Advice to Today’s Physical Therapy Student

Several months ago, I received an inquiry via LinkedIn from a PT student in their first year of training. The student was seeking advice as they worked their way through the academic journey of becoming a physical therapist.

The student posed a simple question: “Considering your experience, what advice do you have for a physical therapy student?”

At first glance, this appeared to be a straightforward question that could be satisfied by a relatively “canned” response. This simple question, however, made me step back and reflect on what I have learned over the years and how I might be able to provide this up-and-coming PT with a perspective that I wish I had been given when I was training.

When I entered the profession myself, I was focused on clinical excellence. I wanted to be the best therapist anyone could find.

I wanted to constantly be learning and gaining more industry knowledge than anyone else. I wanted to shape the landscape of clinical care.

I cared little about the “system” or the “payers” because I was a healthcare professional and my patients’ care came first. In my opinion, healthcare administrators were nothing more than an obstacle to the delivery of quality care.

My perspective at the time was ironic, considering I was challenging my own father, a career hospital healthcare administrator. I often engaged him in conversations about his decision making process as it pertained to the management of healthcare professionals.

To be truthful, I openly questioned his approach.


Because I thought I had it all figured out when I was training to be a physical therapist.

Fast forward to today: I have been practicing for 14 years. I have been directly involved with the administration of clinical services in a private practice for over a decade. Clearly, my perspective has changed a bit. The response that the “new graduate me” would have given to this student would have been one of naivety.

So, how did I respond? Interestingly, when I began to write back, I found myself providing very different advice than I would have provided 10 years ago.

Considering everything I said about clinical excellence, I have come to the realization that I have to trust that PT schools have vetted out their students’ will to learn and their drive to be clinically excellent. In fact, I think academic programs do an incredible job of requiring clinicians to practice by the evidence while challenging their clinical decision making skills in training. The real obstacle that we all face in rehabilitation today, though, is a changing healthcare environment where we are forced to ask hard questions.

What is the value of our services?

How do I get paid for the services I provide?

Why doesn’t anyone know what a physical therapist does?

These questions remain at the forefront of the issues most private practices face and shaped the very advice I offered this inquisitive young clinician.

As a new clinician you need to truly understand healthcare economics and how to promote your skilled services and clinically excellent care so that it does not go unnoticed or undervalued.

I realize now after my tenure in private practice, that without the promotion of work well done, and a heightened awareness of the ever-changing economics of the healthcare business, it will be impossible for well-trained clinicians to provide the services our patients need, as there will be no way for practices to “keep their lights on.”

An understanding of the economics of our industry and the value of our professional services are essential areas of focus for any developing clinician. Whether it is during training, at a first job or at some other point in one’s career, it is imperative that clinicians find mentors who can help them develop these essential qualities. I would also advise students to intern with practices to gain exposure to billing operations and take advantage of every opportunity to become comfortable with outreach calls and public speaking. This will allow them to comfortably share the message of the clinically excellent services they have worked so hard to develop.

Clinical excellence should always be a primary focus for student training. It is the foundation that sits beneath every good clinician and every good business. But a well-rounded clinician in this new era of healthcare will benefit tremendously from a firm grasp on healthcare economics and appreciation for the power of promoting their clinical practice.

By Anthony Buccafurni PT, DPT
Executive Vice President of Operations