Cream will rise


I recently became a member of the private practice section of the APTA.  I have illusions of grandeur, which include working up to 70 hour weeks in order to sustain a small private practice.  We will see if this is just a mirage, but in the meantime, I will also be providing commentary on articles in that magazine.

This will be another short one because it comes from a short article.


  1. “We recommend building a program to mentor your existing staff to become those next clinic directors”


I can’t ever remember a job in which mentoring actually took place formally. I have worked for Wal-Mart, and although it was a great learning experience, the learning wasn’t formal. I learned more by watching the culture from the top down. When looking at the top, there was the GM. I can remember my interview with the GM as a 15 year-old. He asked me about school and I was very cocky back then. I told him that I wasn’t worried about school. He made the comment, “that either means you’re really smart…or really stupid.” Looking back, that was a memorable moment. As a kid, I just blew it off, but as an adult I hope that my kids never make such a shortsighted comment.


I learned a lot while at Sam’s club and made friends that are still friends to this day (20 years later). I made huge mistakes and should’ve been fired for some of them, but I wasn’t and I learned from them. I kept learning through the years and quit the same year that I earned employee of the year. That’s the same year that I got accepted into PT school.


From there I went to World’s Gym Joliet. Again, I learned a lot, but not formally. The owner did not have a way of promoting talent. When a person has no direction and no way to succeed, then the person will slowly sink back to mediocrity. At this job, I became a great student of PT, as it gave me plenty of time to study, but I was a horrible employee. I only did what was needed to get the job done because I didn’t know what else to do aside from the list at the desk. This was horrible management because we didn’t have a way to excel. Needless to say, the gym is closed.


In none of my PT jobs do I have a way to become management. I have specifically asked this of my jobs (all of them to be exact) and the answers are almost all the same, “we don’t know how to promote someone to management” or “we don’t have any room for additional management”. This doesn’t make sense. A manager is someone that takes on more responsibility than those they serve. Although it typically comes with additional resources, it doesn’t always. I don’t think that those above me see the loss that takes place when I am pigeonholed into a lesser role.


I can’t give a good reason why a clinic director would not take the time to develop those they serve to take their place. I can think of many reasons, but none of them good.


Fear: If I groom someone to take my place, then what stops him or her from taking my place? I groom many students to do what I do in the clinic. None of them will be as good as I am with the information that they received from me. This is not an arrogant statement, but I spent thousands of hours studying the information and understanding the information in the studies. The students simply get PowerPoint presentations of my knowledge. This is much better than what they get in school regarding specific topics, but at no point will they obtain my understanding through PowerPoint alone. The same can be said for a clinic director grooming an understudy to be a director. I can obtain the same information, but I shouldn’t know as much as the director regarding the information…unless the director didn’t spend the same amount of study to learn the information.


Power: If only one person can do the job, then all else must bow down to that person as an authority figure. There are certain things that only the director can accomplish, because only the director knows how to accomplish certain things. It can never be delegated because then the director will have slightly less power than prior to delegation.


Lack of talent: This is not a good reason to not develop a person. This is the poor management to begin with, as if a “person wouldn’t be rehired, then the person should e fired”. I don’t know who said it, but I heard it from Entre Leadership podcast.


  1. “Develop a career ladder in your business that points to a staff therapist growing to become a manager”


This seems logical. Those that want to succeed will then have a structured way to climb the ladder to the top. Not everyone wants to be at the top. Not everyone wants the responsibility or the time constraints that come with moving up the ladder. Those that do though…should have a written way to climb the ladder so that one’s wheels aren’t spinning.


Excerpts from:


Martin P. FIVE-MINUTE FIX: Build Bench Strength. IMPACT: Private Practice Section of the American Physical Therapy Association. 2016;May:17.

Author: Dr. Vince Gutierrez, PT, cert. MDT

After having dedicated 8 years to growing my knowledge regarding the profession of physical therapy, it seems only fitting that I join the social media world in order to spread a little of the knowledge that I have gained over the years. This by no means is meant to act in place of a one-one medical consultation, but only to supplement your baseline knowledge in which to choose a practitioner for your problem. Having completed a Master of Physical Therapy degree, the MDT (Mechanical Diagnosis and Therapy) certification and currently finishing a post-graduate doctorate degree, I have spent the previous 12 years in some sort of post-baccalalaureate study. Hopefully the reader finds the information insightful and uses the information in order to make more informed healthcare decisions. MISSION STATEMENT: My personal mission statement is as follows: As a professional, I will provide a thorough assessment of your clinical presentation and symptoms in order to determine both the provocative and relieving positions and movements. The assessment process and ensuing treatment will be based on current and relevant evidence. Furthermore, I will educate the patients regarding their symptoms and their likelihood of improving with either skilled therapy, an independent exercise program, spontaneous recovery or if the patient should be referred to a separate specialist to possibly provide a more rapid resolution of symptoms. Respecting the patient’s limited resources is important and I will provide an accurate overview of the prognosis within 7 visits, again based on current research. My goal is to empower the patient in order to take charge of both the symptomatic resolution and return to full function with as little dependence on the therapist as possible. Personally, I strive to be an example for family and friends. My goal is to demonstrate that success is not a byproduct of situations, but a series of choices and actions. I will mentor those, in any way possible, that are having difficulty with the choices and actions for success. I will continue to honor my family’s “blue-collar” roots by working to excel at my chosen career and life situations. I choose to be a leader of example, and not words, all the while reducing negativity in my life. I began working towards the professional aspect of the mission statement while still in physical therapy school. By choosing an internship that emphasized patient care and empowering the patient, instead of the internship that was either closest to home or where I knew that I would have the easiest road to graduation, I took the first step towards learning how to utilize the evidence to teach patients how to reduce their symptoms. I continued this process by completing Mechanical Diagnosis and Therapy courses A-D and passing the credentialing exam. I will continue to pursue my clinical education through CEU’s on MDT and my goal is to obtain the status of Diplomat of MDT. Returning back to school for the t-DPT was a major decision for me, as resources (i.e. time and money) are limited. My choice was between saving money for the Dip MDT course (about 15,000 dollars) and continuing on with the Fellowship of American Academy of Orthopedic Manual Physical Therapists (FAAOMPT) (about 5,000 dollars), as these courses are paired through the MDT curriculum or returning to school to work towards a Doctorate of Physical Therapy degree. I initially planned on saving for the Dip MDT and FAAOMPT, but life changes forced me to re-evaluate my situation. The decision then changed to return for the tDPT, as my employer paid for a portion of the DPT program. My goal for applying to and finishing the Dip MDT and FAAOMPT is 10 years. This is how long I anticipate that it will take to finish paying student loans and save for both programs, based on the current rate of payment. I don’t know if I will ever accomplish what I set forth in the mission statement, but I do know that it will be a forever struggle to maintain this standard that I set for myself.

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