Pressure and Possibility in PT: Reflections from the 2026 Graham Sessions
What happens when early-career DPTs are invited into a room with seasoned industry leaders to talk openly and honestly about the challenges facing the physical therapy profession? You get candor. You get conviction. And you get a renewed sense that the future of the profession depends on what each of us as individuals are willing to do next.
The 2026 Graham Sessions centered around one word: pressure. Pressure around debt. Pressure around identity. Pressure around sustainability. Thanks to a handful of generous donations from our community, four Rizing Tide scholars received a grant to attend this year’s event. They walked away reflecting on student loans, advocacy, access to care, professional identity, and the urgent need for cultural change within PT. Here’s what stuck with them.
Financial Pressure and Finding Your Worth
For Dr. Lena Parker, PT, DPT, OCS, the theme of pressure hit close to home.
“This year’s Graham Sessions centered around the feeling of pressure in the physical therapy industry—and being a full-time clinician is not an easy job,” Lena shares. “There are so many needs of so many patients whom we have to make sure we’re caring for to our fullest capacity.”
For Lena, the most pressing tension is financial. “I really love what I do. My passion for this industry is so high, but often I feel shackled down by the weight of what I have to pay back to get my footing in this industry.” Balancing student loans with financial stability has meant narrowing her focus to clinical work, even as she feels called toward legislative and healthcare-tech initiatives that could move the profession forward.
One question that cropped up during the sessions stayed with her: What are PTs actually worth?
“A question that was posed to us during Graham’s Sessions was just knowing what our worth is as physical therapists in regards to the services we provide,” she says. “I think as PTs we have this altruistic mindset—that we want to care for everybody. And oftentimes, our desire to do that, the size of our heart, can really kind of get in our way.”
Lena was struck by comparisons to dentistry. “What does a really high-level physical therapist look like? What environment are they in compared to a very high-level dentist?” she asks. “Dentistry is doing well, and it would be fascinating to know how we can maybe reflect some of what they do into our field.”
Student loans dominated this year’s conversations. “The biggest conversation, the loudest conversation we had, was definitely about student loans and the passage of the Big Beautiful Bill,” Lena explains, referencing the proposed $20,500 annual federal loan cap for graduate students. “Without a doubt, this Big Beautiful Bill is going to play a major role in what our workforce looks like.”
Still, she left with a new perspective. “This experience of Graham Sessions was so unique to me because it offered me this 1,000-foot view of the physical therapy industry,” she says. “I wonder if I could be the person to support that. I know that I want to continue to advocate for the world of PT.”
Her biggest takeaway? “History repeats itself unless we do something.”
Debt, Burnout, and Building a Better System
For Dr. Cortez Espinoza, PT, DPT, OCS, the theme of pressure spotlit the realities facing new graduates.
“For new grads like myself, the biggest things that stuck out to me were the loans, fear of burnout, how to provide for a family, and most importantly, how we can shape the future as healthcare professionals,” he says.
Cortez references research discussed at the sessions showing a $150K median debt for PT graduates. “PTs should be paying about 15% of their discretionary income towards their loan repayment in order to get out of the hole,” he explains. “If you’re over the $150K limit like myself, you typically need to have another side hustle to grind.”
Burnout was another recurring theme this year. “Part of it is an internal value thing,” Cortez reflects. “We must believe in what we do and believe in the value that we provide for others and our patients, because at the end of the day, we are healthcare workers.”
For Cortez, the main urgency lies in retention and access to care. “The retention rate of PTs after five years is declining,” he notes. “We need better awareness, we need better access, and we just need a better system.”
His question for the future is direct: “Where do we see the profession going in the next 10 years given today’s current climate? Is it positive or is it negative? Depending on the situation, what are we going to do about it?”
Receiving a Rizing Tide grant to attend the Graham Sessions amplified Cortez’s experience. “Receiving a grant for the Graham Sessions almost feels like an invitation to the White House for the very first time,” he says. “I felt so empowered and inspired to be a future leader.”
Identity, Culture, and the Call to Act
Dr. Thomas Samaan, PT, DPT, left the sessions focused on identity and culture. After hearing leaders discuss research, advocacy, and reimbursement policy, one message stood out to Thomas: “Policy begins with culture.”
“It allowed me to reframe a lot of my concerns to really focus on what I can do today to make that difference,” Thomas explains. “What conversations can I initiate? What problems can I identify to escalate?”
He believes one of the most pressing issues facing PT is identity. “If we do not know our identity as PTs and are not confident in it, we are doing ourselves and the profession a very big disservice,” he says. “Our identity is one of the core issues at the root of all of them.”
Rather than waiting for large-scale reform, Thomas emphasizes individual responsibility. “Change is something that is required of each one of us individually,” he says. “There’s no relying on a figurehead or an organization that will do all the work for us, because it has to begin with all of us, each person individually, day by day.”
The grant that helped him attend reinforced that responsibility. “It showed us that we have a seat at the table,” Thomas shares. “It empowered us to take that out of the discussions and into our day-to-day conversations.”
Access, Sustainability, and the Power of Community
For Dr. Bridget Ochuko, PT, DPT, MPH, industry pressure has manifested in conversations about who can and cannot afford care.
“As an early-career clinician with a passion to improve access to physical therapy, specifically pelvic health PT for marginalized communities, the most pressure I have continuously felt is the pressure to leave those communities behind in my treatments,” she says.
While some advise her to shift toward higher-paying populations, Bridget remains committed to her passion. “Being able to talk to other successful like-minded clinicians who did not give up and who still found success in this profession affirmed for me that I need to keep advocating and pushing for this.”
A panel discussion on PTs as primary or urgent care providers expanded her thinking. “I underestimated the scope of what we can do with the skills and the tools that we have,” she admits. Seeing PTs build urgent care models was “very inspiring” to her.
The question of sustainability also loomed large in Bridget’s mind. “Is the field of physical therapy sustainable in the model we have been working in for years on end?” she asks. “In order to continue to grow and expand with the changing times, we ourselves have to change the way we approach the profession.”
Her biggest takeaway was simple and emphatic: “In order for our profession to survive, we need to unite.” She continues, “We need to come together to not only survive, but to thrive. It’s all about community.”
For Bridget, the grant carried deep personal meaning. “To be a Black woman from an immigrant family and to be able to sit in a room with giants of our profession, while also feeling like those giants wanted to hear what I had to say was bigger than anything I could have ever imagined,” she says. “We do all deserve to be there.”
Future Steps
Across every conversation at the 2026 Graham Sessions, one thread was unmistakable: pressure is real, but so is possibility.
From student loan reform to professional identity, and from access to care to cultural change, the scholars’ reflections underscore a shared truth: The future of physical therapy will not be shaped by a single policy, a single organization, or a single leader. It will be shaped by clinicians who understand their worth, know their identity, and are willing to act.
Thomas puts it plainly: “The time to act is yesterday.”
If this year’s Graham Sessions made anything clear, it is that the next generation of PT leaders is not waiting for permission. They are already stepping forward.
