The 8-minute Rule Interview

🎙️ Walk us through your career journey and what inspired you to be in the position you are today?

I wouldn’t say my career path has been unusual, but it’s certainly a bit different from that of many clinicians. I trained over 30 years ago in England, back when it was a bachelor’s equivalent program. In fact, the PT school I attended no longer exists—perhaps a sign of just how long ago that was. I spent the first ten years of my career as a clinician in the UK, working across various settings, primarily within the public health system—which is, of course, very different from the U.S. healthcare system. I also worked in industry settings and even within the prison system, so it was quite an eclectic background before moving to the States. Once I came to the U.S., I continued working in musculoskeletal outpatient medicine, again across a wide range of settings—from nonprofit hospital systems to managed service agreements and physician-owned practices. For the last 10 years, I’ve been in what I would describe as the for-profit outpatient or retail healthcare space, largely within private equity-backed businesses. I treated patients in clinics for well over 25 years before gradually transitioning into leadership. I think the primary reason I made that shift was because, as a clinician, you help people one-on-one—which is incredibly rewarding. But as I progressed in my career, I felt a strong desire to make a broader impact. Leadership gave me that opportunity. In a leadership role within an outpatient therapy business, I can still help people—just at a larger scale, indirectly. That broader impact is what ultimately drew me toward leadership.

🎙️ What experiences would you say have shaped your approach to leading multiple physical therapy teams around the country?

Several key experiences have shaped my approach to leading physical therapy teams across multiple locations. First and foremost, my background as a practicing clinician allows me to lead with credibility—I never ask anyone to do something I haven’t done or wouldn’t be willing to do myself, and speaking the clinical language helps foster trust and alignment. Second, my diverse academic and professional background—including training as an engineer and earning a business degree—has given me a broader perspective on problem-solving, operations, and strategic growth. Finally, the challenges of leading through COVID significantly influenced my leadership style, deepening my appreciation for generational differences and reinforcing the importance of a people-first, empathetic approach to managing teams and organizations.

🎙️ In your past podcasts, you have highlighted the importance of recruiting talent within physical therapy. Given your insight into industry trends and the post-COVID landscape, are there specific qualities you now prioritize when bringing new team members on board?

I think this shift has happened gradually over many years—and it actually started before COVID—but the pandemic definitely acted as a catalyst. It accelerated the way I evaluate and think about identifying the right talent or clinicians for an organization. Years ago, there was a bit of a joke that if someone had a heartbeat and a license, they were good to go. But that approach really doesn’t serve anyone well—not the clinicians, and certainly not the organization. Ultimately, it comes down to soft skills and cultural fit. The key questions are: Do they have the appropriate soft skills? Are they a cultural fit for the organization? It’s not about whether someone is good or bad—it’s simply that people want different things, and without alignment, it’s unlikely to be a successful long-term match for either the clinician or the company. Those are really the two primary factors I look at now. From a technical perspective, everyone is licensed. Everyone’s gone through a certain level of education, and ideally, they have a baseline skill set in areas like manual therapy or clinical handling. And if they don’t, those skills can usually be taught. But what’s much harder to teach—or find—is someone who naturally fits the culture and brings the soft skills that align with the team and the organization’s values. That’s where the real difference lies.

🎙️ Right. Soft skills definitely play a big role. Most people come in with a degree and a technical background, but how do you approach mentoring young clinicians who are just starting out?

I think the development of emerging clinicians is multifactorial—and it takes time. The first and most important piece is support. Clinicians often struggle simply because they lack adequate support within their team or organization to truly succeed. That support doesn’t always have to be formal; it can be both formal and informal. Secondly, it’s about ensuring there are ongoing opportunities for continuing education—and that those opportunities are diverse. Continuing education can take many forms, and every clinician is different. Everyone has different needs, so it’s important not to push everyone down the same path. Flexibility is key. Once those two foundational components—support and tailored education—are in place, you can build on them. That might include offering certifications, fellowships, or structured development programs. But the real cornerstone throughout all of this is mentorship. No matter where a clinician is in their career, mentorship is critical. And mentorship can take many forms: one-on-one coaching, formal or informal learning opportunities, book clubs, journal clubs—the list goes on. If you can offer all of these components consistently, you’re not just supporting clinicians—you’re setting them up for long-term engagement, growth, and success. And honestly, these principles apply to any employee, not just clinicians.

🎙️ How do you see technology influencing the future of physical therapy practice on a national scale?

Yes, I think this is the beginning of a really exciting journey. The application of AI is already starting to impact businesses, but we’re still very much in the early stages. Take voice capture, for example—while that’s exciting in itself, I see it as just the first step toward more advanced capabilities like video capture and deeper technology-enabled support. But first and foremost, what’s needed is a willingness to adopt technology. And in that regard, we still have a long way to go—not just within the organization I represent, but within the profession as a whole. Change is hard. And while healthcare is constantly evolving, this feels more like a true paradigm shift—a technological revolution within the field. The opportunity lies in using this technology not only from an administrative standpoint, but also clinically. I don’t necessarily believe AI will save a significant amount of time right away, but I do believe it will reduce administrative burden and allow clinicians to focus more on patient care. Ideally, it will also improve quality. I believe that, in time, AI will be able to support clinicians in delivering more evidence-based care—right at the point of service—by helping identify what’s most appropriate for a given patient in real time. So yes, I believe the potential is profound. But right now, we’re just scratching the surface.

🎙️ Do you think there are any pressing challenges facing physical therapists?

One of the biggest problems we’re facing is a structural shortage of clinicians. Depending on which report you read, you’ll see varying estimates of the supply-and-demand mismatch—but for outpatient therapy in particular, the shortage is significant and likely to continue for the foreseeable future. Where I see AI and technology having the most impact is in addressing the ever-increasing administrative burdens placed on clinicians—whether from payers, regulations, or compliance requirements. Ideally, this technology can help reduce that load, easing stress and, hopefully, lowering turnover caused by the non-clinical aspects of care. Ultimately, the goal is to let clinicians do what they were trained to do: treat patients—not spend endless hours on paperwork, eligibility checks, authorizations, or justifying care to payers who are determining whether treatment is necessary. I see AI as a powerful tool to help clinicians get back to the basics—focusing on patient care, which is where they make the greatest impact.

🎙️ How do regional differences impact the delivery and practice of physical therapy in various parts of the country?

There are certainly significant differences in practice patterns between countries, but even within the U.S., we see notable variations in care delivery and practice patterns from state to state. These differences are primarily driven by two factors. First, payer dynamics—particularly with commercial payers—vary significantly by state. Reimbursement rates can differ widely. For example, a UnitedHealthcare contract in the Pacific Northwest might reimburse 20–30% more than a similar contract in the Midwest or other regions. These variations directly impact how care is delivered and what’s financially sustainable. Second, state regulations play a major role. Each state has its own practice act, which can dictate what clinicians are allowed to do and how they’re able to treat patients. These regulatory differences shape the way care is provided across state lines. So, even within a single country, practice can look quite different depending on geography, payer structure, and state-level regulations.

🎙️ Looking ahead, what changes or advancements would you like to see in the field of physical therapy?

I think there are several things that need to happen, but the most important one is shifting perception. Outpatient therapy services—and physical therapists in general—have long been viewed as ancillary providers in healthcare. They’ve often been seen as secondary or even tertiary providers of musculoskeletal care. That perception does a real disservice to the profession and to the value that therapists bring. Over the years, there’s been meaningful progress toward direct access. Laws have now been enacted in all states to allow some degree of it. But the larger goal is to shift the profession’s role—from being a secondary provider to being recognized as a primary provider of musculoskeletal care. After all, the musculoskeletal system is our sole focus. While other healthcare professionals may debate this, I truly believe that physical therapists are the experts when it comes to conservative management of musculoskeletal conditions. What we need to do now is ensure that the public—and patients—understand this. We need to be intentional about how we position ourselves and how we shape perception around the unique value we provide.

🎙️ What advice would you offer to new graduates entering the profession?

There are many important areas, but one thing I believe is especially critical for our profession is advocacy. Outpatient physical therapy—and I’d include occupational therapy and speech therapy under the same umbrella—has historically done a poor job advocating for itself and clearly communicating its value. And that’s really what it comes down to: we need to do a better job demonstrating our value, both in one-on-one patient interactions and at the broader professional level. We need to educate, advocate, and ensure that we have a seat at the table. For far too long, physical therapists haven’t had that seat, and that’s been reflected in long-term reimbursement pressures and cuts—especially when compared to other healthcare professionals. So my message is: get involved. Be a strong voice. Advocate for yourself, for your peers, and for the profession. We need to consistently demonstrate the value we bring—to patients and to the healthcare system as a whole.

🎙️ Just reflecting on your career entirely, what moments have been the most rewarding for yourself?

As a clinician, the most rewarding moments are often those personal milestones—when a patient takes their first step, when we’re able to alleviate their pain, or when they regain their independence. Those are incredibly meaningful. But as a leader, the reward comes from being able to impact lives at scale. For example, our organization has grown from nothing just a few years ago to now delivering well over a million visits annually. While I’m no longer the one directly treating patients, I have the privilege of supporting an incredible team of hundreds of licensed therapists who are delivering that care. My hope is that I provide value and support to the entire organization—both from a clinical and leadership standpoint. And that broader impact is deeply gratifying and rewarding in its own way.

🎙️ Any news or exciting updates to look out for with Alliance PT that the audience should know about?

Yeah, we were the new kid on the block. For many years, we actually weren’t even on anyone’s radar. But I believe we’re doing something really special, and I’m very proud of our organization. So, you know, if we’ve grown this much in a relatively short period of time—and managed to navigate challenges like COVID—I have no doubt that we’re going to continue to grow and become a primary national presence in outpatient therapy over the coming years. So, watch this space.