The rent is too damn high, or is it your expectations?

I've been a PT since 2007, currently own a healthy and growing outpatient PT practice with 3 clinics, 17 employees and counting. There are numerous challenges in the PT profession, and growing a healthy practice while focusing on keeping employees and patients happy is like threading a needle. It takes time, energy, concentration and a hell of a growth mindset. However, it is possible. Is it easy...hell no! Is it worth it? Hell yes. What I would say to some that are frustrated with their situation in the profession of PT is to stay away from work environments that breed poor workplace situations for a return of higher income. I can guarantee you the extra $5,000-$10,000 in salary is not worth the stress and time/energy it will take to earn it. Instead, join a team who is growth minded. If you're a recent graduate, live more frugally and pay down your highest interest debts (student debts over the current market rates are your primary target). Even if it's a few dollars per week, it will add up quickly.

Avoid unnecessary debt in the early stages. Maybe don't get the high rent home/apt in the most desirable areas in your first 5 years out of college. Avoid that nice car, and go for something more functional that delivers high value at a reasonable price. If you live in a big city, this might not be an issue if there is public transportation. This will keep your finances in order for the first 5 years so you don't have to sell your soul for dollars.

Now that you have your finances in order, start looking for a job in a smaller company with growth potential. What does that mean? Look for a business owner who wants to grow by building a great team that will move the business forward. This has less to do with you degree, GPA, certifications, skills or educational background; more to do with your mindset, willingness to learn, humility, empathy, ability to cooperate with a business owner and his team, desire to achieve through growth minded practices. Negotiate a fair pay (don't try to squeeze that owner...he or she is likely trying to put money back into his business to support growth for the business and team members). Once you have established a fair pay that allows you to save money because you got your expenses and finances in order (read first paragraph), you then start doing whatever the business needs to help it grow. That doesn't just mean doing your "job" as a PT. Figure out what else can help to make the operations run smoother, improve productivity in a healthy way (not just seeing more patients in an hour), improve marketing efforts, improve referral patterns, represent the business in a good light to your clients and referring sources, etc.

Build a reputation within the practice as a dependable member. Build a reputation within the community as an elite therapist. Build a reputation within the medical community as the person who always gets the outcomes. Make it so that the owner sees the potential in you, and discuss with them what you would like to see happen within the company.

Once you've established what your goals are, establish if the owner is going to move you there, or if there is anything standing in the way. If the owner's requests are reasonable and you are capable of delivering, negotiate what you would like in return. For example, a business owner may want a strong leader to manage the clinic. If you can deliver it, let the owner know what you would like in return. More pay, more vacation, better benefits, help with student loans, etc. But establish what you and the owner need up front so the outcomes are set in stone. Then work on a strategy with tangible milestones with the owner. If the owner is not willing to discuss these things early on...it's a good sign that they are likely not looking to grow. This is where most PTs start to get the burnout...because there is no future that is worth working for. Get out. Find another place. But before you do...try some soul searching. Don't put the full blame on the owner. What could you have done to make the owner see the light. If it was purely that the owner was never growth minded, what can you do next time to weed this mindset out when interviewing for the job? If the owner was growth minded, but didn't see the potential in you, what could you have done differently to let them see that you were in fact the right person? It's always good to improve self awareness so you have grow.

Ultimately, this will lead you down one inevitable path. Finding the right practice that is growth minded, and a place you can call home with a long and healthy future while doing the thing you worked so hard to achieve. A physical therapist who is not only serving the community, but one who is growing the profession and shining a light that is slowly fading.

I see a lot of PTs complain about the state of PT, and how it's next to impossible to get what they're looking for. The colleges, state boards, private insurance, business owners, hospitals, Medicare, laws are all going to be hurdles to overcome. But as an owner of a growing practice, we worked through all of these challenges and found ways to grown and build a healthy team of like-minded and growth minded professionals. It can be done, but you just have to find your home.