r/physicaltherapy

Hi all - I am struggling, I am a new grad in an acute care setting right now for my first job. I applied to all different settings because I truly enjoyed all my clinicals for different reasons and was up for anything, so when I got offered this job, only having acute rehab experience I figured I could handle it no problem, but I feel like a fish out of water. I'm a new grad, in a new setting, in a new hospital system and I just feel like I'm behind the curve, there's so many logistical things I need to learn (where the supply rooms are on each floor, required things to document in EMR, etc.) that it's causing more anxiety on top of not feeling super confident in my interventions and I just feel clumsy/clunky going through evals. I know a lot of it is probably in my head, but I just so desperately want to come off as confident, calm, and collected that when I'm struggling with fitting the recliner in the room or bed adjustments I just feel so embarrassed internally.

My rehab clinical I was pushed so much to document in session, and that would help with remembering essentials for evals, and this location is the total opposite, some patient rooms don't even have monitors in them, and nurses wheel them in. And I'm also just not used to a 15-20 minute treatments, and I just don't feel like I'm doing enough for the patient if we get up a and get to the chair, Idk if that's just because I am used to my 90 minute rehab appointments or what.

Any advice of things you wish you knew, or good resources for new grads in acute care, I would be open to any thing. I want to be able to stick this out, and enjoy my M-F because deep down I do feel like I'm capable, but right now I have a lot of imposter syndrome and don't feel like I know anything, and I'm wondering how i even passed boards to be here. I’m having stress dreams thinking about pass sessions and I think it’s just making me so much more exhausted overall.

Just over 11 weeks post-op pour a knee replacement. I’ve been doing outpatient PT twice a week for maybe the last nine weeks. At the end of each session, the therapist asked if I would like an ice pack on my knee before I leave, and I’d say yes if I was going to the store instead of straight home. Today I started wondering about not having gotten a bill for my PT, went online, and discovered a big rolling bill that I guess won’t drop until after I’m done on Monday; it listed five “Pt Hot/Cold Pk Therapist/Pta Only” at $30 each. Yes, most of it is going to be covered by insurance, but still…

The most embarrassing part is that I own an insulated backpack that I use to carry my own ice pack and some frozen water bottles when I go to my kids’ Little League games. I can ice up a couple of times during a game. Once or twice I thought about packing it to take with me to PT, but why should I bother if they are providing 15 minutes of ice before I leave. Ouch!

Patient claims that they passed out and fell one day and woke up on the hard floor after falling down the stairs, they passed out because they seen blood.

They have done a lot of bloodwork and image scanning and their tests come clear. Although they say ever since then they feel like their nervous system is out of wack and it impacted their life greatly. Has anyone run into this before?

Thanks.

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Hi everyone,

I recently completed my Class 12 with 72%, and I'm planning to pursue BPT (Bachelor of Physiotherapy) in my home country. My long-term goal is to move abroad for a Master's degree and eventually build my career in countries such as Australia, Canada, the USA, or other similar countries.

I would like to understand how BPT is viewed internationally and whether this is a good long-term career path.

I would appreciate insights on the following:

How is the demand for physiotherapists in these countries?

Is it possible to build a successful long-term career after completing a Bachelor's in India and a Master's abroad?

What is the licensing or registration process like?

Is opening a private physiotherapy clinic possible after gaining experience and meeting local requirements?

What are the salary, career growth, and work-life balance like?

If you had the chance to choose again, would you still choose BPT for an international career?

If you are currently working as a physiotherapist in Australia, Canada, the USA, or another country, I would be grateful if you could share your experience. Your advice could genuinely influence one of the biggest decisions of my life and help me understand whether this is the right path for my future.

😭😭😭😭😭😭😭😭😭😭😭😭😭😭😭😭😭😭

I’m burnt out. I’ve been practicing two years. Just switched jobs 8 months ago to a hospital outpatient clinic due to better benefits, friends working there, and actual opportunity for growth. I am a pelvic therapist and a lot of my work requires hands on with patients. I can’t always finish notes POS. I am always having to take work home and feel just exhausted by everything. I don’t get paid more for this and my productivity is measured up against people that have the option to finish notes while a patient is warming up on the bike. I see patients ever. 45 minutes and feel like I can’t see 10 patients in a day without feeling completely exhausted like I want to do nothing but rot in bed all night. I was thinking of taking 6 weeks off to reset my nervous system ? Has anyone taken time off for this purpose to reset goals and nervous system to be able to treat patients better? Right now I feel like I’m in a constant panic attack and not sleeping. I’m not sure if I can carry on like this but everyone is acting like this is totally normal. I guess I’ll take any advice at this point.

Has anyone left before their contracted time for their sign on bonus? I am thinking of leaving my outpatient PT position. I took a sign on bonus that paid half upfront and will pay the second half at my one year. The plan is to leave by the 9 month mark of being there. Further research of my contract, documents, and excel sheets are pointing toward only having to pay back the first half I took. Is this typically correct? Signed a new grad never taking a bonus again.

We talk a big game about being an evidencebased profession, and DPT programs hammer home clinical research literacy like it's the foundation of everything we do. But then you get into the clinic and watch experienced clinicians use the same techniques they learned 15 years ago, sometimes techniques that newer research has pretty clearly undermined.

I'm not trying to throw anyone under the bus. Some of those clinicians get great outcomes. And honestly patients sometimes respond to things the research says shouldn't work, which raises its own questions about mechanism versus outcome.

But it makes me wonder how much of our daily practice is actually driven by current evidence versus habit, patient expectation, what equipment the clinic has, or just what our CI taught us and we never questioned.

There also seems to be a lag between research publication and actual clinical uptake that nobody really talks about openly. Implementation science is a whole field for a reason.

Curious how others navigate this. Do you actively update your practice when new evidence drops, or do you find yourself defaulting to what works in your hands even if the research is moving on? And how do you handle it when a patient specifically requests something you're not sure holds up anymore?

Just finished my first year as a licensed PT in an outpatient ortho setting and I have to be honest, I'm feeling a little burned out and underwhelmed by the support structure here. Before I accepted the job I was told there would be experienced clinicians to learn from, structured case reviews, and ongoing mentorship to help me develop my clinical reasoning. The reality is that I'm seeing 16 to 18 patients a day, barely have time to eat lunch, and the senior PTs are just as slammed as I am.

I genuinely love the work and I care about my patients, but I feel like I'm figuring everything out on my own through trial and error. I've been leaning heavily on continuing ed courses and journal articles just to fill the gap.

I'm curious how common this experience is across different settings. Did any of you actually find real mentorship early in your career, and if so what made it work? Was it the clinic size, the ownership model, a specific senior clinician who just made time? Or did most of you also end up selftaught by necessity?

Would love to hear what others did to accelerate their clinical development when formal mentorship wasn't available. This feels more like the norm than the exception, but hoping I'm wrong.

I’m currently working in an outpatient ortho setting. Just wanted to see if anyone has done any Telehealth work before and what the pros and cons are.

My job now:

Outpatient neuro
Unionized
1-1
1 more year until vested for pension
Good salary and raises yearly.
Max 8 patients a day with 1 hour doc time.
115k
Excellent insurance.
1 year maternity leave (not all paid but job protected)

Cons:
Op ortho shift
Openings

New job offer:
Got offered school based preschool
Developmental delay
Preschool 3-5
95k
Insurance okay
10.5 month schedule
Off all school breaks
8-2 schedule steadily.
Not my dream population.

Thoughts? I do have a child.

Just wrapped up my first year as a new grad in outpatient ortho and I want to talk about something that genuinely caught me off guard. Before I accepted the position, I was told there would be structured mentorship, regular case reviews with senior clinicians, and ongoing clinical education built into the schedule. The reality has been pretty different.

Most days I get thrown into a full caseload with minimal guidance. The senior PTs are great people, but they're equally buried under their own patient loads. No real time gets carved out for mentorship. Whatever learning happens is usually me figuring things out alone or grabbing a fiveminute hallway conversation when someone has a spare moment.

I get that productivity pressure drives a lot of this, and I'm not blaming my colleagues at all. But I do wonder how common this experience is across different settings, and whether anyone found a way to get meaningful mentorship despite the system working against it.

Did you find better mentorship in specific settings like hospitalbased outpatient, academic medical centers, or home health? Or did you eventually build your own informal network? Curious how others navigated this, because I know I'm not alone and I think it's worth talking about openly.

The ad says 14-16/day., I already know it’s a trap..
What should I expect?
The gig is offered by Concentra in South Florida.

PTA. In outpatient ortho right now seeing 15-16 pts per day. I’m at work past 6 pm most days and take notes home. Sick of the heavy and quite frankly, overbearing caseload and invasive patients who can watch you from the waiting room and who try to walk past the “break room” to see if you’re ready for them yet because the bathroom is right across the hall…. anyways.

Looking into PRN for either HH or post acute so I can choose my days and live my life again.

-I hear great things about PRN and “you build your own schedule” but is that really true? I would prefer no weekends or holidays but I have a feeling most places only need/want those days. Would i likely be barred or cut, if I told a place i’d want 4 days a week? At least for now while I figure my life out?

-Also any issues with patients not wanting to see you because you aren’t who they’re using to seeing?

Thank you all.

Been thinking about this a lot lately — especially after seeing that post about how treatment approaches evolve over time.

In PT school they teach us certain special tests and techniques with a ton of confidence, backed by the research available at the time. Then you get into real practice and realize the field is constantly updating as new studies come out. It’s honestly pretty cool how much we’re still learning.

The challenge is balancing that with patient care. People come to us looking for clear answers, so how do you stay confident in the clinic while staying humble about the limits of current evidence?

Curious how other PTs and students handle this day-to-day. Do you have go-to journals, newsletters, or resources you trust for staying current? How do you blend the latest research with clinical reasoning and what the patient in front of you is actually showing?

I love this profession and the difference we can make, but navigating the “this is what we know right now” part is interesting. Would love to hear how others approach it.

I feel like PT school did a great job preparing me clinically but left me completely in the dark about everything else. A couple years out now and I still get caught off guard by things like productivity metrics, reading an EOB, negotiating salary, or just knowing my worth when talking to an employer.

Nobody warned me that I'd spend as much mental energy navigating billing codes and insurance denials as actually treating patients. The mentorship piece is a big one too. I shadowed some great clinicians in school but none of them ever sat me down and explained how the business side of PT actually works.

I ended up learning most of this through trial and error or random YouTube rabbit holes at midnight. Which honestly feels like a waste given how much we all paid for our degrees.

Curious if others dealt with this and what actually helped you fill those gaps. Did you find a mentor who got it? Pick up a specific book or course? Just suffer through it until things clicked? This feels like one of those things nobody talks about openly but pretty much everyone deals with. Would love to hear what resources or experiences actually helped people here.

How do you encourage your patients to show up clean?

Hello, like everyone else on this subreddit I’ve burned out on output and want to try HH full time.

Edited to include salary

Been an outpt ortho PT for around 4 years so have the basics of treatment down. And I’ve done some on the side HH and frankly the company was hot garbage with training consisting of a emailed powerpoint, one 1 hour phone call, and having to text/email repeatedly for all other questions. (The people were nice, there was just no training.) But I know the basics of Kinnser.

I’d be happy with either full time offer (and I made sure they both actually had an onboarding program) but I don’t have the experience to know which Cons would suck harder.

TL;DR

Offer 1 110kish yearly has more driving, more pay with a little less work on me for scheduling but much, much higher risk of being stuck in traffic and it screwing up the rest of my schedule. Offer 2 90kish yearly has less availability to group my visits in specific areas, more phone calls/schedule adjustments on me, less direct support but less driving/being trapped in traffic for an extra 30min-1 hour a few times a week.

Offer 1

SOC 180$

Eval/re/dc 110$

Follow up 75$

Pros:

• Team meetings once a week where I can get feedback/help
• Scheduling Team, all visits are given to me at beginning of the week and then I map them out

Cons:

Bigger coverage area, 50% south that main access by high way that is notorious for being terrible, construction, at least 3 wrecks a week, can use tolls but that like 20-30$+ a day

• Start of Cares, I’ve never done these, Oasis frankly sounds like a nightmare
• have to learn Homecare Homebase and Oasis

Offer 2 outsource company

SOC120$

Eval/reval/dc 85$

Follow up 65$

Pros:

• Smaller coverage area, more to the east on a road that doesn’t suck ass
• Rare SOC/ Oasis visits
• No monthly meetings
• rating on Glassdoor, I’ve never seen that

Cons:

Patient list

• is sent out daily, with “front loading” at the beginning of the week
• No weekly team meetings, people have to reach out on their own if there’s a problem
• Rare SOC/Oasis visits
• Uses multiple EMRs: Kinnser, HCHB, Oasis, and whatever the notes are under from the company I get outsourced too

I am a BS Physical Therapy graduate from a foreign country and I'm planning to apply as a PT Aide in ATI, Any thoughts about this? Since I've been seeing a lot of red flag about it.

Not a doctor. Sharing what I learned so others don't have to spend 100 hours reading like I did.

The 5 things that mattered most:

1. Quad strength is #1. Not stretching, not "activating glutes" — pure quad. Every serious protocol I read (Australian sports med, JOSPT reviews, PT clinical guidelines) put quad strength at the center. If you have weak quads your knee gets loaded weirdly and the meniscus takes it.
2. Terminal knee extension is underrated. VMO activation matters more than "all-quad" work. A tiny 20 degree ROM band exercise beats a heavy squat if your extension is weak.
3. Load progression matters more than movement choice.Every source disagreed on WHICH exercises. Everyone agreed that PROGRESSIVE LOAD over 8-12 weeks was what changes tissue.
4. Pain during exercise ≠ damage. This one is huge and PT literature has moved a lot in the last 10 years. Some pain (2-4/10) during controlled exercise is normal and doesn't mean re-tear. But pain that INCREASES 24h post-exercise = you overdid it.
5. The "click" doesn't always matter. Palpable / audible knee clicks stress people out. Most non-surgical meniscus tears click and are still fine. If pain is decreasing and function increasing, don't chase the click.

My actual 8-week protocol summary:

- Weeks 1-2: Isometric quad sets, straight leg raises, heel slides

- Weeks 3-4: Wall sits, mini squats to 30°, step-ups

- Weeks 5-6: Full ROM squats to 90°, lunges, single-leg RDL

- Weeks 7-8: Split squats loaded, box jumps if pain-free, return to activity ramp

Happy to share sources if anyone wants them.