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NGPT explains how outpatient physical therapy differs in the two environments.

Private Practice vs. Large Hospital – Where Should a New Outpatient Physical Therapist Go?

Congratulations! You’ve decided you want to work in outpatient physical therapy. That’s an important first step toward your five-year plan to establishing yourself as an expert in a particular area. The next, very important, step involves a crucial decision: Do you take a job at a private practice or a corporate giant?

Private Practice Physical Therapy

Private practice offers many unique benefits, including a more intimate, family-like environment. Therapists may have the option to help decorate the clinic, have a say in the music playing in the gym, and directly influence the treatment philosophies espoused at the clinic.

Opportunities may arise sooner, as well. With less corporate red tape, you may find yourself receiving larger raises and bonus pay, and achieving more impressive titles and opportunities for growth more quickly than you would at a large system. Dress code may be more relaxed (though not always), and new grads may appreciate the opportunity to be addressed by the title “Doctor, ” after all that hard work in school.

However, it’s not all sunshine and roses in a private clinic. You may find yourself working extra hours “off the clock” to complete your paperwork. This is actually illegal, but a surprising number of private clinics have unspoken rules that therapists get their documentation done, yet overtime is not allowed. If you’re seeing 16-30 patients a day (many requiring tedious Medicare documentation), it can be very difficult to complete your documentation on time.

Vacation time may be difficult to come by, as well, and if you’re in a tiny clinic, it can be quite challenging to get the days off when you want them. Therapists often don’t receive legally required rest breaks, as they’re lumped into a longer lunch or a paperwork block (if you get one.)

Large Hospital Physical Therapy

Working for a corporate giant has its own set of perks and drawbacks. Strict employment laws mean you’ll likely receive break times and can expect to leave work within your scheduled shift (or at least receive pay for working overtime). Expect an enforced maximum number of patients you will be expected to treat during your workday, which limits therapist burnout.

Vacation and benefits tend to be more impressive than in private practice and, depending on the size of your department, it may be easier to get time off. Retirement plans may be available in both settings, but corporations typically have matching programs.  

On the other hand, the work environment may feel stifling. Don’t expect to play gangsta rap in the gym in a major hospital, even if you only have one 20 year old patient in the gym. If you’re excited to launch a new program or teach a course, your ideas may take months (or longer) to be approved. Change is slow or non-existent at times, and this aspect of corporate life can lead to its own type of burnout in PTs. Furthermore, many large hospitals require a weekend or holiday commitment in the acute department every so often, regardless of what type of PT setting you’re in. If you’re not into acute, this could be a deal-breaker.

Whether you opt for a job at a large corporation or a smaller private practice, you first few years will be pivotal to your career. Make sure you focus on the positives, learn as much as possible, and, most importantly, have fun!

About Meredith Victor Castin

Meredith Victor Castin
Meredith is the co-founder of She is originally from Tyler, TX and attended UPenn for undergrad, before graduating with her DPT from USA (San Diego) in 2010. She has worked in outpatient ortho, inpatient rehab, acute care and home health physical therapy, and currently works as a rehab intake liaison.

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