Why I Choose to Specialize

I was recently having a conversation with a few friends from my undergraduate schooling who all hold business degrees. I was telling them about physical therapy education- how I recently completed a residency program and how the program has helped prepare me to become an orthopedic specialist. As businessmen, the topic of money was quickly brought to the conversation. They understood I made less money last year as a resident, but assumed it would be for greater financial gain the year after. As therapists know, this is usually not the case. Being an OCS or fellow does not guarantee an increase in salary. They were dumbfounded that I would still choose to pursue specialization without the financial gain. So why do I specialize?

I choose to specialize because it will make me a more intelligent, intuitive clinician. More knowledge leads to more informed clinical decisions, clinical efficiency, and ultimately better patient outcomes. As one faculty member at the Harris Health System said, "all therapists can arrive at a diagnosis, but your residency training will help you arrive at the diagnosis much faster." The knowledge gained during my residency was unparalleled. The number of one on one mentorship hours received in one year is not attainable by many companies. I seek this knowledge because there are people living in pain that I can treat if I have the proper knowledge.

I choose to specialize because I have the potential to change the profession of physical therapy. Our profession has so much potential in the present moment. We are on the horizon of taking over preventative medicine and becoming completely autonomous, direct access practitioners. It is easy to stop studying after physical therapy school and rest on a generalized education. It is easy to be uninvolved in our national organization. It is much more difficult to spend hours each week studying and collaborating with peers on ideas to better the profession.  We will not get there by continuing to play the role of technician, but rather by defining ourselves as diagnosticians. 

I choose to specialize because of the innate satisfaction of helping another. There is an indescribable satisfaction in decreasing someone's pain and empowering them to control their pain independently. Eliminating someone's pain creates a special connection with that individual that lasts for years. Physical therapists, OTs, and SLPs are the only professions that spends 45+ minutes with their clients. This creates so much opportunity for education and change. I choose to specialize to ensure I am making those 45+ minutes as beneficial as possible. I know I would not be able to successfully treat so many people without my residency training. No, I am not going to immediately make more money, but I am going to change many peoples lives. This brings more happiness than the temporary joy of a paycheck. 

For those of you who cannot afford to spend one to three years doing residency, fellowship, or advanced certification training, I challenge you to think about that commitment as a long term investment. Maybe you will not make more money immediately, but you can use a specialization to market yourself for future opportunities. An advanced degree can be the difference between becoming a clinic director vs. staff therapist. It can be used as a marketing tool to draw patients to your clinic.     

Unfortunately at this point, physical therapy specialists are not appropriately compensated. Insurance companies value quantity over quality and therefore clinics cannot afford to pay for quality either. We can shift this paradigm by continuing to practice the highest quality care and continuing to pursue specializations. I want to conclude with a great quote from Earl Nightingale which reads, "the opposite of courage in our society is not cowardice, it is conformity." Are you conforming to being an average practitioner or are you currently pursuing something beyond the 9-5 work hours? "What greater wealth is there than to own your life and spend it on growing." Do something for yourself, for your profession, and for your patients.  

Why do you specialize? 

-Jim Heafner