Physical Therapy Career Advice

Thinking About Your First Physical Therapy Career Move?

Here’s My Advice for Recent PT Grads.

By Dan Rootenberg, CEO & Co-founder, SPEAR Physical Therapy (and recruiter of hundreds of first-time PTs)

Dream Physical Therapy Job, Take One

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’s exactly what I did.

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

A few weeks later, I came across another PT job posting at that same leading hospital that previously rejected me. While in the process of interviewing for this position, I was simultaneously offered a staff therapy spot at a competing leading and respected private hospital. After years of grad school, I was excited to get my first PT job – even if it wasn’t 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 wasn’t 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 have worked with a good friend of mine from physical therapy school, Craig, who was also working there. I remember that the two of us always laughed a lot on the job, which created for me both an enjoyable, professional environment that was personally rewarding while at the same time, helped our patients heal. Who could ask for anything more?

Dream Physical Therapy 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’d 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 then 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 a bit of 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.  It was actually a tremendous place to work with talented staff. It offered superior clinical learning opportunities. However, the atmosphere was a bit more rigid and hierarchical. There could not have been a starker cultural difference in the day-to-day atmosphere.

Some important lessons come to mind when I think back to how these first two jobs of mine may relate to the futures of recent graduates today. Based on conversations I’ve had with recent graduates, and from the experiences I’ve had throughout the industry over the past 20 years, there is no doubt that fit and culture are more important to today’s PT’s than ever before.

Keeping that in mind, here’s some advice I would give you when making your first – or next – PT career move.

Steps You Can Take to 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 PT 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 haven’t had the chance to fully absorb the lessons to be learned from the position. And they most certainly haven’t 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, which leads to Cultural Step #2:

2) Embed Yourself In Their Culture – Shadow Before Committing

The second important lesson is the critical understanding you must have of 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 utmost importance. I didn’t even know this was an option when I was first starting out! If the practice doesn’t 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’re 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 co-workers will be, and how they’ll 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 going 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 PT 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 even their therapists and directors who are responding? Or is it a template response from a PR agency? Truth can be revealed to you in how they respond to a bad review 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 grad. Are you being thrown into the fire? In and of itself this isn’t bad—but not all practice settings offer adequate support. We use the equation of Development = Challenge + Support to outline our mentoring philosophy at SPEAR.

7) Question Their “Clinical Ladder”

Is there a way for you to develop, internally, from a new grad 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 About Their 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 SPEAR, we have created and implemented a year-long program which has been a huge success; each of our clinical directors have risen up the ranks after formally completing it.

Through this home grown, 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 Physical Therapy CAREER, Or Just Getting a Physical Therapy “Job”?

This leads to the next important factor. It’s 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 like mentioned above, 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 towards personal and career growth.

10) Learn About Your Future Coworkers

Besides the cultural fit that we mentioned above, what do you also know about your future co-workers? Does the employer have the right number of co-workers 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.  Don’t just automatically assume your dream job is actually your dream job – or better yet, your dream career – until you’ve 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 won’t end up working somewhere for two months before jumping ship, like I did.

Best of luck to you on your search.

Dan Rootenberg can be reached at for any career related questions

Named the nation's top physical therapy practice (twice).
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