Drowning in student debt? Feeling undervalued as a PT? Here's why: You're trapped between an artificial floor and a glass ceiling. The floor? PT school costs more than an MBA at MIT—that's your barrier to entry. The ceiling? The AMA's physician-dominated board literally decides what you're worth. And between those two forces, you're stuck. Today we break down the economic trap keeping PTs fragmented, underpaid, and powerless—and what you can actually do about it. You're not alone, and the problem runs way deeper than you may think.

What You'll Learn:

• Why PTs earn less than other providers for the same skills - Discover how the American Medical Association controls your reimbursement rates
• The hidden economic barriers keeping PTs fragmented - Learn why our 400,000-strong profession has less influence than professionals with a smaller number of providers
• Why your PT school education failed you - The critical finance and regulatory knowledge gaps that leave new grads unprepared (and how to fix them yourself)
• The private practice opportunity - Understanding debt structures, consulting fees, and why smaller clinics actually have MORE freedom to innovate
• Your path out of fee-for-service dependence - Practical strategies for recouping your investment beyond insurance reimbursement
• Why certifications actually DO matter (despite what cynical colleagues say) - How specialization opens doors beyond your clinic job

Our guest today is Jon Lee, PT, DPT, MBA, the co-founder of Pickle, former pro sports PT, and someone who's navigated from clinical practice to Oxford MBA to vaccine development to healthcare tech

It's a conversation about the structural economic problems facing PTs—and actionable knowledge you won't get in school. You will enjoy how the three of us challenge each other throughout this hour-long conversation. We keep it real and it's ultimately optimistic.

This episode is great for new grads struggling with debt, mid-career PTs feeling stuck, clinic owners questioning their business model, and anyone wondering if they made a mistake choosing their healthcare profession.

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Dr. Drew Contreras, PT, DPT, SCS—Lieutenant Colonel (retired), former White House Medical Unit PT to Presidents Obama and Biden, and current APTA Vice President of Strategic Affairs—delivers a masterclass in professional evolution that will fundamentally shift how you view your career trajectory.

This is surgical precision strategy from someone who's operated at the highest levels of American healthcare.

Dr. Contreras dismantles the "comfort crisis" plaguing PT, where professionals complain about constraints while avoiding the uncomfortable work of actual transformation. His brings up a great point, too: venture capitalists are flooding PT because they see massive opportunity that many therapists are too comfortable to seize.

The Analogy-Based Insights You'll Gain:

• The Tree-Cutting Analogy: How value-based care mirrors service industries you already understand—and why PTs must stop being "branch pickers" and become strategic planners
• The Netflix Model of Healthcare: Why flexible, on-demand PT delivery (including treating astronauts in space) represents the future of patient engagement
• From Skilled Laborer to Expert Consultant: The mindset shift from counting clamshells to providing high-level clinical consultation that commands premium pricing
• The Spider-Man Principle: Why ordering imaging and labs comes with great responsibility—and how embracing this elevates PT to true doctoring status

Strategic Intelligence from the Inside:

Contreras reveals how political and healthcare leadership actually views PT's potential, sharing insights from Pentagon health clinics to White House medical operations. His perspective on "old guard versus new guard" leadership offers a roadmap for navigating professional transition without burning bridges.

The Uncomfortable Truth: Healthcare's shift is here and we already risk being late to the game. PTs equipped with "coloring-book anatomy knowledge" (it will make sense when you listen to the episode) successfully operated in primary care roles decades ago. Today's DPT graduates possess exponentially superior tools and knowledge, yet many lack the courage to step into their full scope of practice. And the "old guard" has to step up and embrace this too, even if it means adding to your knowledge base.

This episode will arm you with the strategic framework to thrive in healthcare's inevitable transformation.

For therapists ready to evolve beyond traditional treatment rooms into primary care leadership roles, this conversation provides the roadmap. For those comfortable with the status quo, it serves as a wake-up call to the professional reckoning already underway.

Read Dr. Contreras' bio here

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What distinguishes an explorer from a maintainer in the therapy profession? Why are outside disruptors capturing market share while traditional practices struggle? How can clinicians leverage cutting-edge research on mitochondrial DNA and movement disorders to revolutionize treatment approaches? We tackle these questions and more in a dialogue that bridges clinical excellence with business innovation.

Alex offers a provocative parable about buying lottery tickets that perfectly captures our profession's hesitation to proactively engage with healthcare transformation. "We're losing workforce," he warns, "but we're still failing to see that we need to go out and look into these risk-based contracts, at least explore, at least understand what they are and how to operationalize them."

We examine the stark contrast between traditional care models and patient-centered approaches that leverage technology. Is it better to "hold a patient's hand" through dozens of visits, or transition to guided self-management after fewer sessions? This question gets to the heart of therapy's value proposition in an evolving healthcare ecosystem.

The irony doesn't escape us: therapists expertly help patients recognize and build upon their strengths, yet we collectively struggle to do the same for our profession. The gap between the actual value therapists provide and our ability to communicate that value creates the perfect opportunity for disruption – either from outside forces or, ideally, from innovative thinkers within.

External disruptors aren't succeeding because they provide better clinical care. They're succeeding because they've packaged therapy expertise in ways that solve specific problems for stakeholders, speaking the language of value, efficiency, and outcomes that resonates with payers and health systems.

This conversation isn't meant to be comfortable – it's meant to be catalyzing. The explorer's mindset we advocate requires questioning established practices, reimagining care delivery, and having the courage to venture into unfamiliar territory.

As Alex puts it: "I'm optimistic because I think the better days are ahead, because that's my nature, but I'm also realistic that it may take a catastrophe for those models to be absorbed. We just want to be on a good hill when the catastrophe hits."

Are you ready to climb that hill? To join us as explorers charting new territories in healthcare transformation? To balance rigorous clinical standards with business innovation?

Listen now to discover how adopting an explorer's mindset could transform your practice and ensure our profession remains central to healthcare's future. Because the future of therapy will be written by those willing to explore it – and we believe you have an important chapter to contribute.

• The explorer's mindset encourages seeking new horizons in therapy.
• Therapists must adapt to changing healthcare delivery models.
• Curiosity and innovation are essential for professional growth.
• Understanding value-based care is crucial for therapists.
• Therapists need to articulate their value to stakeholders.
• Research consumption strategies can enhance clinical reasoning.
• Collaboration with other healthcare providers is vital.
• Growth can be achieved through efficiency and subtraction.
• Therapists should prepare for risk-based contracts.
• The future of therapy depends on adaptability and exploration.

#TherapyLeadership #HealthcareInnovation #PhysicalTherapy #ValueBasedCare #PracticeManagement

Link to the transcript here.

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Check out our friend and colleague's *course on AI for PTs (and so many others!) by Cody Lee, PT, DPT

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