The grass isn’t always greener on the other side. 

Prior to residency, I talked to Chris Lefever, current D1 sports fellow at Duke University, about his residency experience over at Memorial Hermann Ironman. He told me something that is probably my favorite piece of advice ever: “Grass is greener where you water it”. That was the underlying theme for a lot of the advice I got from asking others about making the most of my residency experience. Their advice wasn’t about what technique to brush up on, what articles to read, or what events to go to. It was about how to be a good mentee with self-awareness and a shift in mindset. There are many great things in every situation if you look hard enough. Every day I am grateful for where I am, and the things I get to do by simply having a good mindset about everyone and everything.

On the other side, I can understand why other new grads can be frustrated with current jobs due to hours, case load, or workplace culture. So below, I listed common frustrations in the PT setting, and ways to “water” it by changing the mindset.

1. I see too many patients.

Mindset shift: I get to help a lot of people, and learn efficient patient care.

I see about 8-10 patients in a 5-hour block which consists of 30-minute follow ups, and 60-minute evaluations. Combined with my PTA’s schedule, we can see 12-14 patients in a 5-hour block as a team. 30 minutes allows you to help more people that need your care. Sure it can be a rush, but that forces you to be efficient. What do you want to test them on? What do you want to measure them on? What exercises do you think are the BEST exercises to see them perform? Which of those will you prescribe? For me I like to answer all their questions (throughout the entire session), get 3 objective measures (2-3 minutes), see them do 2 functional tasks (2-3 minutes), and run them through a total of 6-8 exercises (which includes their functional tasks and supersets; 15-20 minutes), and prescribe them 2-3 home exercises. Yes, the paperwork can be daunting, but again, you can spend time learning the best system to chart and treat. Whether it be pre-charting, pre-planning their exercises for the day, and/or working on multi-tasking, you can become efficient with all of this if you put in the time to self-assess areas of improvement.

Is 30-minutes the best option? No, hard to say what is. It certainly isn’t the worst.

2. I have to cover so many sports which takes up so much time.

Mindset shift: I get to be on the field and cover events that a lot of other physical therapists and people want to cover.

Do you know how hard it was for me to volunteer for coverage back in California? There was so much red tape. Because I would be a volunteer, I would not be able to be hands on at all, and therefore they saw no purpose in me just watching. I contacted high schools, community colleges, universities, and all of them said no. At residency, I cover about 6-9 hours of sports a week, in addition to 2-3 hours in the athletic training room. Sure this equates to 12-15 hour days at times, but I’m grateful I get to be there and learn. Some people may also gripe that they only get to see high school or middle school, but do you think other sports medicine staff will let you be as hands-on with college and pro athletes? Not many. I am grateful I am trusted for on-field and training room assessments with these high school kids and smaller division colleges. Other programs do give you experience with D1 and D2 college athletes, but I am very happy where I am.

3. I have to work weekends.

Mindset shift: I can help those who do not have easy access to healthcare on weekdays.

This can happen beyond residency, and in some private practice jobs. I like to remind people that most patients DO NOT like physical therapy. Here’s a list to consider, no matter how much a patient smiles and jokes:

• They’re painful enough to have to seek your help (on a weekend too)
• They likely have trouble sleeping, so they’re tired
• They have not been able to do their hobby or job
• They are in fear and may feel hopeless
• They are missing time off work or school to go to PT (loss of wages)
• They are paying a lot of money for PT and other healthcare services

So many people can’t come in on weekdays due to some reasons mentioned above. You may hate your weekend work, but they hate coming in for PT on the weekend more. Be the best part of their day, and make them feel better with the small amount of time they have; get in those extra reps of good customer service and clinical reasoning.

As for other aspects of work (admin, coverage, etc.), let’s be honest…what will you be doing instead? Sleeping in (which can be important), watching Netflix, spending money you don’t have, etc. All of this is good in moderation for happiness and health, but it can also be enriching to be productive while helping others with your “spare” time.

4. I don’t get paid enough.

Mindset: At worst, I’ll make $50,000 a year with great benefits doing something I love. At most, possibilities are endless since I can do so many things anywhere in around the world.

Yes, more money is great, and you have a lot of loans. However, you would be surprised at how much money you DON’T need to be happy. If you budget well, you can have a great job that covers your cost of living and loans. PT is a great career to have with high demand everywhere in the United States. The bottom of the PT salary range is $50,000. There are non-clinical opportunities, and plenty of areas where your consulting would be valuable. PT’s forget that they were surviving with less than their current salary prior to PT school, and that many people around the U.S. function fine with less money as well.

Does that mean settle? No. You should negotiate, find the right workplace, and do what you can to maximize your earnings. However, if you ever feel burnt out, just remember you can find another workplace that may have less demands, but will still give you sufficient pay. Also, just be grateful. Many people would be ecstatic for what we consider our minimum salary.

Lastly, consider that other higher paying professions (physicians, software engineer, lawyers, etc) get paid much more relative to schooling required, however they work 60-80 hours a week and are constantly on-call. As a personal trainer in the bay area, I worked with many physicians and CEO’s; none of them worked 9am to 5pm, and stopped working when they got home. If you were to take on that many hours of work, you too could earn $150,000 – $200,000 a year…but are you willing to?

5. My co-workers are burnt out and may not be as up-to-date in current evidence and best practice.

Mindset: I get to maintain high standards and good habits despite being in a challenging environment.

We’re all aware there are “bad” PT’s out there. They can suck the energy from you as you overhear bad explanations, see poor patient care, and poor utilization of healthcare dollars. That doesn’t mean you have to be like them. You are able to self-analyze your current practice patterns and compare it to theirs.

What do you do that they don’t? What do they do that you don’t? What do they do that you do not like, but actually realize you also do? What do you feel you could begin or stop doing? All good things to think about to refine your skills every day. Some things I never settle on, and always perform each session:

• Take objective measures that make sense
• Test/re-test after each type of intervention
• Use functional outcome measures (at certain intervals in their plan of care)
• Ask them if they have any questions or comments
• Compliment their effort, and tell them some objective improvements to indicate they’re getting better (rehabs a long road, many feel defeated along the way)

Long term, it may be best to find a workplace that better fits your needs and interests, however I understand many people take jobs due to the high salary, geography, family, or other factors.

Closing thoughts

The main point of this article is that there are many great things you can make out of a situation. Every place has it’s own problems no matter how great it may seem. The biggest difference in those who are happy vs. frustrated  is a positive mindset and maximizing all their resources. There are always reasons to leave, but there can always be reasons to stay. Although this article relates closer to PT, can you think of ways to “water” relationships, other careers, and other problems? Sometimes the “soil” is just really poor, but at least give watering your own lawn a try before you go on the other side of the fence.