What are some of the best and worst things that you experience as a physical therapist?

Hi Ana,

I'll start with the worst things I experience so that I can end on a good note. The worst things that I tend to deal with as a physical therapist are the insurance companies and the amount of paperwork we have to complete at the end of each day (primarily because of insurance companies. Each patient that I see uses a different insurance company with a slightly different insurance plan which can significantly affect your choices as a PT. In school, we learn that we are supposed to do whatever we think is appropriate and what we think will help a patient the most. When you're in the real world, you do what the insurance companies allow you to do. This sometimes means that you have a patient with severe back pain, but you can only see them once a week instead of the 3 times you'd like to because their insurance won't allow more than that. Super frustrating, right? We go through all of this schooling to be able to make educated decisions about our patients, and a computer run by a random person working for the insurance company ends up making the decisions for us. If you are a good therapist, though, you can use your time with patients wisely and still give them great care.

The paperwork is another bummer about being a PT. We have to document everything we do every day with each patient so that if the insurance company questions us, we have something written down to back it up. See, we get paid (the company you work for) retroactively. Sometimes you will treat a patient for 10 sessions, and the insurance company decides they don't want to pay for those sessions. Your company still pays you but doesn't get paid themselves. Therefore, we have to keep clear records of the services we provide to substantiate getting paid. I will often have to work on paperwork outside of scheduled work hours, which is just no fun. Though some people are able to complete their paperwork during scheduled hours (I have no idea how).

But the benefit of being a physical therapist is that you get to HELP PEOPLE GET BETTER! I believe that I am a therapist who truly cares what happens to my patients after they are discharged. I try to spend as much time with them as possible to help them get better faster (which may be why I don't have a chance to finish my paperwork AT work). And I learn more everyday about the disabilities that humans are able to overcome with perseverance and determination. I have treated a few patients who had a somewhat undetermined prognosis- for instance a 15 year old girl with necrotizing fasciitis who was able to return to playing soccer with only 1/3 of her quadriceps muscle or a 28 year old woman who lost most of the movement of her left leg after having a baby who was able to play paintball last week.

Lastly, pay attention to debt-vs-income. When you are just starting school, it seems routine to just sign up for those student loans, but they become daunting the minute they go into effect once you've graduated and gotten your real job. And tuition just keeps climbing (though income isn't). A new grad PT generally makes around $30/hr, which, in the grand scheme of things, is pretty good. To give you some perspective: I was in school for 6 years to get 2 bachelors degrees (5 is becoming more normal than 4 for a single bachelors), followed by 3 years of PT school (most programs are 2.5-3.5 years). I acquired $150,000 of debt once interest was calculated. I pay a little over $1000/month (sometimes more than a mortgage payment) and will be doing so until 2040 (when I am 51, and retirement is at age 65). When speaking with patients of mine who are interested in becoming a physical therapist, I urge them to also look into Physical Therapy Assistant programs (an associate's degree vs a doctorate). This degree takes a total of only 2-3 years to complete, and PTA's generally start at around $20/hr. Much less debt for the pay (so you can actually start saving money sooner). And there's less paperwork!!

I truly suggest observing a physical therapist if you are able. And when you do, ask them how much time they spend outside of work hours on paperwork, how much pro-bono work they generally do, and how well they are able to balance the demands of work with their personal lives. The job is demanding but rewarding. Seeing it first hand will give you the best idea of what it would be like to be a physical therapist.