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Bruce - Occupational Therapist/Hand Therapy Specialist
75 Plays1 year ago
Bruce has been an Occupational Therapist for over 2 decades now and his journey currently has him specializing in hands. Our hands allow us to create and earn a living so helping others regain the use of their hands is admirable and crucial. There are numerous areas of specialization in physical and occupational therapy so if you think this career may be fore you, this interview will be especially interesting. So pour yourself a cup of your favorite warm beverage and relax as we learn about all that goes into helping others regain function and thrive.
Bruce and his team can be found at www.lopt.com. (Full Disclosure - We have no affiliation with lopt.com, LOPT or their employees)
If you found the interview helpful and/or entertaining and would like to support the show, you can do so HERE. Thanks!
Music by: SnoozyBeats - Song Title - "Keep It Calm". Please check out SnoozyBeats on PixaBay for a ton of awesome content! -LINK
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Transcript
Intro
00:00:21
The Jobs Podcast
Hey folks, thanks for joining me on the jobs podcast. This is your host, Tim Hendricks. Today we have a physical therapist with us. He has made a entire career, 20 plus years in helping others with their physical therapy. And now he specializes in hands as well as a few other things. Bruce, thanks for joining me today.
00:00:39
Bruce
Yes, Tim, thanks for having me. I've enjoyed your podcast and I appreciate you asking me to be on.
00:00:45
The Jobs Podcast
Oh, you bet. So let's start with the origins of Bruce. Tell us your little synopsis of your childhood story and and walk us through your early education.
00:00:55
Bruce
Yeah. So, I was born, in Omaha, Nebraska. And then, uh, when I was two, my parents moved back to central Nebraska where they were both from. my dad was in education and he took a job to be a high school guidance counselor at a small school. They're close to where my, uh, mom's parents lived when, where they farmed. So my parents farmed.
00:01:21
Bruce
alongside my grandparents and help them. And then dad was a high school guidance counselor. So I have a twin brother and then a brother who's five years younger. So it's a great childhood growing up on a farm, getting a good work ethic, working outside, getting your hands dirty.
00:01:40
Bruce
and just enjoyed sports and you the opportunities that a small school, small community provides where we could participate in a lot of different things. And so just really, my dad being a guidance counselor, when it was time for us to look at colleges, we had the benefit of having him just really encourage us to look into what we wanted to do. So doing job shadowing,
00:02:08
Bruce
And just making sure when we went to college we kind of had some direction where we were going so had an uncle who was a physical therapist and so we job shadowed at his clinic some and So I kind of had an idea I wanted to go into either physical or occupational therapy and went off to UNL and so I just kind of had good direction that way.
00:02:34
The Jobs Podcast
What was it when you job shadowed your uncle? What was it about physical therapy or occupational therapy that just kinda tripped your trigger, so to speak?
00:02:45
Bruce
You know, I knew I didn't want to sit behind a desk all day long. And I just liked the variety where you were seeing different patients.
00:02:49
The Jobs Podcast
Yeah.
00:02:54
Bruce
You're talking to people all day long. I did have an interest in science and just human anatomy with sports, having just minor injuries and kind of recovering from that.
00:03:06
Bruce
And so to kind of pursue physical therapy or occupational therapy, it really just kind of fit well for that.
00:03:15
The Jobs Podcast
Okay. When you're dealing with people that are physical, you're a physical therapist, you're dealing with folks that come in. Am I correct in that? Everybody starts off as a general physical therapist, and then they kind of develop their specialty or the area of expertise that like yours with hands, other people may be knees or back. Or how does that typically kind of pan out?
00:03:41
Bruce
Yeah, so and actually clarify, I am an occupational therapist, so I did choose to go OT.
00:03:44
The Jobs Podcast
Okay. Okay.
00:03:47
Bruce
But you're right, when you get done with school, you're a general therapist. And for occupational therapy, I kind of had a bet that I wanted to go into hands.
00:03:57
Bruce
For occupational therapy, you When you get done with school, you can work in a hospital setting and pediatrics. You can go into mental health. You can do a lot of different things. But with the hand aspect, I was fascinated with the hand, the anatomy, and observing you'd see how much progress those patients made.
00:04:19
Bruce
sometimes how traumatic their injury was if they had an amputation or had cut a tendon or is just really debilitating and you'd see them get back to Their normal activity, which was really gratifying. So that's kind of what drew drew me to that Where I work now You know, we see people from all walks of life and so you really see how they ah ah a major injury can have a huge impact on their life, their quality of life, financially, spiritually, family, and just really can affect them.
00:04:49
The Jobs Podcast
Mm hmm.
00:04:56
Bruce
So you feel like you get to play a role in in them recover.
00:05:01
The Jobs Podcast
I jumped ahead a little bit. You were talking about your education. You went to ah you said, is it University of Lincoln? Is that what it was?
00:05:09
Bruce
Correct. And went to UNL.
00:05:10
The Jobs Podcast
Okay.
00:05:10
Bruce
And so for whether you're going into PT or OT, At the time, you would just work on your prerequisites. So you're working towards 20 years ago, you could get into school after two or three years, you'd have the prerequisites done, and you could get into professional school. In Nebraska, it was either UNMC or Creighton. There's some other schools now as well, but now you kind of have to go and get an undergraduate degree. It's probably
00:05:41
Bruce
less likely you're going to get in after three years. But then it's another three to four years for your professional school. So I went to Creighton and that was another three years. And then two years of that is going to be didactic work. And then and then we did two 16 week rotations. They call them field works.
00:06:08
Bruce
kind of like a residency where you go and you work somewhere. but you're learning under a therapist. And so now that's changed. I got out with a bachelor's degree and they've slowly changed that. My class was the last class to get a bachelor's degree. Now it's a clinical doctorate, Creighton and most of the schools are going to that. I think by 2027.
00:06:31
Bruce
everybody has to be at a clinical doctorate level, but it's, so it's another year of school. but there are still some master's programs out there too.
00:06:43
The Jobs Podcast
What what is the general push behind the extension and the schooling? Is it just because there's so much more knowledge about anatomy and physiology or is it a is it it a a technology thing or is it just all of the above or specializations kind of?
00:06:57
Bruce
and Probably all the above. I do think the training's better.
00:07:01
The Jobs Podcast
Okay.
00:07:03
The Jobs Podcast
Okay.
00:07:04
Bruce
There's probably a bigger push for research, evidence-based, which is good.
00:07:12
Bruce
it's it's But then now being in private practice, people are running up a lot of debt. And so the cost of schooling does go up.
00:07:19
The Jobs Podcast
Yeah.
00:07:24
Bruce
Reimbursements going down from insurance companies and from Medicare so there you get does get to be a little bit of a rub that way But that's kind of the world we live in yeah You
00:07:35
The Jobs Podcast
Yeah. Do most folks that get into your line of work, is there a I mean, I'm not asking you for exact percentages, but do you find that most folks that are physical or occupational therapists work for a private company or do most of them work when a hospital setting? Do they start in a hospital setting and then usually transition to private or how does that typically play out?
00:07:57
Bruce
A lot do start out in a hospital setting. And it's, you know, right now there's kind of a lot of competition to find the right therapist.
00:07:59
The Jobs Podcast
Okay.
00:08:07
Bruce
So therapists are coming out at a good time where they've got job options. there's probably more opportunities right away in say a nursing home setting or a hospital setting.
00:08:21
Bruce
Their reimbursement is a little bit different than outpatient orthopedics. So they can pay more. Some of the nonprofits too will have the ability to do some loan forgiveness, but you might have to sign on with them for 10 years or five years to get
00:08:39
Bruce
some forgiveness on some loans. So for some people that can be a great option and then in the rural setting kind of the same way there's probably maybe a little bit better pay and then some of the loan forgiveness as well.
00:08:54
The Jobs Podcast
I recently talked with a nurse and they have options for traveling nurses or folks that will be based in a major city and then maybe they won't travel to an extended place for three, six, nine months, whatever. But, you know, one or two days a week, they will go to a certain rural hospital or nursing home or whatever and do that. Is that something that is becoming more common? Or how does that play into your career path, if at all?
00:09:23
Bruce
It is, and people have opportunities to do that. could travel and you could move around and do a three to six month stint in different
00:09:32
Bruce
There's also opportunities that you could moonlight and do weekends at a hospital setting or in a nursing home setting.
00:09:37
The Jobs Podcast
Yeah.
00:09:42
Bruce
or even, I know some therapists will do home health on the side if they wanted to, or they kind of do a combination of part-time work in several different places doing that.
00:09:55
The Jobs Podcast
is the specialization aspect of your career. When you're new, am I correct in the assumption that you're gonna start probably in a hospital, you're gonna be expected to know how to do pretty much any kind of physical therapy and maybe not dive as deep. But then when you get into a more specialized aspect, a department of the hospital, or you work for a private company, that's where the specialization tends to kind of show up.
00:10:25
Bruce
Exactly. In my case, like jobs were hard to find 20 some years ago.
00:10:27
The Jobs Podcast
Okay.
00:10:32
Bruce
So I was working part time or even on call for different hospitals and doing weekend work and getting some loans paid back.
00:10:43
Bruce
And so you just kind of did what you could, but then you tried to work your way. I know I wanted to do hands and do the outpatient setting. And so I was doing, got a job doing that as well.
00:10:55
Bruce
And then you're doing your continuing education because you've got to maintain your license. You've got to do a certain number of hours every year. And so I would just really try to work towards that.
00:11:05
Bruce
or trying to get your foot in the door somewhere and work towards that specialization. So for hands in both physical and activ occupational therapy, you can sit for an exam to be a certified hand therapist. And at the time you had to have five years experience and then a certain number of hours working directly in the upper extremity. Now they've changed that. So it's three years and you can sit for that exam.
00:11:33
Bruce
So we have students that kind of want to go into hands. And so we just tell them to get on the fast track to do that, where you study outside of work, you're doing your continuing ed, and you just work towards that specialization you can sit for that exam. And then that just gives you more credibility with the doctors. You see in medicine,
00:11:59
Bruce
Physicians are more specialized. There's still some general orthopedic surgeons, but a lot of people or checking who's your shoulder guy, who's the knee guy, who's the hip guy, who does the best with that.
00:12:09
The Jobs Podcast
Mmhmm.
00:12:12
Bruce
You really see that the public has a high demand on high quality health care. They have a high deductible, they're paying high premiums.
00:12:23
Bruce
They want the best care and we place a high value on good health. And so I think the same then trickles down for therapy as well. patients want to see who's your best therapist for shoulders, who's your best therapist for knee or ankle and
00:12:40
The Jobs Podcast
Mm hmm.
00:12:42
Bruce
And so being in private practice, we try to do that and encourage therapists to go down a path that kind of suits their passion and specialize that way because you're going to be doing your continuing education anyway.
00:12:56
Bruce
and maybe try to work towards a specialization and you just build those relationships with your referral sources and your patients. And then you start to get older and you're seeing the same patients back for their second or third injury and you've kind of built that rapport with them.
00:13:16
The Jobs Podcast
I think folks are kind of expecting what you highlighted a second ago. The guy that's a plumber that hurts his shoulder wants to get the same kind of care and treatment that a professional football player that's got a $15 million contract is getting. And I know that I'm not as valuable to you as the football player, but I'm more valuable to my family because I'm the one that keeps the roof overhead.
00:13:37
The Jobs Podcast
So you got to give me the same, know, duct tape isn't going to work anymore in 2025.
00:13:42
The Jobs Podcast
So your, your specialization, do you how, how specific does and and OT get as far as you said, there's a specialization in hands and you can take a test for that.
00:13:56
The Jobs Podcast
Do you typically have a generic breakdown of people that just do the neck or the back or the hips or like how fine tuned does that specialization get?
00:14:06
Bruce
Correct. Correct. It varies a little bit. You can get a general orthopedic specialization as a physical therapist. So in, you're considered an OCS and you'll see those letters behind their, their name. and that goes a long ways with the physicians. We try to, we're in an outpatient orthopedic setting. And so, try to have our therapist work towards that. You can also go.
00:14:32
Bruce
In the, as far as the spine, we have a therapist who, uh, has specialized in manual therapy and he's done a fellowship with that. And so he, um, really, really good with the, the, the back and neck, treats some, patients, maybe just a little bit different than what that would a general, entry level PT would.
00:14:57
Bruce
as well. So you can kind of do that, and I'm not familiar with all of them, but you can certainly work towards specialization in whatever area you'd like to.
00:15:09
The Jobs Podcast
To jump back to your education for just a second, you said that you had to get your license. I'm assuming that at the end of your, you have your bachelor's degree, you've gone to your specialized schooling for about three years, you said, I think that was right.
00:15:26
The Jobs Podcast
then you just have one, is it a state test or is it a, uh, like a national test? Is it a, I mean, is it a, a practical aspect as well as a written test or is it all written?
00:15:38
The Jobs Podcast
Kind of tell me about that process.
00:15:40
Bruce
Yeah, it's all written. So after you get your degree from whatever institution, then you sit for that exam.
00:15:42
The Jobs Podcast
Okay.
00:15:48
Bruce
And then before you can apply for a license, to be licensed with that state, then you sit for that exam and you pass that. You get your license and then you have to go through. Your employer puts you through a credentialing process with all the insurance companies so that you can bill for your services as a licensed therapist.
00:16:11
The Jobs Podcast
Is that a ah ah state license? So if you want to go work in, you know, a neighboring state, you would have to apply. Is there a reciprocity kind of nationally nationally or has that play out?
00:16:21
Bruce
you have to do it in each state. And so when I first started out, I was living in Omaha.
00:16:23
The Jobs Podcast
Okay. All right.
00:16:28
Bruce
So I had a Nebraska and an Iowa license, and I could practice in both both states.
00:16:35
The Jobs Podcast
Okay. What? How many questions are on that test? People always want to know the answer to that.
00:16:41
Bruce
you I forget, Tim, that was a long time ago. But I want to say, it was either a three or four hour test. So, and I'm going to take the whole time because I'm not the smartest guy.
00:16:54
The Jobs Podcast
Yeah.
00:16:55
Bruce
but it's a big test.
00:16:57
Bruce
There's a lot of pressure on it, the schools, you know, really do prepare you for that.
00:16:58
The Jobs Podcast
yeah
00:17:02
Bruce
And, and by the time you've practiced for a while doing your field works, you're well prepared. It's just, it is a lot when you're covering pediatrics to orthopedics, to neurological conditions.
00:17:14
Bruce
It is a big test that you got to study pretty hard for. Yeah.
00:17:19
The Jobs Podcast
What changes have you seen in your career? How many years have you been doing this now since you graduated?
00:17:25
Bruce
So it's been, 24 years now. and it has changed a lot. There's, I would say like the documentation is a lot more, you know, before you were writing in someone's chart, their physical chart, now.
00:17:40
Bruce
with technology, everything's on the computer. So you're documenting in that person's chart on your computer. You're charging or you're billing through that. You're scheduling through that. And so it does make it easier. However, with some of the regulations and with Medicare, there's just more that you have to put in there, which does make us better. And it's well-documented.
00:18:09
Bruce
It's easier to, if you get denied an you really try to document so you can justify what you're doing and and stand up to those insurance companies a little bit for the patient if if it's needed and warranted.
00:18:23
Bruce
Nobody likes change, but it's always changing, so you might as well embrace it. But with AI coming, it'll be interesting how that changes some of the documentation as well.
00:18:36
The Jobs Podcast
Have you seen a big change in the techniques that you use? Let's focus in on the hands. I would imagine that a lot of the stuff it because hands you know we've been around for ages. So what's changed as far as your therapy to are there devices that you use now that 20 years ago you didn't use or is was there a big change to where we used to do this all the time and now we realize that we need to do the exact opposite as far as movement or rehab or conditioning.
00:19:06
Bruce
For sure. That's a good question, Tim. And it's interesting when you go to some of your continuing ed courses or some of the um the bigger courses across the country it's it is always changing and it's good to stay abreast of those things you know you look back what i used to do as a therapist 24 years ago and i kind of cringe or i probably wasn't doing the patient as much good but
00:19:38
Bruce
I guess with hands, what I'll start with is we make a lot of splints for people. You can get an over-the-counter brace to immobilize either a joint or a wrist, but we kind of pride ourselves in fabricating out of an orthoplastic material that we heat up and we can mold.
00:19:58
Bruce
to the hand and so we can change the angles in each of the knuckles of the fingers based on what the surgeon wants or based on what the protocol calls for for fractures for tendon injuries we can modify that so they can do a certain amount of movement in that which helps the movement so from that standpoint we move people a lot quicker after surgery than what we used to and you really see if someone's been immobilized for too long particularly in the hand with having that many joints in a small area they get really really stiff or if they've had a crush injury or um an amputation or uh tendon injury the amount of scar tissue that forms in the hand can be a lot in it
00:20:33
The Jobs Podcast
Mm hmm.
00:20:44
Bruce
It raises havoc where you just cannot get those tendons gliding through there or moving and so they get scarred down. So the surgeons entrust us a lot to get them moving. And so that's one aspect that has changed a lot.
00:21:01
Bruce
And then some of the different machines or we'd say modalities.
00:21:01
The Jobs Podcast
Hm.
00:21:05
Bruce
We used to, we still do heat nice, but we have, there's a shockwave machine now where you do acoustic sound waves through that soft tissue to promote healing.
00:21:17
Bruce
We use some different tools where we kind of mechanically rough up that tendon and cause a bit of an acute injury in a controlled way to stimulate some of that tissue to heal where if there's an area with lack of blood flow your body starts to sort of ignore that and it gets to be chronic and so we cause a little bit of an acute injury to stimulate your body to heal that and then while that's healing we're moving that that joint or that body part so it heals in a functional state.
00:21:52
The Jobs Podcast
One, am I correct in that the shockwave that the ultrasound you just mentioned and then the acute injury type thing. I don't want to grossly oversimplify it but you're trying to increase the blood flow to that area that will increase the healing is that is that the general premise behind that.
00:22:10
The Jobs Podcast
Okay. Do you run into Well, let me back up. What is or is there a common type of injury that you're seeing when you're dealing with people's hands?
00:22:23
The Jobs Podcast
And I'm specifically thinking about is ergonomics still a major issue? I remember in the 90s, I had a supervisor that was just mad about ergonomics chairs and, you know, wrist pads and mouse pads and all that kind of stuff was just all the rage.
00:22:31
Bruce
Correct.
00:22:37
Bruce
Correct.
00:22:42
The Jobs Podcast
It's so common nowadays. Do you still see a lot of ergonomic type things?
00:22:47
Bruce
We do and correct,
00:22:49
The Jobs Podcast
Repetitive injury, I guess would be a better.
00:22:51
Bruce
correct. And so, you know, in a way you could, you could specialize in that if you wanted to. But I think whatever injury you're, any repetitive injury or having, if there's a nerve issue, there's a compression from repetitive trauma in a job, you know, it's important. We're working with that body part, but we're not just focusing on that body part. And that's why conversing with the patient and talking to him, you can really get to understand what is causing this. Cause if we can do all the right exercises and the right treatment techniques, but if they're going back to the same repetitive trauma in their job or at home,
00:23:32
Bruce
then it's not going to get better or we're only going to get them to a certain point. And, or if they're sitting in their chair wrong and it's not just focusing, let's say on the wrist, but you're looking at their posture, how are they sitting? How are they holding their, just everything that has to do with ergonomics. If you look at that and then looking up into their shoulders, you can have but a bigger impact for them for sure.
00:23:58
The Jobs Podcast
What you just said right there about their posture, I immediately gravitated towards electronic devices, smartphones, tablets, and the rolled forward shoulders and the the the head down. Are you dealing? Is that at the root cause of a lot of ergonomic issues?
00:24:16
Bruce
You know, it it is a a ah large part of it. And that might be part of our conversation where if we're evaluating a patient and you're talking about what their symptoms are, but do they think's causing it, and then we'll have our spiel about that of, you know, don't do that, try not to do that, or here's some alternative ways to hold that, or even in sleeping postures, you're spending eight hours at night,
00:24:42
Bruce
in a certain position, try to, you know, try a few different things this way. And then also when you're on your phone or on your laptop, trying to make some changes there as well.
00:24:55
The Jobs Podcast
I may put you on the spot on this question and I don't mean to, but it just popped into my head. Is there any, if you could give just the general population, anybody listening, one or two improvements that you see just walking around Walmart or walking around town or wherever you go, everybody that you look at, because I know you, your posture is impeccable.
00:25:18
The Jobs Podcast
It's really, really good.
00:25:19
Bruce
I don't know about that.
00:25:20
The Jobs Podcast
Well, you stand up straight, you know, and all the things that our moms used to tell us to do. But is there anything that you would tell folks? Like if you would just change one or two things, your neck wouldn't hurt or your back wouldn't hurt.
00:25:31
The Jobs Podcast
Or I mean, I know that that's I'm not asking you to treat the general public over a podcast, but just friendly advice from someone who's informed.
00:25:37
Bruce
Right.
00:25:40
Bruce
Well, I mean, we're all of our bodies that are, God made us all different. And so, our body types are different.
00:25:45
The Jobs Podcast
Mm hmm.
00:25:48
Bruce
But I do think, and I'm biased as a therapist, but if if just moved more, you so many jobs are sedentary and you're overworking certain muscles and you're not working other muscles.
00:26:00
Bruce
And so find figure out a way to have a routine where you're staying active, you're stretching to some degree, but you're not maybe joining a CrossFit class, nothing against CrossFit, but you kind of do what's appropriate for your
00:26:01
The Jobs Podcast
Okay.
00:26:12
The Jobs Podcast
Yeah.
00:26:15
The Jobs Podcast
Mm
00:26:16
Bruce
body type and your age and just stay
00:26:19
The Jobs Podcast
hmm.
00:26:20
Bruce
And it just sets you up for success when you are sedentary, but then you can enjoy your life as well and set you up for success for the long term for sure.
00:26:32
The Jobs Podcast
Walking seems to be something that, if you kind of halfway pay attention, it's just all of the influencers and everybody online, the fitness gurus, are like, just walk.
00:26:43
The Jobs Podcast
If you would just simply walk more. And I think that's one thing in our country that we don't do enough of compared to the rest of the world is we're such a large country. We drive 30, 40 minutes.
00:26:54
The Jobs Podcast
I can't walk 10 miles every morning to work.
00:26:57
The Jobs Podcast
Well, I mean, I guess I could, but I'm not going to get up at 2.30.
00:27:01
Bruce
Right. Right.
00:27:03
The Jobs Podcast
So,
00:27:04
Bruce
it is a beneficial activity. And even if you have back pain, if even if you have, you know, you just modify you're doing.
00:27:06
The Jobs Podcast
sure.
00:27:10
Bruce
Some people swim, some people, you know, have to switch from running to walking and then to riding a bike. And just, but to stay active in some way is definitely beneficial.
00:27:25
The Jobs Podcast
Let's jump back to the education that you got for a minute and talk about. Are there certain schools in the country that specialize or that are really like, you know, the pinnacle of occupational or physical therapy or is there a kind of an industry standard in your line of work that every state is going to have multiple schools most likely that can specialize in this?
00:27:51
Bruce
Yeah, you know, it's kind of an industry standard little bit and the profession kind of has their criteria that each school needs to meet. And there's going to be, each school is going to maybe pride themselves on one thing or another. But, you know, up to this point, it's been kind of the doctorate program where they saw that. But I tell people or students who are looking to go into therapy
00:28:19
Bruce
you know it's you make your education what you can of it and you need to get into school you need to get through but but when we're hiring or when I'm hiring a therapist it's more about the person is it somebody I want to work with or I want to be in the room with all day long and so it's more of a personal fit do they have the work ethic do they we can teach people some of the clinical things. They've got a good background from school, but it's somebody with a work ethic who's humble, who wants to work hard and serve people. And it's not all about them, but it's about the patient. That's who you kind of want on your team versus somebody pounding their chest that they went to such and such school.
00:29:09
The Jobs Podcast
Okay, so the the documentation behind the person while important is not the end all be all to success.
00:29:18
Bruce
Correct.
00:29:19
The Jobs Podcast
If somebody, and you kind of explain some of the things just there, but let's elaborate on that just a little bit. If someone, let's say there's a kid down the street from you that is about to graduate high school and he wants to follow in your footsteps, and he knocks on your door and he says, Mr. Bruce, I want to do what you do. Can you give me some advice?
00:29:40
The Jobs Podcast
and you've got just a couple minutes to give him some high points. What would you, looking back on your career and the changes and what you know of the industry now, what would you advise him or her to do?
00:29:52
Bruce
Yeah. you know, and I, I think back and I, I could think of people that I wanted to emulate myself by, and it's easy thing to do is look, look at them and say, well guys, right place, right time.
00:30:08
The Jobs Podcast
Yeah.
00:30:09
Bruce
you know, I want to be there, but, um, think just encouraging people, there's a lot of information out there where there's a lot of,
00:30:19
Bruce
talented people who maybe aren't going into med school, so they go the therapy route, so they're really talented. It's easy to say, well, there's increased competition for these positions in the in school.
00:30:32
Bruce
I just tell people and I remember, you know, my dad telling me and, and other people, you know, just, you go for it and, and you work hard at it and you're gonna, you're gonna succeed and probably have a backup plan, but at the same time go for it. And, you know, you kinda, you know, you gotta go into science and you gotta do well in anatomy, physiology, those core classes, but setting yourself up for success.
00:30:58
Bruce
in those classes and just really putting in the time and then also doing some observation where you follow a therapist in probably different settings even if you feel like you know what area of therapy you want to go into.
00:31:12
Bruce
show that you're well-rounded and you learn as much what you don't want to do in therapy as what you want to do. But you've just shown initiative. You've shown that you've done your homework and and put in the time to set yourself up for success.
00:31:30
The Jobs Podcast
I can see that some folks may want to specialize too early. And I think, would you agree that, well, you may want to specialize in shoulders or knees, every, you know, the, the knee bones connected to the hip bone kind of thing. And having that general, I need to know kind of everything that's going to teach me before I worry about specializing that comes after I know I say everything, but I've absorbed the whole picture.
00:31:59
The Jobs Podcast
And then I dive into the specialty.
00:31:59
Bruce
Right.
00:32:01
The Jobs Podcast
Do you find a lot of kids come in and go, well, I want to be a back expert. Okay, well, the back is affected by the shoulders and by the hips and by the knees and the ankles and everything else.
00:32:13
Bruce
Correct. And that's a good point, Tim. We're being well-rounded and good at everything. you know, some therapists come out and kind of the hot thing is I want to be a sports therapist.
00:32:25
Bruce
I want to, I I want to treat, this is my wheelhouse.
00:32:26
The Jobs Podcast
oh
00:32:30
Bruce
This is what I'm really good at. These are the types of patients I want to see all the time. And although that's good, you know, this day and age there's a certain amount of Medicare that you're gonna see the older population it's an active population and you're gonna get let's say 25% of your patients that you really want to see that or that's that's your diagnosis that you really enjoy seeing and you have that specialty area but you may not be able to fill your entire schedule with that type of patient
00:32:48
The Jobs Podcast
Oh, sure.
00:33:05
Bruce
And so being able to see a wide variety of patients, while you're building that caseload up, I think is important. And for, that's kind of what we encourage our therapists to do is, is work towards a specialty, but just understand you're going to have to probably see some people that you don't get to cherry pick every patient you get to see too.
00:33:26
The Jobs Podcast
Yeah.
00:33:26
Bruce
we're still going to treat the people that call in for an appointment and we give them really good care.
00:33:32
Bruce
And then we're still marketing to the doctors in our community. This is what we're really good, each therapist, what they're really good at too.
00:33:40
The Jobs Podcast
you're not gonna get every patient that comes in and allows you to be a rockstar sports PT. You've gotta pay the bills with the Baby Boomer that comes in with a bad knee or something like that. They all should get, and you give the same service.
00:33:52
Bruce
Exactly. And the same type of care. Exactly.
00:33:54
The Jobs Podcast
Yeah, yeah.
00:33:55
Bruce
And remember being that way where this is what I want to see or these are the types of patients I want to see. But I don't know, you learn so much from and we were talking before when before you started recording but you know you learn so much from people a lot like your podcast and you're talking to different people you learn so much from them and it's as i've gotten older it's not so much the diagnosis as it is just the the people that you really enjoy talking to
00:34:25
Bruce
everything, everybody from the blue collar worker to the CEO of his company, to the banker, to, you know, people have all walks of life. You learn from, and the farmer and kind of making those connections from my, growing up and just really enjoy that variety throughout the day. and I am fortunate you get to see that in the upper extremity, a variety of injuries.
00:34:52
The Jobs Podcast
It's gotta be satisfying when you see a patient come in who, you know, if their hand is extremely damaged in whatever way, and they can't even, you know, hold a coffee cup or use a spoon or write, and then fast forward, I don't know, six months, however, whatever the timeframe may be, they're able to do just those basic things that I'm sure we all take for granted. And you're able to watch them progress and all of a sudden they do it. That has to be,
00:35:20
The Jobs Podcast
It makes you it's got to make you feel good to see that happen. And you're a part of that.
00:35:24
Bruce
it does and kind of the that camaraderie that you share with them as you walk through them with that.
00:35:31
The Jobs Podcast
Yeah.
00:35:31
Bruce
And I think beyond that too, Tim, is like the, you think about most, a lot of people are living paycheck to paycheck. If you're out of work for some, you weren't doing anything wrong.
00:35:39
The Jobs Podcast
Yes.
00:35:42
Bruce
You're involved in a motor vehicle accident.
00:35:44
The Jobs Podcast
Mm hmm.
00:35:44
Bruce
Somebody came across the line and And you have this horrific injury, you're out of work for three to four months, or you're on light duty and the way work comp works, you're not going to get full pay for being on light duty. Or even if it happened at work, you're not getting full pay while you're off work. So the financial, strain, the family strain, you're walking with people two to three times a week for a half hour to an hour.
00:36:11
Bruce
and you get to know them pretty well and you're seeing their struggles, it is gratifying to kind of help them with that or feel like you play a part in helping them with that, but also the urgency that you feel like you need to help them because it's pretty easy to put yourself in their shoes as well.
00:36:31
The Jobs Podcast
do you find that you have these benchmarks and if the patient can can can get tangible evidence of improvement? Like you can point to them and say you came in here two weeks ago and look at what you've already accomplished. I would assume that it's easy to keep someone going when you can you can check these little boxes of progress and so they can see that I'm not just going through the motions. I'm not wasting my time. This is actually making a difference and I'm progressing towards what I was pre accident.
00:37:04
Bruce
Exactly. And, you know, we serve kind of a large area. So you might have people drive in, you know, half hour, 45 minutes, to an hour. You want to make sure they get really good care and, and it's an encouragement to them, hopefully, because they can get down and day to day, they don't see a lot of progress, but just like you pointed out every couple of weeks, you're showing that, uh, to them.
00:37:13
The Jobs Podcast
Hmm. Yeah.
00:37:28
Bruce
they might be worried that they're not going to be able to keep coming, but you kind of, you know, show them that there is medical necessity that we can, and we're just doing what the doctor is requesting us to do. and, and show pointing out those improvements is an encouragement to them. And then they see how they're meeting those goals.
00:37:49
The Jobs Podcast
Yeah, the progress has got a feed on itself and it just makes it easier for them to keep going.
00:37:54
Bruce
For sure. For sure.
00:37:56
The Jobs Podcast
Have you ever had, and I know that you're restricted on how much patient information you can divulge, so I'll keep it very generic. Have you ever had any cases where a type of injury came in and it was really severe in whatever way, and then you were with them and you just Even doubted, I don't even know if I can help this person. And then looking forward, looking back now, it took eight months or it took six months, but they went from no function to they're back to almost normal or any kind of earth shattering type cases that if you look back at your career are the first ones that pop into your mental Rolodex.
00:38:38
Bruce
Yeah, you know, I really enjoy the, the hand trauma and it's sad to say, you know, we're there to people's misfortune plays a big part in that.
00:38:50
Bruce
But if someone, I can remember people, one guy cut his thumb completely off and they were able to reattach it and
00:38:50
The Jobs Podcast
Yeah.
00:38:59
Bruce
a cabinet maker and you know, and that's his livelihood and for everybody, their hand, their hands are how they make their living. And in a lot of occupations, they're putting their hands in harm's way and, and gets them in trouble.
00:39:10
The Jobs Podcast
Yeah.
00:39:11
Bruce
But some of those really horrific injuries where the gentleman with the thumb replantation or, uh, you know, they almost lose their arm, almost amputated.
00:39:24
Bruce
They're able to save it. Uh, they're hospitalized for a long time and they just think, are they going to be able to get back to their occupation? It is super gratifying and you might walk with them or treat them for a year or, you know, six months. those are the fun ones are, you know, I think of some gunshot wounds where, you lacerate a nerve. So you're losing all function and the surgeons are really, really good.
00:39:51
Bruce
and they can repair that and that nerve regenerates over time. It's really cool to see the progress that they're able to make.
00:40:00
The Jobs Podcast
Yeah, I'm gonna ask you a question that I just thought of. And I think every PT and OT that listens to this is probably going to cheer when I asked this question. But What do patients get wrong when they're looking at their part of this physical therapy process? What can they do at home? You know, because I think about some injuries I've had and I leave and they give me a piece of paper with all these exercises that I'm supposed to do. And I may do them a couple of times and then I lose the piece of paper or I can't find the band that they gave me. And I don't, you know, I don't do what I'm supposed to do as the patient.
00:40:39
The Jobs Podcast
What can patients do when they leave for the day and you're not gonna see them for a few days or a week? Where do patients go wrong in their responsibility for their healing?
00:40:52
Bruce
Sure. And, and that's a good question, Tim. And I mean, we're all, pain's a good motivator. So when you're in pain, you're going to do stuff, right?
00:40:58
The Jobs Podcast
Yeah.
00:40:59
Bruce
And then when you start to feel better, we get away from that.
00:40:59
The Jobs Podcast
Mm-hmm.
00:41:03
Bruce
And, and I'm the same way you get. We start out in January doing certain things and by July, you're on a different routine. But I think, but would say a lot of it's on the therapist too, where, you know, you've got to get that patient to buy in and you're not going to get everybody to buy in.
00:41:10
The Jobs Podcast
Yeah.
00:41:21
Bruce
But if you're given really, really good care and you're really educating the patient on what they can do and why they're doing it, then it is on the patient. I think a lot of it, you know, sometimes us as therapists maybe fall short in explaining the big picture as to why they need to keep doing this.
00:41:40
Bruce
But then we have people come back, you know, six months later and I forgot my exercises. I just need a refresher on that and that's okay too. And some things may have changed, but you're right.
00:41:49
The Jobs Podcast
Sure.
00:41:53
Bruce
It is important that they continue to follow through with that and then stay active and and hopefully follow some of that advice.
00:42:01
The Jobs Podcast
What is it that you like most about your job? And there may be multiple things, but what are the top one or two that they get you up every morning and yeah they're your motivation to go to work aside from a paycheck, of course.
00:42:16
Bruce
Sure, sure. And that's a good point because the paycheck does wear off and inevitably it does get to be work.
00:42:25
Bruce
But what I really enjoy is the camaraderie that we have at our clinic. There's something about an outpatient orthopedic clinic where the patients are coming because they're not in the hospital, where they have to do therapy, they're coming because they want to get better.
00:42:38
The Jobs Podcast
Yeah. Hmm.
00:42:41
Bruce
And we have a really good team of therapists and I get to be kind of on. the ownership side of that with you know other partners who are just really, really good people, same vision. We want to serve of our community, but also serve our employees. and that that That is cool to see other people succeed and grow in our staff, and our therapists, and then in our patients. and
00:43:10
Bruce
and know you're just talking to people all day long and you're learning from them and just want it to be a positive environment. And so I hope it is for other people. For me it is and that that really makes work fun for me.
00:43:25
The Jobs Podcast
Is there anything about your job that you dislike? Is it the paperwork side of things or, you know?
00:43:33
Bruce
Yeah. I mean, no one really chooses physical therapy or activ occupational therapy to do paperwork, and but it is a part of
00:43:39
The Jobs Podcast
Right.
00:43:40
The Jobs Podcast
Yeah.
00:43:42
Bruce
Depending on the setting you're in, sometimes the hours, you it's not always a ah nine to five job.
00:43:49
Bruce
We work for 10 hour days, which I really enjoy.
00:43:52
The Jobs Podcast
Yeah.
00:43:54
Bruce
But and we don't do weekends or at least very often you might have to go in and see somebody but a hospital setting you're rotating on weekends and I wouldn't like that. And that's kind of what gravitated me towards outpatient a little bit. But there are times with a 10 hour day.
00:44:12
Bruce
it's late and I don't want to miss my kids' activities. And now being there for that long and we've hired people where we can kind of share in that and make sure everybody can get a way to enjoy their family as well and help each other with that.
00:44:16
The Jobs Podcast
Yeah.
00:44:25
Bruce
But the paperwork and then there's times where just those those long days where you feel like you're rushed to get to other events as well.
00:44:37
The Jobs Podcast
Is there a certain personality type that you see is common in any type of therapy, physical or or or occupational? Is it mostly extroverted people? Mostly introverted people? Is there a common skill set, like the ability to communicate, things like that? Some people can fake that pretty well. They may be an introvert who, when they get to work, they can flick a switch and become an extrovert.
00:45:01
The Jobs Podcast
But do you find that most everybody around you and in your career shares any kind of a personality trait like that?
00:45:09
Bruce
I think, yeah, most people want to really help people and they, they enjoy being around people. know, we, you see in introverts and extroverts, but just that, that quality of wanting to help people and, and just kind of being enamored with the human body and understanding it. And then that passion to.
00:45:31
Bruce
to explain that and teach your patients, you know, what's good for them or how to fix things, being a problem solver. Those are some common traits I would say that are important or common that you see for sure.
00:45:49
The Jobs Podcast
The one thing that a lot of people want to know when I interview about a career is the pay structure. And I'm always inclined to mention that, well, of course, it depends on where you live because the cost of living will impact.
00:46:05
The Jobs Podcast
You can't take what somebody in New York City as a physical therapist is going to make and translate that to where you're at in Nebraska. There's going to be a pretty big difference, I would assume.
00:46:14
Bruce
Correct.
00:46:16
The Jobs Podcast
So if somebody is thinking about getting into this and they're thinking, well, what can I earn as far as when I get out of college and I've got my license and I'm now starting, is there a ah ah general ballpark that maybe, even if it's only specific to Nebraska, just give us a ballpark idea of what pay and then how that may progress as you've been in it longer and get more specialized certificates and whatnot.
00:46:16
Bruce
Correct.
00:46:41
Bruce
And a lot of it too, Tim, like you said, across the country, it's going to vary. It's also going to vary in the type of setting that you work. So a hospital setting or a skilled nursing facility, their rate of reimbursement is a lot higher so you're really some of those jobs you're not comparing apples to apples and so some of those settings they're getting a higher rate of reimbursement they're able to pay a fair amount more but
00:47:01
The Jobs Podcast
Okay.
00:47:11
Bruce
you know, you Google that and it's going to be a huge range, but you can expect to come out and probably make around 70,000 as a, as a starting therapist and then go up from there.
00:47:23
Bruce
I will, you know, any student who's looking at that and they say, where can you top out at?
00:47:23
The Jobs Podcast
Okay.
00:47:30
Bruce
And that varies a lot, but the starting can be really high at certain places and they'll have an hourly rate. But you may not be guaranteed 40 hours a week, too.
00:47:42
Bruce
And so you're making a high rate per hour, but you may not get 40 hours per week. Other settings are going to be your salaried. And it can vary quite a bit.
00:47:56
The Jobs Podcast
Mm hmm.
00:47:56
Bruce
But school debt is a big deal. But it is worth it, I think, for sure.
00:48:04
The Jobs Podcast
Yeah. Well, I can see the longevity of a career in your line of work. It's always going to be there. It's always going to be a need.
00:48:15
The Jobs Podcast
And especially with the aging populations of the boomers. And then I hate to say it being Gen X, but, you know, we're not spring chickens anymore. So in the next 15 years or so, we're going to be where the baby boomers are, you know, starting to.
00:48:29
The Jobs Podcast
to end up. So what I guess you do have some job security in that standpoint is that human beings are always going to age. And we're always going to need to help them in some form or another. And as long as we're doing work, people are going to unfortunately get hurt. And so there is ah if you can get your foot in the door. And it's I don't know if it's physically difficult to do your line of work, but I would think you might be able to do that for a long period of time.
00:48:57
The Jobs Podcast
You see what I'm saying?
00:48:58
Bruce
Exactly. And you're right. And I'm biased, but it's a great career. And and the long haul, I will say I worked at Children's Hospital part time when I started out and there was a therapist that is a physical job where you're on the floor with the kids, you're crawling around.
00:49:05
The Jobs Podcast
Yeah.
00:49:15
The Jobs Podcast
Yeah.
00:49:16
Bruce
There were some therapists where they had had an injury they had to go into a different line of therapy because physically they couldn't do that.
00:49:24
Bruce
In a hospital setting, you're helping with transfers. You got to be careful that you don't get hurt or hurt your back. But just ergonomics, like you talked about in our setting, you got to take care of yourself as well because it still is a physical job.
00:49:41
Bruce
Standing over people that you're stretching them out. There's a there's a fair amount of that and so we kind of have to practice what we preach but
00:49:47
The Jobs Podcast
Yeah.
00:49:52
Bruce
But there's always going to be a job for sure. And then there's people that go into management in a hospital setting and and they're maybe not doing some patient care. You're always going to be able to find something. there's been therapists that leave the profession and they go do something else as well. But with that education, your training, your experience, I don't think you're going to have a hard time finding a job.
00:50:16
The Jobs Podcast
whenever you get a PT or an OT that is a patient of yours, are they the worst kind of patients you could get? You always hear doctors are the worst patients, nurses are the worst patients, you know?
00:50:28
Bruce
not necessarily, but I know what you mean. Uh, there are times, uh, there may be pushing the limits on the protocol or what you'd advise them to do.
00:50:31
The Jobs Podcast
Yeah.
00:50:38
The Jobs Podcast
Yeah.
00:50:39
Bruce
and so, it is humbling and and hard to probably be the patient for sure.
00:50:44
Bruce
Yeah.
00:50:44
The Jobs Podcast
Yeah. What's your best advice if someone that works for you because not only are you in this line of work, but you are one of the owners of your company?
00:50:54
The Jobs Podcast
Is that correct? Correct.
00:50:56
Bruce
Right.
00:50:57
The Jobs Podcast
Okay. If you have an employee that makes a mistake, I've said it on every podcast that I've done, we're all human. We all have and will make mistakes.
00:51:08
The Jobs Podcast
It's just part of living on this rock. how you deal with it, how you respond to it is usually pretty key. What's your advice when an employee makes a mistake, and you sit down and chat with them about it?
00:51:22
Bruce
Yeah, that's one of my favorite questions you're asking your guests and everybody deals with it different. But I think, you know, we all learn more from messing up than we do with our successes. And so, you know, The biggest thing I think is that you just sort of embrace that and you see it and you make those changes. When working with a student or employee, or I hope if I keep making the same mistake, I want them to point that out that I correct it so it's not making their life worse if it's our billing staff.
00:52:01
Bruce
anybody but just to make those changes and then listening to that constructive criticism and learn from it. I think when I look back like you're all of us have insecurities and just seeing that and kind of embrace that and you kind of have to flex up on those things and and just make those changes knowing that you're you're bettering yourself and you're growing in your profession by learning from those mistakes.
00:52:30
The Jobs Podcast
The mistakes tend to make a permanent core memory just because they're unpleasant. The nice things are there and it's always good to experience nice, but when you royally screw up, I don't think you're capable of forgetting it. And sometimes that's the best way to learn, unfortunately.
00:52:50
Bruce
Correct. and And I think like therapy, you work a long time to build your reputation amongst the doctors. And so you take it really serious.
00:53:00
Bruce
You don't want to mess up really big on certain things.
00:53:02
The Jobs Podcast
Yeah.
00:53:04
Bruce
And, you know, the gals that do our billing, they might roll their eyes when I made the same mistake on some different paperwork issues. But when you're treating the patient, you know, you take it at another level where you know, I got to be on my game so I don't do too much or I tell that person to do too much.
00:53:22
Bruce
And then I jeopardize their rehab. And so those things you really are really careful with that you don't mess up.
00:53:32
The Jobs Podcast
Yeah.
00:53:32
Bruce
And over over the course of that treatment, you're going to make sure you do your homework and you don't mess those things up. Or if there's something little, you're going to correct it. And you're always listening to the patient that, you know, if we overdid it, then we're going to change it real quick.
00:53:51
The Jobs Podcast
If you look back on your life, is there a career that if you didn't get into the line of work that you're in now, is there something that you looked back and you said, you know, I kind of that was always your plan B or if if you were able to go back and shift gears, something else that you would like to have done?
00:54:15
Bruce
I've thought about that and I, I, I didn't have a real good backup plan. Tim, I kind of put all my eggs in this basket, but, but I did at one time I'd maybe go be a teacher and maybe coach.
00:54:29
Bruce
and I think I would have enjoyed that as well, but now having kids, I'm not sure I had the patience for it, but, uh, uh, or my kids tell me I don't have the patience for it.
00:54:37
The Jobs Podcast
Oh, yeah. All right. Would you want to teach physical therapy? And do you see a lot of folks that after they've done PT in the occupational or in the clinic setting, do they do they go then and teach?
00:54:56
Bruce
There are a lot who do or they might be kind of a guest speaker or do different things like that or teach one class or teach a lab on the side.
00:55:05
The Jobs Podcast
Hmm.
00:55:06
Bruce
And so there's service to do that as well. I enjoy taking a student who might do a 12 or 16 week rotation and then you're kind of practicing right alongside them and kind of mentor them.
00:55:23
Bruce
That's kind of where I see myself right now and I've enjoyed that.
00:55:30
The Jobs Podcast
When you have a student come in and you're mentoring the student and they're doing their rotation with you, What are the ones that kind of make you smile as far as this this one's got it? They have what it takes. I mean, is are there some intangibles that you see in a new person when they come in that it just makes you think this what I wish all of the students that came in were like this?
00:55:53
Bruce
For sure. you I think the humbleness and then just the willingness to learn. They're eager to learn and they're not afraid to jump in and kind of get their hands dirty or get their hands on a patient and try things. But just the biggest thing I think is the servant attitude where they just want to serve Not only the patient but just the employees. How can I help? What do you want me to do to help with this patient or? Learning those exercises, but then that they take it upon themselves to really learn The skills that they don't have yet as a new therapist and kind of work on that so that they're confident to put their hands on the patient and Just that that
00:56:43
Bruce
Oh, the drive to just do that themselves and be a self starter, I think is kind of what really makes you smile or think that's the person I want to work with.
00:56:56
The Jobs Podcast
I do find a lot of folks when I interview them, they do tend to either say it directly or insinuate, you can't be a sponge to soak up all this stuff unless you check your ego at the door when you walk in here. The ego gets in the way of learning, it prevents you from doing things.
00:57:17
The Jobs Podcast
getting, like you said, getting your hands in there and actually doing things physically with the patient, because your ego says, well, I'm not going to do that, or for whatever reason, it stops you. So check that ego at the door and come in. And I think you're going to be more successful in the long run. Would you agree with that?
00:57:34
Bruce
For sure, for sure. And just that, that servant attitude or, or people that, you know, they do a strengths finder and you know, they're a type A or they're a leader, but the servant leaders are the ones that really attract people or get people to follow.
00:57:38
The Jobs Podcast
Yeah.
00:57:52
Bruce
And, and so just, uh, that humbleness is a big thing for sure.
00:57:59
The Jobs Podcast
Bruce, I really enjoyed our chat today. How can folks, if they're needing physical therapy, or how can they find you or your company? Do you have a website I assume?
00:58:08
Bruce
We do, Tim. Yeah, I appreciate that. we're Lincoln Orthopedic Physical Therapy in Lincoln, Nebraska, and it's just lopt.com. And then all of our therapists are listed there. They can find my contact information there as well.
00:58:22
The Jobs Podcast
are many locations do you have in Lincoln or around Lincoln?
00:58:25
Bruce
So we have 11 locations in Lincoln and around the area.
00:58:30
The Jobs Podcast
OK, cool. Thanks, Bruce. I really appreciate your time today. You shared a lot of very helpful information.
00:58:36
Bruce
Well, Tim, thank you. I really enjoy your podcast and I appreciate you having me and you're always well prepared and having great questions.
00:58:43
The Jobs Podcast
Oh, thanks. Appreciate it. Have a good day, buddy.
00:58:46
Bruce
Thank you. You too, Tim.