Dr. Gina Fick: I’ve invested a lot. I expect the same out of our employees, especially for a private practice owner. I think what is important for our employees to understand is that because I’ve invested so much when I have employees that care and really value being here. I’m willing to do whatever it takes to take care of those employees because it means so much to me personally.
Dr. Gina Fick: Welcome to the PT Rebels Podcast. This is the place to learn how you can become a PT rebel and take charge of your own health and wellness. We will help you find answers to your questions about pain, injury, and the path towards healing in the most efficient and effective way possible. I’m your host, Dr. Gina Fick.
Welcome back to the podcast everyone. On today’s episode, I have Mason Perry, our new physical therapist here with us and another special guest, Ashley Hart. Ashley is a third year DPT student from Texas Tech University Health Sciences Center in Lubbock, Texas. She is on a clinical rotation with us today. We wanted to discuss the state of clinical education as it relates to physical therapy and the role that clinical instructors play in that, and clinical experiences play in developing our physical therapist.
I think Mason and Ashley have a unique perspective on that. Mason recently graduated from Marris College, and Ashley is about to graduate from the Health Sciences Center at Texas Tech University. I wanted to get their unique perspective on their experiences in physical therapy school, their clinical experiences, and also what they value in terms of employment and also mentorship as it relates to their careers. So welcome Ashley and Mason. Welcome back to the podcast today.
Mason: Thanks for having me again. I appreciate it.
Ashley: Hey, y’all, nice to talk with everyone.
Dr. Gina: So we’ll start with Ashley. Ashley, tell us about your background, a little bit more about yourself.
Ashley: Yes, so I was born and raised in the Dallas, Texas area and like Gina said, I went to Texas Tech Health Site Center in Lubbock. So I’ve currently had a couple of clinical rotations with different cis in different areas of the country, like Nashville, Abilene, Texas, and now I’m here in, uh, Highlands Ranch, Colorado. And so far I’ve learned that your clinical instructors can really make or break your experience in the clinic and your education as a student.
Dr. Gina: So Ashley, what number of clinical experience is this? Free hack? Weekly. This is clinical experience. Five.
Ashley: So number five. Okay.
Dr. Gina: So tell us some of the things that you appreciated most from some of your best clinical experience so far.
Ashley: I think having a CI that really makes you feel a part of the clinic is very important. A CI who’s there to answer your questions, be readily available, but also pushes you to better yourself.
Dr. Gina: I think one of the things that makes a good clinical experience is that connection ahead of time too. And one of the things that I appreciate about Texas Tech and some of the other. Universities that we work with is the ability to, um, interview and look at your resume ahead of time and connect. I know Ashley and I had a Zoom call and right away I could tell Ashley is just very fun personality and is very outgoing and would be good at connecting with her clients, and that made me feel comfortable with Ashley and also. Knowing some of the professors at Texas Tech and I trust their judgment in terms of who they’re sending in as a student into our practice. I think that’s helpful.
Ashley, I think you’ve had a few experiences that maybe you could touch on that weren’t ideal, and without giving any specific information, what are some of the experiences that you wish maybe had gone a little bit better? What did you see in the clinic that you weren’t either pleased with or maybe surprised with in terms of what you saw out there in the clinical world?
Ashley: So something that my program really touches on is a professional development and really being a professional in the clinic, and I think that I’ve unfortunately have been on the other side of professionalism where I’ve had a CI that wasn’t so great at practicing as a clinician and educating his students as far as fraudulently billing or asking the students to do stuff in the clinic that we just know are not super ethical. So I think as a CI you should really hold yourself to high standards. Just like us as students, try to hold ourselves to high standards because it really goes both ways.
It’s sometimes hard as a student to speak up to your CIS if you know that something isn’t going correctly, just because if your CI can really impact your grade. So I think just making sure as a clinical instructor that you’re holding yourself to the standards you want your student to hold yourself to is really important.
Dr. Gina: I think that’s good advice, and unfortunately that happens probably more than we would like in the clinical world. And I think being bold enough to speak out when you know something is not right, takes a lot of courage. Congratulations for doing that. We always learn from experiences in our lives, whether they’re positive or not. So positive. And sounds like that’s what you’ve done.
What are some of the things in your program that you value the most at Texas Tech University Health Sciences Center? From a perspective of experiences that you’ve had there that you really value.
Ashley: So something that, like we do at my program is we have faculty mentors that we get to meet with weekly and they keep us on track as far as like our academic status as far as like how we’re doing. ’cause I know a lot of times students deal with imposter syndrome and feeling like we’re not. To the level of our professors, and so that’s something that I really enjoy. We also have SIM labs where we get to actually practice in the facilities with our instructors, so that allows us to ready ourselves before we even go into the clinic.
Something that’s really neat is that we get the opportunity to further advance our skills. We call this our PT toolbox, and one of our professors at the university allows us to get dry needling certified as a student and. As students, when we pay those fees, they get put into a student account where we get to go to other events that practicing clinicians get to go to. So that way we are well educated to go out to the clinic and we also have skills already in our toolbox that we can use. So those are some neat things that tech does for us.
Dr. Gina: That’s great. What clinical areas are you most interested?
Ashley: So I think I’ve been your outpatient girl. I really enjoy outpatient orthopedic. I’m at a specialty clinic here with Gina, the sports space, which has been so fun. I’ve only been here two weeks, but I’ve enjoyed it so much. I think I’m an outpatient girl. We’ll see.
Dr. Gina: How do you think your experiences as an athlete have helped shape your interests in the outpatient world?
Ashley: So, as an athlete, growing up in high school sports, I unfortunately had many injuries, or I spent time in the PT clinic. I feel like my experience with physical therapists, with athletic trainers, and just a cohesive team to rehab me, shaped me. Then I wanna have that impact on someone else. I can relate to athletes here in the clinic here. God, I know what you’re going through. I’ve been there myself, and although we have unique differences in having an athletic background really helps you relate to this athletic population.
Dr. Gina: I agree. I wanted to get Mason’s perspective, Mason, you graduated in December and you’re working with us now, but if you can look back onto your clinical experiences, how well did you feel prepared and what things did you do during your clinical experiences to help with your own professional growth?
Mason: Yeah, so I was actually blessed with some fantastic clinical spirits. We at Meris, they gave us four clinical rotations and really three outta four of those, I would say were 10 outta 10 experiences. Uh, what made them so valuable? Few reasons. One of which being the CIS themselves, as Ashley alluded to before, when you have a CI who you truly look up to, not only as a therapist but as a person, I think it really goes a long way because they show you the ropes, they show you the techniques that they use, that they time to be effective, but then they also show you. Their mannerisms and their personality, how they approach their patients to treat them with cared respect. Looking up to cis that are teaching you and imparting their knowledge onto you. That goes a long way.
Some other valuable experience I had was going into a clinical rotation where they have structure. They have a plan for you almost even before you get there, saying, okay, week one, this is how things are gonna go. Week two, week three, week four. It’s all progression, right? It’s not just. Showing up on day one and not really knowing what to expect and not really having a plan. They developed ideas for you. They developed a kind of a game plan for you to grow and learn over the course of your time there at that rotation.
As you do that, you’re gonna gain independence, and I would say that’s the most valuable thing that I gained from clinical rotations is independence. I’m confident enough in my skills to treat patient on my own. I don’t need my CI there. Becoming and developing a new, a true clinician so that when I’m done with all the clinical rotations, I’m prepared to go into the field and I, I am capable of doing this myself. A lot of times, like Ashley alluded to, there’s the vet imposter syndrome as a student. So I think gaining that independence in your clinical rotations really develops your own mindset and your own confidence to realize, okay, I do have all the skills that I need to do this on my own. And it’s really just getting that belief. Instilled in yourself that, okay, I can do this. Those are two valuable things I learned.
Dr. Gina: Thanks for that perspective. I think it helps us as more seasoned clinicians also to understand what you guys value in your first, you know, job or work opportunity. So, Ashley, if you can speak to that a little bit and just tell us what things you’re looking for in your first job role as a physical therapist and the type of practice that you see yourself best fitting in.
Ashley: Okay. For me, that’s coming up. I’m gonna have to start doing some interviews. And I think for me, mostly it’s that mentorship being okay with entering a clinic and knowing that I’m not gonna know everything. I am a new grad. And just being okay with asking your fellow peers questions and letting them show you the ropes, giving you guidelines. I would like a clinic that offers a good workplace environment because you’re gonna go to these people every single day and you’re gonna work with them. And if there’s. Stickering. Or if there isn’t cohesion, then it might make that clinic a little miserable.
Something else is continuing education. Obviously the field of physical therapy is growing daily, and so you want a site that is pushing you to better yourself, and then also going into a clinic where you’re not gonna be the Guinea pig taking on 18 patients a day. You’re new. You need to be slowly worked up to that. ’cause I think. That’s how you lead to like being super stressed at the job. You’re gonna be miserable. So those are some things that I look for.
Dr. Gina: Thank you. I think we try to give our clinicians time to acclimate, get to know our clients, and really form relationships with our clients. Mason, can you speak to that, how we’ve let you ease into the job role and what types of opportunities you have each day to prepare for your clients?
Mason: Absolutely. So that’s been one of the best things about my experience here so far. I am still seeing patients, obviously, but in between patients that have the time to reflect on what went well in this session, what didn’t, and then reflect on I’m gonna develop a plan for next time to either add this in or throw this out, whatever the case may be. As Ashley alluded to, when you’re seeing 18 patients a day, you don’t have the time to reflect and learn and grow as a clinician. You’re really just trying to stay afloat. So that’s what’s been so great about my time here so far, is that I’m seeing an appropriate balance of patients, but then also getting that time to learn and reflect and not only develop myself as a clinician, but it’s ultimately gonna lead to better care for the patients. So that has been amazing so far.
Dr. Gina: Cheer that’s actually also alluded to the sad topics here, but I feel like a lot of times, as I mentioned, students come out of school and they feel like they’re expected to know everything. And they have that imposter syndrome deep down, but they’re not gonna display that on the surface because they want their new employer to think the best, right? So they’re gonna be saying some things that they’re not necessarily sure of, or they’re gonna be afraid to admit they don’t know some things. So I would encourage others out there, really be vulnerable and just be honest with yourself because A, again, it’s gonna help the patient, but B, it’s gonna help you as a clinician be vulnerable and say, Hey. I haven’t experienced this before. We didn’t really cover this too much on school. This is something I’d love to learn more about because yes, you do learn a ton in school. You are capable of treating patients obviously, but even seasoned, experienced clinicians, they’re learning every single day. When you can take those words of wisdom and those tidbits of experience of someone like GM has been a physical therapist for 20 plus years, you can learn so much, and I really just would encourage others out there too. Be honest, open with themselves and admit that, okay, I don’t know everything, and I wound there.
I can learn from Mason, just like Mason can learn from me. And we’re always learning, and I don’t know it all either as a clinician or a business owner. And so it’s a constant growth process and we make mistakes. I think having either people in the clinic that you can learn from is so valuable, not only from mentors, but also how other. Clinicians treat patients. Everyone brings their unique skills and experiences to the clinic. One thing I think is really important is for clinicians to find an experience and a job opportunity where you can come in and be your own person and bring your own skills. You can bring experiences and talents into the clinic that maybe other clinicians in the clinic don’t have, and I think that it’s really valuable when. You have an environment that’s accepting of that and that you can learn from each other.
I think one of the most fun work experiences that I’ve ever had was where we were all friends and we got along really well, but, and we had a lot of fun, but we also learned a ton from each other. And it wasn’t that one clinician was trying to be better than the other or be more productive or get better results. I think sometimes we can get stuck on that in the clinic, but it was just. Focused on the experience that we were trying to provide the patient. When we focused on that. It was really a fun time and, and we got really good results. As a practice, once you’re out in the clinic, in your first job role, what are some of the things that you’re looking at in the next year in terms of growth and development?
Ashley, when you see yourself out in practice, what are some of the things that you see yourself doing in the first year or so to grow and develop professionally?
Ashley: I think in that first year, it’s going to mostly be what type of clinician do I wanna be and how do I wanna practice? I feel like it’s gonna be more so developing myself, taking in what everybody has to offer, and then determining the type of patient care I wanna provide. I think. Looking at your peers, like seeing how, like asking questions. I feel like that first year is pivotal for asking questions like, what did you learn as you were growing up as a clinician? Or what did you think is the best round? It’s really just taking all sorts of perspectives. ’cause like people are gonna throw residencies at you, people are gonna throw certifications at you and sometimes like you don’t need those fancy Nancy credentials after your name to be a. Really good practicing clinician. I think in that first year for me is just gonna be taking it all in. ’cause it’s gonna be a lot. ’cause you’re gonna be balancing patient care. You’re gonna be balancing yourself, your mentors, and all the things. So I think that first year is just gonna be taking things in. That’s what I think.
Dr. Gina: Yeah. Ask a lot of questions. I think I’m being in an environment that welcomes that. Mm-hmm. My first job experience, I was just thrown to the wolves. I think the first day I had. Eight new evaluations. I didn’t even know where everything really was in the clinic and I just, um, had to jump in with both feet and ended up seeing 20, 25, sometimes 30 patients a day. It was pretty tough as a new clinician to feel confident because first of all, you just don’t have a lot of time to think. You’re just going through it. And second of all, you definitely don’t have time for mentoring to ask questions. So I would spend a lot of time on my own just trying to figure it out, but. I didn’t feel like I was able to give my patients the best care experience.
Mason, what are your priorities in terms of learning and growth this in this first year?
Mason: Yeah, I wouldn’t completely agree with Ashley. As I said, continued learning is huge. I do agree that it doesn’t have to come from certifications or from developed, established programs that you can learn from. A lot of it can be talking with your peers, talking with your mentors, but then I also do encourage just a lot of independent growth and independent learning. That’s where I’ve learned the most, I would say, is over the course of my rotations. When I was a student, I would have a patient and I would work with them, with my ci, and I would learn some things, but then I would go home and I would reinforce what I learned by, okay, reviewing not only what I did, but then also expanding upon that and doing some research for what I can do the next time. Um, and ultimately I think that’s where the most growth comes from because. You can’t listen to other people and learn from other people, and that’s awesome. But if you don’t put in the time yourself to really absorb that and reinforce that in your head, you’re most likely gonna forget it within a week or two. So I would say that’s really what I’m looking for.
Dr. Gina: What have, yeah, it’s fantastic you guys. I think that’s really solid and I think you both have a very good approach to that. The next direction we’re gonna go with this. I think this can be fun. One of the things that I really appreciated about Mason that really stood out with his interview, he was very prepared. He asked us really good questions. So as a clinic owner, I obviously have questions prepared that I wanna ask, and I have. Kind of different reasons for asking those questions, just to see what the responses will be. And Mason was very well prepared for the interview. One of the things I was most impressed with was just his ability to ask really insightful questions.
Mason, what advice would you have, Ashley, as she’s going through the interview process, and what are some of the most important questions for her to ask her future employer?
Mason: Yeah, absolutely. Like Gina said, be prepared. Do your research beforehand. Learn about the clinic, learn about their values, learn about their treatment mindset. Because that shows the clinic that you care, right? You put in the time to learn and you wanna be a part of this, so you should put in the time to learn and ask appropriate questions. I, for example, with 15 performance, right? Gina has this positive podcast. Took the time to listen to the podcast and get to know, okay, what is her treatment mindset? How does she approach patient care? Learn more just about her as a person, right?
So, Ashley, I would encourage you, maybe I don’t have a podcast, but you can look on, uh, clinic’s website and learn their values and how their workflow exists. I would also encourage you to shadow at a clinic, if at least ask to see if they’d be open to that, because that really gives you insight into how it actually works. People can give you answers. Then sometimes that’s a little bit different than we in relation to clinic. So I would encourage you to shadow, but then I would also, and I think this is one of the biggest things I learned over the interview process, is you want to not only ask about how you’ll benefit from joining the clinic, but you want to ask about how you can benefit the clinic. So working the other way around. Because the clinic wants, yes, to develop your skills, but they also want to obviously benefit from you being so ask questions, saying, okay, where can I add value to this clinic? But also have an idea already in your head saying, this is how we’ll that add value to that. So really it all just stems back to being prepared and, and taking the time to put in the effort to ask those appropriate questions and show that you care.
Dr. Gina: I think one of the things that we could tell right away was that you invested the time to figure out. PT is all about, and for me that’s so important. It’s essential because our clinic model is unique in how we approach patient care. So the fact that you took the time to do that, you were the only person that really stood out in that way.
So Mason, what experience do you feel like you’ve been able to give your clients that you’ve treated so far, and how do you think they’re benefiting from that?
Mason: Yeah, absolutely. So when you’re seeing a patient for the first time. I think it’s crucial that you ask, okay, have you had physical therapy in the past and has it been effective? Um, many times patients will say, yes, they have had physical therapy, and no, it hasn’t been effective. Hence they’re coming to a new clinic to try new things. Um, so you want to get an idea of what they have been through in the past, and then you know that, okay, maybe the patients are a little closed off to certain treatment methods that even you may feel that are effective, and you’re gonna want to avoid those treatment methods at first because if they say. Oh, I’ve, for example, I’ve received traction in the last five visits and traction hasn’t done anything for me. You’re not gonna want to give them traction on that first visit, even if you think it may benefit, right?
So you’re gonna look at alternative treatment methods because there are multiple ways you can treat the patient to bring them back to full health. So really it’s a team effort, right? It’s listening to the patient, understanding what they want and what they feel is valuable and, and meeting. Obviously the physical therapist knows what’s gonna benefit them the best. So it’s a little bit of give and take, but it’s important to listen to that patient, and I talked about this on the last podcast, but develop a relationship when a patient feels that they can trust you and they have a true relationship with you, and they’re just coming into PT to, yes, get better. But okay, I’m in the hands of someone who cares. They’re gonna improve, they’re gonna feel much better, and they’re gonna be much more comfortable and have a much greater experience.
Dr. Gina: Thanks, Mason. I think that. Our model really promotes that value-based care, and we try to get it right. Ashley, what have you seen out in practice? What are some of the differences in clinical settings that you’ve seen in terms of insurance-based or higher volume versus our clinical practice, and what do you value in terms of the clinical experience?
Ashley: This clinic that Lia has a very unique experience because I feel like you can really just build that one-on-one connection with patients. Versus sometimes those corporate physical therapy clinics, it’s hard to build that patient rapport that Mason was talking about because you initially eval that patient and then you send ’em off to either a tag or a physical therapy assistant. They rarely see the, the pt other than that initial eval. And so something that I’ve just observed as a student is the difference in connection when you’re given either 30 minutes, one-on-one time versus an hour’s one-on-one time, it really can make the difference with patient care.
And in school, they tell us, you could know everything on the planet, but if you can’t build a connection with that patient, then you’re not gonna impact their care. They say that. As long as you’re providing good communication, really building the rapport, you can make a difference even if you don’t know everything. And something that I’ve noticed is sometimes corporate facilities, when you’re seeing two patients at a time or even three patients at a time, you’re really disconnected to your patient care. And so that’s something that I’ve really enjoyed just here at Gina’s clinic.
Dr. Gina: Yeah, thank you. That’s what we strive for and I think is the. A clinical experience where patients develop trust and connection with us. I’m glad that you guys have been able to see that. So one of the things that Jean-Michel Brime and I talked about last week was clinician burnout. And so they did a study at Texas Tech, at the Health Sciences Center where they looked at thousands of physical therapists across the country and asked them about burnout. On the very last question, they said, do you feel burnout in your current role? And over 50% of them said, yes.
So I think that whether we want to acknowledge it or not, it’s a real problem. It’s a real thing. I think one of the things that we do to help prevent burnout in our clinic is to have a different model of care where we’re not seeing 20 patients a day, where we are providing mentoring and experiences where we do give you flexibility in your schedule, things of that nature. So what things do you think need to happen to help physical therapists avoid that burnout in the profession?
Mason: Burnout’s a huge problem. I think most PTs are aware of it at this point, especially new grads, which is funny because they’re new grads, right? They shouldn’t be burnt out. But I think new grads are some of the most burnt out individuals because school’s a lot, you have three years of school. So it’s a long grueling process. And then unfortunately, many times. Like Ashley was alluded to, some of those corporate physical therapy, uh, larger corporations, they almost take advantage of you. So they throw them to the wolves and they give them 20 patients a day. I was talking to a few of my classmates and that’s the current, uh, status of their employment. They’re seeing 20 patients a day and spending hours on those, and they’re just feeling fry.
So coming out of school, being mentally drained and then going right into a, a clinic that throws you to the wolves and. Almost uses you as a set of hands versus clinician and a person. It, it just doesn’t lead to success. I think ultimately what we can do is solve the problem is new grads realize that’s not the most effective treatment plan for not only the patients, but for themselves. I’m very fortunate to be at 50 team performance where that’s not the model, but I also didn’t wanna say, wasn’t gonna be happy in that model. I knew that wasn’t gonna be a right fit for me. Um, so I didn’t explore those opportunities and I knew that if I put in the work, I put in the effort, I can get a valuable first job where I won’t have that burnout. I won’t be drained. So I would encourage new grad not to settle and school, they tell us to like really know your worth right off the bat.
Ashley: And if you know your worth and you don’t just settle for a paycheck just because you wanna make the most money right out of school, really just know. What setting you’re getting yourself into can really avoid that burnout early on, because there’s so many clinicians that jump in different fields now because they’re so burnt in one setting. They’ll go to a different setting and just, that’s what Mason said, don’t settle until you’re working.
Dr. Gina: I think when I find clinicians who aren’t willing to settle, that tells me a lot about their character and it tells me a lot about their focus. And I think that really stands out to me as far as people who are interviewing for employment positions with, with our practice. Is that they’ve taken the time to get to know us and what we’re all about, and they really value that. I’ve put a lot into the practice personally, blood, sweat, and tears, and my own money. So it’s really important for me to have employees here invested. I don’t want people coming in here that don’t really care about clinical model. They’re just here to collect a paycheck.
Because I’ve invested a lot. I expect the same out of our employees, especially for a private practice owner. I think what is important for our employees to understand is that. I’ve invested so much when I have employees that care and really value being here, I’m willing to do whatever it takes to take care of those employees because it’s means so much to me personally. If you have a flat tire on the way to work or if you have a personal problem, or if you need a little extra help, so I see you’re working your tail off and you’re really loyal. I’ll do whatever it takes to take care of you. Because I really care and value that big corporations don’t care. They just don’t. And they’re gonna use you and abuse you and pay you as little as possible. And have you see as many patients at PO as possible and still fuss at you about productivity. And that’s where burnout comes.
I guess I just have a small business mindset and that I’m really invested in our employees and we’ll take care of them. And to have that model of really caring and valuing, uh, our employees as people. Their families and helping them have a really good experience. As a seasoned clinician of doing this for so long now, I wanna give back to the professions. There’s nothing that means more to me in terms of our employee development, that helping our young grad new graduates and mentor them and help them to be the very best clinicians they can be. ’cause I had people in my life who did that.
You learn from all of our experiences, like we said earlier, and some, sometimes we take the positive and sometimes we take the negatives and learn from them, but you’re just developing your scope and your out outlook on how you should practice as a clinician. And so I think all the experiences that you have and that you will have really will help shape a model you into. I really value you guys. Thank you for being here. Thanks for being on the podcast. I snuck them in on the last second. I was struggling a little bit to figure out what we wanted to talk about and I thought, well. Piggyback on the mentoring topic from last week.
I think as Jean-Michel said, the biggest thing is to stay curious and to be willing to be mentored and be looking for opportunities that will help you develop long-term as a seasoned clinician. So thanks for being on today. We’ll see you guys next week. Thanks for listening.