Burn-out among physical therapists is on the rise. I even hear talk of it amidst my peers. It’s a sad thing that such a caring, healing, and skilled profession, one that helps heal and restore function across a broad-reaching population, is being faced with this problem.

However, I can understand it. Reimbursement rates go down while costs are rising, yielding the need for busier, fuller days to make a profit. Productivity becomes more of a focus, sometimes to the detriment of patient care. It’s also a physically and emotionally demanding profession that, depending on the setting where you practice, often is not able to compensate fittingly for the energy and time it requires to do the job well.

On the other hand, it is an incredibly rewarding profession. We can see the impact we have on people, improving their function to allow them to lead their best life. What is better than that? It is the rewards that, on a good day, allow a physical therapist to overcome the challenges. I for one have found that keeping physical therapy fresh and continuing to learn has been an excellent strategy in fighting the burn.

My Journey

When I chose physical therapy as my college major and future career I imagined myself as Bradley (Bill Nunn) from the movie Regarding Henry. He had a relatively minor role but the profound impact, both physically and emotionally, he had on Henry’s (Harrison Ford) rehab status-post traumatic brain injury, was something that stuck with me. This was a long-term rehab facility, the place I pictured myself, but so far my 18-year career path never led me there.

Instead, it has brought me to lots of other areas of practice that have been rewarding and challenging in all the best ways possible.

Beginnings

My first job after college was in a small community hospital and included inpatient, outpatient, and sub-acute care. I was excited to start out. Unfortunately, due to unforeseen circumstances, I soon became the only PT performing all the evaluations in all of these settings. Honestly, it was overwhelming, and, in my eyes, not an appropriate fit for a new grad. It was also not what I had signed up for when I took the job.

Finding myself in a situation that I felt was setting me up for failure, I chose to make a move sooner than I would have planned. That less-than-positive experience scared me a bit, and as a result, I returned to something familiar. I took a job where I had done my last clinical, a wonderfully unique residential and school-based facility for children with disabilities. This was a setting where I had never imagined myself when I went into physical therapy school, but a poor lottery number and canceled clinical had led me there… and I LOVED it!

I happily worked there for a little over two and a half years, but then it was time to move on. Something in me yearned to broaden my horizons, both professionally and geographically.

I moved from a very rural setting to one of the bigger cities in the country to work at a well-renowned pediatric hospital. I worked mainly in the outpatient department but gained some experience in inpatient acute care, as well as a couple of specialty areas. And, although it was a primarily pediatric setting, there was an adult patient population there as well. It was a little bit of everything.

This dramatic change was both scary and exhilarating. To say I learned a lot there would be a massive understatement. Providing physical therapy in this challenging environment, where people come from all over the world with the rarest of diagnoses, taught me to be able to treat anything that comes in the door with some degree of confidence.

I will never forget the advice one of my mentors gave me on an occasion when I was feeling overwhelmed by the unfamiliar. As physical therapists, our job is to assess the range of motion, strength, balance, function; start there and the rest can be learned. This is a mindset that has been invaluable to me throughout the rest of my career.

Again, I loved it there, but this type of setting is also incredibly demanding, not to mention emotional. Burn-out was inevitable and I was ready for another change after three years.

Next Steps

My next move brought me to an even greater focus on my pediatric background when I began working full-time as a school-based PT. At the same time, I didn’t want to lose my skills in orthopedics, so I also began working per diem at a private outpatient clinic. My next four and a half years were spent at those two jobs. I enjoyed the autonomy the school setting allowed me, developed strong bonds with my students and their families, as well as the rehab teams. In this job, I also developed skills as a mentor and supervisor, another rewarding aspect of being a physical therapist.

However, over time, again, I found myself longing for something else. I began to feel dissatisfied, in a way that felt like it was carrying over into my care. Those students didn’t deserve that, and I knew it. So I began another transition in my career, leaving schools to work at that same outpatient orthopedic clinic full-time.

Although I had been working per diem at this facility for all those years, there was a definite learning curve that came along with transitioning into full-time. This was now my path, and I wanted to give it its due. I fully embraced the challenge and learning opportunity this provided me and thrived in the new role, the new setting, and the switch from a pediatric population to adults. For my longest role yet, I stayed there for five and a half years, again learning and growing so much as a clinician that I will be forever thankful.

But then burn-out started to set in again.

Now What?

When I left this position I was feeling a bit unsure of where to go. I had tried so many different things already; what was going to provide me with the fulfillment I was seeking? Well, through some time, faith, and patience, I found my answer.

I now work part-time in outpatient orthopedics, and per diem in both a hospital and outpatient pediatric clinic. I love that I have such a variety every week and that I can utilize all of the skills I have developed over the years. This has been rewarding and exciting for me in a way I haven’t felt in a long time, and I am so grateful that I have been able to get to where I am. On top of that, I love feeling like I have become a well-rounded therapist that can tackle any patient challenge that may come my way.

Making this transition has also allowed me to renew and explore a long-lost love of writing, culminating in the development of this blog. This aspect of my life is just in the beginning stages, but I have loved this piece of my past year and am excited to see where it will lead.

Could this be a way for other physical therapists to fight burn-out?

I realize that all the changes and switches in a career may make me seem a little flighty. Perhaps it sometimes felt that way even to me. But the better part of me knows that it all took some courage, and certainly some dedication to learn all the skills necessary to treat to the best of my ability in all these settings. I know that if I hadn’t made all these transitions, I would no longer be fulfilled by my career. There is no doubt in my mind that burn-out would have taken over if I hadn’t presented myself with new challenges, and new areas of physical therapy to explore.

So far I have not had the opportunity to be a Bradley, but who knows? Perhaps someday that transition will come for me.

This strategy will not work for every clinician, and I know that, but physical therapy has so much to offer across so many different areas of practice. It is possible that changing your environment and shifting your field of practice can help PT feel fresh again and help prevent burn-out. Maybe you too can rediscover all the rewards and the reasons you chose this as your career.