence — to travel and family and thriving. You see the end goal, not just the first step on the journey.

3. Adapting Proactively

You’re thrown a curveball — your patient took a step back after the last session. You assess the situation, own the places you made mistakes, and create a new plan on the spot to get everything back on track. You assess the misstep and prepare the patient for future setbacks and how to manage them independently.

4. Delivering Reliably

On day one, you develop a plan of care for your patient. You highlight key milestones along the way and consistently keep on target. Your patient knows the journey ahead, the work required, and the timeframe with which to expect to reach their goals.


Therapists, once confined to traditional clinic settings, are on the cusp of an expansive horizon. From innovations like mobile clinics, telehealth, and on-site health services, to harnessing opportunities in the various digital platforms emerging every day — options abound. Doors swing open to realms outside conventional therapy — consultancy roles, managing hospital systems, or the world of tech startups.

But where to begin? How do you set yourself on the path to the C-Suite and begin your own leadership metamorphosis?

Seek Ikigai2

The Japanese concept means your “reason for being.” It is the intersection of what you love, what you are good at, what the world needs, and what you can be paid for. Define the world you want — if there are missing pieces to the Ikigai puzzle, reflect and seek answers. Let your values and interests guide you — the skills we have apply to every sector and every industry. Let Ikigai guide the way.

Cultivate Curiosity

Seek to understand the roles and the growth you want. Establish mentors who have taken the path already. Network within the sectors and positions you want. Good questions result in good answers. Let curiosity drive you forward. Absorb information from a variety of sources – mentorship meetings, podcasts, books, and articles. Seek to understand the world you desire to join.

Reframe Your Identity

Prepare for an identity crisis. An inner conflict, marked by guilt, self-doubt, and the specter of imposter syndrome, is par for the course. The metamorphosis from a clinician to a CEO is akin to shedding an old identity. Anticipate questions — “But you trained for this career!” or the poignant “Why are you leaving us?” from patients and coworkers alike.

In these moments of introspection, an anchor is essential. Extend compassion to yourself. Realize that evolution, especially self-perception, is a gradual process. Rooting oneself in personal values provides the stability to weather these inner tempests.

Embrace the Squiggle

Helen Tupper and Sarah Ellis, in their book The Squiggly Career tell us that it’s time to ditch the idea of the career ladder. There is no single upward trajectory. Successful careers follow varied, squiggly paths. Take the opportunities in front of you that allow you to build forward momentum towards the position you want. Every experience and position you take adds to your skill set and builds your network. Some steps will feel like leaps ahead; while others will feel like falling behind. Embrace the squiggle all the way to the top.


In many ways, you have already begun your leadership metamorphosis. The demands of the physical therapy clinic began your transformation years ago. The new world of work demands the skill sets we have – we need to take the first step. Pause for a moment after finishing this article and consider:

  • What is my Ikigai? What values define you and carry you forward?
  • How are you intentionally developing the leadership skills required in today’s working world?
  • How do you cultivate curiosity and absorb new information? How do you receive the feedback required for growth?
  • What internal dialogue makes you hesitate in starting this journey?
  • What is the first step you will take today?

Leadership metamorphosis isn’t a static construct, but an ever-evolving tapestry woven by the demands of today’s unpredictable world. So, whether you’re a therapist with CEO aspirations or someone striving to lead in their niche, remember the world is indeed changing – and we are positioned to usher the world forward. 

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1Lytkina BE. 4 things that set successful CEOS apart. Harvard Business Review. Published July 18, 2017. Accessed November 6, 2023.

2García H, Miralles F, Cleary H. Ikigai: The Japanese Secret to a Long and Happy Life. Hutchinson; 2017.

3Tupper H, Ellis S. The Squiggly Career: Ditch the Ladder, Discover Opportunity, and Design Your Career. Portfolio UK; 2020.

Fred Gilbert, PT, DPT

Fred Gilbert, PT, DPT, is an APTA Private practice member and Chief People Officer for MovementX. He can be reached at and @movementxinc.

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

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