HCDM 3 | Physical Therapy

 

When we hear the phrase “health careers” we tend to think of medicine, dentistry, pharmacy and nursing, but there is a wider range of services outside of these that are subsumed under the umbrella term, “allied health professions.” Among these is physical therapy, also known as physiotherapy in some countries. What is physical therapy? What are the physical therapist’s responsibilities? What does the PT’s typical day look like? Dr. Richard Marn brings in Jason Jackson, MSPT to answer these and more questions for us. Jason also tells us why he chose to become a PT and what skills he needed to develop and sacrifices he needed to make in order to get to where he is now. If you’re considering a career in physical therapy any time soon, this episode is full of valuable information that you need to get hold of before venturing into this space.

Listen to the podcast here:

The Everyday Joys And Sacrifices Of A Physical Therapist With Jason Jackson, MSPT

Thanks for joining us again. Before we get started with the next episode, I welcome you to check out the website for this show at HCWithDrMarn.com, HC being an abbreviation for Health Careers. On the website, you’ll get to learn a little bit about me and what this show is designed for in more detail. You get to replay the show directly from the website. You’ll get to find links to any of our guests, if they have any, and you will get to see the show notes and transcriptions for the show, especially if any particular section interests you. On the contact page, you can reach out to me to let me know if you have any comments about the show, if there’s any particular professions you would like to hear about for me to interview, and how will you think I can make this podcast better for you?

For this episode, we will be talking with someone that works as a physical therapist. His name is Jason Jackson. He is a wonderful person who personally took care of me for my own health ailments. He did a fantastic job, an excellent job and just a good person. He attended Ithaca College for his college degree as well as his Master’s degree in Physical Therapy. He has worked at UCSF Medical Center, but since 1998 has worked at Mount Sinai Hospital as part of the Department of Rehabilitative Medicine. He has a very well rounded physical therapy education and experience but has a unique specialization and interests in hemophilia and upper extremity and amputee problems.

For select patients who are interested, he also provides private practice physical therapy services. Interestingly, he has a very passionate interest in photography. His photography has been featured in London in 2019, and he has a website that you can check out at JasonJacksonImages.com. If you like what you read, you can reach out to Jason at Jason.Jackson@mountsinai.org, or his Instagram account, @JasonJacksonImages. I think you’re going to learn a lot about physical therapy in this episode so let’s get to it. Let’s meet Jason.

Welcome to the show, everybody. With me is Jason Jackson. How are you doing?

I’m doing pretty well.

I am so glad you’re here. To our readers who don’t know, Jason and I met more than ten years ago. I was a patient of yours from the neck issue I had that improved under your care. Even as I got older and had other ailments, I still came to you.

Yes, you did. I didn’t mind it at all.

I refer people to you. You have a wonderful touch and intelligent way of doing what you do, which is physical therapy.

Thank you very much.

One of the first things we need to do is tell everyone what exactly is physical therapy? What are your responsibilities?

For me specifically, the setting that I work in is an outpatient department. Patients are coming to me with different ailments. As a physical therapist, rehabilitation medicine, my job has been pretty much to mend people, to put them back together whatever functional impairments they have, to try to improve upon that, maximize that. We can’t get them back to 100%, like I said, maximize their function and their ability and sometimes it’s trying to get their pain to go away.

What is physical therapy itself? What is the responsibility of a physical therapist? What are they charged to do? What does that occupation usually responsible for?

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Is there a guideline or a definition? It falls under the umbrella of allied health professions. What our responsibility is, is improving a patient’s physical function through examination, diagnosis, prognosis, and then doing some type of physical intervention, whether it’s through exercise, immobilization, manual therapies, different things. In some countries, we’re called physiotherapist resident rather than physical therapists. Sometimes there’s also modalities that we may use involving electricity or sound waves, heat, ice modalities, things like that. It’s all kind of evidence and research based. That’s pretty much what I do.

I can speak from experience, but is this also generally true that with physical therapy, it’s also very hands on?

I’ll preface that with saying, yes, maybe. Some clinicians tend to focus more on modalities. I personally, and a lot of the people I tend to work with, and what I like to do is more of a manual approach. That to me is a lot more effective.

What do you mean by manual approach, Jason?

Manual approach is what it sounds like. I’m going to use my hands, my expertise in anatomy, physiology, those types of things to improve that person’s function to heal them, to get them better. There are other alternatives like using machinery, basic exercise equipment machinery, stuff you see in the gym. Modality is some things called ultrasound or electric stimulation can also be used as an adjunct to the manual stuff. It’s a whole big toolkit, a whole big box of skills that you can use. It’s not just one or the other, but manual therapy is a big part of how I practice.

You’re an outpatient setting?

Yes.

This is the approach you use. What’s your typical day like? What do you do on a daily basis at work? Can you tell us a story what typically defines your day?

I’m going to say this is typical day pre-COVID. We’re dealing with the whole pandemic issue right now. As I get to work in the morning, there’s usually a patient list that’s generated for me. That can either be ongoing treatments of patients that I know or potentially new patients for an evaluation, do a chart review, figure out what the patient’s diagnosis is. The physician sends the prescription to us, then based on the physician’s diagnosis, we will then create or formulate a general idea or treatment plan. That may or may not change once we get the patient in front of us. What we see on paper may be different when we deal with the human being in front of us.

We have to do that objective evaluation, getting the patient’s social history, medical history, their daily habits, things like that. That’s what works for the start off of the day. After having the patient in front of us during examination and finding out what the impairments are, and how those impairments translate to actual functional deficits and potential disability, and can we improve on that? Can we make that go away? That’s what we have to take a look at. Those patients are staggered, in my setting, every half hour. I’m seeing patients one after the other throughout the day.

You’re probably seeing sixteen patients a day in average?

Any day is scheduled anywhere from 10 to 15 patients a day, given there’s also administrative stuff you have to do, time for paperwork, documentation, which is the bane of my existence and then meetings, things like that. You put all that stuff in there too.

HCDM 3 | Physical Therapy

Physical Therapy: If you can’t fix an injury, getting the person to be functional and productive and create a new life for themselves is also important in PT.

 

Some of these people reading have never met a physical therapist or have seen a video. If a patient comes to you and they’re introduced to you for the first time, what typical patient duty do you have? Maybe it’s something to do with their arm? Do you have to have them unclothed? Do you have to put your hands on the shoulder?

Every patient’s a little different, but I should probably say one of the things that makes or breaks my day is a great support staff. When you’re working in a facility, the administrative staff is letting the patients now what they need to come prepared with, clothing, things like that. Typically, I’m working with a patient just like you go to a doctor’s office. The doctor wants to do an examination, they’re going to have you put on a robe or if they come in with comfortable clothing that’s breathable, they can move around in. If somebody has a knee injury and they’re wearing pants, I’m going to have them remove those pants, put on a hospital gown or hopefully they brought shorts.

I need to have that body part exposed so I can do proper examination. I’m going to take a look at their range of motion, take a look at their strength, take a look at their function. When I say function, it could be somebody who’s 67 years old and is retired and pretty much sits at home and reads books or doesn’t do anything physically active. It could be a minor league baseball player, so their function in their shoulder is going to be a lot different than somebody who’s 65 or 70 who’s not actively engaging in intense exercise all day. When I say that, to put all those pieces together, getting that patient’s lifestyle and history to determine how the examination is going to go.

You literally put your hands on the patient, help them move their joints. If it’s an elbow issue, you help move the elbow if it looks like they’re having a hard time.

Yeah, exactly. When you pick a specific body parts, let’s say the elbow or the shoulder or the hip or the knee, let’s go with the lower extremity. Start off with the hip or the knee. They have to bear weight on that leg. Can they tolerate that? Is it painful? Do they have full range of motion? Can they pick their hip up? Can they bring it back behind them? Normal things that we have to do. Do they have enough bend in their knee to go up and down steps? Somebody who has a surgery, I often see patients immediately right after surgery. Say they had a joint replacement or they tore a meniscus in their knee, a ligament or tendon in their leg. Has that been surgically repaired? How do I get that strength back for them so that they can walk around town normally or you know play sports again or ride a bicycle, play with their kids, whatever they want to do?

Your patients that come to you, are they a particular type of age range at the ER? I know you’ve done work in upper body work. Is there a type of patient that you typically see in terms of age and their health conditions? Is there a typical patient?

For me in particular, it’s a pretty wide range. It’s children all the way up to seniors. I don’t work with infants, newborns. There are specialties within the profession itself. This is a good way to talk about I have a specific focus which is somewhat broad, but it’s even beyond the profession itself. The opportunities are beyond even what I’m doing right now. They have people who specialize in pediatrics, infants, newborns, if you like working with kids. Typically, I work with children that are eight years or older, sometimes five or older. Once they get younger than five, I’m like, “I don’t want to deal with that.” They don’t listen to me so I tend not to deal with anybody under five years old. Some people specialize in just working with the elderly.

We have an aging population in this country and worldwide. For some people, they love doing that. Some people just want to work with athletes. There are also people who work with patients with neurological disorders, say they had a stroke or brain injury or a spinal cord injury. For me particular, I work in the outpatient department. Patients are coming to me. I work with a broad types of patients, orthopedic patients, patients with musculoskeletal. Those are patients with musculoskeletal issues, broken bones, torn ligaments, muscles, tendons, things like that. I also work with neurologically impaired patients. Think about your nervous system, how you have this web of nerves throughout your body and sometimes there’s damage, whether it’s a stroke that’s internal or whether it’s something that came at you externally and you were injured.

One of the areas that I love to work with is the spinal cord injuries. It’s a pretty devastating injury where somebody could be paralyzed completely or partially. How do they adjust to that? Can I get that function, that ability, that nerve to connect to the muscle in the brain to get their body to function normally again? Sometimes they can’t. If they can’t get that function back or that ability back, how do I get them to live a complete and full life with what they have? That’s also an important aspect of therapy because sometimes you can’t fix it. If you can’t fix it, how do you get this person to be a functional and productive person, and create a new life for themselves? That’s also important.

There are specific specialties that I have, I love my passion, is working with prosthetics, with patients who have had their limbs amputated, teaching them and training them on how to use this new piece of amazing equipment throughout the trauma of losing a limb. Now you have this new mechanical leg where I teach you how to use that and walk again and potentially run again and ride a bicycle with it or go to work, walk up and down the subway steps, whatever you want to do. That’s a personal passion and a specialty of mine, and also working with patients with bleeding disorders. Hemophiliacs is also a specialty area of mine, and other stuff too.

Jason, could you walk us through maybe a patient, of course no patient identifiers, but what you would do with one session just to give a snippet of moment of where you’re working for 30, 45 minutes with a patient and what you do with them. They come in, you may even know them, and some of the exercises you might do with them and how you are helping that person through this maybe one interesting case.

Somebody comes in and they have had an ankle sprain. It’s winter in the city. They’re walking and have slipped. They hit a pothole, whatever. They sprained their ankle, so they’re coming in. They’ve got an ankle brace on. They’re walking with crutches. They can’t put weight on the ankle because it’s swollen. It hurts too much. The doctor sent him to me to physical therapy to basically get them back to normal. They come in as first time patient, I’m going to introduce myself and get to know who they are in terms of their living situation, their job, what are their job responsibilities? What do they have to do? Do they sit at a desk all day? Do they have to walk around? Maybe they work as a post man and they have to walk around and they have to lift packages. All of that becomes part of the bigger picture when I determine what my treatment is going to be because I want to get them back to their pre injury lifestyle,

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They sit down with me to take the shoe, the brace, the sock off. I take a look at their range of motion. There are tools that I’ll use to measure that. I know what the normal range of motion is supposed to be and say they’re lacking and they have a lot of swelling. We need to get the swelling down. I’m going to touch it. I’m going to move the ankle around. What about the joints near the ankle? What about the knee? Did they injure the knee? I have to examine the knee and the hip. Why can’t they put weight on the leg, on the ankle? Is it painful? Is it just stiff? Those are all the things I’m looking at and considering and then once that piece is put together, now it’s time to go ahead and get the patient up. Maybe put them on piece of equipment to try to help them strengthen.

On top of understanding how the joint works, the actual ankle joint works and using my hands to mobilize that, to move that ankle to try to get back normal range of motion. That’s the typical day with that patient and then letting them go home with something. These are exercises I want you as the patient to do to enhance what we’re doing in therapy. I need you to do these stretches. I need you to do these strengthening exercises. You need to put ice on the knee, on the ankle, elevate it. All of those things to try to help facilitate and improve their function and can speed along this process of getting them back to a normal life.

It’s like homework.

Yeah, they get homework. They don’t always expect to get homework. A lot of times they come in and like, “Fix me,” and they’re like, “Why am I not fixed?” I’m like, “You got to do the work.” I like it, it’s a lot of bossing people around. That’s good too.

Are there any particular things that are very satisfying or exciting that you find about tour career? I think you alluded to some of the prosthetic and the hemophiliac stuff. I What about it is very gratifying to you, that you see and that you experience?

Imagine coming in, and your patient comes in. I’ll use another case as an example. There was a young man. a teenager, and he had gone skiing. He’s tired. He wanted to do one last run on the slopes. He decided to go down one of these black diamond slopes, which is a difficult ski slope. Unfortunately, his ski hit a boulder or rock or something buried under the snow, and it catapulted him up in the air. He was spinning, and he ended up breaking both of his legs. One of the legs ended up getting amputated because of the infection. This is a teenager. There are things he wants to be able to do in his life. He wants to play sports. He was active.

He came to me and he was in the ICU, in the Intensive Care Unit inside the hospital for a long time. He was very weak. He’s very sick. He’s a teenager. He’s dealing with the fact that now his body’s changed. His body’s different. He’s lost a limb and he’s scared, He’s in pain, and as we’ve gone through the process of his therapy, I won’t go through every piece, but it turns out the other limb was also so badly damaged that it was impeding him moving on to a more productive lifestyle. He had to make the hard decision to voluntarily get the other leg amputated maybe about a year or a year and a half after the injury, because we could only get so far because of the pain and the restriction in the leg that they didn’t take.

Now he’s got he’s lost both legs. It’s like reinjuring himself all over again. Through the process of that, it was so rewarding to see him grow as a young man, and to take responsibility for his care and to get to the point where when we were done, he could walk. He had these two amazing, technologically advanced legs with computers inside the legs that I trained him on how to use those computers within the leg and how to get his body to control them so that he could walk again. He walks around. He ended up going back to work. He started going back to driving, doing a lot of IT work, computer work. He ended up meeting someone and getting married. He travels around, doesn’t just sit at home. He has a very productive life right now. He’s in his twenties at this point. That is so rewarding to me to know that I’ve had a positive effect on someone’s life to that degree.

That is an amazing story. That is awesome to know and to be part of that team that works with this person. I can imagine you’re also spending a lot of time with them. It’s not like it’s five minutes, and then you leave the room and you let someone else do the work for 25 minutes. Sometimes you’re there the for the full 30, 45 minutes and sometimes 60 minutes with them. You’re working with him, but you’re talking with them. I can speak from personal experience, we’re talking while you’re doing the therapy.

You get to know the person. A big thing that I like about my career is that I’m constantly interacting with people. There’s no career that I could think of where, in some sense, intimately get to know so many people in this world in my direct environment, people that I have connections with, like you and many others, even long after the sessions have gone, have finished. It’s important to have that sense of connection and be able to communicate with someone and have empathy and understanding and to be able to listen to what they’re going through and figure out how to best help them. I’m blessed in that sense.

It must be a bit of a challenge though at the same time. You see some very tragic, tough cases that take months to years to work with.

There are moments when it’s trying. It’s emotionally draining. As I go through my career, as a person goes through their career, they’re able to handle that well. There’s always somebody that gets you. There’s that patient who reminds me of my grandfather, or somebody who reminds me of my mother or somebody who reminds me of my best friend. That hits home with you a little bit more emotionally, but you put it into context, and you understand that this is somebody I can help, somebody that I want to help and you want to invest yourself in. That’s important to be able to do that.

HCDM 3 | Physical Therapy

Physical Therapy: There are moments when it’s emotionally draining. There’s always somebody that gets you.

 

One thing great about you, Jason, is you have a lot of empathy and along with the skill and knowledge, but are there particular skills, and qualities or even just the mindset of colleagues in your career that you think best succeed or flourish in what you do, or even qualities that because of it, they don’t necessarily flourish or succeed in what you do?

I’ll start off with things that that make it difficult to flourish in his career. Not being able to communicate, not being able to talk to someone, and not just talk, even more important is listening. You’re going to be taking in all this information that a patient is giving to you, that they’re talking to you about. They’re spilling their hearts out, their lives or what they’re going through. Not just the injury, but other things, socially, whatever, and being able to listen, and empathize and to apply that to how you’re going to interact with that person. You have to be an active listener. That’s important. If the person isn’t capable of doing that, it makes the job very difficult and they’re less personable. They’re less engaged and connected to the person they’re working with. The communication, listening skills, the empathy, and outside of all that, that touchy feely stuff that we’re talking about.

There’s also having the ability to understand and analyze and execute based on science, based on data driven things. Range of motion, strength, all those things that are hard and fast, being able to take all that information together and put together a treatment plan for a patient and to assess what their deficits are and what things may put them at risk for hurting themselves again. It’s a combination of both kind of the soft, touchy feely stuff, I talk, listen, understand versus the hard and fast data science driven stuff. Being able to combine those two is going to be important for a person to succeed in this career.

You talk about having knowledge and stuff. Do you guys usually have weekly or monthly meetings, you guys get together and share information, learn what’s the current research?

Each facility is different. Some places are very structured and supportive of their staff being going through what they call continuing education. Even in-house learning, like wherever you’re working, that continuing to learn and grow as a clinician, as a professional. That’s important because what I learned many years ago when I was in school, things have changed. Things have evolved, progressed, gotten better, advanced. I need to stay on top of that. Whoever’s practicing clinician, they need to continue to know those things and know the new trends, the new resources that are out there, the new machines, the new manual techniques. All that stuff is important. Having and working for an institution that promotes that is also very important, or having your own internal drive to want to know more, to want to learn more.

I make a point of trying to make sure I go to continue education courses. School is over. I’m done with college. That’s all done. While I’m practicing, I feel like because I want to be invested in my patients, how do I serve them better? The best way is to learn the new stuff and keep up on the new stuff. There’s so much out there. There are things that I’m not interested in, trust me. Certain types or aspects of my career that I don’t work with, I don’t practice but I have colleagues who excel at that and so they stick to that that area. I’m not particularly somebody who works with wounds a lot, with wound care or with a condition called lymphedema or vestibular issues, balance issues, but there are people that I work with who are phenomenal with that. That’s what they love.

Also, part of being a good clinician is saying, “This is not my area. This is not my expertise, but I’m going to refer you to somebody I know. I don’t know everything, so I’m going to send you off to somebody who’s better at this.” That’s important. I think if you run into somebody who’s like, “Yeah, I can do everything. I’m great at everything,” probably not. I personally wouldn’t go to see that person. What’s your specialty? What’s your area? You have to continue to grow.

Every career has trajectories you can go into. In physical therapy, what are the different offshoots or areas that you could describe? We talked about prosthetics that you’ve worked with and some of the upper limb issues, but what other aspects of physical therapy can people go into? Also, you’re working in outpatient. Are there other venues or environments or settings that people can work in as a physical There are therapy and what do they do?

Let’s start off with the settings. When I started out way back when, I had the dream. I was a young at school. I was athletic. I ran track and I did all this stuff. I was like, “I’m going to be a physical therapist for a national sports team or the best track and field athletes and tennis players.” I had grand schemes in how my life was going to go. That was my goal, but I was a teenager. I was in school, and I worked with some athletes. I also did some internships in hospitals. I was working with patients who had organ transplants and who had heart attacks. I went off to an internship to work with some athletes and the athletes were crying about how their big toe was hurting and it was the worst pain in the world. I’m thinking, “I just finished working with somebody who had a new organ put into their body.” After that, I couldn’t relate to athletes anymore. I’m like, “You whine too much. I can’t work with you.”

There’s a certain sense of empathy, but also there’s a certain sense of perspective. For me, I found more meaning and more validation and more reward working with people who were sicker, who had more devastating injuries. That was one aspect of it and then trying to decide where do you want to work. You can work in the hospital. Within the hospital, there’s patients who are admitted into the ICU, the Intensive Care Unit. They may be put on a device to help them breathe. Those are patients that I used to work with, and so that’s more intense. It’s those patients that are unstable medically, and then they move on to the progression to being on the floor as hospital. They move on to what’s called an acute rehab setting where their whole purpose is just to get rehabilitation through a physical therapist, occupational therapist, maybe a speech therapist.

All of us who are in this allied health profession are concentrated to give this person 100% attention all the time before they leave the hospital. They’re still in the hospital setting, but it’s a rehab hospital setting. That’s what they’re there for. It’s like an intense training camp. That’s pretty much what it is. They have to exercise three hours a day, and it’s constant. They may leave the hospital and they may go home, but they may not be fully independent. Maybe you’ll have a therapist whose job it is to come to their house and work with them in their house and give them home physical therapy. They may get strong enough so they can venture outside of their house where at that point, they come to me. I’m in the outpatient physical therapy setting.

There are all these different tiers of care that a person may go through and every step of the way, the physical therapists would be there to help push them through that. The opportunities are out there regardless of what setting you’re in. Within each setting, you have specialties. You have people who specialize in a neurological issues, musculoskeletal issues like broken bones, muscles, tendons, ligaments. Patients with more metabolic issues like blood issues like hemophiliacs or patients who may have had surgery and their bodies didn’t react well to surgery and they have a swelling in their body in such condition called lymphedema. Therapists specialize in that. There are specialists in pediatrics for newborns who maybe can’t feed or can’t eat or have problems with developing normal skills. The possibilities are endless. It’s so many so many things.

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You work with a lot of different specialties. Are there any professions or other careers that are similar to physical therapy that you can think of?

I mentioned one, occupational therapists. A lot of the skillsets overlap. The training is a little bit different. They’re definitely more versed in cognitive or mental disabilities or progression and development than physical therapists tend to be.

For someone like maybe with a stroke, for example,

Maybe somebody after the stroke, they can’t balance their checkbook, or they can’t plan their day. How do you get that person to rewire their brain and think about how do I manage and now get back to living and working in normal society? I have met some great occupational therapists who are very skilled hands specialist. The hand is a very intricate part of your body that people aren’t aware of and the tendons and the ligaments. There are occupational therapists who specialize just in hand therapy, and they’re phenomenal. What they can do in getting a person’s function back, people forget how important your thumbs are. If they’re not working, you’re impaired. That’s another profession that’s very similar to physical therapy.

You’re doing some internships and such. I want to shift things a little bit. I want to get to how you even got into physical therapy. You were thinking about it in high school. Is this something that was on your mind? How did you even get introduced to it?

I had an injury, and I was running and I tore a muscle. The doctor sent me to physical therapy. I was in junior high school. I went to physical therapy, and there’s this guy who’s stretching my leg and causing me pain. I’m like, “I don’t want to do this,” and he’s like, “Shut up, you got to do it,” that kind of thing. I was a whiny kid. He’s doing all this stuff with me, and all of a sudden I’m like, “My leg’s better. How’d you do that?” I can run again. It doesn’t hurt. I was like, “What did he do?” It stuck in my mind because it had such a big impact on what I wanted to do. I love to run. I love track and field. It basically gave me my life back, what I thought was important in life when I was sixteen years old. It always stuck in my mind.

I was always good in math and science in high school. I was a decent student. I liked academically sound. Science and math was always kind of my thing. I like that. My biology teacher, I will always remember him, said, “I want you to go to this this program. You have to give up some summers for your vacation, but this program will bust you to a local university of Stony Brook University.” They had the science and technology in New York science and technology entry program. It’s called STEP program. It was pretty much geared towards minority students, I guess you would say so a lot of black Latino students who were good in science and math, and they wanted to expose them to careers.

I went to the STEP program every Saturday, and for five summers, I was like, “I don’t know if I want to give up my summer Saturdays.” My mom said, “You’re giving up your summer Saturdays.” She got me out of her hair. I went to this thing and they had science and math based professions. They had a physical therapist. They talked about their career, what they did. They had a physician’s assistant, marine biologist, accountant. All these different professions would come every Saturday to talk about what they do, and what their careers do and what they you know what their responsibilities were. It opened my eyes to things and professions that I didn’t know existed. Always remembering my physical therapist, encased now in this program, “There’s that guy. He does the same thing my guy does.” It stuck with me. I love the marine biologist, but I also realized I didn’t like to swim that much. That was out the question. The physical therapy was what stuck in my head. That’s how I go into it.

When you’re entering college, was physical therapy as an occupation on your mind?

Yes. I applied to college and I wanted to be a physical therapist. I only applied to schools that had Physical Therapy programs. The education curriculum has changed since I was in school. When I went, you have the option of getting a Bachelor’s or Master’s degree. I chose the Master’s degree, the higher degree. What that entailed was me going to college for five years. After high school, you’re committed to five years of college. I will talk about that back to the program right now, because it’s changed a lot. The way it works now is you have two options, two tracks you can follow. Typically, schooling takes about 6 to 7 years, potentially eight. You go for your undergraduate degree, so four years of college, and then you do an additional 2 or 3 years of physical therapy school where you specifically focus on physical therapy. That’s one way.

Another way is to apply to a school as an entry level Physical Therapy major. It’s almost like a condensed version. You still get the same education, but you don’t have to go to school for four years and then reapply to another school or the same school to get into physical therapy. You can get any undergraduate degree for four years and then apply for physical therapy school, as long as you have what’s called the prerequisites, like the math, science backgrounds and skills and class history that would allow you to get into physical therapy school. Nowadays, it’s called a DPT, Doctorate of Physical Therapy. It’s an entry level doctorate program. As the profession has progressed, there’s a lot more knowledge, skills, things that a person needs to know. That requires a lot more curriculum hours. It’s been elevated to a Doctorate program.

Do you have to get a Doctorate to become a physical therapist?

HCDM 3 | Physical Therapy

Physical Therapy: You have to be put in clinical settings to learn your craft to practice. You can’t just put your hands on somebody and not know what you’re doing.

 

These days, yeah. That’s pretty much it. No Bachelor’s programs. You go for the Doctorate.

It’s a graduate level training past college.

Exactly. You’re going past the four years of an undergraduate degree. I have an undergraduate degree in Clinical Science and then my Master’s degree in Physical Therapy. The tract was the same as what they’re doing now, except they’ve elevated it to a Doctorate degree.

For someone that’s interested in physical therapy, whether they’re in college or in high school. Are there any particular skills you think that they should pick up to prepare them as a physical therapist while they’re still in high school or college and they haven’t necessarily applied yet to the physical therapy program?

Work on science, the biology, kinesiology, physiology, anatomy, those types of things. Definitely be organized. Being an organized person, being able to communicate, being able to hone your skills on working together with other people. What I do is not isolated to just me. I have to communicate with doctors, with nurses, with other family members that the patient is close to. It’s a pooled effort. There are certain times when it’s just me and the patient and that’s all I ever deal with. For the most part, it’s a group effort. I may refer you out to someone else who has more of a specialty in an area that I think somebody needs. Work on your communication skills. Make sure you understand how to adapt to change and you’re organized somewhat. Sometimes I’m not organized That’s important. Having a good strong base in math and sciences is also very important.

Jason, are there any particular sacrifices or obligations that you have to take on to achieve your goal, to get in school or stay in school.? Was there anything particular for you that you had to deal with?

It’s a competitive program. Most of these programs take anywhere from 20 to 30 students. You may get 200 to 600 applicants for each program or maybe up to 1,000 applicants for some of the top programs in the country, and you only got 30 spots. The students should have a strong showing in terms of their academics. If you don’t have that in high school, when you go to college, make sure you focus on getting that grade point average up and making sure you’re a strong student in those important areas and basically throughout. With all that important strength in math and science and dedication, that takes time. It takes the time to study, to review and to practice and work with your fellow students and quiz each other test.

It’s an intense program but it means you’ve sacrificed time. You’re not out partying in the clubs and doing all the crazy stuff all the time. Some people can manage that. I personally couldn’t. I had to focus on my thing. You give up time in the process. It wasn’t school, like hardcore semesters where you had a whole summer break. A lot of times during the summer, I was doing internships. That’s also part of the academic curriculum. You have to be put in clinical settings to learn your craft to practice. You can’t just put your hands on somebody and not know what you’re doing. That’s part of the curriculum. You’re not just sitting there in class with books. The most exciting stuff for me is, “The academic part is over. Now I’m going to go out and spend 6 or 12 weeks in the trenches working with patients.” Even though I’m still a student, I’ve got a clinical instructor teaching me and making sure I perfect my craft, and that was exciting to me.

This is what I’m going to be doing for the rest of my life working with these people. You give up time. To make sure it’s something you want to do, I recommend that people volunteer. Go to a physical therapy facility, and you volunteer and realize that what you may see in one place, it may be different than another. Volunteer at different spots. Maybe you want to go to a sports clinic and volunteer there, then maybe you can go to a hospital setting and volunteer in a hospital setting so you can see how different things work. You don’t have to make your decision in terms of your specialty right away but definitely expose yourself to the different types of things that are out there.

I know that you work in outpatient setting, but as you mentioned, you also do some at home based therapy for some patients. As you mentioned, that’s one of the ways you can also do physical therapy at someone’s home as needed. With that in mind, you’ve worked in a lot of different venues in your career. Change is constant. Do you expect some changes to occur in your career or other fields of physical therapy, especially after this pandemic that we have? Maybe 2, 3, 4, 10 years from now, what kind of changes do you think may occur in physical therapy, either as a general aspect or very specific to maybe what you’re doing?

Let’s start generally. One of the things with the pandemic that’s happened, people are looking to what’s called telehealth, doing video conferencing to provide health care. I think that works when you can just talk about things with the patient, but for me, for my job and my skillset, I need to be hands on with the patient. Some of that telehealth capability is limited for physical therapists, especially the ones that are doing hands on stuff with patients. The profession itself is linked to society. I mentioned the aging population. A lot of the shift over the last years has been geared a lot towards senior care, elder care. How do you specialize and make sure that you’re taking care of the needs of the aging population? That’s important. Having facilities that cater to them, programs and exercises and things that take into account the aging population.

Also, nutrition ideas change. Being able to make sure you can augment your treatment with giving people the necessary guidance, or put them in the right direction for nutritional for them to maximize their nutrition, for healing, for recovery, things like that. Also, fitness trends have changed. People used to do these crazy stretches and exercises way back in the day and that they never would do now because they realize that’s detrimental to you. That’s going to hurt your back, your spine. It’s a lot more of a holistic approach these days. alternative forms of exercise, whether it be yoga, and being able to have a broad spectrum of knowledge of all of those things is important. It’s not so much the isolated, “Lift your leg ten times and do that exercise for forever and you’ll be okay.” That’s not the case. You really want to have a really holistic approach to everything that’s going on these days.

Physical therapy is a very rewarding career, but you need to do research on what it means to be a physical therapist before jumping in. Click To Tweet

Do you think over time, there will be a little bit more multifactorial?

Yeah. I think it is now. People need to be aware of it. It’s going to be more ingrained in the population that they’re going to come to me and say, “I want you to give me the whole picture. I want you to be able to tell me everything that I need to do, not just give me my exercises.” Granted, I’m not a specialist in nutrition or things like that, but I need to have a clear sense of what is going to help my patient reach their goal. It’s definitely more of a global approach. There’s social media as well. People get all this information on the internet and they’re going to come to you with things they’ve seen on YouTube, “I heard if I do this exercise, this is going to make me better.” You need to be able to either say yes or no, because the internet is great but also it can be a little bit of a problem if you’re getting the wrong information. Everybody’s case is a little bit different. Being able to teach patients how to use technology and use all the information and knowledge that’s out there has become very important.

With the pandemic, because we’re doing more video conferencing, I would think the basics of physical therapy where you’re literally putting your hands on patients sometimes to manipulate their tissue or move their joints, you can’t do that. How does that help? Besides wearing appropriate protective gear and being present, how’s that going to change people’s career in physical therapy?

There’s definitely a change. There’s definitely a barrier. There’s a physical barrier now between myself and the patient. We’re doing this interview during the pandemic, and my job responsibilities have changed. I typically work in the outpatient department, and that shut down now because we can’t keep receiving these patients because of the pandemic. I shifted my care to the inpatient units where I’m seeing patients. To give your readers a little bit of perspective, my initial part of my career was working in the ICU, and working with these patients who were on respirators, who had tubes coming out of their brains and all this other stuff. I loved doing that stuff. I went back to doing that now during the pandemic. I’m working with patients that are now hospitalized. I have to wear this gear.

For so long, I was in intimately touching people and having full physical contact with them and working with their joints and things like that to now I’ve got to put on gloves, a gown, a mask and all that stuff. It’s different, but there’s still a connection that you need to be able to find with that person to get them to understand that you’re there to help them move on with their lives in the best way possible. It’s still possible. I’m still touching them, but now they’re in the hospital bed. The biggest thing I’m trying to get them to do is to sit up in bed without losing breath, without being short of breath or to stand up for 60 seconds before they’re tired and have to sit back down again. That’s just as meaningful and important and sometimes even more so than what I was doing before. I forgot how much I liked doing the stuff that I used to do back then. There are still connections. How you go about achieving the goal may change but it’s still there.

You’ve been taking care of patients in who have Coronavirus?

Yes. I’ve been seeing only people who have the Coronavirus. It’s stressful. That also changes your career. What I thought I was going to be doing from now until I retire has changed because of the world stage. Having that knowledge, having that base, that medical background as a physical therapist was important in my career path. I would never change it. I think when I started out right out of school, I worked in the hospital setting with sick patients and I got to know doctors. I got to know how doctors think, how to interact with the nurses and all these people with these intensely ill patients. It gave me this confidence to be able to know I can handle any situation no matter how severe.

I worked in a hospital setting. I moved on and still work in a hospital setting but in an outpatient clinic. That strong medical knowledge and base will carry me through. I don’t regret my career decisions. Even though I’ve gone back now to doing some of that intense, medically unstable kind of interaction with patients and stuff, it’s okay because I’ve had a strong knowledge from the beginning. Being a physical therapist is one thing, but also making sure you make the right career decisions to make sure you’re well rounded, and you’re valued regardless of what the issue situation is going to be in the real world is important.

You talked about a physical therapist that helped you early on. Was there anybody else that inspired you when you were younger, and maybe even inspires you today that you look up to?

After school, I went to go live in California. I’m from New York. I worked in San Francisco. I worked at the University of California in San Francisco Medical Center. I was there for five years and one of the therapists, her name is Patty, and she was phenomenal. She’s a little spitfire. She’s fun, dynamic, a great therapist. I was in my own world and what I felt I needed to know as a physical therapist working with these intently ill patients and Patty opened my eyes to other aspects of my career. As a manual therapist, things I could learn and do and grow as a therapist who did more hands on stuff with patients. I thought, “I’m young. I know everything. This is what I’m going to do,” and Patti showed me there was so much more. She also opened my eyes to the world of pediatrics, working with kids. I love working with kids, but not all the time, specifically hemophilia, patients with bleeding disorders.

That has carried me through. It helped open my eyes to the breadth of this profession and what was out there for me and what I was capable of. The funny story off the side is I went to a conference in Madrid in Spain. We get to travel sometimes too. I was reading through the flyer for the itinerary of the conference, and on the conference, one of the people presenting, I looked at it and like, “That’s Patty. What is she doing here?” We lost touch. It’s been years. I sent her a text, and she’s like, “Where are you?” It’s like, “Are you in Madrid?” She said, “Are you here?” We were on opposite ends of the room. We left the conference, and it was like a movie. We were running towards each other in slow motion, like running through the fields to give each other a big hug. We had a reunion after years of not seeing each other in another country somewhere. We hung out for the next few days and caught up on things. It was like a full circle. This is the person who had a big impact on my career. We happen to run into each other again. She’s a big inspiration for me,

That’s awesome when someone that you look up to, and you meet up together and they want to hang around you too. One thing you mentioned last time we were talking, you do some travel. As an aside, you have some extracurricular activity that you get involved in, which is photography. I didn’t even know about until now. How did how did that happen? It’s not a health group, but you’re doing something outside of healthcare that you are passionate about. Can you tell us about that?

HCDM 3 | Physical Therapy

Physical Therapy: It is also important to make sure you make the right career decisions, that you’re well rounded, and that you’re valued regardless of what the situation is going to be in the real world.

 

I think it’s important to be well rounded. For so long, it was all about physical therapy, my career, my job. Throughout all this, I love to travel. I’ve always loved to travel. I could travel around and I took pictures. I realized that this is a passion. This is important for me to capture moments in the world and to see things and to share those moments with other people. I decided to take my photography a lot more seriously. To be honest, sometimes you get not burned out, but you get tired of doing the same thing all the time. It’s important for people to have an outlet and not just stick to one thing. I started picking up picking up my camera full-time and doing it more professionally. I honed in on some skills that I need to improve on and start taking care of myself on the other end outside of the healthcare career. I wanted to do something else that also meant a lot to my heart. I had a show in London, which was nice. It’s exploded faster than I expected it to be to be happening.

You have a separate website for your photography. You’ve traveled to Thailand, Burma, Madrid, South America.

My Website is JasonJacksonImages.com. The work is there. I’ve started selling prints and things like that because it was more about capturing moments that were important to me, that were meaningful to me and being able to share that. I figured I’ll do them on the website, and then people have been asking for prints and to buy prints and things like that, which is also great. I’ll do portrait shots of people for commissioned work, things like that. It’s turned into a great second career. Physical therapy is still my love but this is nice too.

I was very inspired when I saw your website. I love your photography. It’s mainly pictures of people.

Yeah, like environmental stuff, lifestyle stuff.

It’s not landscape photography.

No. I do that every now and then, but I need a person. I need somebody in there. Landscapes don’t do it for me too much.

Jason, are there any parting thoughts for students interested in your career or anything that came to mind that maybe we didn’t even go through yet?

Be passionate about it. If you want to do this, investigate, research and figure out what does it mean to be a physical therapist? Realize you’re going to be working with people. Some people like to be behind a desk and looking at a computer screen. Some people don’t. Some people need interaction and for me, that’s important. That sustains me. Think about what’s setting you want to work in. Do you want to work in a hospital? Do you want to work in a sport setting? Do you want to work with kids? You don’t have to have all the answers now. Know that there are options. We have so many options and so many things you can do. The best thing to do is volunteer. Go to a facility, ask, “Can I do a volunteer for five hours a week,” or whatever they allow, and figure out if it’s something that you want to do. It’s very rewarding career. Pay is well. I like it. I love it.

Jason, I appreciate you coming on the show. Thank you so much. I think what you provided is going to be very useful to people that maybe have never even thought about physical therapy. I appreciate you coming on and opening up the world of physical therapy to people.

Thank you very much. Thanks for having me. I appreciate it.

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About Jason Jackson, MSPT

HCDM 3 | Physical TherapyPhysical Therapist at Mount Sinai Medical Center