Burn Out: Pizza Party or Policy Change?
By: Nichole Chakur, PT, DPT, OCS and Lauren Ramer-Morley, PT, DPT
Burnout is a syndrome resulting from workplace stress that has not been successfully managed. It is characterized by three dimensions: feelings of energy depletion or exhaustion, increased mental distance from one’s job, and reduced professional efficacy (World Health Organization, 2019). Some occupations are more vulnerable than others to the effects of burnout, with teachers and health care workers experiencing some of the highest rates of burnout even pre-pandemic (Abramson, 2022). There is currently a group on Facebook with 41K+ rehab professionals looking to get out of patient care and the overwhelming majority state burnout as the reason.
Since the start of the pandemic, employee well-being has been a greater topic of discussion and research within the Fortune 500 companies. Prior, the responsibility was on the employee to reduce their level of stress by using mindfulness, meditation apps, or taking advantage of health coverage for therapy. That trend is changing and organizations are acknowledging the important connection between workplace conditions and well–being. (Stringer, 2023). But, is this trend taking place in the rehab world yet? While some rehab companies and hospitals may be focusing on employee well-being, it seems the overwhelming majority are not.
Physical therapists often find themselves working in positions where productivity requirements are unrealistic across all settings. They are spending many hours outside of work completing documentation and catching up on other tasks. For those who have taken on leadership roles, many are completing administrative duties outside of patient care on their own time. When you factor in the unpaid overtime to catch up, people are often making lower salaries than they anticipated. If we also factor in the rising cost of education, changing and diminishing reimbursement, and the lack of career growth – it all seems pretty grim.
No wonder burnout is at an all time high. About 22,000 physical therapists left the healthcare workforce in 2021. The Bureau of Labor Statistics predicts about 15,400 openings for physical therapists each year, on average, over the next decade, resulting from those transferring to different occupations or exiting the labor force (APTQI, 2022). So what should we do about it? Throw a pizza party! Just kidding, we need policy and structural change. So how do we do that? Here is our shameless plug to join a professional organization, such as the American Physical Therapy Organization (APTA). They provide a consistent lobby presence with members of Congress, regulatory agencies, and commercial payers. Joining the association, volunteering, and adding your voice strengthens our efforts. You can check out what the APTA has already done this year by going to: https://www.apta.org/article/2023/06/14/advocacy-roundup
While policy change can move slowly, there are things that you can do in the meantime to help reduce the impact of burnout. Back in 2019 we did a presentation at the APTA Michigan Fall Conference on the topic of burnout in physical therapy. The two of us shared our perspective of being younger therapists in the field, along with a more seasoned therapist, Karen Frederick. At times, going to work seemed hard and we each felt that we were lacking that initial passion that we came into the profession with. Real change is more often spurred by desperation than inspiration (Turak, 2014).
From our experience, most physical therapists that we know are not experiencing burn out because they just don’t care anymore. In fact, it seems to be the opposite. Many of them tend to care too much. They lose focus of what really matters to them. They overextend themselves to see too many patients per week by trying to meet unrealistic productivity standards. They are giving up their lunches to see patients or tacking a few on to the end of their work day. They don’t want to document during a treatment for fear of not being able to provide a patient their full undivided attention. They feel trapped in jobs that they hate because they feel loyal to their companies and current patients, despite companies having no loyalty to them. They try to be the best at what they do and sign up for as many continuing education classes as they can. While some of these things are not bad to do in moderation, ultimately there is no way that anyone can continue to function this way long term.
Here are a few strategies you can start implementing:
-Reach out to your clinic owner/manager
Discuss what can be done to make the current situation better
Have clear expectations on what your job entails
Point of service documentation
Creating templates and smart phrases that you can access quickly
Only handle documents, emails, etc. one time
Prioritize your to do list and stick to it
Check your email at select times of the day if possible
-Focus on bringing positivity to your workplace
Team building activities
Get to know your co-workers
-Take time off of work
Plan a relaxing vacation or a day off to spend time at home catching up on life
-Switch up your work
Try out a new schedule at your current job
Decrease work hours if needed
Take on a new role that excites you
Step down from a role that you feel you cannot fulfill or delegate appropriate tasks to others
-Set boundaries with yourself and with your patients
Realize that when you say yes to one thing, you are ultimately saying no to something else
Do not constantly overextend yourself
Commit to what really matters
-Take advantage of mental health resources offered by many large workplaces and the APTA
Well-being webinars or support groups
Subscriptions to meditation apps
-Learn something new
Surround yourself with like-minded individuals while you gain a new skill at a continuing education course
Check out a new PT podcast
Seek mentorship from another therapist - it doesn’t matter how long you have been
practicing, you can always learn something new
Read a book on burnout
-Connect with others
Join the APTA
Attend APTA Michigan conferences and district meetings to get to know others in your area
Join special interest groups, sections or academies of the APTA to find common ground
-Be a mentor
Mentor a new grad or serve as a clinical instructor for a student
Reignite your passion by spending time with someone who is very motivated about the profession and challenge yourself to be a better clinician
-Look into a different job
Take on a different role within your current company (ie. management, PRN coverage
Same setting, new company – sometimes you just need a fresh start
Try out a different setting (ie outpatient, inpatient, home health, school therapy etc.)
Non-clinical jobs (ie insurance, medical sales rep for PT products, wellness coaching,
-Look for solutions to decrease your workload at home
Family member support
-Find ways to refill your cup outside of work
Prioritize sleep, health and wellness
Practice resilience strategies
Volunteer to do something that makes you feel good – PT related or not
We still believe the ultimate solution is policy and structural change within all rehabilitation systems. Taking action at a macro or micro level is beneficial to driving overall change and reducing the effects of burnout.
Niki has been practicing in outpatient orthopedics for the last 10 years. She is a board certified orthopedic clinical specialist and alumni of the University of Michigan Flint. She currently serves as clinical manager at Atheltico Physical Therapy in Detroit at the Renaissance Center.
(2019, May 28). Burn-out an "occupational phenomenon": International Classification of Disease. World Health Organization. Retrieved September 29, 2023, from https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
Abramson, A. (2022, January 1). Burnout and stress are everywhere. Monitor on Psychology, 53(01), 72. https://www.apa.org/monitor/2022/01/special-burnout-stress
Stringer, H. (2023, January 1). Worker well-being is in demand as organizational culture shifts. Monitor on Psychology, 54(01), 58. https://www.apa.org/monitor/2023/01/trends-worker-well-being
APTQI (2022, November 28). New Report Shows Thousands of Physical Therapists Left the Workforce in 2021. Alliance For Physical Therapy Quality and Innovation. Retrieved September 23, 2023, from https://www.aptqi.com/new-report-shows-thousands-of-physical-therapists-left-the-workforce-in-2021/
Roundup: Apta advocacy: Getting results. APTA. June 14, 2023. Accessed October 1, 2023. https://www.apta.org/article/2023/06/14/advocacy-roundup.
Turak, A. (2014, January 16). 3 keys to getting and staying inspired. Forbes. https://www.forbes.com/sites/augustturak/2011/09/09/3-keys-to-getting-and-staying-inspired/?sh=5c466e112628
Roundup: Mental health resources for physical therapy professionals. APTA. May 22, 2023. Accessed September 15, 2023. https://www.apta.org/article/2023/05/22/mental-health-resources