Why I Still Work in the Clinic: Lessons for Coaches from a Physical Therapist Who Won’t Fully Leave

“Am I a doctor? Or am I a customer service agent?”

Yes. And strangely, that’s why I’m a better coach.

There’s a growing trend in physical therapy right now: leave the clinic, escape the grind, start coaching full-time. And I get it. The high volume, the never-ending charting, the pressure to bill more with fewer resources it can all feel like a treadmill I didn’t sign up for.

My path however, is slightly different. I’ve chosen to stay, enough to keep my hands firm and skills sharp.

Two days a week, I’m still in the clinic treating, documenting, navigating insurance, and working with people from all walks of life. And while it can be exhausting, I’ve found that maintaining a clinical presence offers unexpected advantages to those of us who coach.

This post is about those upsides.

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1. Volume Builds Pattern Recognition (and Perspective)

High volume isn’t glamorous, but it’s the repetitions lead to mastery.

Every patient I see sharpens my ability to quickly assess, triage, and act. Over time, I’ve developed an intuitive sense for movement patterns, pain behaviors, and subtle compensations that often go unnoticed.

Beyond the diagnostics, the human skills are among the most valuable.

• Can I connect quickly?

• Can I make someone feel seen and get them out on time?

• Can I guide someone toward goals they didn’t even know they had?

These are not theoretical questions. They are daily practice.Take, for example, a recent patient, an industrial worker recovering from a distal biceps tendon rupture. On the surface, the goal was clear: return to work. Emerging conversation revealed something deeper.

“How long until I can shoot my bow again?” he asked.

This man, nearly 300 pounds, was a nationally ranked competitive archer. Archery was his passion. He had already modified his compound bow to make it lighter so he could get in reps, even at the expense of accuracy. Once I understood that, our plan changed.

We tailored his rehab to prioritize mobility, spinal control, breathwork, and lower-body strength.All this, through the lens of preparing him to shoot again. We talked nutrition and swapped recipes using fresh garden veggies. He lost 50 pounds during his rehab, gained elite thoracic control, and returned to work on the fastest possible timeline.

When his formal PT ended?

“I know you coach athletes,” he said. “Would you consider coaching me?”

Challenge accepted.

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2. Paperwork Forces Clarity and Reflection

Charting is one of the most draining parts of clinical practice,but it’s also one of the most underappreciated tools for growth.Every note is a moment to pause and ask what has changed, did this intervention work, what is the next best move? That kind of structured reflection refines clinical reasoning over time. It also improves communication with other providers, with insurance companies, and most importantly, with yourself.

In coaching, I see the ripple effects:

• I write better check-ins.

• I think more clearly about progress and regressions.

• I’m able to justify decisions based on actual outcomes.

Documentation has made me a better communicator. It’s tedious, yes, but it’s also a form of intellectual sharpening. And that pays off in every domain.

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3. Doing More With Less Makes You Creative (and Compassionate)

In physical therapy, you don’t always get the luxury of ideal equipment, time, or space. But over time, that constraint becomes a gift.

It reminds me that:

• Motor control matters more than load.

• Breathwork matters more than gadgets.

• Visualization can be as powerful as VO2 max testing.

With one resistance band and a yoga mat, I’ve helped people rediscover movement. I’ve witnessed them feel safe in their body again. No tool can replace that.

There’s no billing code for compassion. No CPT code for “made the patient feel understood.” Energy, human connection, it changes everything. It transforms outcomes, and it carries directly into coaching. Coaching at it’s core is about trust.

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To the therapists who wish to start coaching

You don’t have to leave the clinic to become a high-level coach, and you don’t have to quit coaching to be a high-level PT. In fact, the two can (and should) inform each other. The clinic teaches rhythm, restraint, nuance, and humanity. It forces creativity, precision, and patience. It introduces you to people you’d never otherwise meet, and stories that shift your perspective.

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To the athletes who’ve battled injury, overcome obstacles, or perhaps just need an extra bit of help to tip the scales in their favor. Consider getting a coach. A coach who’s also in the clinic, might be your perfect fit. We don’t currently have any coaching availability, but will have spots open again soon. Apply today for customized coaching through the Altiva team.