Five common reasons for burnout and how to combat them.

Climbing caseloads, tedious documentation, unpaid overtime—it’s no wonder physical therapists feel burned out. You might not know it based on turnover rates alone—10.7% for hospital-based physical therapists and 13.88% for PTs in home health. The reality is many therapists simply expect exhaustion, perhaps explaining why they stay in jobs that leave them stressed and overworked. The good news is it doesn’t have to be this way!

1. You lack clear values and boundaries

You can read all the work/life balance articles in the world and still not achieve it without a clear focus on your personal values. As a physical therapist, it’s important to take stock of what’s most important to you beyond the obvious goal of helping your patients. For example:

• Do you like to travel?
• In what environment do you work best? At what times?
• What are your family plans and demands?
• How do you prefer to spend your free time?
• What does an ideal workday look like for you?

Answering these questions can reveal deeper values your current job may or may not espouse. From salary and benefits to mental health, take a moment to rate various aspects of your current job as good, bad, or neutral. What are your deal breakers?

With this awareness you can begin to adopt (or break!) habits in alignment with your values—at least those within your control. This includes setting professional boundaries. Maybe it looks like avoiding the chatty coworker who distracts you from paperwork. Maybe your notoriously-late patients inspire you to update your booking and cancellation policies.

2. You’re not getting paid enough

Let’s address the elephant in the room: your paycheck. Whether you’re clocking hours considered un-billable by insurance or last year’s raise was less than favorable, accepting the role of The Overworked and Underpaid PT will only lead to resentment and burnout. Here’s how to get paid what you’re worth:

• Start a cash-based practice. If that’s not realistic, consider a side hustle that allows you to explore the option and build your book of business (just be sure you’re not breaking any rules or creating a conflict of interest at your current job).
• Ask for a raise! Be prepared to explicitly show how you contributed to specific KPIs and the overall success of your team or company. Conduct market research to propose a fair salary based on experience, specialities, and geographic location.
• Look for a higher-paying job with better benefits. At the very least, keep your Linkedin profile and resume up to date. If the right opportunity comes along, you won’t miss it by being unprepared.

3. You’re not taking ownership of your productivity.

In 2020, APTA conducted a study to assess PT burnout. The number one cause of stress? Paperwork. In outpatient PT, clinicians often report having no time to chart between patients. The time they do spend on documentation is often denied (read—unpaid) by insurance companies.

Regardless of the cause, the consequence remains the same: mounting paperwork leads to less time with the patient or, worse, a lower quality of care. If you have to stop every 15 minutes to notate a patient’s chart, how focused can you really be on their treatment?

Depending on your employer, this problem may be difficult if not impossible to solve. But taking ownership of the productivity measures you can control rather than complaining about red tape will take you far. See if you can garner enough support to bring concerns and proposed solutions to upper management. Perhaps it’s streamlining documentation with an upgraded EMR system. Can you propose new policies or procedures that benefit the patient and staff?

4. Your patients aren’t getting better

In the aforementioned APTA study, 34% of physical therapists said that burnout negatively affected patient care. But while it (rightfully) highlighted stressors like paperwork, it didn’t address the biggest factor in patient satisfaction: skill. When you strip away all the office politics, technique is undoubtedly the biggest indicator of how a patient is going to feel getting off your table.

If you’re feeling unsatisfied at work, the best solution is to take matters into your own hands. Literally. Consider expanding your manual therapy skills even if you can’t implement the techniques right away. Investing in an introductory manual therapy course such as SCS Complete Body or Foundations of Fascial Counterstrain can enable you to treat any patient, any time anywhere—no equipment required. From there, you’ll be able to pursue mentorship from industry vets who have navigated similar challenges early on in their careers.

5. You don’t see a way up or out

A blogger for a healthcare staffing company shared an unfortunate experience in which they came across two career paths at a job fair—one in nursing, the other in physical therapy. The RN path was depicted by a beautiful tree with branches extending into numerous non-clinical roles such as diabetes educator and case manager. The PT path, however, showed just three twigs extending from a log. The message? Physical therapy is a dead-end career leading only to supervisory roles, specialized patient care, and overly vague positions of “advancement.”

Does that feel true to you? If so, it’s time to reimagine the tree. The fact is, the career paths of physical therapists extend as far as their skill sets. Becoming certified in adjunct modalities is one way to distinguish your practice. Counterstrain is another way to unlock clinical and non-clinical career opportunities from teaching to sidelining athletic events. Obtaining Jones Strain Counterstrain Certification (JSCC) can make you the go-to provider in your town. When you develop a reputation for getting patients well, the freedom to practice how, when and where you want becomes limitless.

PT burnout is an important conversation that demands serious consideration and nuance. In a perfect world, every healthcare worker would feel fulfilled, balanced, and fairly compensated. And while that may seem far from reality, there are concrete actions you can take toward building the professional life you want and deserve.