This is a sponsored post by FOX Rehabilitation, a supporter of NewGradPhysicalTherapy & new graduate physical therapists! 😎
On May 9, we had a YouTube Live webinar with FOX Rehabilitation on their first career. We sat down with FOX’s Cassandra Hill, PT, DPT, CWC, and FOX’s Director of PT Clinical Services Will Dieter, PT, DPT, GCS, FSOAE. They gave us all kinds of great advice on mentorship for new grad physical therapists, what to look for in a mentorship program, things to look for in a first career, and more!
The confidence gap: leaping from new grad to practicing therapist
When she graduated, Cassandra Hill says, she had passed her boards, a job lined up and everything was looking bright. “My journey to FOX really started maybe about two years prior,” she says. FOX had some representatives at career fairs at her school, “and it just so happened that while I was at my third internship in spring 2017, I got a text about a meet and greet.” She had been interested in acute care as well as geriatrics, but when a job at FOX came up in the region she wanted, Dr. Hill jumped at the chance.
When she did her research, the draw of FOX only grew, she says. “In terms of the autonomy [and] the clinical excellence:That was pretty evident in the environment that I shadowed in—it really became a no-brainer after a while.”
But as a new grad, Dr. Hill remembers that the biggest challenge was having the confidence to practice. “It was really a confidence issue—a lack of confidence issue! Thinking, ‘do I really know enough to be successful in this field?’”
The transition from school to the clinic can be terrifying, since you’re going from learning in a space of heavy supervision to being an independent clinician. “I had a part-time experience in home health when I was a student,” says Dr. Hill, and that experience helped her get over her initial uncertainty when walking into a client’s home for the first time. “Getting over that whole dynamic was beneficial for me early on.”
She stresses that while her prior experience in home health was helpful, new grads without that experience aren’t going to find themselves thrown into the deep end at FOX. If you haven’t done a house call before, Dr. Hill notes, you’re given the opportunity to do your first one by yourself or under the supervision of your mentor. “The mentorship program is very helpful in getting you acclimated to that environment,” she says. “I never felt like I was alone.”
In addition, FOX offers resources to its clinicians—study groups, MedBridge subscriptions, and so on—to support them in their careers. “There’s so many opportunities for education and for growth in that area,” Dr. Hill says. When she graduated, her main goal was to become the best clinician she could be, and her long-term goal was in education. “I love teaching, and education is always something that’s been very important to me,” she says. “I want to potentially become a mentor one day, potentially a clinical instructor.”
There are also a wide range of opportunities for clinical instructor training, as well as the PT Residency with a focus on Geriatric Clinical Specialist Prep-Program. This course is an entire year, and FOX makes sure its interested clinicians are prepared and meet all the requirements for the specialty, along with reimbursing successful specialists.
With FOX, Dr. Hill has taken advantage of all the resources they offer, and says she’s looking into pursuing the Geriatric Specialist Program. “It’s the most supportive environment that I could have—it’s more supportive than I could have imagined,” Dr. Hill says. Her current mentor is willing to discuss cases and offer advice whenever Dr. Hill needs it, and Dr. Hill has been involved in a journal club in her area. “It’s autonomous practice, but you never feel like you are on an island by yourself.”
Mentorship programs and red flags: what new grads can expect
The Emerging Professionals Mentor Program at FOX is structured, says Dr. Hill, with modules mentees complete and a slow ramp up of productivity. “You’re not going into the clinic at full 100 percent productivity,” she says, “and there’s opportunities, again, to spend one-on-one time with your mentor to go over any questions that you may have, but also time in that mentorship program early on to get yourself acclimated to working in the home setting.” During the mentorship period, you have the opportunity to observe your mentor during a house call and to be observed.
“The mentorship program has a very structured ramp-up time,” Dr. Hill says, and the productivity requirements, which are laid out in the beginning, are very low in the first week. In the second week your caseload gradually starts to increase until you reach your full caseload by week 9, and the mentorship period is a total of 24 weeks long. The program is paid, and it is offered in every region FOX operates.
As for red flags in a mentorship program, Dr. Hill wants new grads to know that they should be able to ask for details about the program. Don’t settle for just being told that a mentorship program exists: Ask if there’s a sample schedule and outline of the program that you can see. Ask about productivity standards and one on one time with your mentor—and, of course, whether those productivity standards affect your salary.
“There should be a lot of time for you to sit one on one and really discuss some of those things that are important to you, because that’s where you can build that relationship, and hone in on some of your clinical skills early on,” says Dr. Hill.
“In our mission statement, our colleagues are first,” says Dr. Dieter, “because ultimately, keeping our colleagues informed, knowledgeable, feeling supported, all that stuff, makes good health care.” But, Dr. Dieter adds, a major red flag that new grads should be aware of is if the workplace is trying to create the perception that everything is perfect. “Anyone that paints it that way—there’s probably some issues there,” Dr. Dieter says. What’s more important, and makes for a healthier workplace, is the sense that if you have problems, you are encouraged to bring them to your colleagues so they can be addressed and solved.
“If you do go somewhere as a new grad, being able to speak up and have someone listen to you—and also people being transparent in how things are and how they work . . . those are important things,” advises Dr. Dieter.
A day in the life of a FOX Rehabilitation clinician
People often get FOX’s outpatient on wheels model confused with home health, but as Dr. Hill explains, there are major differences. The most illustrative difference is in billing: unlike home health, which bills under Medicare Part A and requires patients to be homebound, FOX’s outpatient services are billed under Medicare Part B, where clients qualify for outpatient care and don’t have any skilled nursing needs. “Our clients do not have to be homebound, but they can be,” says Dr. Hill.
“We’re really talking about better access to care,” says Dr. Dieter. “It’s a population of people that are really, for the most part, forgotten in the healthcare system. They may or may not go to home health, they’re told to maybe go to outpatient and they don’t ever go there, and they fall.” FOX is focused on bringing care to this population. “You can really engross yourself in the psychosocial piece of an older adult, which we all know is insanely important—sometimes even more important than the physical piece.”
In a typical day, Dr. Hill treats a mix of clients from senior living communities as well as house calls. “I typically see anywhere between six and eight patients in a day,” says Dr. Hill.
Her day starts with house calls, to which she brings her “go bag,” which includes a blood pressure cuff, some TheraBands, a deck of cards, and a few other items. “I don’t really have a lot of bells and whistles with me, because most of the interventions I’m providing in the home are function-based,” she says. “I try to use the home environment that I’m allotted as much as I possibly can to provide interventions, because that’s the environment that they’re accustomed to.”
In her experience, she says, patients can be uncomfortable in outpatient clinics, which are not only sterile but are also unfamiliar to patients, just as their homes are unfamiliar to a therapist who is only meeting with them in a clinic. If a patient has a fall, for example, “a clinician can say, well, how did you fall? And they can describe it all they want, give as many flowery details as possible about that experience, but in that clinical environment, you can’t see it.” But if you’re in their home, your client can actually show you what happened and where — “now, they don’t have to demonstrate the fall, in this example!” jokes Dr. Hill, but emphasizes that when the clinician is in the environment, they can identify any safety modifications that can be made. “In the home, I feel like you have a little bit more insight into how you can best help or facilitate a client to get better and improve their function and overall quality of life.”
Every one of the FOX clinicians we’ve spoken to has expressed a similar sentiment: that house calls give them the flexibility to design treatment plans to fit their client’s needs and individual goals. One of the major benefits of physical therapy is the fulfillment you experience from helping people improve their quality of life and return to doing the things they love.
When it comes to clients, FOX clinicians set individual goals. “They are function-based,” says Dr. Hill. “I have some goals that are based on some functional outcome measures as well, but they’re function-based: can I get to my mailbox without feeling like I’m going to fall, can I access my bedroom with a little bit more ease?”
“The one thing I hear a lot of, is people being actually afraid that someone’s going to literally die on them, in their house. And what I always go back to is . . . if you are a physical therapy student, you are the most highly educated version of a physical therapist that has ever graduated in this country, or really anywhere,” says Dr. Dieter. If something happens in a client’s home, you know to follow the same instructions you would in any other setting. Right now, a client’s house might seem like the great unknown, but as you gain experience, you’ll gain confidence.
Who will thrive doing outpatient on wheels?
“I personally believe that everything is not for everybody, but that doesn’t mean that you can’t improve your proficiency or performance in house calls. But then again, I don’t think that every size shoe is going to fit to me—I only have one shoe size!” Dr. Hill jokes. On a more serious note, she adds, “At the end of the day, you kind of have to reflect, you have to know what it is that you want. What it is that you want to pursue. At the end of the day, what is it that makes you come alive? Do that! And you’re probably going to be a good fit for whatever that is!”
Dr. Dieter adds, “We’ve asked the same question a number of times: you know, who are the people who do well here? And there’s two key things that you have to have, and everything else you can fill in.” The two major qualifications are that you have to be an effective communicator, and you have to be organized.
“It’s not a personality . . . you can be an introvert, you can be an extrovert—it doesn’t much matter,” says Dieter. “I feel this way about our regular clinicians, and I feel this way about our residents: other than that, it’s passion, desire, wanting to do it.”
With FOX, there’s a lot of support for career development, whether that means honing your clinical skills or working towards a managerial position. “If you want to become something other than a staff therapist: if that’s what you want, there are mechanisms to do that,” says Dr. Dieter. Dr. Dieter’s path to Director of PT Clinical Services was perhaps atypical for PTs as a whole, but typical for FOX, which focuses on the long-term goals of its staff. “I was always data-driven, evidence-based, clinical, and I was forthcoming about the fact that that was where I wanted to go,” he says. Being transparent about his goals was important, and he recommends that new grads keep an eye on their long-term goals whenever making career decisions.
As a final note, Dr. Dieter and Dr. Hill gave new grads some advice. “I think that it would be one of the most beneficial things in the world for you if you took some time to be reflective—again, to kind of specify what it is that you want, what it is that you’re looking for. Even if you’re ranking some of the qualities in a practice that are most important to you,” urges Dr. Hill. “Is it salary? Is it location? Is it the patient population that you’re going to be treating? Is it mentorship?” Weighing these aspects, and deciding which are absolutely necessary, will help you articulate your goals and desires—both long-term and short-term.
“Be a true professional,” says Dr. Dieter. “Don’t accept the status quo in the way a practice may be.” Instead, figure out why things work the way they do. It might be different than what you’ve experienced in school. “Advocate, go the extra mile, and spend the extra time,” Dr. Dieter urges. “Don’t take anything at face value.” New graduates have a unique opportunity to take the profession to the next level, and that means innovative models that will not just keep pace with the changing pace of healthcare, but will drive changes—in the direction that will best serve clients and clinicians alike.
“Know what you want, and go find it. Do your research, go after it, and hopefully it’s something that makes you passionate, and that makes you come alive,” Dr. Hill concludes. “Find that.”
Curious to learn more about FOX Rehabilitation?
You can use the chat bubble on the page to speak with the CovalentCareers PT and OT Success team, who will answer your questions and help provide an unbiased perspective about FOX and if it’s a fit for you. If it seems like a good match, our team will refer you to a FOX Clinical Career Specialist to help you get started in your new career as a FOX clinician.