Thrive As A Physical Therapist Without Actually Treating Patients With Meredith Castin

TCLHP 171 | Physical Therapist

 

The thought of moving into clinic director roles may be exciting until you’ve finally settled into your job, only to be given one big task over the next. Now, people are not only expecting you to do patient care but also to become a stellar manager while at it. So how can you properly do your managerial duties when you’re too busy meeting patients? Meredith Castin of The Non-Clinical PT saw the struggles many physical therapists with positions face under these traditional growth pathways in PT. As the owner and founder of the #1 resource for physical, occupational, and speech therapy professionals launching non-clinical careers in healthcare, she shows us the way we can continue to thrive in our professions without actually treating patients. Meredith then talks about the burnout that comes with growing in the career, the problem with not getting more recognition and pay in the industry, and what she is doing to help people transition to non-clinical career paths.

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Thrive As A Physical Therapist Without Actually Treating Patients With Meredith Castin

My special guest is Meredith Castin. She is a physical therapist who I met in 2015 at a CSM or so, walking around the whole exhibition center. We chatted, and it’s taken a couple of years for me to get her on my show. She runs The Non-Clinical PT. She’s helping other physical therapists create, work in jobs, and help other people without just feeling constrained to clinical life. Meredith, welcome to the show. I appreciate you being here.

Thanks for having me.

Did I get that right, like what you do and who you’re helping?

Yeah. It’s all about helping people stay, keeping their identity as PTs, but also exploring what else is out there so they’re not starting over if they don’t want to treat patients anymore.

I can guess, and they’re probably some of the same reasons people end up starting a cash practice, but what are some of the big problems people are having who you’re helping with? What are some of the things that these physical therapists are struggling with in their clinical life where they’re like, “I’ve got to get out of this?”

It’s multifaceted, and it’s not going to surprise anybody with the answer. It’s expensive to become a PT. We all know that. The raises aren’t there. There’s not always a lot of career growth. There might be some growth in terms of your title or your responsibilities, but often you don’t get the commensurate pay with that growth. In a lot of cases, there’s not a whole lot of respect. One of the things that I’ve come across a lot is people move into these clinic director roles, get excited, and kept out there. They hit a glass ceiling.

In physical therapy, a lot more responsibilities do not always mean a lot more recognition or pay. Click To Tweet

One of the reasons is that they’re expected to carry a full caseload. They think that they’re going and growing their careers going into management. All of a sudden, it’s like, “We expect you to be a stellar manager, but only on top of your 75% caseload.” What ends up happening is the patients aren’t going to see themselves, so then managers get stifled there because they can’t move up the ladder. They’re not doing their managerial duties that well, because they’re too busy doing patient care. We see that in a lot of the traditional growth pathways in PT. There are a lot more responsibilities, not always a lot more recognition or pay.

It’s not unsurprising, but it’s that, “I’ve got this job as a staff PT. I have the opportunity to make more money, I now I have to be a manager and now I’m managing other physical therapists, but I still have to treat a full caseload.” What are the additional responsibilities people have as a “manager” now and are they being trained on how to do that?

No. In many cases, that’s the other issue. They’re not getting prepared for these roles. I would argue that it’s not necessarily the company’s job to train you and make you manager ready. You should be prepared to put in some of the work yourself, go and take some leadership classes, read some leadership books, and all of those things fall on your shoulders to become a good manager. I think when your hands are tired, and you’re busy treating patients, that then 4:00 PM rolls around. It’s your manager time, you’re completely exhausted, you have to do your documentation, and you have to run the numbers for the budget, or you have to do some HR stuff or work on culture.

What’s going to take the backseat? It’s going to be the culture. That’s what I see happening a lot is you have these stellar, hardworking, talented PTAs and other professions too. They get promoted because they’re good in the clinic, and they’re ready to grow their career. They’re moved into these roles, and then they are burned out, and then they want to leave the professional together. It’s not just them. Everybody has their reason for wanting to leave. I have new grads coming that say, “I knew when I was in clinics that I didn’t want to do this.” I have people who’ve been in the clinic for 25 years, and they say, “I still love it, but my back hurts,” and everyone in between. That’s one common scenario that someone will be on that growth track, and then I hear it a lot. They go, “I became a manager, and it was not what I thought it would be. There was no upward mobility, and I burned out. Now I want to sell real estate.”

They’re getting to the point where they’re like, “I don’t even want to treat patients anymore because this sucks.”

In many cases, it’s not that the treating patients part sucks. It’s everything that goes with it. That’s going to depend on what their personality is. Somebody might say, “I can’t stand the documentation, but I would sit and treat patients from 8:00 to 8:00 every single day and never worry about it.” Other people would say, “I wish I could document all day, play with the EMR, and streamline it.” Everybody’s got different things they don’t like about it, but what’s expected of us as treating PTs is to get out there and meet unrealistic expectations. The insurance companies are saying they want a mountain of paperwork for every single patient prior authorization or post-treatment authorization, and then you’ve got these clunky EMRs that are freezing on you and old equipment.

Open lines of communication are so important because everyone's going to struggle. Click To Tweet

You’ve got patient satisfaction, and then sometimes the clinic might flow well where you’ve got a tech to bring back the patient. That’s not an issue. Another PT might be like, “It’s frustrating because I can’t see into the waiting room, so I can’t tell them my patients show up late, and I think they’re not there.” Everyone’s got their own issues. That’s a big key to figuring out what you want to do next is, “What is it about patient care that is bothering you so much? Do you dislike patient care? Then you need to do something where you’re not facing the public so much.” If you don’t mind that and you enjoy being on and talking with people all day, that’s going to be a completely different issue. You don’t like being in front of a computer all day.

Playing devil’s advocate like, “I’m a business owner. I’m a clinic owner.” There’s a bunch of other clinic owners on here. Is there something that clinic owners are doing wrong or could do differently to keep their clinicians treating patients and being a manager of the business? Is there something that you’re seeing that people should need to be doing instead before people get burned out and like, “I’m done doing this?”

Open lines of communication are important because everyone’s going to struggle. Some people are going to struggle with the business side of things. Some people are going to struggle with managing others and being the bad guy or trying to go the opposite direction and being too much of the good guy, and being a bit of a pushover. Having open lines of communication and saying, “Where do you feel like you need to grow? Here’s where I see you can grow.” Being amenable to supporting people in those areas of growth rather than being like, “The person before you did it, they were fine, and they moved up.”

I don’t think that’s a good attitude to take. Say, “You’ve expressed you want to grow. You want to be a leader. There’s something in you that says that you want to lead. What can we do to make that happen? Where are you going to meet me halfway later? Are you willing to take these classes? Maybe we can split the cost. Maybe you take them, and then I reimburse you if you’re doing your job in X amount of time.” If you’re not communicating about those things and people don’t feel like they can be honest about their struggles, that’s where we get into trouble. I feel like we could have a whole hour of conversation about communication.

There is also a salary issue. Are you seeing people leaving clinical care because their salary can only go so high, and they’re looking to do something else, even like medical sales? What percentage of people do you see that’s the case? I love treating patients, but if I can’t make more than $85,000 or $100,000 a year, I’ve got to do something else.

There’s a pretty good chunk of people who feel that way. Although, I don’t want to say that it’s the large majority. If anything, I think the large majority of people who come through want more work-life balance. Their issue is not so much the pay. It depends because the younger ones seem to want more pay. I get that because they’re not tied down with family commitments, and they have more student loans. They’re going to be going, “I want to pay these things off quickly.” Maybe medical sales appeal to them because they can travel more. When I have people who want to leave the clinic a little bit later because they’re hitting that financial ceiling, but they’re not drowning in loans, they want to earn more, then they’re usually not going to pursue the sales route. They’re going to typically want more time with their families and want more of a remote role. That’s a big one. People want to go to a remote. Understandably, we’re in a global pandemic. People are like, “I want to stay at home.”

The big problem in the industry is that everybody wanted to leave, but they didn't know how. Click To Tweet

Are there any other reasons that people are wanting to leave patient care or don’t even get into it in the first place?

I’ll throw myself in this category. Some of us feel too much. That was always my issue is I would take my patient’s pain home with me. I’m an impact type. If they had a bad day, I had a bad day. If my coworkers had a bad day, I had a bad day. If everybody around me is happy, I was happy. For some people, it’s a very empathetic field in a lot of ways, and you’re listening to people. We all know this. It’s not just treating their knee. It’s treating everything that the knee has affected. There are a lot of people who leave because they don’t want to deal with OPP, with Other People’s Problems. They want to deal with their own world and their family’s problems or their own problems, and that’s that. They want to be with charts and graphs, the rest of the day.

Now that you opened the door, what was your story? How long did you treat patients, or did you, and was it the fact that it was tough to balance how you felt day to day that sent you out of patient care?

It was a career change for me. When I look back, I was one of those miracle patients at 25. I mean a miraculous recovery from a back injury in PT. I was like, “This is gold. I can’t believe how cool this is. I’ve got to do this for other people.” It was a split decision or spur-of-the-moment decision. I got excited about it and went to PT school. I was lucky. I got a scholarship because there was a new program in town, and they were working on attracting new students. Everything is lined up. It almost felt like the stars aligned. I’ve met someone in one of my community college classes who was like, “You’ve got to become a PT.”

When I was in school, I realized that I had made a grave error because I wasn’t as into a lot of the touching. I’ve never been a particularly touchy person. I don’t think there’s anything necessarily wrong with that, but you shouldn’t go to become a manual therapy. You shouldn’t go to St. Augustine as a manual therapist. That’s where I ended up going. If you’re not that into touching people. I got the sense when I was in school that I wasn’t as interested, and then we went out for clinical, and that’s where the, “This is going to be a real problem.” It hit me because I went to multiple settings, and I was trying to explain it away, like, “Maybe I didn’t gel. Maybe it wasn’t the right setting for me.”

I always had an excuse for why I would come home feeling drained, exhausted, and not super happy at the end of every day. I’m a happy person, so I was like, “What is going on?” Once I got out, and I got into the real world where people say, “Don’t worry. It’s not the same thing when you get in the real world, and you’ll experience what it’s like to be a PT.” I got out into the real world, and I was like, “I’m still waiting on liking this career.” There were aspects that I loved about it, like coworkers? Great. I like interfacing with the patients a lot and talking with them, and making chit-chat, but when they had big problems, it would drain on me.

If I couldn’t get the 100% better, I was one of those people who took it home and was like, “It’s my fault. I’m a bad PT.” Here’s another side note, some people need to see immediate results to feel good. If I had known that about myself, which I need to see immediate results to feel like I’ve done a good job, it’s a character flaw, and it is what it is. I should have become a pharmacist looking back, but I didn’t want to be a pill pusher, not that they’re pill pushers. In my head at that time, I was Iike, “I want to do a physical movement, but I don’t have the patience to wait eight weeks for people to make this much range of motion gain or their pain to drop from 10 to 8.5.” It wasn’t a good fit. I did treat for five years, and I’ve been out for several years. I hit that midway point where I’m half and half. Around when I saw you, I was right when I was making that transition out.

TCLHP 171 | Physical Therapist

Physical Therapist: It’s expensive to become a PT yet, the raises just aren’t there, and there’s not always a lot of career growth.

 

What happened where you made a decision like, “I need to do something different outside of clinical care?” What’d you do to start making that happen?

It was the day someone threw a gait belt at me. I was at my 3rd or 4th job by that point. I had six jobs in five years. I remember I was treating this guy, and he was a jerk. I was trying to get them to work with me because I was like, “I’ve got to get you out of bed.” He had a bad accident, and he shouldn’t have been walking without a gait belt. I was like, “Let me put the gait belt on you. Let’s get up. Walk around. It’s part of your discharge planning.” I was trying to appeal to him. He got super mad and threw the gait belt at me.

At that moment, I was like, “I don’t think that this is the career for me,” because the best of days were great, but the worst of days were people throwing gait belts at you. It was a hard throw. It wasn’t giving it back to me roughly. I feel like there’s got to be something else. Having been a career changer, naively, I thought I could turn around and go back to web design and graphic design, which is what I started out doing. My skills were obsolete after about five years at that point of not working in the field that nobody wanted me. Nobody wants someone who’s like, “I’m going to go be a PT. I was kidding. I’m going to come back and be a graphic designer.” My resume was a mess.

What’d you do because something worked?

It was a couple of things. All at the same time, I applied for a rehab liaison PRN job, and it was such a long shot. The whole time I was sending out resumes, and the thing is, my sister is a career counselor and a career coach. She was trying to help me through all of this, but I wasn’t listening, and I wasn’t taking her advice because she was like, “Try and figure out what you want to do, then do it.” I was in this state of panic, frustration, fear and sadness. I was flinging out resumes, and nothing was happening. This PRN job, I didn’t hear anything from them. I reached out to a friend who worked there as an OT, and she was like, “They said that they never got your resume.”

It was like a bell went off when I realized that I had what I felt like was the perfect background by that point. I’d worked in every setting they wanted. I knew PHIMS and all this stuff they needed you to know. The fact that they didn’t even get my resume was a wake-up call. She was able to pass my resume to the hiring manager. We had a great interview. I was hired, and I was PRN at that job. You met Brett Kestenbaum at that time. He and I met, and we created a website for new PTs around the same time called New Grad Physical Therapy, which is no longer in existence, but it’s part of CovalentCareers now.

Passive income doesn't mean that you don't do any work. It just means that you're not trading time for money. Click To Tweet

He had come up to me at my other PRN job that I was doing. He was a brand-new grad, and he’s like, “I don’t think I want to do this long-term.” I was like, “Yes. There’s another one of me.” We got to talking. It was over Thanksgiving 2014. We were having a meal at the hospital, “Is this all there is?” We ended up launching this website. I got a taste of what it was like to use my background in a completely new way. Between the PRN rehab liaison job and running New Grad Physical Therapy, which was in 2015 or 2016, I was suddenly over the moon happy with my career. That was all I needed to know. It’s like, “I’m not a patient care person.”

With New Grad Physical Therapy, you guys were doing articles, interviews, and creating a resource for other new grads?

That was always part of CovalentCareers. It was this family of websites. I could go through the whole company structure, but I don’t want to bore everybody. They already had a plan for the website, which was nice because, at that point, all I knew how to do was write and make graphics because I had been a graphic designer. My web design skills were obsolete because I was designing before WordPress was even around. I’m dating myself.

I built two HTML websites in 1995.

We’re around the same age because I was in high school when the web was happening. That was my background, HTML, CSS, and everything. They were running the New Grad Family on WordPress. I had to learn WordPress, and then that was fine, but I didn’t know anything about content marketing. I was one of those people who refuse to be on social media. Brett had to convince me to get into Facebook groups and drop articles in there. I had to learn all of that stuff, and then I continued to learn all of that since I left them. That was the thing I worked with them for 2 or 3 years. I ended up leaving mainly because many people reach out to me. Every time I would send an email blast with these New Grad articles, people would write back, being like, “That’s cool but I don’t want a PT job. I want to do something like what you’re doing. You keep talking about being a rehab liaison, or you write and run this website. How do I do that?”

I started informally coaching people on the phone and taking calls. I had to move him to the weekends because Brett and Matt were like, “This is company time.” I was fine with that. I was talking with them on the weekends. I had this idea that this is a big problem in the industry. Everybody wanted to leave, but they didn’t know how and I didn’t know how. It took me three years from that time of the gait belt getting thrown at me to landing the job. That was about 2 or 3 more years until I got to the point where I felt like I was a non-clinical. If people were asking me for help, I would tell them what I knew, but it’s not like I knew that much at that point. I started researching things, and then I would get on the phone and say, “I found this new career. This might fit you.”

TCLHP 171 | Physical Therapist

Physical Therapist: Physical therapy is a very empathetic field in a lot of ways. You’re really listening to people. It’s not just treating their knee; it’s treating everything that the knee has affected.

 

It was CovalentCareers. Was that like a job that you were in for a while, and then you left that?

It’s funny because sometimes, when I try to explain it, it does take a while. Brett and Matt started CovalentCareers together in 2014. Matt had already been running. He started with OptometryStudents.com. When he graduated from optometry school, he started New Grad Optometry. After he started New Grad Optometry, which was probably 2013, that’s when he and Brett linked up and they started CovalentCareers. It’s more of a recruiting thing. They decided to do New Grad Physical Therapy as an offshoot of CovalentCareers. I wasn’t even super privy to all of this because I was like, “Whatever you need me to do. If you need me to do something else, tell me.”

I have always loved writing, but I never thought I was much good at it. I never thought it was a career thing. I enjoyed it. I would blog for fun in the early days of the internet and stuff. I said, “Send me whatever you need to be written, I’ll write the articles, and I’ll edit.” He hates writing. I was like, “I’ll edit all your articles and let me know what you guys need me to do.” New Grad Physical Therapy never made much money on its own. They ended up rolling it into CovalentCareers. Once that happened, then they hired me for an actual full-time job, and that’s when I left my liaison career to work for CovalentCareers.

Around when I was getting to the point where I was inundated with people reaching out with this other stuff, and I was also over-working at a startup, to be honest, it was exhausting. I was like, “I’ll take a full-time job and do the site on the side or the Non-Clinical PT, and I’ll see what happens, see if it ever grows into anything, it’ll be kind of my hobby.” Within five months of taking a full-time writing job after CovalentCareers, the Non-Clinical PT was busy that it was time to make that my thing.

I want to review this for people. You were a PT and treated for five years, and then you did this part-time PRN thing. You wrote for Covalent, and you worked for them for about two years. It was another five months before your Non-Clinical PT became your full-time thing.

What happened with the non-clinical PT is the timing was there because I was noticing a trend. When I was with New Grad Physical Therapy, I thought I was the black sheep. When I would tell my coworkers, colleagues and my former classmates that I wasn’t super happy in the career, they would laugh at me sometimes, and they were like, “This was a career change for you. Do you not like working?” I know they were kidding, but I took it personally and was like, “Maybe I have no work ethic. Maybe I’m kind of a crappy person that wants to enjoy the fat of the land.” I thought there was something wrong with me.

A lot of overnight success takes years to make. Click To Tweet

It was when I started working at Covalent that I was like, “No. I like to work, and I liked my PRN job. I love working, and I liked being a web designer too.” I didn’t like sitting at a desk all day, every day at the time, little did I know. The five-month period between when I launched my site to when it became something where I felt like I was comfortable making it my full-time job was more than I was getting like freelance assignments through that time too. I have WebPT. I guest posted for them a few times, and they said, “Do you want to do some freelance writing?” I had someone from OT Potential reach out and say, “Do you want to do some freelance?” I don’t want people to think, “I built The Non-Clinical PT, and it became this huge thing in five months.”

That’s the point I was trying to make is that you’ve spent about ten years doing it. It was five years of treating and figuring things out and then the whole two years of writing for someone else and answering people’s questions. It’s not an overnight success. A lot of overnight success takes years to make.

I’m glad you put it that way because a lot of times, people might see someone pop up and gain traction quickly. I already hit a huge network of people I’d been coaching and working with inside testimonials right away, and it takes years. The same thing with a course, people sometimes think you can put a course up, it’s a super easy thing, it makes money overnight, and it’s passive income. I was like, “Passive income is passive once you grind unpaid for two years, and then it’s passive until your next launch.” It has moments of being passive, but you have to continue working on it in the back.

Passive income doesn’t mean that you didn’t do any work. It means that you’re not trading time for money. With Non-Clinical PT, you have a pre-populated Facebook group. Do you have courses or mentoring, coaching, or what other ways are you helping people? Are you matching them up with other employers?

The main thing that I have is my online course, which is Non-Clinical 101. In that, I cover the 25 most common easiest to pursue non-clinical career paths that you can make a fairly smooth transition into. You might need a little bit of extra education or certificate or something, but it’s a fairly easy transition. We go over resumes, cover letters, interviewing, negotiating, and also deciding which of those 25 career paths is right for you. There’s a whole chunk of the course that people like to skip. It’s the very first step, but I love that stuff. It’s when you sit there, you sit down, and you go, “What did I not like about patient care? Is it everything we talked about at the beginning? Is it the documentation? Is it being on all day with patients? Is it the fact that you have to go somewhere and be physically present?”

You sit down and identify what it is that you want out of your next career. In order to get to the next career, you need to know where you want to go so that you can make a plan, because all of us who became PTs, it’s not like we were, “I’m going to go be a PT.” We had to do volunteer hours, take tests, get grades, and did prerequisites. It’s easy to forget all of that work that went into becoming a PT. If you want to make a career change and not just get a job that’s not great, then you have to do that. You have to research what’s out there, figure out what skills you need, get the skills if you don’t have them, and tweak your resume.

You need to know how to negotiate and interview and say the right things. That’s my flagship thing. Sometimes I meet people, and they’re like, “I want to become a clinical informaticist. I know I want to become a rehab liaison.” They can take a crash course because it’s that chunk of my course with a little extra on resumes and cover letters. I do coach people, but I do it on a case-by-case basis for people who’ve gone through my course.

TCLHP 171 | Physical Therapist

Physical Therapist: You have to know what your why is and what makes you tick because people are leaving patient care because they don’t feel like it fulfills them.

 

What I was finding is we would get on the call, and someone would go, “I don’t know what I want to do.” I’m thinking, “I have this whole course, and I saved them so much money if they take the course. They work through all of that, and then we can take the coaching part and sit and dig In.” I can say, “Who do you want to connect with?” I connect them with company contacts I know and with the right people. We talk through the resume they’ve already worked on. It would take six hours to tell them what they needed to do to it then it’s already been done based on the course. I say, “I caught a couple of things you could tweak here.” That’s the coaching I do. I don’t consider myself primarily a coach, but I do these strategy calls and interview prep as needed.

That’s a similar thing that I found in my course The CashPT Blueprint is like the mindset, vision, and goal setting workshops that I’ve put in there, less people do those. They want to go straight to whatever else is happening, like they have to set up the business and marketing. I’m like, “We’ve got to start with these other places.”

You have to know what your why is, and you have to understand what makes you tick because people are leaving patient care because they don’t feel like it fulfills them or makes them tick. You don’t want to end up doing something else that doesn’t make you tick because it sounds cool on paper. I relate to that. I didn’t realize that you had a section like that in your course.

You’ve got to have the whole goal-setting thing. You’ve got to know what you want first off, and then you’ve got to have the right mindset going into it for marketing, patient care, and how do we build referrals. It’s a big deal, but everyone wants to do all the good cool stuff first. That’s why they don’t teach you the cool stuff first when you go to karate or taekwondo. You’ve got to learn the foundations.

I sometimes say, “It’s like a CI wanting to take someone who’s gone through PT school before letting someone loosen the clinic under their license.” I like your philosophy better because it’s a little bit more holistic.

I know that you had put this down, I know some new grads who aren’t treating patients, and the internet makes it a little easier for them to find information, but I’m sure new grads can do non-clinical. Would that be crazy to have a new grad do something that wasn’t treating patients?

You're not going to make a lot of money from the vast majority of traditional clinical jobs. Click To Tweet

I don’t think so at all. When you are a new grad, it’s important to figure out what your assets are as a new grad because somebody who has 25 years of experience is going to have a different set of attributes to offer to an employer versus someone who’s fresh out of PT school. I always let people know, “Understand what your special sauce is because if you’re coming out of PT school, you might want to work for an NPTE prep company, in clinical sales, or something where your lifestyle will align with the job.” A sales company is generally not going to hire someone who’s got two small children at home, who is sitting in the interview going, “I don’t want to travel that much because I don’t want to leave my family.”

As a newer grad, that’s the kind of job that would appeal to you. Plus, as a newer grad, a lot of people are going through these programs where they might get a DPT or PhD or something along those lines, so they might qualify for a role like medical science liaison, where they look for that extreme scientific and research-based knowledge. Someone who’s got 25 years of patient care but might not have the DPT might do better in more of a clinical specialist role for a company that does MS Research or has some MS Devices that they’re trying to sell or like a Parkinson’s disease. They’re called implant with deep brain stimulator. If you’ve got 25 years of Parkinson’s disease patient care under your belt, you might make a good educator in one of those clinical specialist roles.

Since you’ve got 25 years of experience, you have a family, or whatever’s going on in your life that might be taking up your time during your 40s, you might not have it when you’re in your 50s, and so then they could hire you into those roles. I’m making a lot of generalizations. I don’t have kids, but assuming people have kids in a certain time of their life or assuming that people have parents they want to take care of, but hiring ages is real and hiring managers do come into things with preconceived notions. To your point with new grads, being able to play that up and saying, “I’m a 26-year-old or 30-year-old. I’m single, unattached, and I don’t have a family. I love traveling.” That kind of thing to being able to play that up is attractive so that you don’t put the hiring manager in a position where they have to ask an illegal question. It’s playing the hiring game.

I wasn’t hired for a job. This is before PT is close. I was in the Bay Area, so I was looking for a job at PowerBar and North Face and this sport street marketing, then they made good jellies. I remember them asking me. We go to trade shows on the weekends and, “What do you like to do?” I was like, “To race bicycles.” They were like, “We want you because of your bicycle racing experience,” but they didn’t want me because as soon as I talked to them about racing on the weekend, they were like, “No, because the job required you to work on the weekend.” They thought I was more serious about it than I was. I didn’t get the job.

It’s funny how they ask those questions that are gotchas and gimmes. I do get a lot of young moms talking about who do I usually have come in. A lot of times, young moms or young dads and want more time with their kids. It’s interesting some of the questions that they get asked, and it always relates back to the kids’ thing, or for women, it’s like, “Are you planning to have kids?” Even though technically, I don’t know if it’s a state thing or nationally. It might be statewide, but you’re not allowed to ask about having kids in some cases. They get creative about it.

From my end, if someone came to me and was like, “I’m hiring you for a job as a physical therapist,” and they are like, “Yes.” I’m like, “Where do you see yourself in five years?” They’re like, “Owning my own business.” I’m like, “I don’t feel like that’s the answer that I’m looking for.” I’m looking for, “Working for your business,” is the answer, but I want people to be truthful as well. Meredith, what are some of the most popular or common jobs for people to get non-clinical, and what are the craziest ones that you’ve heard of?

TCLHP 171 | Physical Therapist

Physical Therapist: If you are struggling with patient care, just know that you’ve got the clinical skills, knowledge, and expertise to do a whole lot of good from the world. You just have to find the right place.

 

I’ll start with the most popular ones. The one that’s like the belle of the ball that everybody seems to want is utilization reviewer, and full disclosure, I would claw my own eyeballs out if I had to do it. You have no variety. I’m a classic variety seeker. I want a job where you’re doing some of everything. That’s why I’m an entrepreneur. You have a similar thing where I love switching tasks. If I can’t get something done on one task, I can immediately know that I can switch over to something where I will be a little bit more productive. Utilization review is like insurance reviewers, prior offs, denials, all those fun things. Some people want it. I don’t mean to downplay it at all.

It’s a good fit for people who like desk jobs, working independently and consistency in their schedule. I personally don’t like any of those things. I wouldn’t enjoy it, but that’s the most popular one. My theory for that is you don’t need much, if any extra training to get into it, though there are some like MedBridge courses out there that help you. There’s a nursing certification that if you get it on your resume, then it looks good and gives you an edge. It comes down to experience for those jobs. If you have five-plus years of clinical experience in multiple settings, you can usually qualify for those jobs. They are great former travelers.

That’s one of the more traditional ones. I get a lot of people wanting to do writing because my whole initial background personally was writing. Even though I wouldn’t say it’s one of the most popular ones, I get asked about it a lot. People ask me a lot about sales because that’s one that’s got that more exciting, sexiness, and it pays a lot. Even though some of them were entry-level, sales jobs aren’t always super lucrative, you can move up. You’re saying, “What are some of the crazy ones?” I would argue that you’re one of the crazy ones. We’ve got entrepreneurship, that’s great. I’ve been seeing a lot of people running online businesses, but if we’re talking about not doing entrepreneurship, one of my favorite ones that I think we belong in is medical science liaison. It’s like if research, sales, clinical specialist and maybe clinical trainer had a baby together, and it would be a Medical client’s liaison.

You would work for a company and represent some intervention or product or device. You travel the world meeting with Key Opinion Leaders or KOLs as they’re called. You meet with them and tell them everything there is to know about your company, their device, latest research, contraindications, and indications. It’s an exciting role for people who are like, “I want to be the absolute expert on this thing and get a lot of accolades.” This comes back to the holistic view of, “What makes you tick? What do you want out of a job?” Some people want recognition. If you like recognition and you like people thinking that you’re smart then medical science liaison. You’re traveling the world, making bank and have an impressive title. The caveat to this is that you need some background either in sales, marketing or research. You need something to get you to that role. I don’t see many people going straight from patient care to there.

It makes my skin crawl. The travel sounds cool, but all the other stuff is no. I’m not going to say that, but the point I want to make is that if you know yourself well, you can figure out what you want to do. You’ve been telling me how you know yourself well now. I’ve been working on that, and I know why I do what I do. Wouldn’t you say that’s one of the keys to figuring this whole thing out?

A hundred percent. Unfortunately, part of the issue with PT is that it’s touted as this stable career, which it was for a long time, and it will be again, with good earning potential. Unfortunately, even though you can earn a lot, you can start a cash-based business and make a bank but the vast majority of traditional clinical jobs, you’re not going to make a lot of money. What they’re leaving out is that you’re going to be in so much debt. The joy that comes from patient care, which is another thing that’s touted, isn’t there either.

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People sign up for it because it sounds perfect and it’s the best of everything, but the reality is it fulfills some of those things sometimes for some people, but it’s still a job, and it’s one of those jobs that’s not always ideal especially during a pandemic, reimbursement cuts and mounting cost of education. What’s happening is people are going into it because we’re still imagining what it was like in the early ‘90s almost or in early 2000s at least. The reality is it’s a very different profession from what it used to be. You can still get there and be adaptable. You are a perfect story for that. You were able to take this education and training, make your own business, it’s been great, and it’s thrived.

There are many success stories like that. If you’re going into it because you’re signing up, it’s stable, you can have this career, never get laid off, get benefits, get treated well, and respect, the reality is you won’t get all of those things in one job. It’s hard. At least not in a big city. That was the other point is I think in big cities, a paycheck that would be incredible where I grew up in Tyler, Texas, you would live high on the hog to make that kind of money. The schools are cheaper. There’s a school at the University of Arkansas. It’s so much cheaper than a lot of the schools in these bigger cities.

If you went to Columbia or somewhere in San Diego. People aren’t necessarily thinking about that. They go, “This is a great career. It doesn’t matter how many loans I have to take out. I’m going to do it. I’m going to get there, and everything’s going to work itself out.” If you plan to live in Chicago, Minneapolis, San Diego, San Francisco or any of these big cities, that paycheck is not going to get you where you want to be. So much of it to your point is you have to know yourself, your circumstances, and what are your must-haves? If you must live in San Francisco and have a certain lifestyle level, you might not want to be a PT long-term. Whereas if you want those same things, but you must live in the outskirts of Tyler, Texas, then you’ll be perfectly happy being a PT forever. I see that all the time. Most of the people who come in and work with me, not all, but quite a few, are in bigger cities because they see a financial cap, and it’s not working for them.

If you must live in San Francisco, you must have roommates as an adult, which I did for ten years. That has been a long time. There’s a concession. You can’t always have the lifestyle to live in the same city you want. You’ve got to choose from a couple of different things. Meredith, that was awesome. That’s a great point that you made and important. If people understand what they want and what their requirements are, they’ll find the right fit. Is there anything else? Did we leave anything out? If someone is maybe disaffected by their careers at PT or their choice, is there any advice that you have for them, or they’re getting burnt out and like, “I’m done with doing this?”

The biggest advice I could give anybody who hits that point is to take a deep breath and don’t make any sudden moves. Don’t jump from the frying pan into the fire and take a job, some job, any job, because it’s not your current job. Unless your current job is toxic that it’s affecting your health negatively, in which case, yes, make a move. If you’re feeling disaffected or unhappy, but you can hang on and then stick it out, try to take the time to put yourself in a position where you will have transferable skills. You have transferable skills as a PT, but put yourself in the position where you understand what those transferable skills are, and you know where you’re going next so that you can then develop any skills that you’re missing because transferable skills are soft and hard.

You’ve got soft skills like negotiation, building rapport and time management. You have hard skills such as, “I know this particular software. I know how to create a wireframe for a UX job.” They’re all these different things to keep in mind. I urge people not to jump into utilization review because you’re scared everybody’s going to get saturated, and then you won’t be able to get a job. Think about what you want to do? What your end goal is? What is your 5 or 10-year plan? I always recommend to, don’t just look at it career-wise. Think about it life-wise.

Think to yourself, “My ten-year plan is I want to be not working that much. I want to be semi-retired.” If that’s your ten-year plan, then you need to be focusing on money. Not necessarily even just earning. This is going to impact where you live, how you save, and what kinds of jobs you take. If somebody’s ten-year plan is like, “I love working, and I want to work forever, but I want to have a bunch of kids. I need to support them. I don’t want kids. I want to travel.” Think about how your life is going to be, then think about, “What kind of career fits in with that? How does my PT experience fit into that career?”

If you take it from that top-down mentality, then it’s so much easier to feel confident and have a direction. All of us were successful getting into PT school and becoming PTs if we’re tuning into this show. It’s not like you can’t do it, but you have to have a plan. Many people would come at it from this place of desperation where they’re like, “I’ve been sending out resumes to hundreds of companies and not hearing anything.” I’m thinking, “That’s because you’re sending out a clinical resume to 90 different jobs and you’re not qualified for any of them, but you can’t get qualified because you can’t decide. You’re panicked, and then you go to sleep every night, hugging your knees.”

If someone wants to get in touch with you, where do they find you online, and what’s your Facebook group called?

My Facebook group is Non-Clinical Networking & Jobs For Rehab Professionals. There is a link from my website. I would encourage people to go to TheNonClinicalPt.com. You can find a link to my Facebook group. I’ve got a ton of spotlights. I’m too shy to do a show like this, but I ended up doing Spotlight Series, where I email people questions and interview them. It’s a bunch of people who’ve taken these nontraditional roles. It’s people who have done unique and nontraditional things with their careers. I feature them 40 Sundays out of the year. I encourage people to start. If they’re feeling overwhelmed, and they said, “Where do I start?” Start by looking at the Spotlight series because there are many ideas in there. I have heard many people say, “I went to your website, read the Spotlight, and it touched my heart. I decided to do it. Now I’m in that kind of position.” When I hear that thing, it’s the best feeling on earth.

Meredith, thank you so much for coming and chatting with us. This has been awesome.

Thank you so much for having me. This is great.

I look forward to seeing you again in person sooner than later. Thank you for sharing all your insights and experience. Readers, if you are struggling with the whole patient care thing, know that you’ve got the clinical skills, knowledge, and expertise to do a whole lot of good from the world. You’ve got to find the right place. Thank you very much. We’ll see you next time.

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About Meredith Castin

TCLHP 171 | Physical Therapist

Meredith is the owner and founder of The Non-Clinical PT, the #1 resource for physical, occupational, and speech therapy professionals launching non-clinical careers in healthcare.

Her mission is to help therapists and assistants find renewed joy in their careers by supporting their pursuit of fulfilling, impactful, and high-paying roles beyond direct patient care.

About The Author

Aaron LeBauer

Aaron LeBauer PT, DPT, LMBT started a 100% cash based physical therapy practice right after graduation. He's on a mission to save 100 million people from unnecessary surgery & enjoys helping passionate therapists build successful businesses without relying on insurance.

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