Launching Your PT Career: 4 Questions to Ask When You’re Ready for A Career Change
This is the fifth and final blog post in Rizing Tide’s series about launching your PT career and landing the right PT role for you. In our previous posts, we covered how to approach interviews, evaluate job benefits, choose a specialty, and decide whether or not residency is a fit for you. In this installment, we look a little further down the road: what to do when you’re not satisfied with your physical therapy job.
Landing your first physical therapy job feels like crossing the finish line after years of school, clinical rotations, and boards. But then, you start working. You settle into the rhythm of patient care, and realize something: your current PT job isn’t hitting the way you thought it would.
Maybe you love your patients, but you’re ready for a new challenge. Maybe you’re interested in leadership, specialization, or eventually owning a practice. Or maybe you’re a few years in and beginning to wonder if you really belong at your current clinic.
You don’t need to have your entire career mapped out when you leave school. You do, however, need to pay attention to what you’re learning about yourself along the way.
For this installment, we spoke with two physical therapists whose careers have taken them well beyond where they started. Amir Rand, PT, DPT, began his career with Spear Physical Therapy as an aide before PT school, eventually becoming a clinician, clinical director, partner, and now a leader in recruiting and talent development.
Michael Silva, PT, MSPT, MS, spent his early career as a practicing PT before opening his own clinic, growing it for 20 years, selling the business, and ultimately moving into consulting and practice ownership from the business side.
Both came away with a similar lesson: Be intentional about what comes next.
Here are four questions to ask yourself as you start setting those intentions.
1. Is it your career that isn’t working—or your environment?
A few years into his career, Michael Silva came surprisingly close to leaving physical therapy altogether. In his first position, he worked for a large corporate healthcare organization. When that environment didn’t feel right, he moved to a smaller private practice, expecting the change to help.
It didn’t.
“I was a little bit miserable,” he recalls. “I was working with patients who I wasn’t really passionate about working with. I was working for people who weren’t really motivated in their jobs. It wasn’t a good initial introduction to physical therapy, and I came really close to leaving the profession altogether.”
Eventually, a conversation with his wife (who is also a physical therapist) helped him separate his feelings about the profession from his feelings about his actual work. “I realized it’s not that I don’t like being a PT,” Silva says. “I just didn’t like who I was working with, who I was working for, or how it was being run.”
That realization ultimately led him to open his own practice.
Amir Rand has seen a similar pattern among clinicians who assume dissatisfaction means they need to change settings. Instead, he encourages PTs to look carefully at what is making them unhappy before deciding what needs to change.
“It’s not the setting,” he says. “People don’t leave settings, people don’t leave companies; they leave managers.”
(Though it’s worth mentioning, of course, that the problem could also be compensation, burnout, a difficult commute, limited opportunities for growth, poor mentorship, or a workplace culture that simply doesn’t fit.)
Pay attention to the people around you.
Rand believes the people you work with deserve much more consideration than they receive during a job search.
“You spend a lot of time with those people, more than your family,” he says. “They should be people who support you, build you up—not tear you down.”
Some warning signs about a position may even appear before you accept the job. Rand borrows a phrase from recruiting: “Where there’s smoke during the interview process, there’s fire on the job.”
If an employer is disorganized during interviews, disappears for days at a time, gives you conflicting information, or makes promises that become less concrete when you ask questions, pay attention.
Before deciding PT itself is the problem, take a closer look at what isn’t working in your day-to-day experience. Sometimes a different environment is the change you actually need.
2. What kind of career are you trying to build?
When Rand talks with clinicians, he likes to ask a deceptively simple question: “What do you want to be when you grow up?”
Yes, you already became a physical therapist. But that still leaves plenty of room to decide what being a PT will mean for you. Some clinicians want to spend their careers deeply focused on patient care. They may pursue advanced credentials, take students, develop programs, complete coursework, or become an expert in a particular niche.
Others discover that they’re drawn toward leadership, management, entrepreneurship, recruiting, education, or another avenue they may never have encountered in PT school.
What matters is figuring out what interests you and making choices that can help you get there.
If leadership is part of the future you envision, Rand suggests looking for an employer that will actively help you develop those skills. “PTs don’t learn that in PT school,” he says.
That doesn’t mean a new grad needs a 10-year career plan. In fact, Rand says the first six months can be so mentally demanding that simply becoming comfortable as a clinician takes most of your attention. But once that initial period settles, start looking beyond what’s directly in front of you.
“If owning your own private practice, for example, is where you want to be, starting at a hospital just because it pays more is a bad idea,” Rand says.
Silva makes a similar case for looking toward the future before making career decisions.
“Your career and your job shouldn’t be things that just fall into your lap,” he says. “Look down the road at what you’re trying to build, what you think your career path is going to be—whether it’s entrepreneurship or whether you want to be the best clinician—and let everyone else deal with the business side. Then make your decisions strategically.”
Your interests may change over time. That’s okay. You don’t have to predict your entire future in your 20s, 30s, or even your 40s! The important thing is to make decisions today with some idea of where you want them to go.
3. Who is helping you figure it out?
You don’t have to make major career decisions alone!
Both Rand and Silva point to mentorship as an important part of career growth, especially when the person advising you can help you see options you may not recognize on your own.
At Spear, Rand says developing other people is considered a fundamental responsibility of leadership. “Anybody who is a leader or manager at Spear, their number one charge when they wake up in the morning (and the question they should be asking themselves) is: Who am I developing today?”
A strong relationship with a manager or mentor can also give clinicians room to be honest when something isn’t working.
“When you have a culture that’s trustworthy like that, you can say things like, ‘Hey, I’m burning out of this. I need to do something different,’” Rand says. Instead of treating that admission as a problem, a good leader can help the clinician figure out what needs to change.
Build your own personal board of advisors.
Your manager doesn’t have to be your only source of guidance.
In fact, Rand recommends seeking multiple perspectives, because every mentor brings the biases and experiences of their own career. “I don’t think you could have too many mentors,” he says. “You get different perspectives on things from different vantage points.”
Silva agrees. When he was considering leaving clinical practice for a medical device sales position early in his career, his wife helped him work through what he actually wanted. Later, after launching his practice, he hired a business coach who helped him develop skills he hadn’t learned in PT school. He also found support among other practice owners who were navigating similar challenges.
For clinicians contemplating a change today, Silva recommends building what he describes as a board of people you trust.
“If you have a team, if you have a board of people you can go to and be like, ‘Hey, this is what I’m feeling, this is what I’m thinking,’ I think that’s invaluable,” he says.
Those people could include former professors, colleagues, classmates, family members, professional mentors, coaches, or clinicians whose careers resemble something you might want for yourself.
Sometimes, Silva says, simply answering the right questions out loud can produce a realization of its own: “I know what I need to do.”
4. Are you choosing the next opportunity, or just escaping the current one?
When you’re unhappy at work, almost any new opportunity can look appealing. That’s why both Silva and Rand encourage clinicians to consider what an opportunity offers beyond the most immediate benefit.
For new grads in particular, compensation (understandably) carries a lot of weight. Student debt is a major problem, and salary matters. But Rand cautions against allowing the highest offer to automatically determine your decision.
He has seen clinicians focus heavily on compensation while overlooking mentorship, career development, workplace culture, and other factors that may shape the next several years of their careers.
Silva has seen the same thing from the employer side. In one case, a candidate accepted an offer from a clinic Silva was involved with, then backed out the following morning for another position paying $1,000 more per year.
The difference was roughly 50 cents per hour, Silva says. The candidate was giving up structured mentorship, stronger continuing education support, and a potential path to equity in the business. “I don’t judge anyone for trying to chase to get more money,” Silva says. “But you’ve got to look at the long road.”
Give yourself permission to change course.
Thinking long-term doesn’t mean you’re locking yourself into a decision—especially if it’s one that no longer fits. Silva’s own career is proof of that.
After 20 years of growing his practice from a solo operation to a multi-location business with 25 employees, he sold it. Eventually, he found himself back in a corporate healthcare environment similar to the one he had left early in his career.
More than two decades had passed, but his reaction hadn’t changed. “I realized that in 23 years, my feelings had not changed,” he says. “That wasn’t fulfilling to me.”
So he changed course again, this time moving into consulting and helping other PTs start, improve, grow, or exit their practices.
Rand’s career evolved in an equally unexpected direction. After progressing from clinical work into leadership, his recruiting background eventually pulled him into talent acquisition. Today, instead of treating patients, he leads a recruiting team that hires hundreds of therapists.
Silva’s and Rand’s paths changed as they learned more about the work they enjoyed and where they wanted their careers to go. Being intentional doesn’t mean you have to know exactly where you’ll end up. You can choose a direction, learn from it, and adjust as you understand more about the work you enjoy, the people you want around you, and the kind of life you want your career to support.
Keep your eyes on the distance.
Your first PT job is important, but it doesn’t have to determine the rest of your career.
Pay attention to what energizes you and what drains you. Pay attention to the people and environments where you do your best work. Think about what each opportunity can teach you and where it could lead.
Most importantly, give yourself permission to keep figuring it out.
As Silva puts it: “Be intentional.”
Rizing Tide will continue to support you with resources, scholarships, mentorship, and stories from clinicians who have navigated these decisions, so you can build a PT career that continues to grow alongside you.
