Physical Therapist – Mentor, Kimberly Briguccia
Kimberly has been a physical therapist since 1995 and is also a Certified Lymphedema Therapist (CLT). She is also a successful businesswoman who has her own outpatient, orthopedic and spinal clinic. As the population ages and obesity and diabetes increases, demand for physical therapists is expected to grow by 36% over the next ten years according to the US Bureau of Labor Statistics, a rate that is almost three times faster than the average occupation. In her article, Kimberly talks about the college courses you will need to complete get your degree, licensing requirements and the various employment opportunities for a PT. She also discusses how she has built a successful therapy clinic and the key points you should know about running this kind of business. Her article will be of interest to anyone considering a career in physical therapy as well as people interested in opening their own independent clinic.
Overview
When I graduated from high school I thought that I wanted to become a physician. After three years of college, I decided that I needed to pursue another field that allowed me to have a personal life. I was dating someone whose father was a surgeon at the time. I saw that he was called out at all hours of the day and night and worked 80 to 90 hours per week. I knew that I wanted to be able to have more balance in my life. I applied to the University of Oklahoma Health Science Center Physical Therapy Program and was accepted. The program was a Bachelor’s degree at that time. Several years after I graduated it became a Master’s program. Beginning in 2008, it transitioned into a Doctorate program with the first Doctoral class graduating in 2011. You must now have a Bachelor’s degree prior to applying to Physical Therapy School and decided to pursue a doctorate in physical therapy instead. At that time you could enter the program with three years of undergraduate studies. Now most physical therapy programs, including OU’s, require a four-year bachelor’s degree. That degree does not have to be in any specific major as long as you complete all your prerequisite courses. These are generally the same kind of science and math courses required by a pre-med student.
You should understand that getting admitted to a PT program is highly competitive no matter where you live. In my state of Oklahoma, there are only about 100 openings available each year at the two colleges that offer the program and well over 500 applications. Besides a high undergraduate grade point average, you will also need to submit test scores from your ACT and the Graduate Record Exam and have demonstrated either volunteer or observation experience in areas of physical therapy. The doctoral program course work includes subjects like human physiology, kinesiology, anatomy, biomechanics, musculoskeletal system pathology and neurology
While the doctoral program for physical therapy costs less than medical school, it is still fairly expensive. The American Physical Therapy Association completed a survey in 2013 and calculated the mean tuition rate per year for a Doctorate of Physical Therapy program in the US:
Public In-State $14,470
Public Out of State $29,157
Private $31,716
Because this is the mean tuition cost, half the schools were below this figure and half were above the mean. Here is a link to the APTA’s site that lists all the colleges in the US that offer doctorate programs in physical therapy:
https://www.apta.org/PostprofessionalDegree/PhDScDPrograms
After you receive your Doctorate Degree, you must then be licensed by your state. All states require that you pass the National Physical Therapy Exam. In Oklahoma, you can take this exam up to 3 times. But if you do not pass after the third time, you can never go back and take it again. Once you have your license, you then have to take 40 hours of continuing education every two years and also renew your license each year.
There are more classes you can voluntarily take to gain additional certifications. For example, I am a Certified Lymphedema Therapist and have the CLT designation after my name in addition to PT. This type of therapy involves dealing with trauma to the lymphatic system caused by surgery, radiation therapy, and cancer that often causes swelling. The primary purpose of the therapy is to reduce the swelling and pain associated with this kind of body trauma. The CLT designation required me to take additional course work as well as more clinical training. Here is a list of some other PT specialties:
- Cardiovascular and Pulmonary
- Clinical Electrophysiology
- Geriatrics
- Neurology
- Orthopedics
- Pediatrics
- Sports
- Women’s Health
There are many different settings where physical therapists work. Inpatient acute care takes place hospitals after surgical procedures or trauma. Many work in outpatient clinics like mine that are independent rehabilitation centers. There are also inpatient rehabilitation centers where you work with patients two or three times a day. These patients often have spinal cord injuries, trauma, brain injuries or strokes. Professional sports PTs usually travel with their teams. PTs also work in skilled nursing homes, schools and home health.
Regardless of the specialty, to be a good physical therapist you must like meeting and dealing with people. You have to understand that you are sometimes the last person they want to see. Your patients are in pain and often would rather be left alone. You must have empathy for their conditions and be cognitive of their particular personal situation. As you help them relieve their pain and get them back to a productive life, their attitude towards you changes and you will often make life long friends.
Operating an Independent Clinic
I opened my clinic, Physical Therapy of Jenks, in 2002 and now have nine employees. Before you consider opening your own clinic, first make sure you are willing to accept the extra responsibilities of running your own business. Here are some things to consider before you take that step:
- You have to be able to generate new business and maintain those relationships. If patients like your services they will give you referrals, which is the best source of new business. I make sure all my patients know my staff truly cares about them and that my patients feel they are not a number. We always talk to our patients, learn about their personal situations and try to build strong personal as well as professional relationships.
- I also have someone full time to do marketing for my clinic. We put ads in local newspapers, journals and sports magazines. I also make presentations to physician groups to and worker’s comp companies to get referrals.
- You have to insure that your clinic offers exceptional customer service. Many rehabilitation centers are owned by hospitals and physicians where the doctors and hospitals refer their patients for rehabilitation therapy. A good reputation is important if you are an independent and are going to be able to compete for patients with these competitive markets I want my patients to be treated like I would want to be treated if I were in the same place.
- I try to differentiate my clinic. For example, we have drivers to bring patients to our clinic and then take them home. This alleviates the stress trying to get to and from therapy. Often patients can’t drive for a period of time after surgery other patients rely on family and friends for transportation. I am also only one of a handful of clinics in the state that is licensed for Lymphedema therapy. We also offer aquatic therapy.
- Management of a staff can be challenging. You need to see that your staff gets along well with each other and presents a positive image to your patients. To be able to hire good people to represent you, you have to treat them well. You also have to set a good example. I am the first one at my clinic each day and the last one to leave. If something needs to be done like cleaning a table and someone else is busy, I do it myself. I believe you need to know every aspect of your business to be successful.
- You must have good accounting systems to do billing with the insurance companies, handle your payroll and generate the financial reports you need to analyze trends in your business. I use a management company that just works with physical therapy clinics like mine to handle my accounting, payroll, insurance benefits and legal matters. They also keep me up to date on HIPPA regulations, Medicare and other insurance guidelines.
- You also have to be able to deal with insurance companies, which is the one thing I dislike about the business. These companies often have guidelines for the type of therapy they will pay for and the number of visits they will allow a patient. I am often on the phone trying to explain to these companies that their guidelines don’t fit a particular patient’s situation. Patients often need more treatments than what is in their policy guidelines for a particular diagnosis.
Summary
I enjoy physical therapy because everyday I see I am helping relieve people’s pain and restoring them to a productive life. It is a rewarding career where you meet a lot of interesting people and often make life long friends. But it is a difficult career to enter because of the limited number of admission opportunities. It is also a minimum of seven years of school Like many other skilled professions, PT also offers you the opportunity to build your own business, something that has given me a lot of personal satisfaction and allowed me to make more money than working for a salary.
US Bureau of Labor Statistics Data on Physical Therapists
The median annual wage for physical therapists was $79,860 in May 2012. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $55,620, and the top 10 percent earned more than $112,020.
Job Outlook
Employment of physical therapists is projected to grow 36 percent from 2012 to 2022, much faster than the average for all occupations. Demand for physical therapy services will come from the aging baby boomers, who are staying active later in life. In addition, physical therapists will be needed to treat people with mobility issues stemming from chronic conditions such as diabetes or obesity that are increasing in the general public.
Most physical therapists work full time. About 1 in 4 worked part time in 2012. Although most therapists work normal business hours, some may work evenings or weekends.
There are also opportunities to be physical therapist assistants (PTAs) who work under the direct supervision of a PT. Most states require PTAs to have an associate’s degree from an accredited physical therapist assistant program. For people without the ability to attend a seven-year program and/or pay for PT program tuition, this is an option where you can work in the field and earn a good income. The BLS salary survey in 2013 showed median earnings of about $40,000, which is equivalent to $19 per hour.
