Hello everyone and welcome back to the podcast. On today’s episode, I have the honor and privilege of talking with my dear friend Zuzana Rogers, who has been a physical therapist for over 20 years. She’s an amazing clinician, mentor, educator, and business owner. The purpose of today’s episode is to discuss the incredible power of coaching and mentorship as we move through our physical therapy careers, and I really hope this episode sheds some light on the highlights, nuances, and difficult periods of physical therapy careers, and also motivates and empowers newer clinicians to excel in their personal and professional lives. Welcome to the podcast Zuzana.

Gina: Did you always want to be a PT?

Zuzana: You know, when I was in high school, I played multiple sports and had injuries as this. You know, often the story with physical therapists, they had their own experience with either sports or different physical therapy experiences. So I knew I loved the medical field, I loved the sciences, and when I went through physical therapy myself, I saw so much value and benefit and knew that that could be a career that I would potentially enjoy. And then when I entered college my freshman year in college, I tore my right ACL playing basketball. The fifth game of the season, I was a scholarship athlete, so that was pretty dramatic in terms of injury and time away from sport. And I had the absolute best physical therapist for gosh, probably over a year he worked with me, and not only did we become really good friends, she became a great mentor and really guided me towards the profession. And that’s, you know, that’s really my story and how I got started as a physical therapist.

Gina: That is really cool. And you know, the funny thing is our very beginnings are very parallel as well. I’ve been an athlete for so many years and during my sports career I was fortunate enough I didn’t have many injuries. But we had a sports physician, an orthopedic surgeon who took care of us as a downhill ski team, and we became friends and, he kind of showed me the ropes of the orthopedic medicine and I just loved it. I read stuff about it and I really wanted to be an orthopedic surgeon. So, and you know, listeners probably know how hard it is to get into medical school, so. And in my naivety, I thought, well, you know, I’m gonna get into medical school, become orthopedic surgeon. Life will be great. But I did not get in and I was crushed. And at that time, that was right after college. I worked at a physical therapy place as an aide and I absolutely fell in love with it. And my boss at that time made me apply to physical therapy schools. And really tell you what, I would not change it for anything right now. I think it’s the best career.

Zuzana: Absolutely. I would agree. It’s been so fulfilling and just a constant learning process for me that I’ve absolutely loved the whole journey.

Gina: I have a question for you, Zuzana. How did you become an expert in your niche, sports physical therapy, downhill skiing, cross country skiing? What’s your background?

Zuzana: That’s a great question. You know, and the simple answer is really one step at a time over a long period of time. But let me tell you the wrong answer, too. When I was graduating from physical therapy school, I really didn’t know what I was gonna do as a PT. I kind of was like pediatrics and maybe I was gonna go into peds. My school, the University of Washington in Seattle was really strong in manual therapy and orthopedics and I really liked that. So I was like, maybe I wanna go that direction. I really didn’t know anything about sports PT, and I was actually really intimidated about being a sports physical therapist because I thought I didn’t know enough. You know, and you go see games and see big competition and you see all the athletic trainers on the field. They, they know what to do. They wear the gear and the logos and they just feel like they belong there. It feels like they belong there. And I feel like, I feel like I was not there so.

Straight after PT school, I was fortunate enough that I got connected with an amazing mentor in manual therapy and orthopedics, orthopedic manual therapy, and I stayed with this mentor for about 15 years and I’m super thankful that she showed me the ropes of orthopedic manual therapy. So step by step. You know, I did my manual therapy certification, and then I did my scientific doctor at the ScD through Texas Tech, and my area of research was sports injury prevention in adolescent athlete. And that really opened that whole area of sports physical therapy. And as you know, Gina, you start reading, you start learning about something and you learn more. And then you’re like, oh my gosh, this is so cool. I’m gonna learn a ton more about it. So little by little you gain more knowledge and experience and then.

I started volunteering with sports team and dance teams in Anchorage where I was working, and little by little I got connected with a cross country ski team in Anchorage, and they invited me to cover some bigger competitions and I got connected with the national team, which gave me a little bit, kind of the, the kick in the butt to learn more about sports. And I did my sports sports certification and some other certifications. So sport PT is something that I do right now and I absolutely love it, but I really tell you what, and you probably have the same experience. You really have to stay on top of your game to be a sports PT, a successful sports PT, because it’s always changing and the demands are so high. What do you think, Gina? How about you?

Gina: I would absolutely agree. There were a few things that you just said that really resonated with me. Number one being when I graduated from PT school in 1999, I knew I loved the concept of orthopedics, sports medicine. So I was fortunate enough to find a job in Waco, Texas, in a outpatient sports medicine clinic. Once I started working in the clinic. I felt like as a new grad that I knew a lot about, a little, so I knew, just had broad knowledge of physical therapy, but I definitely wasn’t a specialist in any area. And I think you and I are very similar in that if we’re gonna do something, we’re gonna do something, we wanna go 110% and be experts and excellent in our field. And so I had the vision of just becoming an expert in my field of sports medicine and orthopedic physical therapy. I wasn’t sure exactly how to do that, except I knew I needed to learn more about the diagnosis and management of orthopedic injuries. I knew I needed to get better, my manual therapy skills, so I also had a fantastic mentor. Phil Sizer from Texas Tech University Health Sciences Center and Jean-Michel Brismée, and they both pointed me in the direction of the Doctorate of Science program. And so in the doctorate of Science program, there’s extensive training in orthopedic manual therapy and I really just dove in and took the opportunity to learn as much as I could to just become not only a great clinician in manual therapy skills, but I also want to become a really good diagnostician because one of the things that’s really important in sports medicine, oftentimes you are the first responder or you are there on the field and you need to make a good judgment call. Not only an emergency management situation, but you’re making judgment calls on whether or not that athlete can participate or what you need to do quickly, if possible, to help manage their injury and get them back on the field. So.

One of the things I think is really vital that you mentioned is connections. I think it, I was asking a patient of mine a couple of years ago how he became a successful billionaire with 26 companies and he said, and this man never graduated from college and he was extremely wealthy, extremely successful, and he said two things. He said, it’s all about connections. And he said, I read a ton of books. And so I think it’s so important to really invest in your career, especially as a young clinician, and really dive into the literature, dive into books. You’re gonna get as much out of this career as you invest in it. And you and I both know that now as business and clinic owners. We’re still learning every day. You know, we’re diving into books, business classes, coaching, just to become better as business owners. So it’s a constant learning process and for me it’s super exciting because of that. I think I’m a, we’re both lifelong learners and we really enjoy the process. But as far as sports medicine, it was just a natural fit for me. But once I got into the field, I realized that it’s just a constant process of bettering yourself and staying on top of the game. And as females, I think that when we first started in sports medicine, it was very challenging because we are essentially pioneers in some, in some respects, just because there weren’t a lot of females at our level in those positions. And so now I think there’s more opportunities for female physical therapists to be in these roles, which is awesome. But a lot of times I kind of had to fight my way through and prove myself to some extent, I feel like I’m still doing that in some avenues, but again, if you make the right connections, you’re gonna, it’s one way to really get ahead in this profession.

Zuzana: No, that is so, so true, and a mentor of mine really described this really well. You cannot do great things on your own. You have to stand on the shoulders of giants, you know, and like you described, you have to have really good connections, but not just in physical therapy field. You know, it might be, it might be a surgeon, it might be a coach, it might be a parent. And being a female, I think we have the ability to really connect with our athletes, be almost like motherly, you know? But sometimes they can play against us. So when I treat my athletes, treat my teams, I kind of position myself, yes, I will take care of you. I’m your coach, I’m your physical therapist, and I know what I’m doing and where I’ll take it towards your goals, whatever that might be. You mentioned your studies at the Texas Tech University. We actually graduated from the same program, and it is, it was such an amazing experience. And like you mentioned, being a good sports PT, you have to have the foundation of the diagnostic skills and manual therapy because that’s what you do, you know? Many athletes don’t need to be shown straight leg raises, exercises, but you really need to know where they are right now and what’s missing in their sports endeavor, in their road to recovery, pretty much to have them reach their goals and make them better than when they were before. What do you think?

Gina: I would absolutely agree. It’s, it’s, I say it’s next level in that you have to have a really good connection with your athletes. So that starts with building a foundation of trust with your athletes, with the coaches, with this whole sports medicine team. And once you have that established trust and respect, you can really optimize your relationship in terms of physical therapist to athlete and help them maximize their function by, you know, different diagnostic tools that we have.

Zuzana: Absolutely. Let me tell you a story, and I was just thinking about it. It was several years ago and I was covering World Cup in cross country skiing and I had an athlete that had a back injury, you know, that happened week before she was supposed to start on the World Cup and very high level athlete and using my manual therapy skills and diagnostics. I figured out what was going on with the athlete, and I’m not gonna tell the details because of the privacy acts, but, and protect the athlete. But we figured out I’m gonna see her two or three times a day and we created a plan and we definitely did manual therapy with the active rehab exercise, neuromuscular progression towards her sport and. I was the only PT obviously covering this team during the competition and with it was on my shoulders to figure out can I put this athlete in to race next weekend or not? And in cross country skiing you have several different distances, different disciplines, so. Turns out that we held her back from one of the starts and we put her in the other start and she actually placed on top of the podium. So that was really, really cool to do. It was frightening, but it was really cool because I connected my manual therapy experience and knowledge with diagnostics, with my sports background, with the knowledge of cross country skiing and all the forces that go through the body. When you put high effort in the competition and kind of everything came together. We worked together as a team, was the team physician with the coaches, with the massage therapist and myself. So at the end it turned out great, but it was, it’s frightening really, when you are the person who has to make that big decision for the athlete.

Gina: Exactly. It, it, it is frightening, but I think also once you see them up on the podium and you get the chills and kind of the tears in your eyes thinking, oh my goodness, I played an instrumental role in helping this athlete get to this point. It’s so gratifying and so exciting as a, not only as a physical therapist, but as a team supporting that athlete and there’s no better feeling.

Zuzana: Seriously, there is no better feeling, and I would do it over and over again. I’ve been with a national team for 10 years and it’s all volunteer position. We don’t get paid for it by, even though you don’t get paid for it by money, you get paid for it by so many experiences and just what you said, it gives you so much power and satisfaction to see your athletes succeed.

Gina: For us as physical therapists, it’s so much about the journey and not necessarily as much about how much we’ve been compensated through the years or, you know, what we’re getting out of it from either our company that we worked for or you know, you worked and volunteered for 10 years now. But it’s just seeing the culmination of all the hard work and effort and education that you’ve put into this to be able to get to that point and help the athlete, and it’s so satisfying and so exciting, and I think it’s what continues to drive us as physical therapists after all these years to continue to pursue education and to continue to pursue helping these athletes.

Zuzana: Yeah, you’d never stop learning, and the more you know, the more you know how much you don’t know, and that pushes you forward. There is actually a really good quote that I bring up with one of my newer clinicians. And what it is, it’s actually a quote from Neil deGrasse Tyson, the Astrophysicist, and it says, one of the great challenges in this world is knowing enough about a subject that you think that you’re right, but not enough about the subject to know you are wrong. I can tell you an example. I was a new clinician. I think I was like one year out of school, and I was working in this really great clinic, working with physicians, pain physicians, and I had a patient that I thought I completely nailed the diagnosis. I was so confident. Yes, this person has a pain generated that is coming from cervical disc disorder and blah, blah, blah, and I know exactly the treatment. I know the succession of my training treatment sessions, and I’m gonna get this person better. Well, turns out my treatment did not work at all, and I was so blind. And thinking that I knew it all, that I missed. Very crucial part of the history taken in the very beginning. So, you know, when we talk about new clinicians coming on board, I think it’s very important to keep your mind open and just really knowing, yes, I know something, but there is just so much that I don’t know I need to strive to learn. Did you have any experiences like this, Gina, in your early years?

Gina: Oh, absolutely. There were so many times where, you know, I would look at a patient and feel like I was pretty spot on in terms of my diagnosis and treatment and then to try that treatment and it didn’t work or, so I had to go back to the drawing board and really tease through what I had missed. And so the more you sometimes the more you mess up and you realize how much you don’t know. It really encourages, it really forces you to go back and really dig deeper into learning more about what you may need to improve upon. And so I think it’s just having that humility to know and to understand and realize, you know what? I don’t know it all and, and I can tell you I still don’t know it all. It’s a constant learning process to have that humility to recognize, I don’t know it all, but I’m gonna find the answer somehow, whether that be, dig into the literature, dig into the books, go and talk to her mentor. So I think it’s really essential to have that attitude of humility and have that attitude that we’re probably never gonna fully get there and we’re never gonna know it all, but it, one of the things that is exciting about the physical therapy profession, that is that it is a constant learning process that drives and challenges us to do better and to do better for our patients. And so having a clinical mentor is a great opportunity to learn and to grow as a young physical therapist and just hone in on your skills and your differential diagnostic capabilities so that one day when you get into the scenario of being at a national world or Olympic championship, that you can be the one to make that call and help the athlete stand on a podium.

Zuzana: Oh, totally. So let me ask you this, and I know our listeners will probably ask this. How does one go about finding a mentor? Do we need to find a mentor in a physical therapy field? Or how, how do we even start this conversation?

Gina: I feel like there’s so many different mentors that I’ve had in my life. I’ve had mentors in physical therapy, but also as a parent, as a wife, I’ve reached out to people just trying to feel, just trying to understand like, how can I be better, a better wife in our marriage? How can I be a better mother? How can I be a better business? And so I think one thing is just to watch people who are very successful in their field. Watch, watch and listen. Sit back and go, oh, I wanna be more like that person. How can I become more like that person? And sometimes it’s just about reaching out and asking that person if you could possibly have coffee or sit down and have lunch with them and just pick their brain and ask them what made them successful. I talk to my patients a lot, who I really respect and go. What made you wanna become a physical therapist? What made you successful in your company? What made you successful in life, in your business? And I think it’s just recognizing the qualities in others that you want to emulate yourself. And then just asking those people for opportunities. There’s so many opportunities in life and people that you come across and connections where you can make those, form those relationships and really learn from others. And so in the clinic. Early on, I asked, you know, my supervisor, my boss, I would ask him questions about, not only about diagnoses, about skills.

Zuzana: You know, we were talking about how do we approach potential mentors and I think newer clinicians, especially when I was a new clinician, I was like, oh my gosh, you know, this is a great person and I don’t know if I’m even worth the talk. Come and talk to this person. And now I’ve been a PT for 20 years and I mentor a lot of students. I mentor a lot of newer clinicians or even people who want to go to medical field that they don’t know which area of that. You know, it tickles me pink when somebody asks me, Hey, can you, can we sit down for coffee and can I ask you some questions about the profession and what you do? I was like, yes, please do. I love talking about this awesome profession that’s called physical therapy, and you know, we are just people. We’re normal people and we love talking about our knowledge and experience, especially sharing with our potential colleagues. So I encourage students from physical therapy school, it doesn’t matter whether you’re finished or not yet, or even if you are just thinking about going into the field. Or you know, if you’re a new clinician and you want to get into certain areas of physical therapy, reach out to people who might be a little bit beyond your normal just colleagues and friends in your job site, but reach out to somebody who is way above you or a little bit above you because like I said before, you have to stand on the shoulders of giants to get better, and they will pull you forwards. They will show you the ropes on how to become a lifelong learner, how to be successful in the field that you’ve chosen.

Gina: I absolutely agree, and it’s one of the best things that I’ve ever done is really connect with mentors, and you and I are both still connecting with mentors on a weekly and a monthly and a yearly basis to become better business owners as well. So it’s just a constant process of growth for us, and it’s exciting to see where we both come from, where we’re going, and I think a lot of that can be attributed to our ability to stay humble and really reach out and seek the help of others and mentors in our lives. Let’s switch topics just a little bit. Gina, you’ve been a business owner for several years. Did you want to be a business owner when you were a younger clinician? How did you get into this idea of actually owning a practice?

Zuzana: That’s a great question. Interestingly, I did really have a dream of one day owning my own practice. I had no idea how to get there and when I graduated from PT school, I knew that I had a lot of learning and experience to gather. So I, as we talked about earlier, just dove in and tried to learn as much as possible. And then through the years I worked in several orthopedic outpatient orthopedic clinics, hospital based private practice, corporate owned, and gathered a variety of experiences in that way. As a young clinician, I actually had the opportunity to lead a sports medicine team and department, which I was completely unprepared for, but sometimes the best way to learn to get, just to dive in with both feet. And so I did and I took the opportunity to learn as much as possible from a business side and realized again that I had no idea what I was doing in terms of budgeting and planning and employee management. I was only 26, 27 years old. But what a great opportunity to embrace in terms of just learning more about not only who I was as a physical therapist, but who I was potentially as a business owner, a leader. And then fast forward a few years, we moved from Texas to Colorado and I finished the doctor’s science program. I finished the research that I was involved in and we had children. And so that was just such a blessing and an opportunity to focus on raising kids and our family, and we’re still focused on that. But as they got older, I had the opportunity to consider opening my own practice, and I had a really unique clinical experience and that I was working in a practice where it wasn’t the highest amount of job satisfaction, honestly, because it was a PT mill type setting. Insurance based and we were asked to see a lot of patients vary. There was a lot of pressure on productivity and numbers, and I wasn’t really able to treat patients the way I had envisioned treating them. They weren’t getting good outcomes. I feel because of the way that they were rushed in, rushed out. We weren’t really able to adequately communicate with them, and so my job satisfaction honestly went down to the point where I was starting to seek out other ideas for what I could do in the future at that point. I had been a physical therapist for about 15 years, and I thought there has to be a better way. And so I started on the side looking at different options for physical therapy. Looking into could I even start my own business? I sought the help of mentors in the profession. I started reading books, started perusing websites online, and I thought, you know what? I think there’s a way to do this better, but I’m not sure if I can do it. So I just continued to learn and grow on the sidelines as I continued working in this practice and one day, something that our clinical manager said, really just spurred me on to pursue this private practice idea even further. We were in a circle, I’ll never forget it, it was a lunch type business meeting and we were going around the room and we each had to report our productivity numbers. And so I started reporting my productivity number and I was chastised for that. Told it wasn’t good enough, told that I needed to put a hot pack, ice or EIM on every patient. Seriously, and bill for that. My goodness. It just ruffled my feathers. And then I was asked what I was doing for marketing and I had all these marketing ideas to start a sports medicine niche in our clinic. And she really shot those down. But also I said, well, I think this could be a potentially a really good idea. I’m willing to go volunteer. I’m willing to do all this work on the side. You don’t even have to pay me for it. And she said, well, Gina. If you can do those things, why don’t you just go out and do that on your own? Fantastic. And so two hours later she had my resignation.

Gina: Wow. Gina has a sense also.

Zuzana: Yeah. Yeah, I decided to, I actually did call my husband before I resigned and asked if it would be okay if I did this, if he thought we would be okay financially, and he gave me his blessing and I called and resigned, and the rest is history. Then I just dove into starting a practice from the ground up.

Gina: That’s fantastic. What a story. That’s cool. And you know, there’s so much truth in that. We have these PT mill clinics that see three, four patients an hour per PT. And then, you know, you always think about, is this what I want to do? Is this how I need to serve my patients? And you know, there’s subset of population that are totally fine doing that, but then there is that other population of PTs and patients, that’s not enough. You know, and just like we continue to learn in our professional career within the PT and read research and the clinical stuff is the same. You are, you’re developing as a person and I can speak to myself, my values have developed. They never changed, but they develop more and more as I was going through my PT career in a way that I really, really want to give my patients absolutely the best and in sports physical therapy practice or sports-based physical therapy practice, there’s a lot more than putting hot packs and ice on the patient. Now you’re working with a patient from the very beginning towards the very end towards them being able to run a marathon or whatever their goal is. And just like you, I was not able to provide that level of care in my previous practice. So, you know, that’s where the new practice and my clinic started and I wouldn’t, I would not change it for anything. The learning curve was super steep. And you know, we’re talking about mentors in this podcast, and I’ve had many mentors, many business mentors that help me kind of establish who my clinic is in the community and who I am as a business owner. And it never stops. You have to keep on your toes. You have to keep learning. So looking back, Gina, I know we’re talking to maybe newer clinicians or new grads, would you recommend somebody starting a clinic straight from PT school?

Zuzana: Just based on my experience, I would recommend that a new clinician really focus and hone in on where they want to specialize and what their niche is. Really work on becoming experts in that field first as far as their skills, their knowledge, and their ability to be experts in that particular niche before you just jump out and start a general practice. I think that one of the, it is very exciting to have your own practice. It’s also a lot of work as we both. Well, there’s a lot of things that go on behind the scenes that can be you know, very overwhelming, just as a seasoned physical therapist. So I think that one thing that’s critical is to become an expert. Know what your niche is, know what you’re really good at, become really good at that first. You don’t have to become the, you know, we’re, we’re all continuing to learn. I think we’ve talked about that, but I think one of the things that’s really vital is growing and learning as a clinician first before you reach out and start to dive into the world of private practice, because there are so many challenges that just come with that. So I really see my career in two phases. I see my career as a physical therapist and I see my career as a business owner. Zuzana, do you remember when I came to get you from Denver International Airport and we’re riding up towards Boulder to meet with a clinician up there and you had your…

Gina: Oh yeah. We were really just dreaming and I think that was the start of phase two for both of us, honestly.

Zuzana: I think so too. Yeah. That really opens up your eyes with the possibilities might be, and you know, just to say same thing as you did, I think clinicians or new grads need to learn how to fail first. And there are so many mistakes and failures that we go through as new grads and newer clinicians. And it’s much, much, much easier to make these mistakes when you’re in a bigger clinic, when you’re not your own boss. So, and learning about yourself as well, you might realize that maybe being a business owner straight from school is not what I really to do I need to gain experience, gain mentors, get good expertise in the area, and then maybe, and there might be people who are like, Nope, this is not for me. I’m very happy in a big institution where, you know, I work nine to five and I do not have to think about my business at midnight. But then there is a subset of people that just really need that challenge. And being a business owner, there’s every day there is something new and you have to wear so many hats that other people just don’t see until they get into the area.

Gina: That’s right. Yeah. So tell us a little bit about your business, your clinic. I know you strive to learn and learn a lot about the new clinical advances and what’s going on in sports medicine. What is your clinic clinical niche all about?

Zuzana: Well, I’m excited to talk about this just because it’s really evolved and changed over the last, you know, six years. When I first started, I started as a mobile cash-based outpatient physical therapist. So I traveled around the Denver Metro area. Again, just making connections. I volunteered a lot with local sports teams and made connections with coaches, high school coaches, club coaches. And then had the opportunity to join a sports performance center and sublease space from that sports performance center, which has been a great experience, very exciting to be able to collaborate with strength and conditioning coaches. The athletes and the their coaches and parents association, we with those teams. So the business evolved from a mobile outpatient practice to a smaller scale sports medicine orthopedic practice. And as the years have gone on, I’ve had the opportunity to take on more space in the buildings we’ve grown in space and also patient numbers. And I have the opportunity this year to move into a new space, which is about four times larger than what we have now, which is will enable us to just serve more people and help more people in the community, and to continue to become experts in our community and help establish ourselves as a leading provider in sports medicine.

Gina: Congratulations. That’s amazing.

Zuzana: That’s amazing. Thank you. So how many clinicians do you employ now?

Gina: Right now we have two physical therapists besides myself, and then we also are hiring a full-time operations manager in September, which will help a ton. I think that as we grow our business, we discover again how much sometimes, how much we don’t know, or how much we need to offload to someone else in order to be most productive as business owners. So I’ve become wiser in that. So I have an operations manager coming on to help take over a lot of the job roles and descriptions that I’ve, I kind of did it all for a long time, and that’s not the most productive way to do it, as we all know. So that’s where we stand right now, and we’re looking to probably hire another physical therapist in the next year.

Zuzana: What a great growth. And so when we talk about a niche clinic in very specific area of the sports physical therapy, how much do you think that’s important? Is it important to serve a wide patient population or is it more important to really be specialized in a subset of that?

Gina: I think in our area, especially in our practice, it’s really important to specialize in a subset or niche. There are so many private practices around this area. There are so many corporate hospital owned and private practices. There’s a lot of physical therapists in Denver, Colorado area, and so for us to specialize in, hone in on the why and who we’re really trying to reach and who we’re trying to treat, I think that’s helped us be successful as a business. We, I always say we don’t have to. We’re not the PT for everyone, and that’s okay. I think at first when I first started, I tried to be that and I wasn’t as successful as when I narrowed that focus and become. And became more of a niche based practice and a leader in that specific niche. So one of the things I tried to do is specifically market to our niche. And once I honed in that focus and honed into the why and honed into our