Six years ago I did something I never thought I would do.
In December 2018, I walked away from a profession to which I’d given my whole heart, my whole life, and multiple 6-figures of investment, and more brain power than could ever be measured.
I didn’t go without kicking and screaming.
But eventually, the moment arose where my Soul said “Enough. You are complete.”
And in celebration of this anniversary, I have 6 truths to tell about why I still think this was one of the best decisions of my life.
This is Part 1 of 2 - I'll share three truths along with some reflections and stories in each part.
Because it merits saying: I have great respect for the physical therapy profession, the APTA, and all the people who continue to pour their hearts and souls into advancing PT across the world. I have great gratitude for the formative and valuable place it had in my life. I have great love and respect for the colleagues, friends and mentors who helped me grow and who challenged me to become better, and continue to do so.
AND – I share and stand by these truths as they colored and shaped my personal experience. They may not be the same as anyone else’s experiences, and may be difficult for some people to read and hear. For other people, they may completely resonate. At any rate, I am not here to convince anyone that their experience has to be and feel the same as mine. But – if you resonate and see yourself in any of these stories and truths, you are definitely not alone!
Would I go back to PT? It’s a question I used to ask myself a lot. That question has faded over the years, but it still arises from time to time.
For me, it has never been a bitter or hard departure.
I’ve always left the door open – if a time comes where it does feel aligned to return, then return I shall.
When I walked away, it was not out of spite or disgust. It was not out of burnout.
It was because at that moment in my life, I truly felt complete with it. And what a powerful place from which to leave -- when you're at the TOP, feeling good, and feeling like you have nothing else to give to or gain from something.
But when I graduated from PT school, I’d envisioned staying in the profession for life. I thought "feeling complete" would come when I was ready to retire. After all, that's what dedicated people did, especially after sinking so much time and energy and money into their training and education, right?
Turns out, it only took 9 and a half years to outgrow that vision. Turns out, I tend to be an outgrower in more things than just my professional life. I have since learned this is actually a unique sign of genius and giftedness -- sinking oneself into something intensely, juicing the life out of it, and then moving on. And there is nothing wrong with that.
Truth be told, I probably outgrew it before the 9.5 year mark, and probably would have walked away sooner, but there’s this little thing called cancer that came into the picture and slowed my roll just a bit. That's a different story for a different day.
And interestingly, from the moment I walked away – I wasn't actually done. How I contributed to the profession simply evolved and changed form.
I began mentoring other physical therapists (and healthcare providers in general) to redefine and reshape how they showed up not only in their careers, but also their lives. Whether it was taking a look at their deep inner worlds and Souls and making their outside lives match their inside world, or building a joy-filled business -- I was still there, contributing to the profession.
So even though I personally am not practicing as a PT, I still work with people who do.
Occasionally I even have dreams where I am joyfully practicing as a PT.
This even happened last night. You should see the swimming PT empire I built in that dream. It was epic.
When I woke up this morning, the visions in this dream stopped me dead in my tracks.
I wondered -- Was this an invitation to return? What did this mean?
Alas, as I sat with it today, I realized it was not an invitation to be taken literally. It was simply an invitation to build a different type of empire around something that brings me great joy. Which I'm already doing.
As I grappled with this dream, I was reminded of not only the deep reasons I continue to pursue life as a coach, but also the deep reasons why I walked away from practicing as a PT.
There are many practical and logistical reasons that practicing as a PT no longer works for me – like making more money as a coach and having more time and space to do what I want, when I want, and how I want.
And while those reasons are incredibly important, they're not the deeper reasons I won't return to PT.
No, for me -- the truth is that there are 6 deeper, more vulnerable, and sometimes “hush hush” reasons why I continue to say “No thanks” to practicing as a PT.
Some of these are more hush-hush than others, and some are far more obvious.
But I think it’s time to give an equal voice to all of them.
So let’s dive in.
Truth 1: There are rules and regulations that felt so strangling, they suffocated the essence of why I wanted to do it in the first place
This one is pretty obvious and pretty much goes without saying, but I am going to say it because it just so happens to be in the news lately and it’s on everyone’s mind. Therefore it feels a bit tone deaf to ignore.
One could argue with sound reason that this particular point applies to most healthcare professions as a whole, so I see you if you’re in any other profession and you’re here nodding your head.
Between back-assward insurance regulations and federal/state laws that are written based on anything EXCEPT what’s best for the patient and provider -- being a physical therapist is not an easy place to be if you also happen to value integrity, keeping your license, and not committing insurance fraud.
Pile on the fact that corporate-run healthcare systems and practices get squeezed by these regulations and pass those regulations down to their staff (and therefore patients).
They expect providers to go the extra mile squeezing in way too many patients in way too little time, spend endless hours charting endless useless information in EMR systems they have to relearn once a year due to “updates”, all while being a “team player” who volunteers and serves on committees and project.
It’s a recipe for disaster.
This applies even if you work for a company or your own single-member private practice which is out of network with insurance companies or is cash pay / concierge only.
Like it or not, you still have to follow the laws and rules where you practice, and your patients still can submit claims to their insurance companies, which means you can still get in trouble for insurance fraud if you don’t dot your i’s and cross your t’s. It's a better situation that in-network, insurance-based healthcare, but I still found myself watching my back, making sure to follow the rules. And that weighed on me.
As a patient in this system, it’s not any better. I wrote blog after blog about this in my own cancer experience. And we clearly see that front and center based on the most recent United Healthcare (UHC) news. Which, by the way, sadly doesn’t surprise me. In a country where “the people with power” don’t do anything to serve the people who are powerless on tender issues like this, it’s sad but true that people resort to violence to feel heard.
To be clear, I’m not condoning violence. My heart breaks that it came to this, that someone felt so powerless that their only option was to take a human life in cold blood. I weep deeply for the family who lost a husband and father and son, and for the colleagues who lost a friend and leader and coworker. I ache for the family who looks at their son and brother as a murderer and tries to come to terms with this. And I ache for the patients and providers who may not see real change happen, even after something as extreme as this.
But here’s the scary part – if it wasn’t a patient or family member of a patient resorting to violence, it very well might have been a provider, which is what brings it back to my story.
Case in point, I once worked for a practice where UHC deemed an hour of physical therapy for each patient worth a whopping $55. Divvy that cost out over all the overhead and expenses of the practice, and – assuming UHC didn’t deny the claim in the first place – I was taking home about $7.27/hour for treating.
That's earning less than minimum wage for a service delivered by someone with a doctorate degree, umpteen credentials behind my name and nearly $180,000 in medical school debt. The math simply doesn't math in that situation.
There are way too many systemic issues to continue to unpack here in this point without this turning into a dissertation, so hopefully you get the idea.
What's heartbreaking to me, as a provider AND patient -- is that so many of us as providers have gone to bat for our patients, advocating for them, trying to get insurance to pay for and cover our services, trying to get laws changed to improve their access to care. And we've done this above and beyond the call of duty -- outside of our paid hours, and simply out of the goodness in our hearts and the willingness to fight for justice in the system.
BUT -- even as providers, we get silenced. We get shut down.
It's like Cassandra from Greek mythology. She warned of a problem, and nobody listened until it was too late and tragedy struck. And we're seeing that play out on a grand scale this week.
Personally, the big heartbreaker for me is these rules and regulations completely suffocated the passion and vision that got me into the profession in the first place. I couldn't be myself, I couldn't expand and stretch and grow -- not without running up against an external barrier that limited what I could and couldn't do.
For me, this is a non-starter. I cannot subscribe to a system with a problem this pervasive. I have an impact to make, and being this silenced and suffocated prevented me from doing that.
So I left, and I get to make this deep impact every day. Unrestrained, unconstricted, with full breath and full life.
So many people leave healthcare practice due to constraining insurance and legal expectations alone. Which is why I have it here as an obvious number 1.
But some of the other truths for why I won't go back aren’t as obvious, especially if you’re not on the inside of the profession.
Truth 2: There is a not-so-subtle one-upmanship between female colleagues that masquerades as “supporting each other”
I’ll never forget the question I received from a friend/colleague when I opened my own physical therapy practice
“So, exactly how busy are you these days?”
Seems like an innocent question from a fellow business owner who asked me to a coffee date in an effort to “support my growth.”
But something didn’t sit well with me when she asked it. I bristled and resisted answering her question and couldn't figure out why. Eventually I gave in and told her “I’m about 50% full, seeing 7 patients a week”
It didn’t feel right to withhold the information. But soon I realized I didn’t just get this question from my friend. I got it from so many other colleagues.
And this question would show up in lots of different forms.
“How full is your schedule?”
“Where do you find patients, and how easy is it to get them on your schedule?”
“Are you ready to hire another therapist yet?”
“Who is sending you all these referrals?”
On the surface, these questions may seem curious and really supportive.
And in truth, many times they were innocent and indeed supportive.
But most of the time, that icky scratchy feeling I would get deep in my gut was in fact accurately picking up on something icky, scratchy, and not so supportive coming from my "friends."
This was their way of trying to size up how many patients I had, and therefore how much money I was making.
This therefore put me into the invisible and unspoken ranking system of “who is the best PT in town, and how do I make sure that I get more referrals and patients than she does.”
And before you go and tell me that I’m making this up, I'm too sensitive, or it's all in my head – I’ve talked to thousands of physical therapists over the last 7 years as a coach who have told me the same thing.
And yet, nobody has the courage to speak up about it or call out their friends – because all of these questions appear well-intended and supportive.
But to me, I've always known they are just like artificial sweetener -- seemingly great until they twist your gut inside out.
Then there's the fake sorority -- we live for each other, but we actually don't -- vibe.
Go to any conference and you see women screaming and squealing “oh my gaaaaaaaaawwwwd it’s SOOOOOOOO good to see you” to each other’s faces, and then silently checking each other’s social media profiles to see who has the most likes, followers, and funniest Reels and TikTok videos, cursing your friends when they post something YOU wanted to post.
What I’m describing here is the invisible “race” that exists between women in the profession – far more subtle, far more covert and passive aggressive than that between men.
Just open any facebook group claiming to be supportive of other physical therapists – whether it’s offering support for clinical practice, growing a business, or finding an alternative career in healthcare.
Read the comments. Yes, some are supportive.
But soon you’ll see – it becomes a veritable sport.
Who has the most knowledge, the most experience, the most wisdom to offer?
Who can be the one with the last and final word?
Who can assert their superiority over everyone else the quickest?
Who can jump in and overly celebrate someone who posts to try and be more liked, more accepted, and more popular within the group?
And my favorite – when someone posts that they’re selling a course or book or program and asked you to comment if you want in on it – who CANNOT HOLD BACK from racing to type “me!” in the comments because you’re afraid that if everyone else gets this new thing that you don’t have, that you’ll miss out and be lesser than everyone else? Yes, EVEN THOUGH you know you don’t actually want to take the course, you don’t actually want to spend the money, you’re not actually going to show up to the livestream…or whatever it is?
No shade, btw, if you've been one of those people RACING to comment out of FOMO. I've been that person too.
You're just doing what centuries of human institutions have taught you -- be associated with the "royalty" that sits atop the PT throne, or be a worthless peon in the trenches.
But the one-upmanship isn't always as crowd-centered as that.
It also happens in clinics and behind closed doors, literally.
There was the time that a colleague cornered me in an office to yell at me for trying to collaborate on a patient. My boss literally just sat there as I was berated and "put in my place" by my colleague who was older and wiser and more experienced, and therefore "above" collaborating with a newbie like me.
So even when the intention is good and supportive, there is the unspoken -- or in my case -- loudly spoken -- rule that no, we don't actually collaborate--
We compete.
And there is a pecking order. Those with more experience are higher up and therefore God-like, and those who are lower than must be put in their place, earn their right to speak, and earn their seat at the table.
It’s really no different from the popularity contests of middle school playing out here in adulthood, only now the means of competition are more sophisticated and “professional" and "supportive."
To be clear, this one-upmanship does not exist in every person in the profession. I know plenty of people who don't subscribe to it.
But it’s rampant enough and nearly impossible to avoid unless you dig yourself into a hole and don’t interact with anyone. Which I also don’t recommend.
So, for this reason, I unsubscribe, simply because I don't believe in working in a profession full of so much performative "support" and competition. No thanks.
Truth 3: The glorification and celebration of self sacrifice and “doing all the things” in the name of “balance” – especially among working mothers
Three things I’m going to own right out of the gate here:
Number 1 – I am not a working mother if we are defining “mother” as “mother of human children.” Along that vein, I write this in honor of so many friends and clients who are mothers of human children, who have spent countless hours crying on private coaching calls with me. Do I know exactly what it’s like to carry the load of mothering a human child? No. Can I still empathize? Yes. Does that mean I get to weigh in? Also yes. Because I believe it’s just as important for people who aren’t working mothers to stand up for working mothers.
Number 2 – this is absolutely not unique to physical therapy as a profession. But as a profession that is chock full of parents from all genders, but especially those who identify as women and mothers, it’s poignantly present.
Number 3 -- this applies to you even if you aren't a mother in the traditional sense. You're included, you're valuable, and you're welcome here.
Ok, now that we have that out of the way…let’s dig in.
Somewhere along the way, women / mothers / parents were taught that you shouldn’t have to be the ones to stay at home with the kids all day – because you, too, can have a career! A professional identity! You can make a name for yourself! You can have your own income! You can be independently wealthy from your husband! Rah rah equal opportunities and feminism!
I love this. Totally support it. Love this journey for so many women (and marginalized populations in general).
This gets amplified in lower paid helping professions (i.e., professions that tilt toward the feminine qualities of service and nurturing) where you pledge allegiance to your profession through a rigid schooling and training process – and you’re taught and celebrated for going ALL IN out of service and the goodness of your heart.
You’re also taught that a team player is one who is empathetic and puts the needs of others above yourself (subtext: at the expense of yourself).
Aye, there’s the rub.
You’re still the bearer of children. You’re still the one who is biologically responsible for keeping those children alive and safe and fed. Yes, even when there are alternative feeding and childcare options. It’s still hard wired into that extra X chromosome.
So, you get fed the message that because you CAN, therefore you SHOULD be a doting and perfect mother and a doting and perfect physical therapist and doting and perfect spouse/partner.
AND AND – nowadays you also get fed the message – "make sure to find balance and take time for being doting and perfect to yourself, too, and make sure to ask for help, delegate, set boundaries, and practice self care”
Chances are, you’re saying this exact message in the name of “wellness” to your own patients, knowing full well how impossible a standard it is to hold for yourself.
I also see you if you’re now in middle age and starting to carry the load of perimenopause and caring for your aging parents. Wheeeeeee FUN, right?
You’re carrying the weight of the world on your shoulders, being celebrated for your ability to “balance” it all – and yet, it’s a tenuous balance at best – because even though you’re managing to keep all the balls in the air – if one ball drops, they all drop.
You may have it all together and then WHAM your 9 year old brings home the flu...now you all have the flu...now you have to miss work...now you haven't worked out in 2 weeks...now the dishes have piled up and you're living out of laundry baskets and you haven't spoken to your husband about anything other than transactional kid things in #godknowshowlong
As someone who may appear to have built a million dollar business on helping working mothers find balance – you might be looking at me going “pot, kettle! you help people find balance!" ... but that’s where you're reading me incorrectly.
I don't subscribe to the "do it all, keep a balance" mentality.
I don’t tell working mothers they need to just work on self care and set boundaries. I don’t tell them to just learn to ask for help so they can balance it all. Like literally -- if it were just that easy, these rockstars and problem solver mamas would have FIGURED IT OUT ALREADY.
No, I help moms and non-moms figure out exactly what they WANT to do in each season and section of their life, even if that means they shift and mold and change how much they show up at work, at home, and vice versa.
This isn't a process of balance. It's one of letting go, of grieving, of reinventing identity, and reconnecting to joy.
This isn't a process of keeping balls in the air. It's a process of letting the balls drop, accepting your own mess, and then picking up only what really matters. Or maybe leaving all the balls on the floor indefinitely. And being ok with that.
I’ve helped PTs who have climbed all the way to the top of the profession walk away from all of it so they can follow the inner tug to go be a stay at home mom. For years they struggled with trying to “balance” it all, with trying to build a business AND be there for their kids’ basketball games on weeknights AND get a million CEUs AND AND AND – when really, they just deeply yearned to “just” be a mom. Yep, they had to grieve the profession they'd poured their soul into, and reinvent their identity. It was messy yet beautiful work.
I’ve helped PTs go from being at home with kids for 15 years and losing touch with the profession to reinvent who they are and return to work, finding hew purpose and passion in ways that look starkly different to the PT profession they once knew. Yes, they had to grieve the life they'd created -- being everpresent for their kids, while also welcoming the season where their kids got to grow in their independence and witness mom doing something for herself.
I’ve helped moms build a side hustle coaching business while running a huge brick and mortar PT practice all while being fully present for their kids as much or as little as they desire. And sometimes these moms realized they actually don't want to be as involved in their kids lives as society tells them to be. And they discover how to make peace with that so that they don't lose themselves.
I’ve helped moms find that sweet spot in hiring a nanny, driver, meal prepper, personal assistant, virtual assistant, or office manager to take some of the day to day load off of them so they can stick to their running and yoga schedule all while making the parent-teacher conferences and fully unplugging while on family vacation.
The point?
You don’t have to sacrifice yourself to fit into a mold that the world or the profession expects of you, especially if you carry the responsibility of keeping small and not so small humans alive, happy, and sane.
You don’t have to do it all. Yes, even if your heart feels tugged in a billion directions. Even if you’re at your teen’s soccer game on a Saturday and feel guilty for not working on your marketing plan.
You get to change and morph what you do in every season. Nothing is permanent, and nothing is absolute.
Needless to say, even though I am not a human mother – this pressure applies to people in the profession who aren’t human mothers, too.
And this is another reason why I’ve unsubscribed from both the identity and practice of physical therapy.
Not because the practice or identity itself is wrong, but because the energy of so many people in the profession continues to feed this narrative, all in the name of “excellence” and “balance” and “service.”
Add in the not-so-subtle one-upmanship that exists, and it’s a recipe for constant pressure and martyrdom, even if you try to block it out or avoid it.
And why would I want to be a part of something that I need to routinely block out or avoid just to keep my own peace within it?
Up next ...
So those are the first 3 reasons that I walked away from physical therapy 6 years ago, and why I continue to stay away.
To be clear, the things I loved about it continue to outweigh the things I don’t. This is why I have fond memories of and so much respect for the profession and the people who continue to move it forward.
Two things can be true at once – you can have fond memories of something, and you can see the bitter truth that perpetuates behind some of those memories.
For me, the bitter truth became something I couldn’t unsee, no matter how many good parts were there.
There was so much good, but I was ready for great.
But leaving the good for the great did not come without its own grieving process. It didn't come without sinking my own ship, dropping all the balls, re-evaluating, and reclaiming who I was in each chapter that unfolded.
When I pledged allegiance to the profession – long before I ever went to school for it – it became part of my identity.
And what I didn't want to do was reinvent a new profession and carry with me all these beliefs, energies, and feelings.
I had to reclaim my identity while leaving these truths behind.
In Part 2, I’ll describe that grieving, letting go, and reclaiming process.
I’ve written on it and shared on it before, but as things go with time – my perspective on it now is different than it was even a year ago.
And in Part 2 I’ll also share the final 3 unseeable truths that led me away and keep me away from the profession.
As a sneak peek, I'll be discussing:
The war on anything deemed "anti-PT"
The addiction of "alphabet soup"
The need for a marketing and sales overhaul in the profession
Make sure to stay tuned if you're curious about any of those topics.
Until then, I leave you with some thoughts --
Will I always stay away from practicing as a PT? I don’t know.
I’ll let time and life make that decision. This could change tomorrow, next month, or never. And I’m perfectly at peace with that.
Do I still keep my license current? Do I still take courses? Do I still stay up with the newest research? Hell yes, because I am never going to put myself in a situation where I would need to take an exam or go through a rigorous training process again.
I’m still a student of the craft – that part of me hasn’t died.
I just choose to evolve what I do with that craft at this point.
So that has me curious --
Have you left your profession, shifted gears within your profession, or considered doing it (but haven’t done it yet)?
I’d love to hear from you on how this process has looked and felt for you!
I'm so grateful to physical therapy as a profession and all that my experience with it brought me -- including the hard lessons and hard truths.
No profession is perfect, and I strongly believe that while there may be huge challenges present for people -- you are not powerless to your profession. It may not be immediate, and it may not feel accessible right away - but you can make a shift into something that fits you better.
You have the power to pivot when something no longer works for you. You don't have to stay in or with something simply because you once thought you'd be in it for life.
You don't have to know what's next yet. The first step is to give yourself permission to believe that.
I'm so grateful to myself for having the connection, wisdom, and courage to listen to my Soul and move on to the next chapter.
In fact, I've moved on many times since then. I have evolved many times over since I walked away from PT 6 years ago. It's just in my wiring. It keeps life interesting and exciting, and I can't wait to see what chapters continue to unfold for me moving forward.
If you don't want to wait for the social media algorithm to inform you of what I'm up to, get instant access to my blogs, stories, and announcements by joining the email club.
Until then, see you in Part 2!
Julie
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