Treating Our Future – Part 1: The Bane of the New Professional

As a professor in a few entry-level DPT programs over the past several years, I’ve had the privilege of getting to know many students. By and large, the graduates from these programs are some of the smartest, most motivated people I’ve met.  However, they’re not always greeted with the same sentiment by employers. It’s concerning. It’s a situation worthy of not one, but several blog posts and so what follows is the first of a three-part series. I’ll start us off with this post to start a conversation about how the profession treats the people who are it’s future.  In “New Grads: An Asset for Clinics,” Lauren Kealy, a DPT student at Regis University, gives a student perspective on why new grads are excellent assets in the clinic.  In part three, we’ll look at some solutions, and incorporate feedback from the community as the conversation progresses.

Treating Our Future – Part 1: The Bane of the New Professional

My motivation for this blog post, and this series of posts, is not a good one. That said, I hope it sparks a constructive conversation that proves beneficial. Simply put, I’ve seen too many new professionals in physical therapy treated like dung by potential employers.

Here’s a story about how it goes for new grads here up in Colorado:

The new Grad looks for jobs. They don’t find many options, as the positions posted primarily request those with 3-5 years of experience. The newly minted doctor of physical therapy waits patiently for the ad accepting new grads. It never comes. They network, they reach out, they apply to jobs which request 3-5 years of experience anyway. Eventually, they get an interview, only to be told they don’t have enough experience. That’s even if they get a reply at all, as most often they get a polite thank you and never hear from the employer again.

After a while, they find a clinic who’s pressed to hire. Or they have a particularly strong networking connection. They then, to my personal dismay as an instructor, must perform a practical exam as part of the job interview to “test their hands.” I thought we already did that as part of their physical therapy education process? Was it not good enough? Didn’t the new graduate pass the NPTE? Is that not enough? Shouldn’t clinical reasoning be the thing you test instead of “hands,” especially if your clinic’s therapists use ultrasound regularly for patients with back pain? I don’t get it. But, let’s continue the saga of the job-seeking new graduate.

Provided they “pass” their practical exam, they are then sent on their way. If not hired, they still don’t often get a call back to let them know they weren’t hired. Silence is the most common answer. If hired, well, good for them. They’re on their way to greatness, albeit usually without benefits, or with minimal benefits and a salary that soon leads to sticker shock, as they contemplate the grizzly reality of paying off their 7 years of student loan debt and trying to afford a place to live.

At a recent #PTPubNight, I listened to a conversation between two clinicians. When one, the older, found out the person he was conversing with had less than 6 months of experience, he responded with a sneer, a statement, “Oh, you’re fresh!,” and a turn away from the previously strong conversation. Is this how we should be treating our profession’s future?

Dehumanizing our Future

It’s tragic to watch this process. From graduation and all of its ecstatic highs to the low of never even hearing “No,” new professionals in physical therapy can be in for a rough ride. It’s not that each new graduate deserves every job they apply for. However, they deserve the respect of a professional, qualified and ready to work. To not even return their application with a negative response, to question their skill set, to demean them for their lack of work experience is wrong, and unproductive. As the profession works to inspire leaders, innovators, and entrepreneurs to carry us into the future, a first stop characterized by disrespectful professional behavior is not a good strategy.

I know it’s not like this everywhere. In Texas, graduates from Texas State University were gobbled up like delicious pieces of bacon by clinics around the state. Texas is a positive job market, and so employers are happy to see the new graduates arrive. The point is, this happens somewhere. Colorado is not alone. I’ve conversed with many students from around the country and I hear similar themes: “They never even called me back, even after I did a hands-on practical.” “All the jobs want 5 years of experience, how am I supposed to get experience if no one will hire me?” “I had to sit and listen to what a liability I’d be for the clinic since I was a new grad.” “They made me do a practical exam, but the stuff they asked me seemed way out of date compared to what we learned in school.” I’ve spoken with many PT’s who declare, “I’ll never hire a new grad!” without remorse or pause. Many of these are the most respected and seemingly savvy PT’s around, even one’s with a large social media footprint.

It’s time for a conversation.

There are reason’s employers don’t want to hire a new graduate. Some of those are valid, while others are not. Some of the valid reasons, like lack of business skills or billing proficiency, should spark reform in education. Some of the invalid reasons, like assuming new grads can’t possibly manage patients with low back pain, should spark education and discussion. At no times, should the new professional be treated like dog meat as they rush excitedly into their first professional experiences. This issue is closely tied to the often discussed disconnect between education and clinical practice, but it’s more than that. It’s about respect, and a forward thinking strategy for how and where our new professionals go.

I’m very interested in feedback on this post. If you’re a clinic owner who doesn’t hire new grads, tell us why. If you’re a new professional, tell us about some of the hardships. If you just have an opinion, join in!

In part two of this series, Lauren will discuss the benefits of new professionals. Part three will look to solutions, and feature conversations that spawn from our posts, as well as highlighting some very successful practices who have embraced new graduates heavily. I look forward to this conversation.

 Links to Treating our Future Series
Part 1: The Bane of the New Professional 
Part 2: New Grads, An Asset for Clinics
Part 3: Resolving the Bane of the New Professional

15 Replies to “Treating Our Future – Part 1: The Bane of the New Professional”

  1. Looks like the start to a great series. As a year 2 PT student, future employment is certainly near the top of my list of goals and concerns. I don’t feel like I’ll understand employment process difficulties until I’m actually immersed in that very process. That said, I am very excited to learn what people have to say (both employers and year 3/recent DPT grads)! Looking forward to learning and applying what I’ve learned from this series. Thanks also for caring enough about our [future] generation of #DPTstudent(s) to write this kind of article!

  2. Thanks for this post and series, Eric. I’m a new professional (1.5 years on the job) and I was fortunate to get a job with a company where I completed an internship. My company actually hires quite a few new grads! As I do not participate in recruiting or hiring, I can’t speak for the company about why they do pursue new grads. I can imagine, however–we are fresh out of school, so we still have passion, we know the evidence (hopefully), and truthfully, I think we are cheaper labor than hiring someone with a lot of experience. We are the potential. The initial decrease in productivity and clinical experience can be made up for in the long run, assuming the company is able to retain us. I did not have to do a practical, but perhaps this is because I completed a two month practical through my internship. This makes me begin to think about the importance of quality clinical internships, but that’s an entirely different issue!
    I admit that I love CO, however, but was warned against applying there because of the rumors that good outpatient ortho jobs are impossible to come by. I was happy with the job I got, so I didn’t pursue CO. Interestingly, I had a similar experience at #PTPubNight as you described–I was speaking with a previous employee of my same company about some of the struggles of patient motivation, reimbursement, etc. My tone was a bit more positive than his, and his comment to me was that I was not jaded yet (I disagree–I think we have different personalities). It’s unfortunate to see this type of apathy in more experienced clinicians.
    There is more to say, but I’ll leave it at that for now. Looking forward to hearing from others!

  3. It is a super hard road first coming out of school as a PT. Each clinic you are at is totally different and it is hard to get a job that suits you. I felt that there was a lot of questioning of my skill set when I first got into the job market as well. I felt as though I was overly scrutinized because I was young in the profession. Lucky for me I was at a clinic that had some great people who were there to help me learn. There unfortunately are too many places out there who do take advantage of young grads. Terrible hours, poor pay, and little support. I have been there before. It was very discouraging and made me doubt my decision to become a PT at all.

    I think that this is a very important conversation in this field at this time. The DPT degree gives you a lot of extra education but the real world experience is what matters. I don’t believe the DPT degree does that. I also feel that the investment in the education for a DPT does not even come close to the return on what your income is as a professional. If we were a true “Doctorate” level profession, new grads wouldn’t be working 2-3 jobs to be able to afford payments on student loans.

    I wish the APTA would have left PT as a masters degree and instead added paid residencies as a requirement for graduation. That would give young professionals more time time to hone there skills with expert clinicians who are there to guide them and not take advantage of them. I feel this would be better because it would give young professionals more time to work on the skills themselves so they are very confident when they get into the work force. This would likely translate to better documentation, billing, and patient interaction if the skills are more second nature to young professionals.

    Thanks for starting this conversation and I look forward to reading the next parts in this series.

  4. What a thought provoking piece you have written! It amazes me that there are employers out there that think experience is what it truly takes to find a great physical therapist to hire. I couldn’t find anything to be further from the truth. We love hiring new graduates and let me share why: 1) the energy and excitement of starting a first job cannot be topped 2) the desire to learn and be a part of the culture 3) cutting edge hot-off-the-press knowledge. What a shame folks don’t see the values of the new grad! And yes, I am hiring in the Southeast! Denise Etter, DPT at BenchMark Rehab Partners

  5. Great topic for a series. Great info above and I agree w most of it. I am 8 years out of PT school. I was the senior PT at a busy outpatient clinic for 5 years and intimately involved w the hiring. I currently do consulting work as I move around for my wife’s job.

    I am hesitant to hire new grads, but would absolutely consider hiring new grads. The new grads we hired have all been SPTs in the clinic prior to becoming an employee. My hesitancy w hiring new grads has nothing to do w their clinical product. My hesitancy includes:

    -New grads inexperience w billing/coding. The insurance world is very dynamic and definitely not black & white. My experience has been new grads are very resistant to learn the intricacies of 3 party payers and delivering treatment that respects the insurance guidelines.
    -Lack of real world experience. Experience does not need to be related to PT, but if this will be your first “real” job, I have a concern.
    -During the interview, many new grads reference “taking a break” after graduation & the boards. Not meaning time off but implying taking a break from studying and the stresses of school. Employment, especially as a new grad, will bring new stresses (challenging cases requiring off the clock studying, documentation over lunch & after last pt leave, learning the company culture, finding your niche, seeing pts over lunch because a MD calls you up asks if you can “squeeze” this pt into your schedule, etc.). I want clinicians that want to work hard, not “take a break”.

    I like to see new grads that show passion, engagement in the profession/company/self improvement, and open mindedness.

    Just my 2 cents. I would absolutely consider a new grad for hire, as long as there are no aforementioned red flags.

    1. As an SPT, I understand Nick’s pause surrounding applications of billing and coding. The details of how billing and coding occurs differs but I am only familiar with the system from my first clinical site. I feel under-prepared in this area of our profession for anything other than an outpatient ortho clinic. I hope that this changes somewhat during our health-care systems class next term.

  6. I wholeheartedly agree with Brett’s response. I am a first year DPT student at Columbia University and I do have concerns about how much I will have to pay in loans per month after graduating. I will graduate with around $120,000 in loans, which will come to around $1200 a month payment. We have increased the PT degree to a doctorate, BUT clinics aren’t willing to pay more for a DPT compared to a PT or MPT. Our investment into education has increased but our compensation has not. I like Brett’s suggestion of having our third year be paid residencies instead of students paying to thousands of dollars to have an internship. Isn’t that backwards or what?

    In responding to the article, I haven’t had experience looking for PT jobs yet, but I’ve talked with Columbia graduates and I have not seen an issue with hiring. I’m pretty sure every graduate lands a job either prior to graduation or within a few months after.

  7. Hopefully the discerning student reads between the lines and moves to South Texas… where we love, mentor and develop our future (although likely at a low salary). Employers should be working from the beginning of the interview to retain people and set the tone for their practice… even if they don’t hire the applicant. What you describe is symptomatic of practices that probably don’t treat their existing employees all that well, either. In our practice, those hired as new graduates and mentored by us have become our leaders and the catalyst for our growth.

  8. As a practicing physical therapists, I look forward to students and new grads entering the clinic. These individuals tend to be the most current in research and have just been exposed to various techniques on their rotations. They are a huge asset. While students and new grads come armed with fresh information, they don’t always have a broad knowledge of exercises to progress patients with. I have developed an online resource that has proven to be useful in developing and progressing exercise programs. goPT is an online physical therapy exercise library composed entirely of professionally filmed videos. Since it is online, students can “play” with the program at home by creating protocols and saving their favorite exercises, helping them be more prepared and more efficient. Check it out. http://www.gopt.com

  9. This is such a real problem! It’s unfortunate that most employers use two binary statistics for their hiring–in other words, do they have enough experience, and are they certified? That’s what it takes to get in the door even though we are each individuals with separate strengths and types of qualifications!

    I’m hoping to change things a little bit with some technology tools…you can see more of them at http://pt.fiveme.io

    Let me know if you have any questions or comments on anything!

    Thanks,
    Jed

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