physical therapist

physical therapist assistant

physical therapy aide

patient care coordinator

occupational therapist

Upstream-Rehabilitation

When I started working here more than two years ago, I saw myself staying here and growing within the company. After inflation, priorities have definitely changed and it is obvious. The PT's are expected to see as many patients as possible even if it is impractical and does not allow enough one-on-one with patients. Quality care cannot be provided if they are seeing patients that both have demanding cases. This naturally causes conflict between the front desk and the therapist. Office coordinators are expected to fill the schedule up as much as possible, complete reports, micromanage their team, keep up relationships with referring providers for referrals, and when new duties were given to us with the promise of a title change and promotion, the promotion never came yet so much more was expected of us. Just because one person can do all of this does not mean it should be done! Your employees are now resentful. Operating all on the back end and the front desk while having to now do collection reports and call patients whether active or not, to collect due payments. They managed to somehow dump collections on the OCs. This creates a combative work culture because the PTs are expected to provide great quality of care while somehow keeping up with patients that fall off the schedule, juggling a large caseload, treat double or triple patients per hour and then be expected to complete all notes in a timely manner. The company went from valuing quality to now preferring quantity in the number of individuals treated per week so we can meet our budgets. While transitioning to the new standard of operations, I was expected to basically be a 2nd manager. I was not paid more for it and did not feel appreciated at all for the time I dedicated coming up with solutions. Do not take on more responsibilities you are not comfortable with. I felt like I was punished with more and more work to do for being vocal and trying to find a middle ground for everyone in my clinic. All of the OCs I started at the company with immediately started dwindling as they switched departments or left for better opportunities because of these unrealistic expectations and changes. Of course it was hard for all of us to get EVERYTHING done on a deadline. We had to compensate for a lack of support from other departments and leadership plus handling our own duties. I would recommend having two office coordinators fully trained at the start of employment. My team was not set up for success with the amount of collateral damage we had to fix because of poorly varied insurance information from another vendor. This directly effected cancellation rates and report numbers for unscheduled patients which were expected to be kept at a low percentage. My coworkers at the clinic and the Office coordinators were great people to work with and friendly. Conflict naturally arrised due to conflicting  interests and goals between the PT and office coordinator positions. You will continue to see really dedicated great employees leaving if this is not addressed. It is always sad to see this happening in a company. Lastly, I was constantly dealing with conflicting guidance from leadership. I was told to prioritize teamwork while sometimes having to make up for the slack by my team at the same time? They will try to say that they are just trying to provide you resources/ tools by giving you more to do on your teams behalf then hold it against you when you do not want to do it. In the downtime we did have, it was challenging to try to get the PTs to adhere to new operational standards which directly made my work harder to do. Where was leadership in this? They would constantly communicate expectations with the PTs yet nobody was being held accountable for not doing their part. That's not teamwork. Not all of the PTs were like this but those who just did not call patients, go marketing, or assist with plan of cares just simply didn't do it and I had to go out of my way to get it done because then it would fall on me somehow. Though unspoken you will be expected to operate your duties with a smile on your face, always consistent, and end up overworked and experience burnout because of it. I will say the hours are flexible as long as they are made up. Do not go above and beyond because then they wille expect everything of you even when something is out of your control or is not directly your responsibility. 

I worked here for almost a year in one of the physical therapy clinics in Las Vegas and at first everything seemed fine. The director and front office supervisor of all of the PT clinics are best friends and will pick eachother over listening to their employees. When I first started working here, the girl who was supposed to train me refused to give me any work for the day. She was nice to my face, but would tell the supervisor that I was not catching on to anything. They became suspicious because one of the therapists brought it to our director’s attention how the girl was treating me. Instead of having a talk with her, they brought us into a meeting where she just sat there and cried. She wouldn’t admit anything and said she thought we were friends ??? Then after the meeting she didn’t speak one word to me. The next day, she quit and didn’t show up. At that point our supervisor was trying to keep me there by trying to be nice to me and made it seem like I was her right hand person, but things quickly changed.
Since I was never trained in anything, I had to learn it all alone as the supervisor was constantly texting on her phone or online shopping on the company computer. When I would ask questions, she would act offended that I even asked them and give me an extremely rude response. It came to the point I would call the girls at our other clinics to ask for help. I pushed through this job because I needed it and it was a 5 minute drive from my house, even though I was severely underpaid and was given hope for false promises constantly by the supervisor and the area director himself. I was overloaded with work, and it took them a month to get someone in to help me. I was so lucky with that, because this person will be a lifelong friend to me, and she noticed how POORLY management treated me, and how our supervisor did absolutely nothing. 
When COIVD-19 started picking up, there were no precautions set up at our job to protect employees or patients until someone complained. Then, they started having a medical assistant check temperatures at the doors. Masks were not even required until mid April for staff, NOT EVEN REQUIRED FOR PATIENTS?? Anyways, once we had multiple patients call and say either they or someone in their household had contracted COVID-19, I started to worry as I have an autoimmune problem, and I also take care of my elderly grandpa and have been doing his errands for him because he is high risk. Knowing my job was not protecting staff or patients (as masks were only required for staff, not patients and rude remarks made by my supervisor about a pregnant coworker with an autoimmune disease for having concerns behind her back), I told my supervisor I may want to self furlough myself until everything dies down, for the sake of my own health and that of my grandfather. Her response was “so you would quit just because of your grandpa?” I was absolutely mortified by this response, and my coworker heard it too as she was in the room. All I could muster up to say as I was in shock someone would be so disrespectful and just plain heartless was “yeah, I have to think about it” she huffed and puffed and said “well I need to know before Monday” and walked out. My coworker couldn’t believe what had just happened either. It was a Friday, so I went home and after speaking with my significant other, decided to send a professional email to the area director that due to events that took place today, I am self furloughing myself. He never responded, even after I texted him two more times in the weekend. When he finally responded he was extremely upset and his only concern was “well I have no one to cover you” even after I told him EXACTLY word for word what the supervisor had said to me. He didn’t have any comment or ask if I want to get in touch with HR, his only reply was “Ok” and then has the audacity to text me at 6am asking “so are you coming in”??? Are you kidding? Eventually he sends me an email from corporate with my furlough letter, and I think okay finally. I then notice on all social media, even ones I don’t have her on, my manager has blocked me and blocked my cell phone number. Whatever though, at least I can stay healthy. I get a text that day asking me to return all of my things to the office, so I did. I can not believe all of this happened and not one person was empathetic to my situation. This place is the absolute WORST.

Compensation is well below state and national average. Raises are poor and do not keep up with cost of living.  Loyalty is not rewarded. Upstream doesn't like to post salaries in their job listings here, so I'll do it for them. In PA, you'll start around 70k. Raises are between 1-3.5% per year.

401k plan is worded confusingly. You have to work for the company for 6 years and put in 5% of your salary to get the company's full 2.5% match (national average for company match is between 4%-6%).

At meetings managers will constantly stress maximizing units billed. They often do so under the premise that it is simply a metric for how much "care" our patients our receiving, implying or outright saying that the company does not care about money. Which conveniently plays into their answer when questioned about low compensation: that we are "servants" to our community and we should not be in this industry for the money, and that you should find a different career if you aren't happy about it. Well, serving my community is nice and all, but it doesn't pay my mortgage or daycare bills. And with 6 figures of student loan debt (and no help offered by the company on that front), I'm not really in a position to switch careers. I would be curious if our company's executives hold themselves to the same standard of accepting low pay in the name of servitude, but that information is not publicly available.

Health insurance is bad, they raise the premiums every year, raise the deductible every year, do not raise how much the company puts towards your HSA...ever, and charge you a $100/paycheck penalty if you put your spouse on your plan if they have the option to be insured at their own place of employment. Which successfully dissuades many of my coworkers from using the company's health insurance plan, meaning Upstream can pocket several thousand dollars of your compensation package every year.

1-4 hours each week documenting off the clock. 

Quadruple bookings of patients in one hour are not uncommon. My record is 6 in one hour.

After working through the entirety of COVID, rather than reward us with a bonus, we received "awards" on the company's in-house social media platform. Everyone got the same award and they are nothing more than digital badges on your dashboard.

On the plus side, the patients are nice and the team that they've put together is good. That being said, if there is an employee who is not pulling their weight, there are no repercussions and it becomes everyone else's job to pick up their slack. Fortunately this was only a minority of coworkers. 

Every year this company becomes more and more "corporate" and it becomes harder to ignore that profit is valued over patient care and employee wellbeing.

Prior to 2023, it was a fairly easy going environment. Back then, I would sometimes cover other clinics, but mostly was at my main clinic with a reasonable amount of patients for one PT and it was an easy job. Copay collections and scheduling were sent out weekly, but it was more of a goal than a requirement to hit them. 

Nowadays…good grief.  There were a lot of upper management changes that summer that completely sucked the joy out of the job. Shrewd micromanagement and policy changes made the core tasks of the position 10x more difficult. Collecting a copay now has six additional steps, patients are forced to save cards on file and sign waivers that send them to collections if there isn’t enough money on their account for them to automatically run a payment. And they really discourage cash, despite most patients being older and preferring it. There is no longer freedom in how you schedule, SEM constantly has PTs doubled and tripled even if they are the sole provider in the clinic. Insurance verification is no longer automatic after adding an eval, it had to be manually requested through Infinix…incressing your chances of a missed verification. Don’t even get me started on Infinix authorizations. Micromanagement is to the nth degree. You had to send emails to your RPMs explaining in detail why you didn’t meet a certain metric, even if you were only off by a point. Scheduling your entire caseload by Wednesday is insane, especially for a busy clinic. Being dinged on copay collections because someone paid in advance for the week instead of each time is insane, but it happens. They watched your Journey referrals like a hawk. If you didn’t call a new patient 5 days in a row, they’d let you know. 


I left in the middle of 2024. I keep in contact with my coworkers and it has only gotten worse in its restructure. It is common now for  OCs  (now Patient Care Coordinators or PCCs) to be outsourced to cover for not only multiple clinics in addition to your own, but clinics in other states. I believe the other reviews that say they plan on eliminating the position with all of the outsourcing. Underperforming PCCs were let go from their clinics and made remote to cover other states with only a few days notice. Their positions were not posted, so they’re relying on stretching their current staff thin to make up for it.
The phones were redesigned so that new referrals call PLCC scheduling instead of the actual clinic. Infinix outsourced authorizations. They’re essentially cutting duties to avoid paying a raise or justify your value in the clinic. It’s sad. It was a good company to work for in the beginning, but the increasing stress they place on front desk is not worth the hassle. There are better places to get your foot in the door. 




Was employed here for eight months, and had four different managers in that time. Training was disastrous, riddled with technical difficulties and hostile office environment ( I very nearly walked off the job after three days due to treatment by one of my trainers).
It's clear that this company is just growing too fast to be sustainable. Clinics merge, but another three are purchased so everyone is still run ragged. Coworkers and colleagues have harrowing stories about the restructuring growing pains that plague Upstream.
My location was chronically under-staffed, but I was punished and eventually let go for not being able to reach scheduling and collection goals that I had no way of actually attaining. Staff will also punish you for taking PTO/time away, the day after you come back will always conveniently be a multi-hour meeting where you have to explain why your work hasn't been getting done, even though you are promised to have someone covering you remotely. Honestly, there are so many useless meetings, and you will absolutely be micromanaged at all times.
Pay is measly and bonuses are a joke, when I gave my target pay range at my initial interview, I was told that it was "in the ballpark" with the bonuses that "everybody usually gets" but even if I was attaining those bonuses every week (which was, again, extremely difficult with the sporadic staffing and constant changes), it would amount to less than $100 added to the check total after taxes. 
The amount of work  and required knowledge in the PCC position should necessitate higher pay. The fact that this is considered an 'entry level' position is insane. Entry level would be just maintaining the calendar and greeting guests. There is significantly more to it than that.
Meeting the patients and assisting them was often lovely and rewarding, and the PTs were always wonderful to work with. Management left much to be desired, and the high turnover rate is unsurprising. 

Work nonstop on many processes and reports to keep the front desk/administrative support of patients. physical therapists. and referring doctors to a level of excellence.  I learned many marketable skills of running a front desk at a medical facility.  Management was usually sincerely kind, responsive and intelligent. However, I was outright lied to about being sent help for a morning in a clinic where the dynamics changed due to hiring an extra physical therapist. I was told I would receive help for a morning, but instead was abruptly fired. Although the manager admitted the company had already planned to eliminate OCs, no lay-off package was offered. The hardest part of the job was being told one could never fulfill all the tasks required in a day, and to learn to be okay with that, but it was never really okay, and a convenient way to purposely have high turnover. Hands down the most enjoyable part of the job was helping patients get the healthcare they needed.

I was led to believe I’d be training in the office I’d be working at, but found out the day prior I’d be driving 45 minutes to train there. I understand dress code but a lady there picked on me constantly saying I was not dressed appropriately whenever she wore clothes much more revealing than mine. When I got to the office I would be working at, the lady that was suppose to help train me acted like I was such a big inconvenience. I was told I could only ask 5 questions a day. The clinical director during my 30 day assessment made me look like I was doing such a horrible job when I literally had 3 days of training at a different office where they do things differently. I told the clinical director about another meeting that had been cancelled per my supervisors email the day of my review and he took it as I was telling him my review was cancelled and brought that up during the review but didn’t say which instance and he told me not to question him because he was the boss and I tried to explain which other meeting I was speaking about and he cut me off and moved to the next subject. The lady that was suppose to train me huffed and puffed every time something new would happen and I’d have to ask a question. It’s a two person job truly. They are just too cheap to hire two people to do that job. Oh and the scheduling  spots and learning how to schedule is miserable and you have to role play about scheduling. 

I have enjoyed my time with the company, but the compensation is just not enough. There are some good benefits but at the end of the day, the paycheck itself is just not what it should be. I've talked to countless people in the same position as me with other companies and they are all shocked when they hear how little my role is compensated. When working part-time you don't get the FT benefits, which is expected, however, they will try to work you as many hours as they can without you hitting full-time status. This means a below-average paycheck with no added benefits. The amount of work is normal compared to other companies with the same position, but you simply don't get paid enough for the amount and kind of work you are doing. On the bright side, my clinic has always felt like a family and I love my coworkers. If there are any issues (which I haven't seen many of in the couple of years I've been there) they're typically dealt with effectively. It is an AMAZING learning experience for someone new to the field, so that is good too. Turnover rate seems kind of high, and they are also big on numbers but that doesn't affect this position too much.

There is a lot of turn over in front office, mostly due to identifying the position as entry level but requiring nuanced knowledge of insurance from the first day in the clinic. They have great education systems in place and there is a lot of support for those that seek it out but their internal system can be hard to navigate. Management varies wildly from excellent to subpar. The company states it wants to create a work life home life  balance but this is difficult to find in middle management with ever increasing responsibilities and low pay raises/compensation. Bonuses can be tricky and difficult to achieve. The clinic culture is the best thing about working at Upstream and some of the clinic directors are great partners to the front office staff. There is always a sense of pressure and a push for more on metrics and that can seem to distract from patient care and interaction when the goal is presented as the opposite. Overall, it’s a decent company to work for with fair benefits and good communication. 

This is clinic dependent so do your due diligence with deciphering whether a prospective clinic is one of the good ones. 

Internal leadership was poor, unsupportive, and could care less. I have seen other clinics within the company with excellent internal leadership. Schedule was chaotic and hard to manage. Autonomy over schedule was more so given to OC rather than the providers, and they are getting extreme pressure from higher ups for more, more, more, with no care for how it affects the PT or patients. They also have an offsite scheduling system that will move your patients off of you to get more evals, without communication with the PT.  It was common get jumped around to multiple providers without communication. You may feel overworked, under appreciated, and underpaid. This lead to constant turnover and instability, which also falls back on the PTs trying to provide any stability. Can feel like an uphill battle for the PT that cares about their work and the patients they are supposed to be responsible for, leading to burnout. 

Top Job Titles	Average Salary
Physical therapist 1281 salaries reported	$101,751 per year
Physical therapist assistant 140 salaries reported	$31.33 per hour
Physical therapy aide 60 salaries reported	$16.05 per hour
Patient care coordinator 49 salaries reported	$19.09 per hour
Occupational therapist 30 salaries reported	$88,650 per year

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