If you decide to join the armed forces or the U.S. Public Health Service, you will apply directly to these and accept the post they assign you. If you decide upon a position in civilian life, however, you must make several choices before beginning to look for a job.
You must decide which is more important to you-a job in a particular hospital or living in a certain locality. Must you live in Boston, New York, or San Francisco? Do you want to make your home in a ski center in Colorado or a sailing area such as New England? Do you yearn for the perpetual summer of Arizona and Florida?
After you decide, you will begin looking for the job just right for you. Many new graduates accept positions in hospitals where they received a part of their clinical experience. These institutions are teaching hospitals and offer the new graduate excellent learning opportunities. The department director and the clinical faculty know the students and can observe which students are best fitted for the job requirements. Clinical students know which hospital has the type of cases that interest them most and the department structure that will help them perfect their knowledge. Students who wish jobs in such a hospital usually apply for their positions during their periods of clinical experience. They may be invited to join the staff of the clinical facility during their affiliation or very shortly after they leave it.
Some institutions delegate either a physical therapist or a personnel officer to interview students on college campuses. Students who are fortunate enough to attend the annual physical therapy conference in the summer may request interviews during the week of the convention. All physical therapy schools have lists of positions available. These are compiled from letters sent to them by hospitals and institutions who need therapists. The national office of the American Physical Therapy Association supplies lists of employment opportunities to its members.
The American Physical Therapy Association also maintains a placement service at a local level. The national organization is divided into chapters, usually by states. Large or heavily populated states are further divided into districts. Each state has a placement committee with a chairperson. If the state chapter is divided into districts, each district has a placement committee and chairperson. These chairs keep up-to-date listings of all positions available at the area. They supply the list to any member of the American Physical Therapy Association. This service is free to both the recruiting institution and the physical therapist.
If you have always had a great yearning to work in a certain hospital or certain town, but find no opening listed, don't despair. Write to the hospital or to the organizations in the area. Few facilities are completely staffed, and the turnover is rapid enough in most departments that a job might very well open up for you. Remember, too, that many institutions with openings run advertisements only periodically and then wait for applicants. Some smaller hospitals who need staff just sit back and wait for a miracle-like you. They have learned that advertising isn't always effective.
JOB HUNTING
Job hunting is an adventure, and it can be fun. It shouldn't frighten you. Remember, everyone who has a job once hunted for it, even the directors of physical therapy departments.
Unless you accept a position in one of the hospitals where you received your clinical experience, you will have to begin job hunting. Start by writing to the directors of the departments where you would like to work. Submit a resume. Give several dates when you would be available for an interview. Occasionally therapists have been employed sight unseen, but this is rare. Most directors prefer to interview prospective staff members.
THE INTERVIEW
You should arrive for your interview equipped with pen, Social Security number, names and addresses of references, dates of previous employment, a copy of your resume, and perhaps a transcript of your college courses. When you complete the application form, don't hesitate to include jobs you have held that were not directly related to physical therapy. Working as a waitress, typist, or camp counselor may not make you a better therapist, but it will make you a better employee because someone else has polished your rough edges.
Interviewers are impressed by many things. If you have graduated from an approved school, you will be qualified for a job; whether you get the job depends upon you.
Manners are as important as knowledge. Don't sit down until you are invited; then sit, don't flop or sprawl. Don't answer questions in monosyllables because you are scared, but also don't chatter needlessly. Speak with good grammar, good diction, and in a well-modulated voice.
Good work experience is more important than a few dollars more a week. In discussing the job with the interviewer, you have a right to inquire about the working conditions, but stress your eagerness to find a job where you will learn to be a better therapist. Your first job is your most important one. You are inexperienced, impressionable, and vulnerable. If you are only interested in the size of the paycheck and the length of the vacation, you may find yourself in a job nobody else wanted.
At the conclusion of the interview, the human resources representative will probably tell you that you will be notified by mail, if your references have been satisfactory. If you have had ten interviews, you may well receive ten job offers. Obviously, you can only accept one. Today it is a job hunter's market in physical therapy. The demand far exceeds the supply. If you succeeded in getting into the physical therapy curriculum and staying through graduation, you will have many opportunities for positions.
CHOOSING THE RIGHT JOB
As soon as you decide which job you will accept, notify the director of the department. Then, either phone or write all the other institutions where you applied to inform them that you have accepted another position. Physical therapy directors will want you to survey all the positions that interest you, but they cannot hold a job open indefinitely.
As you graduate, you are a professional, and as a professional, you now have responsibilities to others. In a field as short-supplied as physical therapy is today, have the courtesy to notify the directors that they may take you off the list so they can resume recruiting other applicants.
It is very important that you select a job that is well suited to you. Often, the young therapist who performs poorly is unhappy because the work situation is not suited to her or his ability or personality. Some people have a flair for working with children but lack the patience to handle geriatric patients; others are just the opposite. Some can perform outstanding work in a well-staffed center where the workload is light and the therapists have unlimited time to devote to a few patients. These people in understaffed and busy clinics may be frustrated, morose, and often inefficient.
Often, the tone of the department makes the difference in the successful performance of physical therapists. Some prefer to work where there is close and direct supervision by a physician or by the director and where the rules are clearly defined and strictly enforced. Others would rather work where they have free rein to use their imaginations, to improvise, and to make decisions within the framework of the rules of the profession.
It is important for all of us to heed the advice of Polonius in Hamlet. Polonius tells his son Hamlet, 'To thine ownself be true." This is as important in life as it is on a stage; as important today as it was in the sixteenth century. Recognize your abilities and your limitations, your likes and dislikes, and find the job that appeals to you. Don't play the martyr and work in a job just because someone is needed, knowing that you don't like working with a certain age group or a certain type of disability-or that you can't stand the boss. If you accept a job you really don't want, you will be personally unhappy, you will hate your job, you will reject your profession, and you will be a failure. If you choose a job you want, it will challenge you to make great contributions to your profession and to your community. Moreover, you will find yourself a bigger and better person because of it.
LEGAL AND PROFESSIONAL REQUIREMENTS
Educational and professional qualifications for physical therapists were established by the American Physiotherapy Association in 1920. In the 1930s, the American Registry of Physiotherapists established its standards. During the years between 1920 and 1950, most hospitals and institutions required their physical therapists to be members of either or both organizations, because this membership meant that the therapists had completed an acceptable course in physical therapy and had passed a very difficult examination to qualify for registration.
In the early 1940s unqualified, poorly trained people were beginning to call themselves physical therapists. At the same time, some states were putting therapists into categories with limited practitioners not recognized by the medical profession. One state, as the ancient Chinese did also, classified physical therapists with barbers.
LICENSURE
Some time ago, it became increasingly apparent that licensing would be necessary in order to establish standards of performance, because incompetence in this field is a threat to public safety. Following the hallowed tradition of state's rights, each state enacted its own licensing laws, complete with standards and regulations. Proof of graduation from an approved physical therapy school and the successful completion of the examination provided by the state are the usual criteria for licensure.
The American Physical Therapy Association is endeavoring to establish nationwide standards of competence for physical therapists. In 1953, this organization contracted with the Professional Examination Service of the American Public Health Association for the construction and maintenance of an examination. This test is now the qualifying examination for state licensure in almost all states.
THE APTA-PES TEST
The APTA-PES test is a well-constructed, up-to-date examination prepared by professionally active physical therapists with the guidance of professional examiners. The test contains multiple choice questions and is divided into three parts. Part I covers the basic sciences, part II covers the clinical sciences, and part HI covers theory and procedures. The test is given in one day, in three periods totaling seven hours.
The test is usually given in the state capital, but other areas may be designated. A therapist who has taken the test may choose to have the results listed in the Interstate Reporting Service and kept on permanent file, to be sent to any state upon request. You may wish to be licensed only in the state where you are tested; or you may ask for reciprocity for one specific state.
State licensing fees are variable. In some they are nominal, but in others the cost is relatively expensive because of legal fees involving state licensure and amendments.
The American Registry of Physical Therapists was disbanded in 1970. For approximately forty years it had functioned as an examining board to qualify physical therapists and, during that time, members encountered no problems in seeking employment in many different states. When state licensure became mandatory, the ARPT no longer fulfilled its purpose and was abolished. The American Congress of Physical Medicine, which had supervised the ARPT during its existence, continued to publish a monthly journal called The Archives of Physical Medicine.
It is a requirement for therapists to be licensed in the fifty states. It is important for every therapist to belong to professional organizations and to participate wholeheartedly in their activities. Being a professional person means many things. It means dedication to the profession by investing money in dues to assume your share of the operating expenses and an investment of your time to promote the objectives of your organization. It is unfair to expect other therapists to work and pay while you ride along on their coattails to benefit from their efforts.
MALPRACTICE INSURANCE
Most hospitals pay the cost of malpractice insurance for physical therapists in their inclusive insurance policies. Physical therapists in private practice and in some agencies must purchase their own insurance protection. The rates vary with the type of work that a therapist engages in. This is a problem that you need not consider until you are actually employed. Malpractice suits against physical therapists are increasing, just as are those against physicians; the possibility of a lawsuit must be on the mind of the therapist constantly.
ADVANCEMENT
A new graduate usually takes a position as a staff therapist in a large hospital in an urban community. After a year or two you have proven your worth and may be promoted to a position of senior therapist, where you will assume a greater share of professional and supervisory responsibilities. If you remain in that position, you may eventually receive an appointment as assistant chief, chief, or director. Most young therapists, however, prefer to look for a different position after a year or two. This is often the position of assistant in a small department. After another year or two of experience, the therapist seeks a position as the only therapist in a very small department or as a chief in a small department. With this added experience, the position of director of a large department is within reach. A therapist who wants to establish a private practice should have varied experience in several departments before beginning to work with little or no professional supervision. Although it is not a requirement, it is wise for new graduates to work for at least a year in a large general hospital. The specialties teach a great deal, but all this knowledge is founded on general experience.
Today, an ambitious, eager, and dedicated therapist, even though comparatively young and inexperienced, may rise very quickly to a position of responsibility and prestige. The old Welsh proverb says, "The cream always rises to the top." The exceptionally well-qualified person will be singled out for promotions, for better positions, and for offices in professional organizations. The indifferent, lackadaisical, or negative personality will remain in a rut, plodding through life with neither challenge nor reward.
Of course, not everyone wants to be a chief in a large department. Many therapists want only to devote themselves to the service of humanity or to do research in one of the specialties. This need is great, and the service they give is important. Remember, even in physical therapy we need more braves than chiefs, so never look down on therapists who are not department directors.
PROFESSIONAL ORGANIZATIONS
The American Physical Therapy Association is a national association of physical therapists formed in 1921 to standardize the developing education and service of physical therapists. This organization continues to define the function of physical therapists and to promote standards of ser-vice by developing educational requirements. In addition, it aids in planning the development of new facilities and the organization, administration, and curricula of new physical therapy schools. The American Physical Therapy Association also promotes legislation for the membership and health and welfare programs. It promotes and protects the economic and general welfare of its members, and it represents those members as the spokesperson with allied professional and governmental groups.
The APTA is divided into chapters, usually comprised of states. Each chapter has a president and an executive board of the officers. Some large states have more than one chapter, while other large states prefer to divide into districts. Districts, like chapters, have officers, committees, and committee chairs. The smaller chapters and districts hold monthly meetings, which usually combine a business meeting with an educational program. Most chapters and districts sponsor evening and weekend workshops at cost for the members. Each year the chapters hold a two- to three-day conference combining business sessions, lectures, and recreational programs.
The APTA publishes a monthly journal, The Physical Therapy Journal. It contains articles written by members, scientists, and physicians. The APTA also publishes the Progress Report and the PT Bulletin.
PERSONAL QUALIFICATIONS
Everyone in a profession is eager to advance as rapidly as possible. Promotions and advancement bring salary increases, prestige, and greater opportunity; "Nothing succeeds like success."
Success in physical therapy depends a great deal on how well suited you are to the field. Although there is no "typical" physical therapy personality type, personal qualifications make the difference between an outstanding therapist and an ordinary one, even though the two might have had identical educational training.
Dr. James Conant said, "Ideals, like stars, can never be reached, but we use them to chart our course." Several authors have written about the necessary qualities of a physical therapist, and Katherine Worthingham, in an article entitled "The Selection and Education of the Physical Therapy Student," give us excellent suggestions for the qualifications for a physical therapist.
Every physical therapist must have the ability to become a good teacher who can help the patient help himself. The physical therapist must be capable of communicating with the patient and his family and must be able to draw information from the patient, to hear what he has to say, and to listen to the patient with silent understanding.
Good physical therapists take responsibility for helping to build their profession as well as their own personal future. They will not submit to routine or uninspired performance of duties, but will participate in research activities, as well as assuming responsibility for their share of the rehabilitation work.
Physical therapists must like people regardless of size, weight, color, creed, income level, or disposition. They must have friendly, kind, and patient personalities. They must be sympathetic, but not possess maudlin sympathy that destroys the working relationship. They must be dignified but not stuffy. They must have the emotional stability to be professional persons who perform their obligations during working hours without letting their personal lives interfere with their work. By the same token, they must not become so involved with their patients that they carry their patients' problems into their own personal lives. Their personalities must be both mature and flexible, so that they can vary the programs they administer; they must not let themselves become automatons.
Good working habits are especially important in careers that require both knowledge of scientific subjects and the ability to deal effectively with people. Physical therapists must be industrious, conscientious, neat, clean, punctual, attentive to details, and able to concentrate completely on their work. They must be able to organize a schedule because most departments carry heavy workloads. It is important that they keep accurate records and be meticulously honest with themselves and others.
Physical therapists must possess leadership to influence those who look to them for guidance and support. They must also feel pride in accomplishment. To perform at the highest levels, they must keep abreast of new procedures and treatments. They should be able to assume the responsibilities and duties of all citizens, cultivating their minds as they study and serve the society in which they live.
THE REWARDS
In the past, salaries of all workers in the health field were lower than salaries in business and industry for positions requiring a comparable amount of formal education and demanding as much responsibility. During those years, personnel directors had a favorite cliche. "This is the price you pay for the privilege of serving humanity."
Fortunately, those long years of low salaries never deterred or influenced anyone who wanted to become a physical therapist. Admittedly, the long hours of hard work, the great responsibility, and the low salaries did have a discouraging effect on many therapists whose college classmates were earning four times as much in business careers.
Recently, there have been dramatic changes in the salary scale and in the personal benefits for physical therapists. Today salaries compare favorably, and often exceed, with those for other positions demanding similar educational backgrounds and responsibility, such as teaching, library science, and social service.
Salaries alone, low or high, could never compensate a physical therapist for the physical expenditure of energy and the emotion spent on patients year in and year out. A mountain climber braves the hazards of a precipitous ascent in thin air because "the mountain is there." Mary McMillan, founder of the APTA, once said, "There was a job to be done, and I was there." The physical therapist invests his or her life in the patients because they, too, "are there." Patients are like magnets, drawing those who must devote their lives to the rehabilitation of the handicapped.
Physical therapy is more than a way of earning a living; it is a way of life. There is a story about a famous English architect, Sir Christopher Wren, that can be applied to physical therapy. Sir Christopher was inspecting the building of a cathedral that he had designed. He stopped to talk with the workers, and he asked three of them what they were doing. The first person answered, "Cutting a piece of stone." The second replied, "Earning five shillings a day." The third said, "Helping to build a cathedral." Like the third man, a physical therapist does not exercise a hip joint, or earn $50,000 a year, but helps people to rebuild lives.
WORKING CONDITIONS
In the United States, hospitals, institutions, and organizations that provide care for the sick and disabled usually provide pleasant working conditions. Most American hospitals have central heating during the winter and provide air conditioning in the summer. Some hospitals provide living quarters, meals, and laundry, either at cost or free, for their staffs.
Departments vary in size depending upon whether the department was designated as physical therapy before a new building was erected or whether it was stuck in the only space available in an aging and obsolete structure.
Space may be generous or limited; departments, crowded or spacious. In many institutions, physical therapy departments are located on a portion of a single floor. Sometimes, a department occupies several floors of an entire wing or, possibly, a whole building. Some departments have a number of generous-sized treatment and dressing rooms, exercise areas, and private offices. In other departments, there are curtained cubicles in one or two large rooms. Some departments must use corridors for gait training and waiting rooms, while others have luxurious furnishings. Some departments are light, airy, and quiet, while others are dark, stuffy, drafty, or noisy.
Therapists who treat patients in the patients' homes may find circumstances varying from servant-staffed mansions to rickety shacks in a poverty area, depending upon whether the service for home-bound patients is a private practice or a public health service. The therapist engaged in a home-bound service may spend a great deal of time traveling through summer heat or winter blizzards. At other times, however, the traveling therapist may pass through the fragrant apple blossoms of the spring and the breathtaking foliage of fall. Climate and weather must be taken into consideration.
Therapists who volunteer for foreign service will not always find working conditions pleasant and comfortable, but relatively few therapists work overseas.
The majority of employed therapists work forty hours a week. Traditionally, this has been Monday through Friday from 8:30 A.M. to 5:00 P.M. Some general hospitals are open on Saturday mornings, with rotation of a minimum staff. These persons are then given a half-day off during the week or are paid time-and-a-half for the overtime. Increasingly, departments are open on weekends. In some California institutions the departments are open twenty-four hours a day, seven days a week. With the recent health care budget cutbacks, and increasing demands by third-party payers for efficiency, physical therapists will probably treat patients in many hospitals seven days a week in the not too distant future.
Department directors who treat patients only 40 percent of the time are not eligible for overtime compensation, however, because they are grouped with administrative personnel.
The usual labor laws regarding luncheon and morning and afternoon breaks, legal holiday time, and vacation scheduling apply to physical therapists. Self-employed therapists do not have to observe the labor laws.
ADVANTAGES AND DISADVANTAGES
In a job, career, or profession, will you ever find a Utopia? In any field there will be moments that are dull, routine, tedious, and irritating. No job can promise you a forty-hour workweek filled with constant mental stimulation, emotional reward, and recognition of your knowledge and ability. Every career has something special to offer you, and, simultaneously, every career lacks something you desire. You must exchange one thing for another. Only you can determine what you want to gain and what you prefer to reject.
Disadvantages exist in physical therapy just as in any other field. Specifically, the work is physically, mentally, and emotionally exhausting. You will be lifting patients who cannot move, and this is hard physical labor. The workload will be heavy because almost every department is inadequately staffed. Ironically, the shorter-staffed the department, the more urgent the need for additional recruits, but the more difficult it is to find replacements.
Despite the stress that physical therapists place on body mechanics, a sudden motion by a patient may catch a therapist off guard and cause an injury. Occasionally a therapist has been hospitalized in traction, braced, or operated on as a result of an injury suffered in the line of duty while performing routine tasks.
A day's work can leave you completely drained of energy because you are superimposing your will upon your patients' in an effort to draw from them the response you want. Often it is a response they don't want to make. You must achieve your result by positive encouragement, never by scolding and criticism. This is infinitely more fatiguing than the physical handling of patients.
The advantages of physical therapy as a career far outweigh the disadvantages. First, the job potential is constantly increasing. During the past few years, salaries have doubled and even tripled in some areas. Professions always offer prestige to those who practice them. Other health workers respect physical therapists for their role on the rehabilitation team. The lay public surrounds physical therapists with an aura of glamour because they help people walk again.
In actuality, the advantages and disadvantages are superficial. Physical therapy offers you an opportunity to participate in the drama of life. It gives you an opportunity to contribute to the world and not just to take from it.
If you need more information, contact APTA or visit their web site.
