We sat down with Don Reagan, PT, DPT, CSCS, an orthopedic and sports medicine physical therapist. He shared his thoughts with us on picking the right clinical affiliations, and finding that "spirit animal" of a mentor so that you always keep your passion for PT growing and growing.
NGPT: Tell us a little about where you work and how you got there.
I am the team leader at Mountain River Physical Therapy in Chatham, Virginia. It's in the rural south side of Virginia. We have 1,100 people in my town. The primary reason the clinic is there is because we're located on the Functional Movement Systems headquarters campus. Gray Cook wanted high quality physical therapy in his hometown, and invited Mountain River to come and put a clinic on his campus. I ended up being the PT that runs the clinic.
NGPT: Where were you working before then, or was this your first job out of school?
This is my third job out of school. Before this, I was working in outpatient orthopedics in Lynchburg Virginia (an hour north of here), and when I first came out of school I worked in an outpatient clinic in New York City. I attended USA in San Marcos (San Diego) and graduated in April, 2010.
NGPT: So what made you decide to take this opportunity in particular?
Well, Gray Cook - his thoughts and his ideas - were extremely influential for me, even when I was in school. And so the opportunity to receive physical therapy mentorship from him and really see a master clinician in practice was extremely valuable. I think it was the best decision I've ever made professionally.
When I was in school, I had come across some of his content and really liked the way he synthesizes conditioning concepts with physical therapy, manual therapy, and exercise - all under the umbrella of movement assessment.
NGPT: How were you initially connected with Gray Cook?
Early on, I purposefully went to a conference in Seattle, because I saw that Gray Cook and Kyle Kiesel were both presenting at the conference. David Butler was the keynote speaker, and I had an awesome chance to go with some of the faculty from our program. In attending the conference, I especially wanted to see Gray and Kyle speak.
So that was the first connection with Gray, and it just so happened that my alma mater, Liberty University in Lynchburg Virginia, was an hour or so away from Gray's town and where he was located. I think he remembered that unique connection from the conference, so when I moved back to Lynchburg, Virginia to teach at Liberty, I reconnected with Gray and went to a couple of FMS summits at Duke.
I made sure to let him know I was back in town and hoping to connect and kind of get involved in anything that he was doing.
So for about a year or so, we had a few clients that we referred to one another. He did some consulting with the track and field department at the university that I was working with, so I made sure I was there with him when he was there. I made myself available to him in any way I could.
I've always done this in my career - I've been aware of who's around me geographically, like who is who, and who is within connecting distance, and then done whatever I could to make sure they knew that I was there and eager to learn from them.
And that eventually led to a job offer. I absolutely think you have to be proactive. Or even maybe even borderline aggressive - or at least that's my personality. I'm comfortable with that. And I wanted him to know that I was nearby and also interested and inspired by him.
NGPT: What is it that drew you to Gray Cook in particular?
I think there was just something intuitively about the way he spoke about the profession and the practice of physical therapy that I just found infatuating. And I think that's probably a really simple way of describing it. One of the best ways for a young clinician or a new grad to seek out physical therapy mentorship and apprenticeship opportunities is to find people who inspire you. My initial passion was in strength and conditioning, and I had my first job in a gym when I was a sophomore in high school. Since then, I've worked in countless gyms as a personal trainer and a strength and conditioning coach.
I've always found Gray Cook very inspiring, and clinically the majority of what he says, thinks, and does just makes sense to me.
NGPT: When you say that you were inspired, how can someone find their own inspirational PT to seek physical therapy mentorship from?
In order to find people inspiring, you have to know who you are. I'm not trying to get too philosophical, but you have to know what excites you. What motivates you. What inspires you.
Ask yourself why you are entering this profession, and try to focus on the aspects of PT that really resonate with your own values. And then once you do it - once you determine those things - I'm certain that you'll find other people who are infatuated with the same things.
NGPT: So you took quite a bit of initiative to reach out to a respected clinician. Would you recommend that someone start out with an e-mail, or a call, or is the best approach to just show up and have that face time with them?
I suggest building your professional network immediately and also building your personal brand. And when you find somebody that you find appealing, reach out to them. I don't think it really matters how you do it, and don't be shy or bashful. Just reach out however you want to, and do whatever is comfortable. Because if that person is in the industry for the right reasons, they're usually happy to help out a budding clinician.
I have had folks that I appreciate and look up to during my entire career. I will reach out to them - just cold call e-mail or contact on social media. And most of them turn out to be good people. By "good," I mean the people that really want to connect with other clinicians. They respond, and they're excited to connect, support you, and just be a part of your network.
And then there's been plenty of folks in my career that I've reached out to and they've never responded or they made it evident that they weren't interested in investing in me. The way I've always felt about that is that it's fine; it's not personal. Who knows what's going on in their life?
I regularly utilize LinkedIn, Facebook, and Twitter. I was on Google Plus, but didn't really use that one as much. Yes, Instagram, too. I use all of those and I've had a website off and on.
NGPT: Did you always know that your passion was orthopedics? Did this help you get clinicals that you wanted?
I knew I wanted to be in manual therapy courses. And because of that, USA was a great experience for me. I enjoyed those courses, and I felt strongly that my manual skills were really good coming out of school. I did have to ask for my own clinical affiliations, despite our school's policy that we could not do this. This further proves my point that you simply cannot sit back and wait for things to happen for you.
Be respectful, and have good reasons, then approach your CCCE with your rationale for wanting to choose your own clinical affiliation. If you can convince the school and have compelling reasons for creating a new relationship with a particular CI or clinic, this will hold more weight than simply saying, "I want to go to Colorado because I like to ski."
And I think that's all part of maturing and becoming professional. Some folks have it during PT school, and others develop those articulation and communication skills after they graduate. Creating a new contract with a new site/CI is extra work for a CCCE. You need to effectively explain why you deserve extra work and a specialty opportunity. When you solicit a clinical experience, you're taking time and energy from that clinician, and then you're also creating extra work for your CCCE. So this is why many schools might discourage students from finding their own clinicals.
It worked out for me, but I've heard students can be penalized or disciplined or ostracized for trying to solicit their own clinicals. And that's the type of behavior that I think is really counterproductive for our profession.
NGPT: That said, would you be open to students requesting to have a clinical with you? Especially ones who might have been instructed by their schools to accept whatever clinical they happen to get from a lottery?
Absolutely. In fact, I want to see that change in our industry and in our profession. I guess it depends on the school, but the clinical supervisor seems to dictate how the schools react to students reaching out to me. Some schools I've worked with are extremely open and supportive of that. They encourage their students to go find their dream clinical and their dream CI - to be proactive and facilitate the relationship. But the majority of PT programs frown on that. And I personally want to see that change.
If we're developing graduate students with doctoral degrees, we have to trust them to be professional enough to interact with their future colleagues. And that includes creating relationships and forging ties with clinical sites. So I'd like to see that mentality change. I'd like to see that improve across the country because the best students I've had have been students that have solicited their clinical with me and have put the effort into creating a relationship between Mountain River and their academic institution.
NGPT: What makes a contact or a student stick out to you in a good way?
That's a great question, and I probably require and demand more of my potential interns than most anyone else, so I'm picky about them. Really, I want to hear their passion for PT.
I want to have a phone conversation and communicate often. For example, one of my best students over the past 3 years (I've had 10 students) was an excellent communicator and very proactive. I spoke with her off and on for a year before her clinical even started. And one of the things that really appealed to me about her - and I vividly remember this - is that when I would call her, she would answer. That may sound trivial, but I call a lot of people. I sort of measure someone's interest in me this way. How many times they answer, or how long it takes for them to answer, or how long it takes for them to get back to me. And one of the things I loved about her was that if I called she answered. I guess short of being in class or being in the bathroom, I'm pretty sure she answered - to me, this shows passion.
NGPT: What type of student would be a good fit for a clinical at Mountain River?
I look to see that they love what they do and that they're passionate about what they do. I'm trying to facilitate a relationship to determine whether or not this is the right student for me, as well as whether I'm the right CI for them. That's why I do this proactive relationship building - because I've turned students down before when it's not the right fit.
And it's not personal. It always starts with a phone conversation with someone. Sometimes they'll tell me that they want to be in a skilled nursing facility or at a school, and that's great! Go be the best geriatric SNF physical therapist you can be.
But that's not the student that I'm looking for. Their goals just don't align with what they will get from this clinical. It's not the right fit, and that doesn't mean that I couldn't learn from them or that they wouldn't learn from the geriatric population that I treat, or the approach that I use.
But I want that slot - that opportunity - to go to someone who wants to do outpatient orthopedic sports medicine because I want to make it a coveted opportunity. I want to have someone come in who knows what they want and I want them to feel passionate about it.
NGPT: Have you ever reached out directly to a student?
I can think of two situations where I directly reached out to a current PT student, and their university was welcoming. One student ended up deciding that they wanted to do their clinical with me. Because it worked out, we then had a contract with that school. But then we had a very similar situation with a different student at a different university. That university was vehemently against the idea, primarily because I had a preexisting relationship and the fact that I was being selective.
I think part of it is that there are some outpatient private practices that abuse students and clinical placements, and so I think for some universities, they become hyper vigilant about that. They think I might be the only CI in the country that's soliciting students like that, and I understand that in that regard, I'm an outlier. But I guess I'm looking for trust from the university that if I'm going to join the university as kind of a "clinical faculty" member by being a CI, then you need to trust that I'm a professional, and until proven otherwise, I deserve your trust.
Now, if I take advantage of a student, or if I abuse your good will or your student, then I fully understand never sending a student to me again. But until that happens, I would appreciate the respect and goodwill that even though I'm soliciting your student, it's for a reason. That student wants to do a clinical with me. They're a paying student at your university, and they're exploring a clinical opportunity that they think is going to suit them best for the rest of their career. For an administrator to get in the way of that just seems wrong.
NGPT: What if a student had terrible clinicals and is looking to find passion? What do you recommend?
I think that if you're a couple of years out of school, and you're struggling with inspiration and motivation, and you're thinking maybe I made a mistake in this career choice, you probably just haven't been in the right clinical context, and you haven't been around a master clinician.
And so I think the first place I would research is residency programs in your specialty of choice. The other suggestion would be to connect with people who have found their passions in our industry and build relationships.
NGPT: That said, are you ever open to being shadowed by a licensed PT? Perhaps someone looking to ignite that passion, or to simply learn?
Absolutely. And I've developed relationships with students through social media who, for whatever reason, their clinical didn't work out. It could be that their school did not allow them to get a contract signed with me, or they were unhappy with the clinicals they had. So these PTs will reach out to me and tell me that their clinicals didn't work out.
Bad clinicals shouldn't stop you from having a healthy mentoring relationship. And I still see this as an opportunity to invest in them. And so yeah, I mean I think there's there's so much value in that, and for the 10 students that I've had, 3 of them have gone into professional sports immediately out of school, and then I think I've helped 2 or 3 other ones get their first jobs.
I say all that to mean that when you do have the right clinical experience, you end up networking and connecting through your CI And a lot of doors open when you're passionate about a certain thing, or a certain approach. But again I want to circle back to the idea that it all starts with introspection that you have to actually know what you're interested in. If you're passionate about sports medicine and orthopedics, you should talk to me.
If you're not really sure what you want from your physical therapy career, you should definitely do some introspection and consider what branch of PT will best ignite your passion for the profession.
NGPT: Do you ever go and shadow other clinicians?
Yes. I think wherever you are, and whatever your community is, it's always wise to research the people within a reasonable driving distance that you can shadow and get to know. I think, especially in private practice, and probably just in medicine in general, we don't shadow each other enough.
We go to conferences and we go to workshops, and we practice on each other on a weekend. And then we just go back to our work, because unfortunately, medicine has become more of a blue collar career path. And what I mean by that is that it's become more about profit and less about the actual practice of honing and mastering your craft.
I've gotten more out of shadowing practitioners in my various communities that I've lived in than any workshop or course or conference because the opportunity to go and watch someone practice their skill set with real live clients or patients in a real setting is invaluable. It's so much different than standing up in front of a group and pontificating about the subject matter, and so much more vivid and valuable to watch that same person interact with their clients.
NGPT: What is the best thing you can get from shadowing other clinicians?
I know one of the things that I really gleaned from my time co-treating with Gray Cook was his communication skills. His ability to communicate with patients and connect is astounding. And then, how he would scale the communication depending on the client was amazing to me. I was mesmerized by Gray's ability to articulate himself and connect with his patients and really make sure that they understood what he was saying.
I really enjoyed learning that skill from him, and would have never gotten it if I'd gone into 100 clinics that Gray taught. I would have never gotten that because a classroom is just not the right setting to learn that nuance of patient care. But to watch him interact with patients - and I still do have the privilege to do that on occasion - it's just really valuable.
So yes, going to shadow people in your community is so wise. I don't think that this is about professional boundaries, either. I've shadowed chiropractors and massage therapists and acupuncturists because they have a lot to share with a PT. And you can just be there to learn. Don't look at other professions as folks where the real purpose for you being there is to solicit their referrals. I don't go and shadow a chiropractor because I want to be their preferred physical therapy provider.
If I go shadow somebody, I want to learn from them. But I think in general and in private practice, we just don't do enough of that. We have all of these ulterior motives for connecting and building relationships, and I think that's ultimately why the private practice community has become overly skeptical or overly cynical about people within the community coming in to shadow...because they feel like everyone's got an ulterior motive. It could be that they're scoping out how they do things and they're trying to learn from their efficiencies or inefficiencies.
And the reality is that, at least in my opinion, that there's enough business to go around and competition is good. If you're competent at what you do and you're good at what you do, you should never be afraid to have people shadow and do your own shadowing. I've had chiropractors and PTs and others come in. I've had an orthopedic surgeon.
It's a great learning opportunity. And that might be too idealistic for some, but that's how I run my practice. It's an open door for students and for practitioners to come and shadow, and I actually feel sort of saddened by other practitioners who live a career of hoarding their expertise, talents, patients, and clinical success stories. That just seems like a really stressful way to spend your professional career. And I understand the rebuttal narrative, but I respectfully would disagree with it.
NGPT: Does it ever get stressful being shadowed?
It can be uncomfortable, of course. We have to get comfortable with being uncomfortable in order to grow. It's not comfortable for me to have to have Gray in the exam room when I'm doing my thing, nor any of my students or any other practitioner. Having someone see you practice like that is never comfortable. Try manipulating someone's neck with a chiropractor in the room... it's not comfortable!
But I've had chiropractors as patients and I've manipulated their spines. And then I'm like, "OK what do you think?" I appreciate the feedback. I've had chiros who have shadowed me and been my patients. I mean they've been awesome. It's been so helpful in improving my technique. And the same thing goes for massage therapists that have shadowed me. I regularly solicit their feedback whether they're my patient or they're just shadowing because I want to be continually growing and making sure all my patients and colleagues are comfortable with the treatments I provide.
That's partly why I develop relationships with students ahead of time. It's the same thing with practitioners that are going to come and shadow. I want to develop a relationship in advance so that we can get that awkwardness out of the way ahead of time. The last thing I want to do is unintentionally make them uncomfortable because they don't know my personality or my sense of humor, or they don't expect me to solicit their input.
NGPT: You mentioned networking and connecting a few times. What can people do to connect with people in their area? This applies to students and practicing PTs.
Do something. Just start putting yourself out there, making a name for yourself, and connecting.
Remember that every email you send is an investment. If the investment is 15 minutes into a message on Facebook or an e-mail to somebody - let's say in the NBA - and they don't respond or they give me a short little, "I'm not interested," that's fine! But what if those 15 minutes end up being a professional relationship that provides value and perspective? So just think that any time spent networking is a good investment in your career.
And the more relationships you build, the better off you are. The profession is relatively small and there's a small circle of people you know who are tightly connected. If you get a relationship with one person, it could lead to many more. According to the book, The Tipping Point by Malcolm Gladwell, you need three types of people: salesmen, mavens, and connectors. If you can connect with the connector, who can get you in contact with the right people or the right opportunities, you're set.
These connectors are out there and they're in our industry. And they get excited about connecting the right student with the right clinical experience or the right first job. I like to think of myself as a connector. (Editor's note, so do I!) I enjoy that, and I really altruistically enjoy the experience. I don't get kickbacks when my student goes and takes their first job. Other than the employer saying, "Hey thanks for training this student and giving us an opportunity to hire them."
That's all the kickback that I that I'm looking for.
NGPT: What is the biggest professional lesson you have learned regarding career growth?
The biggest professional lesson I’ve learned is that you can’t just take what’s given to you. The squeaky wheel student is gonna get the clinical that he/she wants. The proactive student or young clinician will be the one to get the dream job. If you want something, you have to go after it. Waiting for things to fall in your lap is not the way to become successful in any profession.
NGPT: What is your favorite part of being a clinical instructor/mentor/connector?
I feel honored when people solicit me for my thoughts or my advice. I find it flattering and consider any platform an opportunity to become a better communicator - just generally a way to articulate myself better.
I'm sure there are plenty of clinicians out there who would think that the amount of time that I spend on the phone with potential students - or even students that have come and gone - is crazy. But I find it to be very rewarding, and I learn a lot from my students. Now, this isn't all my students. I don't keep close relationships with all of them - maybe not even 50 percent of them - but the few that I really connected with are now some of my closest colleagues, and it's very rewarding.
I also want to note that I've enjoyed watching students from far away just blossom. Lots of students who come from farther away tend to perform better in general, and they're unfamiliar with the culture and the geography of our little rural community in Southside Virginia, and they just become very engrossed in it.
They're here for two months or four months or six months, whatever. But they are 100 percent engrossed in the opportunity, and so they're consuming lots of educational materials on the weekends because there's nothing else to do, and they're doing literature reviews and reading research. We're having a lot of conversations because many of these students become part of my family when they're here. They'll have meals out with my family, or go to church with me, or socialize, go to the gym with me, play basketball. Because it's such a small community, many of my students really become a big part of my life when they're with me!
NGPT: Considering your feelings toward interdisciplinary mentoring, shadowing, etc, how do you feel about some of the intra-professional factioning going on these days?
I think we've gotten to a place in our culture where skepticism has become sort of the vogue thing.... everyone's skeptical of everyone. And I think it's OK to ask questions, as long as we do it respectfully. If we're not careful, skepticism quickly becomes cynicism.
But when we have a true candid conversation, I think we can be honest about things, and the fact that there are a lot of things that we do in physical therapy that are more art than science. And I think we have to accept that we want to be evidence-based practitioners. That's great and the body of literature needs to continue to grow and develop and be invested in.
A lot of great things come from practitioners challenging one another and not being apathetic or satisfied with mediocrity. And so that's my objective when I shadow someone or when they come out to me - we can learn from one another. In a respectful way.
NGPT: This is important for students to hear. How do you feel about students challenging you? Some students have had very bad experiences challenging their CIs.
I tell my students straight up, whether it's on the phone ahead of time or their first day or first week, the only two reasons for you to fail this clinical is if you're unsafe or unprofessional.
As far as a student and I disagreeing on different methods or different approaches and what not, that's part of why I prescreen my students. So any major red flags that indicate we may have serious disagreements on practice philosophies will be taken care of through the screening process that I do.
But if they get here and challenge me on legitimate concerns, I definitely encourage it. I facilitate that. I like when people speak their mind. This is a teaching clinic. I really pride myself on leading a teaching clinic where I've had approximately 25 students over the last three years, including undergraduates and graduate students. And I need that type of stimulus to be challenged. And so really, I've had some students who have been uncomfortable being in a setting where they are challenged. And so we are not for everyone. I'm not for everyone. But that's why I consider communicating and connecting in advance of clinicals so very important.