5 Qualities of an Excellent Physical Therapist

As in all professions, physical therapy has excellent clinicians and it has poor clinicians. That probably means different things to different people, but as a consumer or potential patient, you ought to know what to look for. I offer five criteria beyond “good listener” and “compassionate” and do not plan on regurgitating the core values of the APTA (although these are great attributes to have); but think there are several distinct standards truly “excellent” physical therapists uphold.

1. Perpetual student: This may seem obvious: more educational courses, certifications, etc. equals better clinician, right? Well, that’s not even what I am suggesting. Think beyond continuing education credits. I’m saying any physical therapist who does not put forth a consistent effort to personally educate themselves tends to work themselves into a practice pattern “rut” which typically translates into substandard care. Enter therapeutic ultrasound, tiger balm and bumpy ball. Conversely, journal clubs, continuing education courses, board certifications are all footprints a perpetual physical therapy student might leave.
   
   What this PT might look like: Their coffee table at home is covered with PT-related magazines and the last “vacation” they took was a three-day course geographically somewhere that brought them back less tan than they already were. With several proven treatment techniques as a foundation, this physical therapist will be eager to try something they just learned with you. End result, your new physical therapist is a bonafide nerd, but you should love them for it.
    
2. Critical thinking: Believe it or not, not all conditions present the same for all patients. A teaspoon of Sherlock Holmes in your physical therapist is a good thing to deduce cause and the best strategy for resolution; neuromusculoskeletal conditions are much more quantum physics than arithmetic. Some Holmes-esque witty banter is an added bonus.
   
    
   What this PT might look like: If you are coming into a session for your shoulder pain, expect this physical therapist to assess everything from neck to hips likely leading to a conclusion that makes sense to you, caused by a deficit you weren’t aware of, and with treatments and corrective exercises you didn’t expect. End result, your shoulder will feel better, but remember that back pain that has bothered you on and off for years? Yeah, that’s better now too.
    
3. Personal experience: Not necessarily years of experience, but personal experience. A physical therapist who is or was an athlete will manage athletes more effectively, a runner will relate better to runners, dancers relate to dancers. You won’t always find a physical therapist who has had the same surgery, injury or condition, but being cut from a similar cloth goes a long way with the therapist-patient relationship.
   
   What this PT might look like: Typically with some battle scars of their own to compare, he or she seems to have an uncanny ability to explain what your condition feels like with minimal information. End result, your recovery will likely be more focused, sport-specific and dare I say more “fun.” Needless to say, you will feel as though you are in great hands.
    
4. Passion: It seems cliche and this characteristic may be a bit more subjective than the rest, but it’s a palpable enthusiasm that can’t be taught, trained or tutored. Knowledge, intellect and expertise sans passion will essentially translate into a boring, booksmart physical therapist. Knowing the in’s and out’s of cadaveric anatomy or randomized controlled clinical trials doesn’t necessarily correlate to a better therapist. But it seems passion for the profession, proficient practice and ultimately your well-being as a patient does translate into a more effective clinician. You may not be able to find “passion” on Yelp ratings, but it is most definitely a quality to seek out in a potential physical therapist.
   
   What this PT might look like: Aside from ongoing conversation about evidence-based practice topics and athletic injuries around the office; this physical therapist brings up PT-related matters at the baseball game, gym, brewpub, family get-together, dinner date - you get the idea. They may or may not have an “I <3 PT” or “Anatomy Rocks” shirt, but nothing gets them going like a conversation on PT versus surgical management.  Obnoxious? Possibly. Passionate? Undoubtedly. End result, maybe not the most fun during game night, but you want this physical therapist in your corner when you are dealing with pain.
    
5. Communication: I must admit this is the quality I struggle with at times. I personally have a more subdued personality, but that’s not the ‘communication’ I’m referring to. I speak on translative communication versus motivational communication. To clarify, I’m not saying a physical therapist who cheers on every single miniband sidestep you take is a better clinician. I’m alluding to the open, concise and coherent communication of the contributing factors of your injury and how the treatment plan will correct those factors. My personal struggles come when I try and detail a pain response containing C fibers, neuroplasticity, fear-avoidance behaviors and proper biomechanics to a patient simply asking why their low back is still in pain.  It’s a slippery slope that can leave a patient feeling like they are trying to sip from a firehose. Knowledge is power, but only if that knowledge can be delivered to the patient through an effective communication.
   
   What this PT might look like: They encourage questions and can typically tell from the look in your eye if they are drowning you with jargon or if you were looking for more. After inconspicuously correcting that the “lateral dorsimus” is not actually a muscle they will have you reciting entry-level anatomy by your third session. An Australian accent wouldn’t hurt either. End result, maybe they give you more information than you asked, but it makes sense and can make you feel like an expert on your injury when all is said and done.

There are certainly excellent physical therapists of every background, practice pattern and philosophy and by no means do I suggest this list of qualities as an exhaustive checklist of a competent clinician, but rather a set of consistent characteristics I have observed in respected mentors and admired professionals in our field. As always, feel free to share your thoughts or post a list of qualities you feel an excellent physical therapist should demonstrate.

What other qualities would you include as essential to an excellent physical therapist?

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About the Author: Dr. Paul Killoren is a member in both the American Physical Therapy Association (APTA) and the American Academy of Manual Physical Therapists (AAOMPT). He is also a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA).

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