Speaker You’re listening to Allied Health Podcast, talking all things Allied Health with your hosts, Danielle Weedon, physiotherapist, and Clare Jones, occupational therapist.

Danielle Weedon In this episode of Allied Health Podcast, Clare chats with Courtney Donaldson, an ESSA accredited exercise physiologist. Courtney graduated in early 2020, and not only did she take on the challenge of establishing her own EP business as a grad, she did so just as COVID took hold. Now, working in her own business and as part of a team with a physiotherapy private practice, Courtney shares her insights and advice when it comes to starting a career in exercise physiology, and highlights the positive impact she has on the lives of her clients as an EP.

Clare Jones Hi Courtney, and welcome to Allied Health Podcast. It’s great to have you here.

Courtney Donaldson Hi, thanks very much for having me, I’m excited to be here.

Clare Jones Now, Courtney, you’re an ESSA accredited exercise physiologist working in the disability sector. Can we start by you telling us a little bit more about your journey as an EP so far?

Courtney Donaldson Yeah, absolutely. I suppose when I compare my journey with a lot of my peers or exercise physiologists that I know, my journey does look a little bit different, but it’s all very exciting to tell. So, I graduated at the end of 2019, or I was class of April 2020 graduate, so I got my accreditation at the start of 2020, which also was the start of COVID for all of us. And I was, at the time I was working as a personal trainer at a gym, so I’d been there for a couple of years, just working as a trainer while I was studying and the manager of the gym actually said, oh Courtney, we know you’ve just graduated and we’re looking for an EP, we’d love to have an EP at the gym. We have a really big strength life programme at the gym that I work at. So that sort of fit in really well; went hand in hand quite nicely. And he said, You know, if you want the role going for it, it’s yours. We’d love to keep you basically. So yeah, I suppose I’d never at that point in time even dreamed of starting my own business. And there I was as a new graduate. And then the start of the COVID pandemic, starting my own business, which was daunting. And it all happened so quickly that I probably didn’t even get much of a chance to sit down and think, OK, what am I actually doing here? So that’s where my exercise physiology journey really began, I suppose, and it started slowly, and then of course, we got into the thick of the pandemic and we are all in… South Australia was in a sort of semi lockdown state where gyms were closed, but exercise physiologists were still essential. So luckily enough our gym being family owned, they were happy enough to give me the keys and say, you know, use this space as you need to. So they were all doing personal training sessions outdoors, and I was lucky enough to stay in the gym and work with my clients in the gym. But it was a slow start, you know, building up my client base in the beginning. So it was stressful in a sense, but it was also kind of nice easing into it as well, despite the insecurity of it all.

Clare Jones I guess typically when you start your own business, you do generally start slow, but starting it at the beginning of a worldwide pandemic, I guess it’s, really does give you the opportunity to take things slowly, if you’re looking for a positive.

Courtney Donaldson Yeah, absolutely. And slowly it was, you know, I think the business side of things didn’t really start picking up for me until the gym had reopened. And we all sort of had a little bit more security with what was going on. And then, I suppose, what our future was going to look like as we were, you know, walking day by day head on into the pandemic. So it started to take off once things had started to open back up, which was, I don’t even remember now, it was probably spring time last year, I would say sometime around August, September when we started to open up again. And yeah, it was a weird time. But the business slowly started coming together and in September of 2020 as well, I actually secured part time employment with a family owned physiotherapy clinic. So I’ve been working there for the last year, just a day and a half a week, but that’s been really, really good, really fulfilling as well because I’ve had a team that’s very supportive and I’m not just on my own 100 percent of the time, which can be and still is stressful and you know, scary.

Clare Jones Do you work with another EP at the physiotherapy practice?

Courtney Donaldson Yep, so our practice has always had at least one EP, or in the last few years has had at least one EP, but their position hasn’t been very stable, so they’ve had a few come and go. And at about the same time, or a couple of months before I started working there, another EP started working there, and we actually together developed the exercise physiology component of the physiotherapy clinic. So that’s been really exciting as well. I’ve almost had two sort of businesses being started up. Just one with a team of physios to be supportive, you know, so we had lots of referrals coming from them, which was a lot easier than working for myself. I had to go out and source my own clients, and that process looked, I suppose, a little bit different. But my colleague and I, we sort of developed our exercise physiology programme, and we’re just about to start looking for a new EP to join our team, hopefully.

Clare Jones Fantastic! So working in the two roles, so working for your own business, Move Better Exercise Physiology, and working with the physiotherapy practice; what does a typical day look like in both roles? What does it look like in your own business to start with?

Courtney Donaldson Yeah, I mean, I suppose the services that are offered between my business and the physiotherapy clinic look pretty similar. My business is run out of a gym. Over at my other role, it’s out of a physiotherapy clinic, so there is a small gym space. Over at Move Better, I have the freedom to run around an entire gym, so I have a lot more equipment and machines and things to play with. But as for my day to day, it looks pretty well similar I would say, in that I see on both ends, a handful of NDIS clients, and I also have a little bit of the other stuff come through, like Medicare and DVA and even some private paying patients coming through from time to time as well. So, you know, it looks pretty well similar. Most days I’ll have some kind of in clinic or in gym work where people come in and they see me, and other times of the day I’ll be heading out, doing home visits, visiting people in their home or in their retirement village or wherever it is that they’re staying and doing exercise services at their house. So there’s a bit of both of those going on, you know, with both businesses. So nice and busy.

Clare Jones And in terms of running your own business, what do you need to do outside of seeing your clients face to face? What else is involved?

Courtney Donaldson There is, there is a lot that’s involved, and I almost feel like when I go to the physiotherapy clinic, it almost feels like a little bit of a holiday because I don’t have all of that admin work and management work weighing over my head because there are administration teams and accounts teams and management that does those things that I have to do for myself when I’m working for Move Better. So, you know, of course, I have to take care of my own accounts, and that’s actually harder than what you would think, you know, especially when there’s a third party payor involved. Often, you know, invoices aren’t paid on time and you’re chasing up plan managers or, you know, case coordinators or whoever it is that’s paying their client’s bills to me. There’s a lot of that involved. So, you know, bookkeeping, make sure you’re always on top of having those things assigned to sessions, or patients or things like that. You know, sending out invoicing and even just the tax side of things is always doing my head in. I have to make my own HECS contributions and my own superannuation contributions. And these are things that I didn’t think about before I started my own business. So I am very lucky enough to have a very good tax accountant who is just all on top of that for me, and he keeps me in check. He’s always chasing up the things that I need to provide. So the administration side of things is much heavier than what I thought it would be. But as long as I suppose, you know, you’ve got the initiative to go out and take the time to learn, or take the time to find the support, like with my tax accountant. You know, it takes a load off by doing that, rather than just, I suppose, trying to take things as they come and finding… I mean, I’ll say finding good systems to put in place. I’m still not so good at that myself. You know, I still find myself going, Oh my God, I bet there’s a way more efficient way of doing this, and I’m still doing it, you know, this very slow, tedious sort of way that could just be well and truly improved if I actually sat down and took the time to, I suppose, implement a better system.

Clare Jones I think running your own business can seem really easy and seamless when you’re looking at it from the outside. And I think you’ve made some really, really valid points there, that it’s very time consuming. Everything that happens in terms of, you know, everything that’s not face to face is time consuming. It’s time consuming getting those systems, creating systems, getting those systems in place, they’re all things that you can’t bill anyone for. So they’re all hours that you’re really not being paid to do as such. So financially, you really need to factor in the hours that you that you need to set up, and to continually run your business as well, don’t you?

Courtney Donaldson And yeah, absolutely.

Clare Jones And I really like the point you make, that you need to work out what you’re not expert in and find an expert to do those things for you. You need a general understanding of things like accounting and tax, maybe it’s best to hand it over, again factoring those fees to your financial [?], then hand it over somebody who actually knows what they are doing.

Courtney Donaldson Definitely. I couldn’t even tell you the amount of times that I’ve probably screwed something up, and my poor tax accountant has had to come in and pick up all the pieces. And, you know, it’s that time of year now. So he’s been chasing me up for all those little bits and pieces that I haven’t sent him. And you know, he’s like, Courtney I need, you know, x y z, can you get them to me? And I’m like, Oh, I’m sorry, you know, I’ll get them to you eventually. But pulling those pieces together to get them to him as well.

Clare Jones Even that’s a lot of work, isn’t it?

Courtney Donaldson Yeah, yeah. [?] is definitely the right word because most often, you know, the tasks themselves aren’t hard or, you know, big, but they do take time. Yeah. And it’s just, you know, other people have the admin team, like I said, who does that for them, and that’s why I didn’t realise that, you know, having to do this all myself, you know, I would almost go as far to say that my business is 50 per cent face to face with clients and 50 percent behind the scenes administration. You know, emails, phone calls and even outsourcing, you know, advertising. I don’t even do that very well, either. But yeah, it’s definitely, definitely time consuming. There’s a lot of it. So if you’re thinking about going to start your own business, be mindful of that. Probably look into that first because I didn’t and I was hit by a train with administration work.

Clare Jones Given you’ve got experience starting your own business as a brand and working as an employed EP with the physio practice, what advice would you give graduates who might be contemplating going down either pathway or maybe even down both, as you have done? Key pieces of information there, key pieces of advice, sorry.

Courtney Donaldson Yeah, look, there’s probably a few that pop to mind immediately. I mean, like I said, if you’re thinking about going out and starting your own business, do your homework first. Because I think, you know, like I mentioned previously, it is scary and it is daunting. And you know, more often than not, you’re probably just going to be doing it yourself. So doing your homework, making sure that you know what is involved before taking that big leap. If I could do my time over, I would have looked, you know, looked far more into it before stepping right on in because I did step right on in and I thought, Yeah, what a great idea. And you know, I set up my ABN and I made a business name and then I went, Oh my goodness, you know, I’ve got all of this work to do now. And even still to this day, you know, it’s sort of approaching that two year mark of having my business. Still to this day I’m faced with things where I’m like, I had to do that, like I didn’t realise that or, you know, it’s something that I hadn’t been doing, and it’s just gone all this time now without having done it. And now I’m like, Oh, my goodness. So yeah, that’s probably the number one in that sense. And again, having some kind of support around you, or people you can ask questions to. Like, you know, definitely a good tax accountant is probably number one because, yeah, I’m an exercise physiologist. I don’t know how to pay my tax. I don’t know how to do my BAS. You know, that’s super important. But in terms of exercise physiology as a job in general, finding, I suppose a team that you can work in and you can work well with, because it can be very hard on your own. So if you find a, you know, a workplace or a team that you seem to gel really well with and you’re all on the same page in terms of philosophies and ideologies and things like that, I think that’s very important. And that’s I’m very lucky to have that over the physiotherapy clinic. You know, we all have very similar philosophies and I suppose, you know, we’re all very passionate about what we do, which makes our job that much easier to do because, you know, if you like what you do, you don’t work a day in your life.

Clare Jones So true. So working at the physio practice, once you, I know that you started in that role for about six months after starting your own business, what did it feel like then to have that clinical support and exposure to experience and professional development? How did it feel, opposed to working on your own?

Courtney Donaldson I think my skills as an exercise physiologist have definitely improved, you know, double, triple what they did in that first six months, because I have had people to ask questions to, I have had a team to bounce off. I have had access to far more professional development opportunities than I had on my own. So I think my skills and my knowledge is a huge improvement. From just joining a team. And my confidence as well, my confidence on my own. You know, I suppose you could say that I was confident because I was confident enough to go out and start my own business. But, you know, in the beginning, I still thought, I don’t even I don’t know what an exercise physiologist does. I’d sit in an initial assessment and go, Oh my God, I don’t, I don’t know what to do. And it feels like you practise that so much at uni and then you step out and suddenly you’re doing it on your own and it’s all out the window and you’re just like, This is nothing like uni. I have no idea what I’m doing, and I still feel like that, you know, a lot of the time now, but less so. Less so. I have the confidence that, you know, if I don’t cover everything in that initial assessment because I’m unsure, I can then go regroup with my team, ask them questions, get some feedback. And then in the next session with that person, I can go over what I’ve missed.

Clare Jones Yeah, they’re really, really typical feelings for so many grads. I know when I was a grad OT I felt exactly the same way, and it’s like a penny drops, when you do think – I can’t know at all? I’m I’m only a graduate, and that’s all you need to do is stop and go and seek the information that you know…do as much as you can, go and get the information that you need, then come back to it.

Courtney Donaldson Yeah, absolutely. And I feel like you come out of uni and everything has sort of been programmed almost like we’re robots. But you know, then you step out into your first initial consultation or, you know, your first real exercise physiology session. And it’s it’s absolutely not the same. You know, these are no longer just made up case studies in the classroom and suddenly they’re a real person and they have real things going on at home and they’ve got real psychological challenges and things like that. And, you know, sometimes an initial assessment, most times an initial assessment, doesn’t go the way you hope it would go or it doesn’t go the way you’d want it to go. It just goes how it needs to go on that day for that person. And that’s fine.

Clare Jones Yeah. I think as a grad, I often had these expectations around what, how it should run and how it should be and what it should look like. And I quickly learnt that every assessment, every intervention is completely different, and you really need to accept the fact that they are all different and it’s, and you can’t pigeonhole things. I think the other point, too, is when you step out as a graduate, all of a sudden your clinical placement supervisor is no longer standing beside you and your thoughts go from, you know at uni it was everything that you did know, to all of a sudden you think about everything that you don’t know. That’s when you can get really overwhelmed.

Courtney Donaldson Yeah, absolutely.

Clare Jones So Courtney, you’ve had a really interesting experience considering you’ve been an EP now for 18 months and you’ve had your own private practice and you’ve also worked in another private practice. What have been some of your most memorable moments so far?

Courtney Donaldson There are just, there are too many memorable moments to count, and you know, there are memorable moments most days, I think. Especially working with NDIS participants, that is often super duper rewarding. And you know, I’m always celebrating the wins. But one of my most memorable moments is, this client was actually someone who was handed over to me when I was a personal trainer, and he’s still working with me to this day, and I’ve had permission from him to share a little bit about his story. So he, like I said, started working with me when I was a personal trainer. He actually has a diagnosis of cerebral palsy, so he mobilises full time in a wheelchair. He sometimes uses a walking frame to get around his house, but for the most part, he is just in his wheelchair, and he was going to the gym and working with a personal trainer before he started working with me. But, you know, there are a lot of things that probably, I suppose aren’t thought about on a personal training perspective as what there are on exercise physiology perspective. So I mean, I guess one day, you know, there was treadmill walking in this programme, and I sort of said one day, why don’t you walk holding on to, holding on to me, you know, because you walked on the treadmill? He was really leaning onto handles of the treadmill and he was really relying on that treadmill to be there, and it just looked super uncomfortable for him. I didn’t really like it personally. So I said, you know, why don’t we go for a walk? Why don’t you just hold my arm, and we’ll walk? And he did. And you know, it surprised him. It surprised me and it worked. And that was the first time he’d actually properly walked in, you know, so many years. He’d sort of walked without his frame by scaling across the wall when it was really necessary. And that’s usually when somewhere is unaccessible, like a bathroom out in public or something like that. But I suppose that’s not really considered actually walking, going for a walk. So, you know, why don’t you just hold on to my arm? And off we went and we walked around the gym and we gradually started adding obstacles. And then we were going upstairs into the second ground floor of the gym and we were walking around upstairs. And, you know, now he can walk comfortably everywhere as long as he’s got someone to hold on to. So he feels now that he can access public spaces a lot more comfortably because he’s been able to build up this confidence and this mobility with his walking. So that’s been something that’s just been so fantastic for me to be a part of. And it’s not a huge, I suppose, physical improvement or physical win, but it’s psychological and he’s got that confidence now, and he’s got that feeling of he can do it. And he doesn’t have to, you know, I suppose, consider where he’s going or what he’s doing so much because he knows that he, if need be, will be able to get up and have a little bit of a walk as long as someone’s there to give him a little bit of a hand. So that’s been really nice to see.

Clare Jones And it must have had such a positive impact on his functional ability in terms of just accessing, you know, his space around his house and accessing outdoors. It must be a great feeling to be off a treadmill and actually, you know, while he’s assisted, you know…

Courtney Donaldson Putting it into practice. Yeah, for sure. And you know, he thanks me every day for the help that I’ve given him. I always tell him, you’re the one who puts in the hard yards and I’m just here, you know, making these things accessible for you or, you know, helping you to develop the confidence to be able to do them yourself. He puts in the hard work, he lifts the heavy weights and you know, I am just there, you know.

Clare Jones And have you, in terms of working within the NDIS scheme and working with this gentleman in particular, have you often [?] practitioners in a position where they can advocate for more services? And have you had any any involvement in that capacity with this particular client or other clients?

Courtney Donaldson Yeah. I knew pretty well nothing about the NDIS when I started working.

Clare Jones Another thing you had to get your head around.

Courtney Donaldson Yeah, absolutely. The extent of my knowledge was they paid the bills and that was about it. And he, when I started working with him, he actually was paying out of his pocket for personal training services. And I started working with him and I sort of said, you know, what are you doing? Why are you paying for this? The NDIS should be paying for it, because you know you’re eligible for that. Yeah. And he was like, Oh, you know, they give me my wheelchair every five years, and that’s the only thing that they’ve ever paid for. And yeah, he was one of those people that sort of got lost, I suppose, in the cracks. He’s 28 now, and he, I think, was with Disability SA before the NDIS was brought into effect. And so he automatically got put on to the NDIS, but he never had the education around, you know what services he was able to claim through the NDIS. So that’s when I sort of decided to take the time to do a bit of learning about what the NDIS is and what, you know, services people can claim through the NDIS. And you know, that’s when we started to really hone in on his NDIS plan and start to gather the funds in, the budgets that he needs, basically. So there are so many things that he needed that he was never getting, still doesn’t get. So it’s an ongoing battle, unfortunately, but we’re getting there. You know, he’s no longer paying for these services out of his own pocket. He’s able to, you know, use his money for the things that he wants, you know, and he’s able to save money now. He never had savings before because it was paying for physical therapy of sorts, because that’s what helped him, you know, mentally and physically. And that was his entire disability pension pretty well gone once he paid for all of that. So yeah, I sort of stepped into a little mini advocating role for him, in a sense. And it’s been a journey. And, you know, I think I’m so much better off for it now because I’m able to provide other people advice that I wasn’t once able to provide. And I think I’m even able to provide better recommendations in my progress reports. I [?] someone’s plan now than I was ever able to before, because I just have so much of a better understanding of what the NDIS is looking for and I suppose all those little nooks and crannies of the NDIS that you never sort of really aware of until you start digging down those rabbit holes and finding that information?

Clare Jones And it’s one of those things that’s often underestimated when you’re working through any scheme, but particularly NDIS, is that you can play a huge role in advocating for your clients and your participants to really improve the quality of services that they’re receiving and ultimately having a really positive impact on their quality of life.

Courtney Donaldson Yeah, absolutely. And you know, while it is a battle at the moment and it is very stressful for him because he’s constantly worrying about, you know, we don’t have enough money and what are we going to do and things like that, but I’ve got to keep reminding him that, you know, you never had these services before, like this is a win so far. You know, we will keep working at it. We’re already 10 steps ahead of what we were, you know, when we started working together. So, you know, a huge, huge difference for him. And he hasn’t actually had modifications done to his house since he was eight years old. So he’s still using rails fitted for an eight year old and trying to get his wheelchair through a narrow, narrow doorways. And, you know, so there’s some things that we’re trying to work on at the moment, making his home, his own home more accessible.

Clare Jones So I would imagine a lot’s changed for him since he was eight. I’m sure he’s …the wheelchair size alone has increased.

Courtney Donaldson Absolutely.

Clare Jones I hope it has! Well, thanks so much for joining me today, Courtney. It’s been so interesting to hear your journey so far, in particular because you have gone down that, you know, private practice dream and gone into another practice. And I’m sure that for all the student EPs and early career EPs out there who’ve been listening, the advice and information that you’ve shared has been really, really valuable. So thank you.

Courtney Donaldson Yeah, thanks very much for having me. It’s been lots of fun and I really hope, you know, I do like to help people and that’s why I work the job that I work. So I hope that some things I’ve shared today are able to help some of those new grads or some students that are still trying to decide what it is they want to do when they finish uni. That’d be great if I can help some more people.

Clare Jones Fantastic. Thanks, Courtney.

Courtney Donaldson No worries, thanks Clare.

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