Read This Before Applying to PT School (Here’s What They Don’t Tell You)

If you're thinking about becoming a physical therapist, I need you to pay attention to this. And, honestly, this is also for those of you who’ve already made the leap into physical therapy and now feel like you’ve been played. I’m going to share the truths about the PT business that no one tells you upfront – truths I wish I knew before committing to this career.

Whether you like it or not, you’re stepping into a business, and if you don’t understand how this business works, you could end up in a mess – financially and personally.

Understanding the PT Game

Here’s the deal: Physical therapy is a business. Everything is a business, including physical therapy school. You’re the customer paying for the degree, and the school is there to help you “become” a physical therapist. But nobody teaches you how the business side works, and that’s where things can get tricky.

So, here’s the big takeaway: Businesses exist to make money. Every business – including physical therapy practices – needs to make more money than they spend. That’s how they stay in business.

This isn’t just about helping people; it’s about generating revenue. And the game? It's all about how much money you make versus how much you’re spending. If you don’t understand this, you could be working your butt off without seeing the payoff.

The Hidden Truth About Insurance

Let’s talk about insurance. This is a HUGE part of the game.

When you work in physical therapy (about 90% of you will), you’ll be dealing with insurance companies. This isn’t the same as going to the grocery store and paying for what you pick up. Here, your company has signed a contract with the insurance providers. That’s how they get paid for your services.

But here’s the kicker – you don’t get to decide how much you get paid. Even if you bill out $300,000 in a year, your company may only see anywhere from $100,000 to $220,000 of that, depending on the insurance rates.

So, while you’re busting your chops, seeing more patients and working more hours, the amount you’re paid won’t change much – not unless you’re billing more, seeing more, or offering longer sessions.

Now, here’s something they don’t teach you in PT school – Experience Doesn’t Mean More Pay. Whether you’re one month out of school or 50 years in, the amount you get paid for a certain service (like an initial consultation) stays the same. It’s not about your experience; it’s about the contract your employer signed with the insurance companies. Crazy, right?

The PT Business Players and Why They Matter

In every business, there are different players. Here’s who they are in the PT world:

1. The Insurance Companies – They’re the ones you’ll be working with. They dictate how much your company gets paid for services, and therefore, how much you’ll get paid.

2. The Employers – These are the clinics or hospitals that hire you. They sign the insurance contracts, and they dictate the rules for your workday.

3. You, The Therapist – You’re the one delivering the services. The more patients you see, the more your employer makes, but unfortunately, this doesn’t always translate into higher pay for you.

And then there’s the ultimate player, which is the system as a whole. If you understand how this system works, you can make it work for you. If not, you’ll be burned out and disillusioned, wondering where your paycheck went.

The Bottom Line: Know What You’re Getting Into

Before you even think about applying to PT school, make sure you understand how this business really works. PT is a career that can be incredibly rewarding, but only if you understand what you're signing up for. If you don't get clear on how the insurance game works, how compensation works, and who the players are, you might find yourself stuck in a grind.

So, here’s what I recommend:

1. Do your homework: Understand how the business side of physical therapy operates.

2. Be realistic: Know that the pay you get won’t change drastically based on your experience.

3. Look for opportunities outside the traditional model: There are ways to impact more people and make more money without trading all your time for it.

At the end of the day, PT can be a fulfilling career – but only if you understand the game and make sure you’re playing it on your terms.

Much Love,

Greg Todd

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