What I Didn’t Learn In PT School

For those of you who don’t know me, my name is Joe Rinaldi and earlier this year, I graduated from PT school. I have been practicing under a temporary license for the past couple months while studying for arguably the most important test of my life, the NPTE.

I am proud to announce that I just passed the NPTE. However, if I’m being honest, passing the board exam doesn’t mean much to me. In my eyes, it was just another hoop to jump through and the extra letters behind my name don’t change who I am, what I stand for or how I want to live my life.

I know that you read the title and before I keep going, I need to make something clear; I had an excellent experience in Drexel’s DPT Program and I wouldn’t change it for the world. I learned so much, I met some incredible people and I grew more than I thought possible. This blog is not about a specific school, but rather, the collective whole of the current state DPT education and where it falls (very) short in my personal opinion.

Feel free to disagree.

Time to buckle up.

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Listen, I get it.

On some level, most DPT programs function like they do [because of politics (cough*CAPTE*cough) and that’s unfortunate. However, I also recognize the tremendous value in the foundational information and skills that these programs provide to their students. It sets the foundation for which confident and competent clinicians can build from.

I understand that that there is not substitute for clinical experience and that there are just some things that are hard to teach in a classroom setting. One thing that I loved about Drexel’s DPT Program was the variety of integrated clinical experience and 40 weeks of clinical rotations that were spread throughout the curriculum. I think that clinical experience is imperative to student growth, but I’m not here to talk about that.

This blog is about what goes on in the classroom.

I will keep the rest of this blog short and to the point. Having experienced life as a new graduate, here are some things that I wish I learned in school.

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Words Matter.

Sticks and stones can break your bones but words can do some damage too.

We are the stories that we tell ourselves. I was taken back to realize how many patients come in with negative narratives that are clearly holding them back. I realized that we (PTs) are in the perfect position to reassure our patients, encourage them and empower them. We have the incredible opportunity to help them re-write their story in a way that benefits them. Through our dialogue, we can help them shift their perspective, feel more confident and become more resilient. Those things are all associated with more positive outcomes, and that shouldn’t be a surprise.

I wish that school gave me the opportunity to practice using positive language and encouraging narratives because those things changes the game.

Embrace Uncertainty.

If there’s one thing that I’ve learned since being out of school, it’s this: we don’t have all of the answers. To be more precise, we don’t have most of the answers.

The world of (outpatient) physical therapy (as well as life in general) is filled with uncertainty and that can be a scary thing, especially for patients who are experiencing pain, feeling vulnerable and are suffering. I’ve come to realize that a large part of our job isn’t to fix people (that’s never the case), but rather, to help guide people through the uncertainty that they are experiencing. In most cases, that is what people need; a guide.

I wish that school gave me the opportunity to practice becoming more comfortable with uncertainty and developing strategies for dealing with it.

Meet Them.

Meet people where they are so you can take them where they want to be.

Meet people where they are. We all see the world through a different lens. Everybody has a different perspective and no two people are in the same place. Because of this, different people need to hear different things. To maximize effectiveness, communication need to be tailored to the individual sitting in front of us. In order to do that, we need some level of social awareness. We need to be able to meet people where they are.

Take them where they want to be. Whether you think so or not, [outpatient] physical therapy is a customer service profession. It is our job to help take people where they want to be, not where we think that they should be. If a patient wants to be able to do something, it is our job to help them get there, not to tell them that they can’t [exceptions exist].

I wish that school gave me the opportunity to learn more about the psychological aspect of human interaction, to practice effective communication strategies and to develop social awareness skills.

Know Them.

People don’t invest into products, they invest into feelings and people.

If we want to be an effective physical therapists, we need to build a relationship with our patients that is set on a foundation of genuine interest, compassionate caring and empathetic love. In the most basic terms, we need to get to know our patients and actually care about them so that they feel comfortable and compelled to invest their time, energy and effort [not to mention money] into letting us help them.

With few exceptions, people who seek healthcare are vulnerable on some level and it is a privilege to be able to help people who are in that position. One way to strengthen therapeutic relationships is to be open and vulnerable as healthcare practitioners ourselves [in an appropriate manner]. In addition to genuine, open and honest care, there are other simple ways to make people feel valued, heard and cared for [e.g. using their name, active listening, motivational interviewing, etc.].

I wish that school gave me the opportunity to practice building healthy, safe and supportive relationships in meaningful and practical scenarios. In short, I wish that school placed more emphasis on human interaction and relationship building.

Not Everybody.

I am a people pleaser. I am an eternal optimist.

In my first month out of school, I learned a tough lesson.

I might not be the right PT for everybody and that, as much as I don’t want to accept it, despite my best efforts, I won’t be able to help everybody who I treat. There are some people who, for one reason or another, might need something else, whether that be a surgical procedure (gasp) or another kind of therapeutic discipline (e.g. mental health).

However, even if I can’t help someone in the “healthcare” sense, I can, without a doubt, leave them better off for having met me. In everything that I do, strive to make people better, even if that just bringing a smile to their face or giving them a few minutes of undivided attention.

That’s something we can all do.

I wish that school gave me the opportunity to fail more. I wish that I was given the chance to deal with difficult people and challenging patients on a more regular basis so that I could grow in my ability to stand tall and remain positive in the face of struggle when it comes to clinical practice.

It’s Different.

Pain is not equal to suffering.

I guess I knew it deep down; I think we all do. However, it didn’t take a long time for me to be reminded that while pain and suffering can happen together, they are by no means the same thing.

On the surface, people often seek physical therapy services because they are in pain. However, when you dig deeper, pain itself is not the reason that people want help. People can deal with pain. People seek help because the pain is affecting who they are and/or disrupting how they see themselves.

For me, the hardest people to treat are people who are suffering. These are the people who are often consumed by their illness. These are the people who let pain/illness dictate their story and often times, the pain/illness becomes their entire story. The people who are suffering need us the most, but we can’t do it alone… and if I’m being honest… I struggle with what comes next. I’m comfortable with the fact that I’m new to this, but I’m far from complacent. I will have more insight into the world of suffering and what we can do about it, but for now, that’s all I have.

I wish that school gave me the opportunity to learn more about the human experience, the psychology of suffering and how to deliver empathetic and effective care to vulnerable people in need of hope.

It Depends.

I’m just kidding, they’ll beat this into your head.

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Holding true to my promise, I want to keep things brief, so I’ll begin wrap up here with a list of quotes that speak to the sentiments shared above.

“People won’t care how much you know until they know how much you care.” Theodore Roosevelt

“Not everything that counts can be counted, and not everything that can be counted counts.” Albert Einstein

“Whether you think you can, or you think you can’t – you’re right.” Henry Ford

“People might not remember exactly what you did, or what you said, but they will always remember how you made them feel.” Maya Angelou

“It’s not what you look at that matters, it’s what you see.” Henry David Thoreau

“Remember that a person’s name is to that person, the sweetest and most important sound in any language.” Dale Carnegie

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This blog is bigger than healthcare.

Yes, it’s geared toward the profession of physical therapy, but it’s more than that. It’s about how to connect with people, how to encourage people and how to care for people. Those are skills that we all use on a daily basis.

Each interaction, no matter how small or how brief, has the potential to lift someone up or bring someone down. That’s powerful stuff. Being more aware of the power of human interaction is something we can all be better at [myself included]. It’s time that we take that to heart, put effort into honing those skills and do better as humans first.

For those of you who are in healthcare and are looking for an actionable step to grow in your ability to connect with others and improve your ability to navigate the uncertainty that is the human experience, I would highly recommend looking into The Level Up Initiative. It is an educational and transformational platform that centers around four main components: facilitating a growth mindset, developing critical thinking skills, improving listening skills and fostering individualized communication. Through personal experience, I can attest that this platform is well worth your time.

“You might not be able to change the world, but you might be able to change the world for one person.” Paul Shane Spear

Go change someone’s world.

Thank you for taking the time to read – I appreciate you!

Joe Rinaldi, PT, DPT

IG: @joerinaldi.dpt

6 thoughts on “What I Didn’t Learn In PT School

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  1. This is so accurate! I talk to my co-workers in different disciplines all the time about the power of patient communication vs actual skill set. Sometimes they just need someone to listen and work through their current situation mentally before the physical therapy can truly be effective! Love this post! Keep it up! PA grad myself!!

  2. Joe,
    This is so perfectly stated and written. I missed a workshop this past weekend in Chicago that I believe you were speaking. I look forward to speaking to you in the future. You blog here is on point as I continue to teach in a DPT program for another year I am challenged always as to how to get this important information across to the students and struggle with watching them blow this off or at least observing what I believe is them not understanding the importance.
    Laurie

    1. Laurie,

      First off, thank you so much for the comment – you made my day! I wasn’t speaking in Chicago (that would be cool though)! I would love to speak sometime down the road and if there’s anything I can do to help you get these points across to your students, please let me know (feel free to share this with them).

      All the best,

      Joe

  3. Congrats on becoming a colleague. Well said. I teach at MSMU in Los Angeles and teach a three part series, Therapeutic Interactions. I tell the students that I hope down the line that they determine that they are the most important courses they take in PT school, not because I teach them, but because of the information they gain. We spend the three semesters on self-exploration, understanding differences, and discussion special populations and their experience in the healthcare system. My biggest take home message for the students (not mine, but borrowed) is that each of us carries around an invisible backpack of thoughts, beliefs, and experiences. It is our job as PTs is to know what is in ours and understand what our patients have packed in theirs and how it may affect the therapeutic alliance.

    1. Ben,

      I love everything that you just said! Thank you so much for taking the time to read and share your thoughts with me. I would love to be able to teach in a DPT program and do something similar to you. Keep up the great work and have a great week!

      Joe

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