Ever since my 2 year old daughter was born, I have taken a long hiatus from writing (she’s quite a handful!). Despite my absence, I have been so encouraged by the emails that I have received from physical therapists (PT), PT students, healthcare colleagues, and students from other professions who have contacted me about their own career. I have been emailed by countless people from inside and outside the PT profession, asking about how I ended up where I did. Regardless of branching into another profession or not, making tough choices about your career is arduous and challenging. Each set of decisions have their own set of benefits and consequences. It can be difficult to navigate which path to take; consequently, they almost always ask me these questions:
“Why PT AND Nursing?”
“Why did you become a Nurse Practitioner vs. a Physician Assistant?”
“Why did you choose to not go to medical school?”
“What made you decide to not pursue a PhD/DSc?”
I was honored to be interviewed by Dr. John Childs and Dr. Mark Shepherd on the Evidence in Motion (EIM) Clinical Podcast (click here if you’d like to take a listen). We discussed a variety of topics, which included some of the questions listed above. These are all good questions. My simple answer to these questions is this: do you. Look in the mirror and realize that you are your own person with your very own unique potential. If you read my first blog post, you’ll know that I wanted to be a history teacher like my father. I wanted to be a high school teacher up until my senior year of high school. I had zero interest in science and medicine. It wasn’t until I was assigned to do a research report on another profession that PT came into my cross-hairs. I took a leap of faith, applied, and was admitted to a Doctor of Physical Therapy (DPT) program. Classes like exercise physiology, pathology, pathophysiology, and pharmacology opened my eyes to a passion that I didn’t know existed. All I could think about was medical science. During my 2nd year, I contemplated the idea of leaving PT school altogether and applying to medical school. I had many discussions with my girlfriend (now my wife of 8 years) and my parents, both strongly urging me not to quit school. I was at a crossroad because I only had one year left before finishing. After much prayer and meditation, I realized that I had not fully given PT a chance: I hadn’t even finished the program or went on a clinical rotation yet. I decided to finish PT school and I discovered that I had a strong passion for orthopedics. Upon finishing my doctorate, I pursued a full-time orthopedic residency to sharpen my clinical decision making and learn from the best. I was mentored by board-certified orthopedic PTs, orthopedic physicians, sports med physicians, and radiologists. I soaked information up like a sponge: I relentlessly immersed myself in research and spent time honing my craft. I worked long hours and enjoyed every minute of it; to this day, it was one of the best decisions I’ve ever made for my career.
Even though residency was life changing, thoughts of continuing my education still lingered in the recesses of my mind. I slowly realized that being fully immersed in orthopedics and sports medicine was not sufficient for me. Seeing patients with complex medical conditions made me want to provide care across the continuum, not just rehabilitation. Nothing stuck out to me like primary care: a world where you see everything and anything. My passion for primary care continued to grow and I knew I had to do something. My ambitions were itching at me daily and I couldn’t stop thinking about it. I spent hours and hours researching different careers, weighing the pros and cons of each one. I eventually narrowed down my decision to MD/DO (hello again), PhD/DSc, PA, and NP school. I had all the necessary prerequisites for all the fields. The idea of getting a PhD/DSc dissipated, as I did not foresee myself dedicating my life to research. I realized that I needed to pick something that directly impacted patients in an interpersonal way (research undoubtedly impacts patients, just not in the same capacity). I was accepted into PA school, but I did not like the job prospects outside of clinical practice. The outlook for hospital administration and leadership positions didn’t seem as promising. MD/DO eventually went back to the top of the list and it was within arm’s reach. To solidify my decision, I reached out to two of my wife’s cousins, both of which were physicians. Shockingly, their answers to me were quite surprising: don’t do it. I was surprised, as I thought they would have encouraged me to pursue this noble profession. I thought to myself “Isn’t a medical doctor at the top of the healthcare hierarchy?” “Isn’t being a physician the ultimate career achievement?” Am I reaching my true potential if I don’t go to medical school? We discussed the cost of tuition, lost income while being in school for 4 years, quality of life in school, red tape and politics that hamper physicians, and most importantly, my family. My good friend’s father was a world-renowned physician, and I remember asking what it was like being the daughter of a physician. She told me she absolutely hated it, so much so that she doesn’t want to marry a physician. Even though he was a tremendous husband and father, he was so busy with his practice that he did not get to spend much time with his family. My daughter is 2 years old now and it has been an absolute privilege watching her grow up. If I had chosen medical school, I would not have had the same opportunities to spend time with her. Those are times you can’t get back. Unexpectedly, my good friend’s father who was a physician passed away from a heart attack. He is survived by his wife and three daughters. His passing made me think about my life a lot. If you haven’t read When Breath Becomes Air by Paul Kalanithi, read it. The theme is eerily the same. Being a physician did not trump spending time with my wife. Being a physician did not trump spending time with my daughter. The physical, social, and psychological sacrifices that physicians make are real. Other disciplines make significant sacrifices as well, just not to the same degree (in my opinion). Would I have been a great physician? I think so. Would I have been average relative to my medical school counterparts? Maybe. Possibly. I’ll never know. What I do know is that medical school wasn’t for me. It’s not for everybody. Becoming a physician may be the pinnacle achievement for someone else, but that doesn’t mean that’s the prize waiting for you at the top of your mountain. Just like anything else in life, it’s a calling. You’re going to regret it if you weren’t meant to be there in the first place. Please don’t misunderstand me: going to medical school and becoming a physician is a great career path. I know many physicians who absolutely love what they do. The question is…what do you value and what sort of sacrifices do you want to make? Our decisions always have a trade off and that’s important to remember.
Ultimately, I decided to pursue the field of nursing. Many colleagues and classmates who found out about my decision felt like I was taking a step backwards: “You’re going to become a nurse? Why would you do that when you have a doctorate in PT?” “Won’t you get paid even less as a nurse?” Sometimes in life you have to take a step backwards in order to move yourself forward, whether it’s financially or psycho-socially. You have to hit those bumps in the road to get to your destination. There’s no way around it. I became an emergency department (ED) nurse and learned how to treat, stabilize and manage the sickest of patients. I learned from the best and was mentored by wonderful ER physicians, nurses, NPs and PAs. While practicing as a PT and as an ED nurse, I continued my studies and became a family nurse practitioner. I now practice as a Nurse Practitioner + Physical Therapist hybrid in primary care. Having a background in all three disciplines has equipped me with a well-rounded skill set that is valued by my patients and colleagues. I get to incorporate all of my interests into one setting: family practice, emergency medicine, orthopedics, sports medicine, and strength and conditioning. There is mutual respect between me and the family physicians I work with: they teach me about family medicine and I teach them about orthopedics. We respect one another and fully understand what each person brings to the table. The beauty of our team is that we all know what we don’t know. We know our limitations. There are no egos. There are no pompous attitudes. They call me their equal and I am honored.
So why did I pursue physical therapy AND nursing? Because I want to carve my own path. I want to be different and travel on uncharted territory. I want to reach my own potential and not travel in someone else’s footsteps. I want to be the greatest PT + RN + NP hybrid that I can be. I am inspired daily by my MD/DO/NP/PA/DPT/PhD colleagues, but my goal isn’t to be them. The great Kobe Bryant once said to outwork your potential. This is one of my favorite quotes because it highlights the importance of maximizing your potential, not someone else’s. I have 12 years of education under my belt, so trust me when I say this: there will always be other people who have more intelligence, more degrees, more certifications, more letters, more publications, and more achievements than you. For every DPT there’s someone with a DPT, PhD. For every person with an MD, there’s someone with an MD, PhD. For every person who has an MD, PhD, there’s someone out there with an MD, PhD, JD. For every neurosurgeon, there’s someone who’s a neurosurgeon-researcher-journalist-writer. You’ve published 10 articles? Great. Someone else has published over 100 in more prominent journals. And you know what? That’s totally okay. Dr. Jordan Peterson coined the phrase “compare yourself to who you were yesterday, not to who someone else is today.” Comparison and envy of other people can be your worst enemy. It can turn someone with purpose into someone who questions their very existence. Work hard. Compare yourself to who you were yesterday. Be the best that you can be, and you’ll never have to compare yourself to another person again. Find your passion and strive for absolute excellence. That’s a path worth taking. There’s a passage in Psalm 103:15 that says the following:
“The life of mortals is like grass, they flourish like a flower in a field; the wind blows over it and it is gone, and its place remembers it no more.”
Whether you’re religious or not, this verse is a solemn reminder that our time on earth is limited. We have to be purposeful with the time that we have and make it count. What type of legacy do you want to have? What’s important to you and what do you want to be remembered for? These are questions worth thinking about. A meaningful career matters, but so do other things in life. There is such a thing as gaining the whole world and forfeiting your very self.
I was working with an ER physician one day and he was asking me about my career. After we finished our conversation, I’ll never forget what he said to me: “Well shit, man. You’re a PT-RN-NP? I’ve never heard of that. You’re a damn unicorn.” His kind words continue to resonate with me to this day. It was an ultimate compliment from an eventual friend and colleague. He considered my gifts and talents unique. The beauty of life is that we’re all born with endless unique possibility and potential; it’s up to us to harness those talents and abilities. Don’t go chasing after dreams that aren’t yours. You are unique and you bring something special to the table. I couldn’t be happier with my life decisions and I am excited for the years to come. I am always trying to outwork my potential. Be inspired, but be yourself.