Episode 14
Allison Jones: Good morning, good afternoon, and good evening, and welcome to the Therapy Matters Podcast, your one-stop resource for expert insights and advice on everything therapy and rehab. I’m your host, Alison Jones, and today I’m joined by Dr. Meredith Castin, a licensed physical therapist, entrepreneur, career strategist, and founder of The Non-Clinical PT. Meredith, thank you for joining me today.
Dr. Meredith Castin: Thank you so much for having me. I’m excited to be here.
Allison Jones: We’re excited to have you. today, Meredith was kind enough to join me in discussing a near and dear topic, non-clinical alternative careers for PTs. But before we dive into that, I’d like to give the listeners a bit of background on who you are.
You’re a trained PT and used to work with patients. What made you decide to find another career path?
Dr. Meredith Castin: It’s a long story, but to keep it brief, I kept going from job to job, thinking that maybe it was the setting, patient population, or something that was making me feel anxious all the time and not feel—I just didn’t feel right. Things didn’t feel like I was enjoying my work. I always felt exhausted and drained at the end of the day, and I jumped around and jumped around and jumped around until one day it dawned on me that it just wasn’t the right fit for me. It was not the issue of any specific job. It was that maybe I didn’t belong in patient care.
Allison Jones: You had shared a couple of stories with interactions with your patients that were the turning point. Do you mind sharing those with us today? What were those interactions like?
Dr. Meredith Castin: Sure. Well, there were quite a few interactions that made me feel like this wasn’t the right fit for me, but a few really stuck out. One of the patients in an outpatient clinic had an accident where he made a bowel movement on the gym floor, which is not a big deal. It happens to people. He was an older gentleman, and it was gym shorts. I went to clean it up because it was a distraction to the other patients and therapists.
I remember somebody said something like, “That’s not your job.” Instead, we had to sit there and shut down the entire clinic and stare at it through the glass charting window until maybe hours later, someone came and cleaned it up. I remember thinking how wasteful that was on so many levels and how silly it was that I couldn’t just glove up and throw it away. I mean, I’m a cat owner, so I’m used to these things. It’s not a big deal.
That was one moment, and it was more an indication of how I felt like the system was just so broken. But the one that really broke me and made me feel like I can’t do this anymore was when someone threw something at me. It was one of those hard plastic gate belts that you use in the acute care setting. It would be one thing if the patient was confused or had something going on mentally that could justify just chucking something at a therapist like that, but it was a perfectly coherent VIP patient, a CEO, and he was just being a jerk because he could.
I just realized that I could never be happy in a profession where I had to do so much schooling and had to pay so much money and had to really put my heart and soul into taking years out of my life in my twenties and thirties to get where I was, only to have someone roll in who’s like a “VIP” and throw something at me with no recourse because the patient’s always right, and patient satisfaction scores are king.
In that moment, I realized it’s a lack of respect from management, patients, and coworkers. The nurses were very sweet and kind and let me cry at the nursing station after that because I was so upset, but other than that, I just felt profoundly disrespected by a lot of the system. I thought to myself, this is just the last straw for me. It was just that moment where everything broke. I realized I couldn’t do this until I was 65 or 70.
Allison Jones: These are pretty common themes among PTs looking to transition out of those roles. A lot of red tape issues, they’re tired of waiting around for somebody else to take care of something that’s pretty straightforward and easy to address. Then there’s the issue of respect and workplace violence. Healthcare is probably one of the professions that has a lot of workplace violence issues today. those are two themes that a lot of our listeners can relate to and maybe have experienced themselves in their workplace today.
You could have left PT altogether; you could have left the therapy world entirely. But instead, you decided to start The Non-Clinical PT. Why did you do that?
Dr. Meredith Castin: Well, it’s interesting, because for me, I don’t really feel like I could have easily left PT because even though I had a prior profession, I had been a graphic designer and web designer, and I did a tiny bit of writing at this job I had for a couple of years before PT school. I just felt like it was really hard to get back there. I remember calling my old bosses and asking around, and it was just a lot harder to get back into my old profession.
There was also a part of me that was like, “I’m still making a little bit more as a PT.” It felt like I was moving backward to just call up my old bosses and see if I could come back and get my exact old job back and be in the whole financial—so there was this part of me that was thinking, “I’ll do that if I have to because I really don’t think I can continue in patient care,” but it wasn’t working anyway.
What ended up happening is I struggled for quite a while, and I have a sister who’s a career counselor and career coach, so she really knows this stuff, but what was happening in that moment is that I didn’t know what I wanted to do next. I had no idea what I was even trying to do. You usually have to work through these things, and it takes multiple sessions with coaching and everything.
My sister was giving me these great pieces of advice for how to update my resume for certain jobs, but I had no real focus because my focus was desperation. I was trying to get out of patient care as quickly as possible so I didn’t have to cry after work every day, which was starting to happen. As this got worse and worse, I just started throwing spaghetti at the wall and hoping something would work.
I remember taking one job where I was getting paid like $15 an hour to try to connect with PTs at different hospitals. Then when I would try, it was just a really weird situation where I was hired in November, and then they laid me off in December three weeks later, but that was because they ran out of their—I don’t even know what the name of it is, but you would probably know in marketing. It’s like a contractor budget that big companies have. At the end of the calendar year, that runs out.
I hadn’t even barely gotten a chance to do anything, then I was already laid off, even though I was just a contractor anyway. That was really demoralizing because I was not making any money anyway, and they literally just onboarded me and showed me the facility and been like, “Here’s your badge.” Then within probably three days, I was laid off. That was upsetting.
I remember at that point, just getting desperate and saying, “Anybody who’s got any ideas, please come to me, tell me.” I was telling anybody and everybody who would listen. I was working over Thanksgiving one time, and my coworker said, “Well, I want to start this blog as part of this other business that I’m starting with my friend who’s an optometrist.”
He asked me if I like to write, and I said, “Yes, I love to write. I’ve just never done it really professionally except a couple of little projects I helped out on a couple of years ago before PT school.” He was like, “Well, let’s see what happens. We don’t have anybody who likes to write, so try it out.” I ended up starting out blogging with him, but that was an unpaid thing. It was completely just launching this website on the hopes that it would maybe work out someday.
Simultaneously, I applied to a job for a rehab liaison, and that was a PRM position. That one is the one that I consider my first non-clinical job because even though I never got a call back from management for it, I knew someone working at that hospital. I called her up and I was like, “Please, anything you can do to get my resume noticed.” She was able to pass it on to the hiring manager.
That’s where I talked to my sister, who’s a resume expert. She said, “Oh, okay. That’s because it wasn’t optimized for this particular position.” It was a situation where I realized too late that I hadn’t even put my resume together the right way.
All of these things were all coming together to where I did land this position, and I did start blogging. It was all so wonderful. But at the end of the day, I was still in healthcare, and it just turned out that I stayed in healthcare.
Then I started The Non-Clinical PT when I decided to actually leave healthcare, probably like two years later when I decided to leave. I wanted to just go be a writer, and I took a job at a content agency. I started The Non-Clinical PT because I kept getting emails from people who found me on LinkedIn or they found me through that blog that I was working on. They wanted help creating their path out of patient care.
I started The Non-Clinical PT because I knew when I leave this particular job where I’m blogging, people are going to miss being able to reach out and ask me questions about their resume, about their cover letters.
It’s a long story, a long answer to a short question there.
Allison Jones: Okay, great. It was just a need. There were other people who were in the same situation, and they saw that you were successful in making that transition, and they said, “How do I do it? Help me.”
Dr. Meredith Castin: Yes, definitely, because everybody was struggling at this point. In one way, it was easier because there were far fewer people trying to make the leap out of patient care, but on the other hand, it was much harder because nobody knew what was out there. These days, it’s pretty easy to find out what your options are, but back then, there was just nothing, so you’re just completely guessing.
Allison Jones: Is that because it’s not part of your curriculum when you’re going through school, it’s not part of becoming a PT, they don’t teach you the business side or how to transfer those skills? Is that part of the reason?
Dr. Meredith Castin: Yes, that was part of it because when you’re in school—I can’t speak to it now because it’s been like 13 years at this point—but there was nothing in our curriculum that had to do with anything non-clinically related except one class called professional communication, which I loved. That was my favorite class, which should have told me something. Then the other one was some business plan class where we had to put together a business plan for a clinic, so we weren’t even exposed to the idea of doing anything else.
Of course, we knew we could go into management or education because our professors were clinicians. We realized on clinicals that our managers were often clinicians, but that was about it. that was a big part of it. We just weren’t exposed.
Then there’s also a bit of shame involved. Even some of our professors would say, “Oh, well, I teach, but I still work in the clinic. I’m not a sellout.” They would say stuff like that, where they would follow up by saying, “I’m not a sellout.” I would have never thought they were a sellout by becoming a professor, but by having to say that at all, you’re going, “Okay, what is this? What’s going on here that makes someone feel like by leaving clinical care, there’s something wrong with them?”
Maybe they didn’t say “sellout” in that particular term. I heard “sellout” used when a Dynasplint rep came in and was selling some of their elbow immobilizers. I heard it thrown around there, “Oh, sellout, going into sales.”
With professors, it was more like maybe out of touch or something, but it always seemed like there was some negative connotation to leaving patient care. Not many people were doing it, so the few that did, the people gave them this raised eyebrow, “Why would you do this?” I just don’t think it was ever even something any of us considered.
Even when I started to confess to my coworkers and to my classmates, “This isn’t right. This doesn’t feel like a good fit for me. I don’t know what I was thinking. I don’t think this is the right career for me.” Some of their reactions were pretty negative, and so it was just a different time. That was back in 2015 when I wanted to leave, so that’s already been eight years, but it was just a completely different environment and a completely different response from my colleagues, from my professors, from anybody I mentioned it to. Everybody was like, “So soon? Oh, you wasted the spot for somebody else in the PT school class.”
Allison Jones: Do you think that sentiment has changed now? Do you think there’s more of that acceptance of, “Yes, there are going to be some people who have gone through this process,” and then realize, “It’s not quite for me, but let me see if I can find something else where I can still use some of these skills, but in a different way that benefits therapy.”
Dr. Meredith Castin: Oh yes, it’s changed so much in the past eight years. It’s pretty shocking because I think about it all the time and how people will brand themselves on LinkedIn as a non-clinical PT. They’ll actually call themselves that in their headline, so when you see those people proudly using that expression in a LinkedIn headline, things have changed. It’s been really cool to see people more accepting of it.
I think a lot contributed to that. We had some major reimbursement cuts at the end of 2019 and the beginning of 2020. Then obviously, we had something big happen in 2020, the pandemic. With all the furloughs and layoffs that came with those two things, along with people feeling unappreciated and unsafe during COVID and not being given the protective equipment that they needed, a lot of people hit their breaking points.
Once, there was this mass exodus and the Great Resignation during that era, between 2020 and 2021, now it’s just become accepted. I’ve even met some students, who come through and say, “Hey, I’m already thinking about what I can do after I practice for a couple of years.” Back then, it was only if you had a traumatic injury or something where you couldn’t practice anymore that it was considered professionally acceptable to leave patient care.
Whereas now, there’s a very non-clinical career, maybe in rehab technology or anything else, public health perhaps, while you’re still in school. That, to me, is really cool.
Allison Jones: Something that I want to stress here is that leaving the clinical role and choosing to do something in a non-clinical capacity is still a very good thing. There’s still a lot of things that you can do that have a very big impact on the therapy industry.
Dr. Meredith Castin: Yes, I’m really glad that you asked it that way because that’s what draws so many people into becoming a PT or an OT or an SLP. You want to make an impact. There are many ways to make an impact, but many of us were sold on the idea that when you’re in healthcare, you’re doing—for lack of a better term—the Lord’s work. You’re doing really good work and you’re making such a profound impact on people’s lives.
That’s what a lot of people, myself included, grappled with initially when leaving the concept of leaving patient care or healthcare. That was what made me want to start my business, I felt like we have so much to offer in a really broken system. If we go back to the patient-pooping-on-the-floor story, it’s a broken system where someone cannot glove up and safely document that they just got rid of some feces and move on with their day. It’s broken in so many ways.
I look at these therapists who have moved into the coolest roles, including at your company. There are people working on EMR platforms and doing product management and doing customer success. There are just so many ways to still make an impact on healthcare, whether it’s helping other clinicians have a better day because their EMR runs more smoothly, or if it’s helping patients because you’re helping clinicians indirectly or directly, or you’re doing public health, so you’re still really working with patients, they’re just not called patients, they’re called clients or the population.
Ther are just so many ways to make an impact while still leveraging your degree without feeling like you’ve somehow wasted your education. While I have the mic in front of me, I want to add you can go leave healthcare altogether and do something completely different. It’s still not wasting your education because you learn essential skills of how to deal with just about every personality type. You can communicate extremely well. You can collaborate, have time management skills, utilization of resources.
There are so many transferable skills, and the problem-solving that we develop as clinicians is top-notch, so you can take those skills anywhere. You don’t have to stay in a “non-clinical” healthcare role. But I like seeing clinicians stay in those roles because we have such a broken system. It’s just really nice to see rehab clinicians who care, who are really hard workers, and who are really good problem-solvers try to tackle this broken system.
Allison Jones: Absolutely. You touched on it a little bit, but let’s call this out as a very specific question. What examples of alternate career paths have you helped PTs find?
Dr. Meredith Castin: many. It’s too many to list because even though I have an online course where I group them into 25 career paths, each of those career paths has multiple routes you can take and all sorts of different job titles in those career paths.
The ones that stand out as the popular ones right now are customer success. I think one of the reasons that one stands out is that you don’t need a ton of extra education to get there. It is becoming more competitive recently. It’s recommended to sometimes take some additional certification or an online upskilling program. But it’s pretty easy because it’s mostly customer-facing in the sense that you partner with customers to help them get the best possible experience from working with whatever product or service you’re representing as a customer success professional.
That one’s really cool. It’s a really easy transition for clinicians. Then some other ones—I’m using the trendiest ones because it changes over time. Medical sales went from being something that people were really scared to do and felt a lot of guilt about doing because that’s one that, again, I kept hearing that term “sellout” attached to it. But now people are embracing it and realizing that we are the exact people who should be selling a lot of the products that we’re encouraging other healthcare providers to buy.
We’re also proving to be excellent salespeople and also clinical trainers or clinical specialists, which is a hybrid of sales and training, so a lot of these jobs overlap. That’s why I think of them as career paths rather than siloed different ways you can go, but there are a lot of different directions you can go where you are required to have a clinical license.
Clinical specialist or clinical trainer would be one of those. You might work for a robotic exoskeleton company or another rehabilitation technology company that comes out with a new upper extremity piece of equipment for stroke patients, perhaps. You have all these options, and then someone’s got to get out there and sell this equipment. Someone’s got to get out there. That would be the salesperson. But someone’s also got to get out there and iterate and say, “Okay, well, we tried it, and it turns out that the switch really needs to be on the other side of the device.” That might be someone more like a user experience professional.
Then there are other roles that also come into play like product manager, and some of these user experience and product management, you definitely want to have some more education and more upskilling, even more so than customer success. But whenever people balk at that and they say, because I hear some people say, “Oh, I’m never putting another cent into my education,” or “I’m not spending another moment in school.”
Believe me, I’ve said the same things. But you have to look at it like, “Well, then you never would have become a PT if you didn’t invest in your education.” You can’t expect to waltz into a completely new career path without a little bit of upskilling. If you do want to do that, you do have options, but those options are exceedingly competitive, and you might not always enjoy them.
Another one that tends to be pretty popular is a utilization reviewer. That one’s one of the ones that can be very controversial because when you’ve worked on the clinical side of things and you’ve worked with insurance companies where sometimes your claims will get denied or you have to really fight to get visits for your clients, for your patients, that can really put you in a sour mood toward utilization reviewers.
Technically, what they’re really meant to do is make sure that patients are using the amount of visits that are deemed necessary from clinical practice guidelines but what happens is, sometimes, these clinical practice guidelines are developed by other utilization reviewers who maybe haven’t treated patients in years, so it might turn out that you probably want more visits than they’re saying.
It’s just a difficult conversation. It’s a difficult topic. It’s a very controversial career path, but that is probably one of the easiest ones to literally just leap right into because you do need a clinical license. Some will hire clinicians, some will hire assistants, just depending on the company. You can literally just transition right in if you have the right background and can speak to your skills accordingly.
But then you find some of the same issues that we have in clinical care. Your time is very much documented and watched carefully. It’s not always the most flexible role. Sometimes there are high productivity requirements for how many charts you review per day.
I often tell people it’s just leaving patient care for the sake of leaving patient care because you’re unhappy is a really bad approach. Think about it from dating or anything else. When you’re sitting on a date with somebody, you don’t want to hear, “Oh gosh, my ex was so awful and blah, blah, blah. He was smelly, he was mean, and he hit me. That’s why I’m out on this date.” No, you want to hear why the person wants to be on a date with you.
That’s what I always think about with job searching. You’ve got to be excited about your next path. Part of getting excited about it is testing it out and interviewing people and asking them how they like that path and shadowing and taking some upskilling courses. You can get some really low-cost upskilling courses online.
Get out there and check it out and do your hours like you did for therapy and make sure that you’re making the right decision and don’t just jump into something else because it’s not patient care, because that’s usually not going to be a good fit for you. There are a lot of other routes you can go that are fairly easy to get into that people don’t really like.
Allison Jones: I would think that doing a bit of self-assessment before choosing your next career path would be really important. Figuring out what you liked and what you didn’t like, and then looking at potential alternate careers to see how that aligns with helping you find the right next fit.
Dr. Meredith Castin: A hundred percent. That’s how I coach people to do it, primarily through my online course, but that’s basically what we do. We take a four-step approach.
The first step is devoted entirely to why you are leaving. Not just why you are leaving, but also what could keep you in patient care. You want to know those things too. There are certain aspects of patient care that I didn’t realize I would miss so much until I didn’t have them anymore. One of those things being that the day goes very quickly.
So, sometimes you need to sit down and think, “What do I love about this? What do I not like about this,” or even hate about it—for a stronger word? But also, what comes easily to me and what is a real challenge? Because some people find that time management is a real challenge. But then you have to unpack that deeper and say, “Well, is it time management or is it unrealistic productivity expectations?” Because a lot of us are actually incredible time managers. It’s just that we’re set up in a system where no matter how good you are, you’re never good enough.
Looking at that strategically and thinking, “Not just in my professional life, but in my personal life, what do I like to do?” I know a lot of people who love finance; they do finance stuff in their free time and they use spreadsheets and everything. So, those are skills you can take to another job. If you know how to do a financial spreadsheet, you’ve got Excel skills. Those are very valuable in all sorts of roles. I see you nodding with marketing. Yes, that’s a great skill to have.
Allison Jones: Absolutely, data analytics is very valuable. Another thing that we had talked about is there’s a lot of career coaches out there nowadays, so maybe not when you first started this way back in 2015, and you were making this transition and started The Non-Clinical PT.
Today, there’s a lot these career coaches out there that claim they can help you with your changing career. There’s a lot of information out there for PTs looking for a career change. Some are trustworthy; others may not be as trustworthy. For our listeners out there, what are some of the things that PTs need to be aware of when they’re exploring assistance in making a career path change?
Dr. Meredith Castin: This is a good question. I’m glad you asked this. Basically, there are some red flags to look out for. If you’re hanging out in a lot of Facebook groups, people immediately recommend something, and then they say, “Mention my name or drop my link.” It’s fine if somebody says, “I recommend this program. It really helped me. I am an affiliate for the program, which means that I have financial compensation attached to this,” and they’re transparent with it.
It’s just that most people don’t admit that, and they’ll say something like, “Oh, this is such a great product,” or, “This is such a great coach. I worked with them,” or, “This is such a great x, y, z. Use my link.”
Referral or affiliate marketing can be done very professionally. I’m an affiliate for MedBridge, a couple of courses that I’ve personally vetted. I’ve taken those courses, ensured that they are not some pyramid scheme or multi-level marketing deal.
But not everybody is looking for it, not everybody is looking out for those pyramid scheme types of things. I’ve even had people call me a pyramid scheme because there are so many out there. People have started to assume that anybody who’s online, running an online business trying to teach therapists anything, is sketchy.
So, it is frustrating as a business owner who’s always tried to be on the up and up and always really tried to overdeliver. It’s frustrating that I have to sit and be like, “I’m not like the snakes,” but there are just red flags to look out for someone who’s just trying to figure out: is this coach legit?
First of all, look at them. Have they been successful? there are a lot of people who have gone through some training program for maybe entrepreneurship or any career change, or it could be anything. Then all of a sudden within days or in months or something, they’re trying to get other people to come into the program, or they’re trying to teach other people without even having spent more than maybe a couple of months doing something.
I see this a lot with the cash-based business world more than the non-clinical world. I haven’t seen too much sketchiness in the non-clinical world, although it is out there. Another sign is someone who’s constantly doing something else or selling something else.
So, if they’re one day teaching you marketing techniques online, like how to use a website or Facebook ads or Instagram, then the next day they’re doing a branding coaching program, and the next day a financial well-being or CEO training. You’ll start to see signs of people selling something or offering something new constantly.
Then it tells you, what are they the expert at? What are they really knowing? What are they spending their nights and weekends learning about? You can’t identify that because they’re constantly changing. Those are the main red flags, like somebody asking you to DM them in a Facebook group for more information. That’s usually going to be a pyramid scheme.
Or if they say, “Oh, I love this thing so much. Here, use my link.” Then you see a bunch of people dogpiling with their own links. It’s funny because Medbridge is a very respectable company, but they’ve traditionally relied a lot on affiliates to promote them. For a while there—I don’t know anymore because I don’t hang out in Facebook groups as often as I did, except for my alumni groups—I know there was a time where in some of the doctors of PT groups, someone would say, “Hey, what CEU provider is the best?”
Then everybody would be in there with their affiliate codes trying to beat everybody else just like drop mine. Again, Medbridge is a good company, so it doesn’t necessarily mean that the company is bad. Just buyer beware because there are businesses that use that same strategy that aren’t Medbridge, and they’re not good, and they really do operate on a scheme of getting someone into this expensive program. The person takes the program, recruits somebody else in and earns like 50% of the recruitment scheme to pull the next person in.
Then you start to wonder who’s actually succeeding in this and whose success is coming from just recruiting more people into this program. Those are the main red flags.
Then anybody who has really not been out doing something for at least maybe two years or so and successfully doing so and trying to teach entire courses on it, it’s a little bit more suspect.
Allison Jones: Great advice. Bottom line, do your research, and you should be okay.
Dr. Meredith Castin: Yes, there are a lot of really good coaches out there in this non-clinical space too. I don’t mean to come across at all like they’re not good because plenty are good. Just like exactly what Alison said, do your research, ask around.
One time, I’ve used a coach, it was a spectacular experience, and I asked for a ton of references before I worked with her. That’s what made me feel comfortable because there were people who had found the exact success I was looking for because of their work with her. So, just ask those questions, don’t be afraid to ask for references.
Allison Jones: Yes. References are a great. They’re a great way to verify a company. If a company’s not willing to do references, that’s usually a telltale sign. Any final thoughts for our listeners today?
Dr. Meredith Castin: Yes, my final thoughts for anybody listening are, first of all, thanks for listening. Also, if you’re wherever you are in your career, whether you’re still a student, early in your career, quite experienced, mid-career, don’t feel bad if you want to change. Don’t feel bad if you don’t want to change either.
If you’re perfectly happy and it feels like the hot thing right now is to leave and go non-clinical because everybody’s talking about how much money you can make, but you like what you do, stay put. It’s your life to live. That’s what I always want people to understand at the end of the day. I wish, when I was having this reckoning moment, that everybody had been a lot more kind to me for wanting a change.
I want everybody to know that it’s okay to have a change in your life. It’s okay to not want to change in your life. It’s okay to think you don’t want to change and then decide you do want to change. It’s just like having kids. You might not want them and then change your mind, or you might think you want them and change your mind and not have them after all. We are all our own people in this world, and your career path is your business.
Please don’t let what other people say impact you or make you feel bad. If you’re picking a career path, even if you leave patient care, that isn’t the hot one or it’s not going to make as much money, it doesn’t matter because hopefully, you have done the work to identify what really matters to you and is going to make you happy as a non-practicing PT or practicing PT or any other clinician.
Allison Jones: Excellent. Thank you so much, Meredith. Follow your passion. That’s the bottom line. Thank you so much for joining us today. We are out of time but thank you to our audience for tuning into the Therapy Matters podcast, your one-stop resource for expert insights and advice on everything therapy and rehab. We look forward to seeing you on the next episode.
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