E851 | Should You Go To Med School or PT School?

PT vs. Medical School: How to Choose the Life You Actually Want

A former intern sat across from me at lunch with a familiar question: “Should I go to PT school or medical school?” He had the grades and the options. He also had the same interests I did at his age—orthopedic surgery on one side, physical therapy on the other.

I’ve lived that fork in the road. I spent time in military hospitals watching different worlds up close: the OR, family practice, rehab. The deciding factor for me wasn’t prestige or even pay. It was lifestyle—sleep, family, and whether I could show up for the life I wanted outside of work.

Here’s how I coached him to think about it.

Lifestyle vs. Income
If you love surgery and can’t imagine doing anything else, you already have your answer. But understand the cost. Surgeons carry call, work nights, and live with shift patterns that grind down health and family time. PT isn’t glamorous, but there’s no such thing as a “physical therapy emergency.” You can build a schedule that looks like a normal human life.

Income is different. Surgeon averages are high. Staff PT salaries, by comparison, aren’t. That’s reality. But that’s only part of the story. PTs who become business owners—especially cash or hybrid clinic owners—change the economics completely. You decouple your income from “hours on the table,” build recurring revenue, and create an asset you can eventually sell. I know owners earning in the surgeon ballpark without surgeon hours.

Loans and Length of Training
Medical school isn’t just one more year than a DPT program—it’s the residency and often fellowship that stretch the path to 13–15 years before you’re fully independent. PT has a shorter runway to practice, and if you spend a few years getting truly good, you can step into ownership far sooner.

AI and the Future of Work
Hands-on healthcare—whether in the OR or the clinic—remains durable. The world will keep changing, but people will still need someone they trust to repair tissue, restore function, and guide them through the long arc of getting back to life.

What “Wealth” Really Means
Money matters. But real wealth is also time, health, and relationships. I’ve watched shift work chew through all three. I’ve also lived the other extreme—building a business, sleeping too little, and paying for it. The solution isn’t to avoid hard things; it’s to choose the hard that leads to the life you actually want.

Who Should Choose What?
If the OR is your calling, follow it. The world needs you. If you want deep impact, a family-friendly schedule, and the chance to build something bigger than your billable hours, PT plus entrepreneurship is a powerful path. It’s not easy. You’ll be time-poor at first. But on the other side is a rare mix of autonomy, financial upside, and the ability to be present at home.

Next Steps
Shadow both paths for full days—clinic, OR, post-op, and call. Write a one-page decision memo with your goals, trade-offs, and non-negotiables. If you lean PT, start learning business now: pricing, sales, local marketing, and continuity offers. Protect your sleep. Play the long game.

The mission at PT Biz is simple: help build a model of practice that creates time and financial freedom for clinicians while delivering world-class care. If that’s the life you want, you’re in the right place.

Resources & Links
PT Biz Website — physicaltherapybiz.com
Free 5-Day PT Biz Challenge — physicaltherapybiz.com/challenge

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Ready to elevate your practice? Book a call at the link below with one of our expert consultants today and start your journey to delivering unparalleled physical therapy.

Podcast Transcript

Danny: [00:00:00] Hey, Danny Matta here, and yesterday I had an interesting conversation with a former. Intern, the clinic that I owned [00:00:10] and the topic was, should I go to physical therapy school or medical school?

[00:00:20] Now I'm gonna take some time to answer this question and I'll give you a little backstory real quick. This person I had a chance to catch up with, we grabbing lunch and he was a [00:00:30] patient of mine. Years ago was a competitive soccer player. We worked with basically every single one of his family members, including his parents and his and his sibling.

And this is a [00:00:40] great kid. Somebody I really enjoy keeping up with. And we sat down for lunch. He's in, finishing up undergrad and he said, Hey, what are your thoughts on [00:00:50] the difference between going to medical school and PT school? He pretty much has the opportunity. He could do either one.

He has the grades, he's smart. He has many of the [00:01:00] prerequisites already done and we talked about it for a little bit, right? Because ironically, I had a similar. Debate with myself as someone his age of what I should do. [00:01:10] And that was a challenge for me. At the time, I didn't know what I wanted to do.

In fact, I was leaning pretty heavily towards orthopedic surgery, which is actually what this kid is interested in as well. [00:01:20] And potentially, maybe non-surgical route. But, but I had a very similar, whatever fork in the road for me to decide what I wanted to do. And I was fortunate to be able to spend time [00:01:30] in military hospitals.

My dad worked in a military hospital, so I was able to spend some time in these different situations, different, these different departments and really see what [00:01:40] life looked like for people that were in the surgical world, what life looked like for people that were. Doing family practice what life looked like for people that were doing physical therapy and the lifestyle side for me was the [00:01:50] biggest determining factor.

But I wanna talk through this a little bit because I had some, some advice for him. And I think for people that are students, they. [00:02:00] They have to decide. Many of you that are a physical therapist, maybe you had a similar sort of debate with yourself or, decision to make of what you wanted to do as far as which school you wanted to go to and [00:02:10] what you wanna do for a career and.

Sometimes we look back and maybe we have a little bit of regret in terms of what we chose. I have zero regret for what I did, and, but I know people that have [00:02:20] gone to physical therapy school and then they go back to medical school, right? I've seen that, I have some friends that did that as well.

And it's a lot of school. That's a hell of a lot of school to make the wrong decision. So I'm glad I could talk to [00:02:30] to to my friend about this and and we could, she hashed out a little bit, but this is basically the way that I look. Data and my advice and if you're listening to this, I'd love to know what you think as well.

You can put that in the comments in a, in [00:02:40] YouTube or, if you're listening to this. As far as a podcast goes and you're listening to this on a podcast app you can always go ahead and message me on Instagram. It's Danny Matay, PT is the handle. I would love to have [00:02:50] a conversation and see what you think, but here's the way I looked at it.

Okay, I looked at a couple buckets, lifestyle, income, loans, school duration, and and I basically told him, I said, Hey, [00:03:00] look, if you want to go to school to become a physical therapist, I think it's incredibly rewarding career. You're not gonna make you income. As you would [00:03:10] as an orthopedic surgeon, if you just take a job working at a clinic for somebody else, like that's, let's just be clear with that, right?

You're gonna come outta school, you're gonna have a decent amount of loans, [00:03:20] probably a hundred to, $175,000 in loans, depends on where he goes to school and the options that he has. If you go to medical school, it's gonna be more than that. [00:03:30] And the road is a lot longer and I'll talk about what some of those numbers look like.

But he's not interested in going to school just to become a pt. He wants to open his own clinic. He's somebody that's been around the clinic that I had athletes [00:03:40] potential for years. Like I said, he was an intern there. And that's something that he is interested in is building his own business.

But doing so in a way that it's it's a mission-driven business. It's [00:03:50] a, there's a lot of impact on people and that's what he saw with physical therapy, and that's what he saw working at the clinic that, that we own. So when I had this conversation with him here's the direction this went and I'll go ahead and.

Layered [00:04:00] this in for everybody as well. Number one, I told him I think this is a really, good way to or good direction to, to focus in regards to the technology changes we're seeing happen in, [00:04:10] in artificial intelligence right now. In particular. In fact he was telling me a story about a couple of his friends that went to school for computer coding and that's a pretty difficult.

Job to [00:04:20] leave with right now, you're gonna be a junior coder. And there's, those are not getting hired nearly as much. It's just a lot of that's being offset by senior coders being able to leverage tech in a [00:04:30] more significant way. And they don't necessarily need to make those hires. So I think from a, from an AI installation standpoint, doing something with your hands, doing something in healthcare is a good idea.

Especially if it [00:04:40] involves surgery and, or, manual work with a physical therapy. So directionally, I think he's going the right direction. Now when we took a talk about lifestyle, this was the big [00:04:50] differentiating factor for me. The lifestyle, the difference that I saw between PT and orthopedic surgeon wasn't even close.

Okay. That was the nail in the coffin for me, [00:05:00] because I knew I wanted to have a family one day. I knew that I wanted to have. Some amount of work-life balance. And I didn't I'd already seen what it looked like with family [00:05:10] members that were involved in, emergency medicine, working swing schedules, night shifts, and I know what that does to your body and your health, and I know how hard that is on your family, and I didn't want anything to do [00:05:20] with that, frankly.

So that was. The number one determining factor for me was, did the job seem cool? Absolutely. Like it seems cool. You get to work [00:05:30] in some pretty cool environments. There's prestige that comes along with being a surgeon. There's obviously it's a very useful skill in many ways, but the lifestyle factor, it's a [00:05:40] plus one for pt.

It's not even close, right? You can go home, you don't have to work a night shift. There's no such th thing as a physical therapy emergency. You can have the weekend off, right? You can disengage. [00:05:50] In a way that you can't really, as, with being a with being a surgeon. It's a it's definitely a tougher lifestyle.

When we look at income. It's not even close. Orthopedic [00:06:00] surgeons, the average is about $500,000 a year. Is the income that they're gonna make some less, some more depends on if you're in a private practice. If you're more senior, you've been [00:06:10] around longer, what type of hospital organization you work for.

There's lots of factors, but that's roughly where kind of middle of the career is. For a physical therapist. If you're making a hundred thousand dollars, you're doing pretty good. So [00:06:20] it's a vast difference as far as income is concerned. When we look at school. It's a lot shorter for physical therapy and not necessarily medical school is one year [00:06:30] longer than than a DPT program, but you gotta look at.

Everything you have to do after the fact, right? So if you're an orthopedic surgeon, you have four years of undergrad. Same with pt, you have [00:06:40] four years of medical school, three for pt. Then we're done with that part of it. If you wanna be a surgeon, an orthopedic surgeon, you're looking at a five year residency after the fact.

[00:06:50] Plus, you also, in some cases, will do a one to two year fellowship. It, it may even be more depending on what you're specializing in. So you're talking about [00:07:00] 13 to 15 years until you're actually not. In a residency or fellowship, and you're fully functioning as a, as an orthopedic surgeon this not still going through training, [00:07:10] okay?

That's not the case with physical therapy. Even if you did four years of undergrad, three years of your DPT program, you did a year residency after [00:07:20] the fact, you wanna do like an orthopedic or sports residency. Okay? Maybe it's two years. You really draw it out. But even still, it's not quite the same.

It's not as intense as as being a [00:07:30] resident in a hospital learning how to do surgery. Like it's not even close. When you look at school, it's much faster and really the path to becoming a full on orthopedic surgeon, 13 to [00:07:40] 15 years the 13 year window that I looked at for PT to start your own business and have, and really scale it, it's about what you're looking at.

So you got four years of undergrad. Three years of [00:07:50] PT school, then you have three years of getting experience. I think this is actually really important for a lot of people that, that they go into their own clinic too fast. It's, they usually struggle [00:08:00] with the competency side, like the ability to feel confident that they can get some of your results.

And really. Like selling themself. I think that's a challenge when you don't maybe feel all that great about your clinical [00:08:10] skillset. So three years of that, before you start a clinic, you start your own clinic and then you get three years of scale. And we've seen people scale businesses, these clinics pretty fast within three [00:08:20] years.

Getting to, 700,000 to a million dollars a year, top line revenue by the third year in business for us. Net profit for us. This was obviously 2000, [00:08:30] this was like 2018, 2017. So it's a little different as far as like income is concerned. But we were around $300,000 a year in net profit and [00:08:40] income after three years of starting our clinic.

Yeah, no, it's still not quite where you're at with an orthopedic surgeon, but I know plenty of cash-based clinic owners that are, that make, four to [00:08:50] $600,000 a year depending on how many clinics they have. Some more than that. If they have a number of clinics or they have a really, like a larger clinic, they can definitely be in the seven figure range in terms of profit.

And. [00:09:00] You could do the same thing as a surgeon. There's definitely earning potential to be higher than the average, especially if you go into private practice or something like that. But if you're gonna take a chance on [00:09:10] yourself as a clinician, as a physical therapist, that's your best bet to have income earning potential, similar to an orthopedic surgeon.[00:09:20]

And what you're swapping out though, is you're swapping out the lifestyle. Still now owning a business. It's no joke. Okay. There's definitely some drawbacks to [00:09:30] that from a time standpoint, from a challenging schedule standpoint. But there's no night shifts, there's no, you're not on call necessarily.

They may have stuff that pops up, [00:09:40] whatever. Somebody doesn't come in, you gotta fill in for them or something to that effect. And there's obviously challenges of running any business, but, for me, when I look back on it, and with this conversation I had with this with this [00:09:50] guy, it was pretty obvious. I think he was like, okay, I don't really want to do this, but it seems like I need to explore this because I could, I could do it. And it seems like there's [00:10:00] maybe it's more of a a sure path as far as, your compensation is concerned and the lifestyle that you know, you can expect when you go down the path [00:10:10] that I did and that many people that listen to this podcast did.

It's hard to say. You know what it, what you're gonna actually do, but. When [00:10:20] we look at the monetary side of things, and this I think is a really big concern for anybody that's deciding to go to this advanced school, is you're investing in yourself to be able to get a degree, [00:10:30] which you don't wanna make the wrong investment.

You don't wanna be, my friend that went to PT school and then went back to medical school. Unless you just love school in that scenario, cool. That's go [00:10:40] for it. But most of us, like we don't wanna make the wrong decision and spend all this time and money and effort and energy getting the wrong degree and ending up in the wrong career [00:10:50] field.

Having the right understanding of what you wanna do is very important. But when I went to physical therapy school. I went to physical therapy school in the [00:11:00] army, with the Army's Baylor army Baylor Physical Therapy Program. I didn't have any idea what it would look like to own a private practice.

I didn't know [00:11:10] that was something I could do. I had zero interest in it, frankly. It, it just wasn't even on my radar. I just wanted to be a physical therapist in the Army. I thought it'd be an awesome job. It was, had a great time, [00:11:20] would totally do it again, and, just. By circumstance and in some cases, luck.

You end up getting connected with people to give you opportunities to do other things. [00:11:30] And you evolve and you have a different career trajectory. But if you can go into that sort of understanding where you want to go, like I ended up where I am today in some ways, just by [00:11:40] accident.

Just by just saying yes to people that I thought were influential in my life and things that I wanted to do. And if you can be a bit more structured with what you're trying to [00:11:50] do and ultimately what you want, I think you're gonna get there faster even than I did. And that does put you in a trajectory where.

You really can make surgeon money without the surgeon [00:12:00] lifestyle. And I think that's the cool part about what we can do as a physical therapist, where we can still have this like incredible impact with [00:12:10] people from the standpoint of what we help them with to so much so like we would do it for free.

Like we love helping people get over injuries and back to things they like to do. There's nothing better than that, frankly, in my opinion. [00:12:20] But we can do that and we can have. A financial stability that. It is hard to achieve in our [00:12:30] profession unless you go into your own thing. Because of the income earning potential of being an employee.

It's restricted, essentially by the revenue you can generate. We don't generate a huge amount of revenue, like per [00:12:40] provider. If you can get to $300,000 in revenue generated as a provider, that's like really good. That's you're pretty damn efficient as a pt. If you're a veterinarian, you're looking at a [00:12:50] million dollars a year in revenue generated, right?

So like the, what they can earn. Based on a portion of that they're getting paid versus what a PT can earn. It's just not gonna be in the same ballpark. [00:13:00] The economics of it don't work out. So if you go and you build your own practice, that's when you start to change your economics in terms of what you can actually generate.

And not only [00:13:10] that, but we're not even talking about the time side of it. We're just now we're, we can get to there or to, to that side of it, but. If we can get even close [00:13:20] economically to the income levels of a orthopedic surgeon, which is possible, like I said, I could point to people all across the country that are there, and this is just the difference between being a [00:13:30] business owner who happens to be a physical therapist and someone who has a highly specialized skill set as like an orthopedic surgeon, but the lifestyle side of it, completely [00:13:40] different, especially as you build a successful business.

Other people are involved. You have administrative, staff, you have clinicians, you have maybe a clinical director. You have [00:13:50] people on your team that are supporting the business. And it's not just you doing everything. It's not just you your efforts based on how many surgeries you [00:14:00] do, tied to how much you're gonna get paid.

You, you decouple from that. And this is what I did not understand whenever [00:14:10] I started a business. This is actually the most important thing to understand that if you're gonna go this direction, you are building the infrastructure to decouple [00:14:20] from your efforts being rewarded on a per time, per session, per minute, whatever basis.

You're still gonna do things, but [00:14:30] those things can be. Compounded differently because I might make this video, okay, I make this video, it takes me x amount of time. I'm not getting [00:14:40] paid for that time directly. But this might actually create who knows how many clients that we get a chance to work with and help them build businesses.

Because the effort that I've put into this [00:14:50] and hopefully the ability to educate people on how to run a business effectively and build trust to where you may say, you know what physical therapy biz seems like? Reputable people, they're doing [00:15:00] solid work, and I need help. They seem like the right people to help me.

Cool. We'd love to be able to have the opportunity to do that, but this video is, it's not a, I'm getting paid a [00:15:10] hundred dollars an hour to do this video or something to that effect. This is something that is gonna decouple from that exchange. And real wealth is not just [00:15:20] monetary. This is really important.

Real wealth is not just monetary because I can tell you if you look at the World Health Organization and what they look at when they see shift work, it's viewed as a [00:15:30] carcinogen. Cancer causing shift work is cancer causing. That means you're gonna fucking die earlier. So if you take a job where [00:15:40] you're working, shift work, just know that's what's gonna happen.

Why do they have a differential at night when they pay? Pay people more because they have to. 'cause people know it's bad for their health and people don't wanna do [00:15:50] it. We're not nocturnal. We sleep at night. So you have to pay people a lot more money to work the graveyard shift as, because it's going to literally shorten your [00:16:00] life expectancy.

It's terrible for our health. We know that. When we go that path, that type of traditional medical surgical path and many other fields within healthcare, [00:16:10] it's hard on you. It's hard on your physical health, it's hard on your relationships. It's hard on everything around you to have normalcy. Super difficult.

And if you want that and that is a, [00:16:20] there, there are something very admirable about people that wanna do that. It's fantastic. I have family members that do that and. We need people like them, like the healthcare system needs more people [00:16:30] like them. In fact, they're having a hard time finding people like that because it's such a challenging career lifestyle.

But if you don't want that, like I didn't want that. If you wanted to be able [00:16:40] to drop your kids off at school and pick them up and go to their games and not have to miss life along the way, this is a fantastic compromise in a [00:16:50] way where you can create time freedom. And I didn't always have time freedom.

I. In fact, I had the complete opposite of that for years as we were [00:17:00] building our business. My wife and I, just, God killed ourself in the process of building our practice up is hard. It's not easy, and not everybody's gonna be [00:17:10] successful either, but if you can get to the other side. Now all of a sudden you've created an opportunity where you have just such a unique life, such a rare opportunity to enjoy the [00:17:20] time that we have here with the people that we wanna spend that with.

And that is something that I would never ever exchange. I've never changed that. I, you couldn't pay me enough to trade [00:17:30] that out because I know what it feels like on the other side, and I know what it feels like now and. I like it here a lot more, but getting here takes a lot of effort and you will be time poor for a long time.

As you're [00:17:40] building a business. You're gonna have to make sacrifices, and that's just part of it. But I can tell you, if you want to be a surgeon, go be a surgeon. If you want to be a surgeon, if you really want to be a surgeon, go do it. [00:17:50] But just understand you're, you are exchanging some things that might be very important to you.

You're swapping those things out in exchange for, very [00:18:00] demanding, stressful. Job that, and if it's your calling, you gotta do it. You gotta do it. And you just know that, my, my family who are in emergency medicine, it's their calling. It's what they [00:18:10] do. They don't have a choice.

It's a thing they're supposed to do in life and they know that, right? So if that's not you, then don't just go become a sur become a surgeon 'cause you think you're gonna make more money. That's not [00:18:20] necessarily the right path either. So being able to pick the career field that you want, and in, in this case, many of us, it's physical therapy.

Obviously we, we chose that even knowing [00:18:30] maybe, our income earning potential is far lower, but being able to couple that with a business that creates time and financial freedom for you and your family creates an asset. Creates a, creates an asset you can [00:18:40] sell if you're a surgeon, you work for somebody else.

You can't sell your job to somebody one day. That's not how it works. If you have a practice that you build, cool, you can do that. That's even harder. Can you imagine going through [00:18:50] all that school to to go to the surgical paths? Then you have to learn how to run a business or partner, in, in some way.

That seems even harder to me than what we do, which is obviously like far less [00:19:00] intricate. Let's be honest. Helping somebody with back pain is not nearly as intense or intricate as replacing an ACL, so it's far less that technically that we have to learn. [00:19:10] And we can become really great business owners and we can help people in a really meaningful way.

And these businesses are growing. People are looking for businesses like this. They want someone that can be proactive in their health with them. Like [00:19:20] they, they want to have the ability to say, yes, I don't wanna wait until there's a problem. I wanna stay on top of my health. I want to. Live a high performance, pain-free life for as long as I can.

What a great time to have a business like that. I don't see that [00:19:30] going anywhere, anytime soon. So I think you're in a great spot. This was a super interesting conversation that I had with the, with this buddy of mine. I, I'm excited to see what he does in the future. He is, he's a sharp [00:19:40] guy. And it's it's fun for me to be able to say, Hey, I remember having that same conversation, man.

With myself and expose myself to what it really looked like in these different environments [00:19:50] and these different jobs. And, I wanna make sure that I at least share this with you. And for those of you that have gone through the same thing, maybe you would find the same conversation.

Interesting. And also just, I'll end [00:20:00] it with this. I'm very thankful for the opportunities that I've had for the career that I chose and the life that we eventually have been able to build. And if you are a physical therapist and you [00:20:10] wonder, man, am I ever gonna be able to. I put myself in a position where I feel like truly like financially secure the path for most people to do.

Unless you have a spouse that has a [00:20:20] really great job and you can do a fantastic job of living well below your means and not moving the goalpost. That's the key for most people. But. If not, and you need to increase [00:20:30] what you're making, this is probably the best option you have besides switching careers.

And then that's an option for some people. But I would I would hope that we keep the best people in the profession and. [00:20:40] This is a proven path at this point where you don't necessarily have to be completely in network. It can be a cash clinic, it can be hybrid clinic. It can be whatever you want, but it's there.

It's a growing [00:20:50] portion of the field. I'm excited to be a part of it and I hope that you enjoyed this one as much as I enjoyed having this conversation with my friend. And as always, I appreciate you watching and listening. If you are listening [00:21:00] to this on the podcast and you wanna see the video version of this.

Head over to YouTube. You can check us out there. We have all of our clinic tours in there as well, which we have a whole nother batch of those that are gonna be [00:21:10] coming up. We're gonna be changing that a little bit and really just sort highlighting the cool stories of the people that we get to work with.

We're excited for that. So if you wanna watch those, head over to YouTube. If you wanna listen to this, you can listen us to anywhere you [00:21:20] listen to your podcast. I'm a Spotify guy. I dunno about y'all, but I choose to have me for years Spot. Spotify is where it's at for me. So I appreciate you listening.

Appreciate you watching. We'll catch you on the next [00:21:30] one.