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! The following are five common reasons for burnout and how to combat them.
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:
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.
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:
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?
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.
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.
Randall Kusunose founded The Jones Institute in 1988 with Lawrence Jones, D.O., the original developer of Counterstrain. He was the first therapist to be board certified in orthopedics by the American Board of Physical Therapy Specialties in California. Randall has trained all Jones Strain Counterstrain Certified Instructors (JSCCI) in the U.S., France, Italy, and Australia, and developed over 60 Jones Strain Counterstrain techniques along with the Facilitated Counterstrain curriculum. When he’s not practicing, you can find Randall skiing, scuba diving, and relaxing on the sand in the beautiful beach town of Encinitas, California.
Holly Christy earned a Bachelor of Science from the University of Washington, Master of Acupuncture from Northwest Institute of Acupuncture and Oriental Medicine, and Doctor of Naturopathic Medicine from Bastyr University where she currently teaches as an adjunct clinical faculty member. Holly started her practice in 2000 and became a lead instructor for Counterstrain Academy in 2014 after a mastery-level internship with Tim Hodges, LMT, JSCCI. In 2019, she became a Jones Strain Counterstrain Certified Instructor (JSCCI) of Fascial Counterstrain (FCS) for the nervous system. Though Counterstrain is her primary modality, Holly also offers primary care, acupuncture, prolotherapy, custom orthotics, and intravenous nutrient therapy.
Robert Dowd holds a Bachelor of Science in medicine with a certificate in physical therapy, Master of Healthcare Administration, and Doctor of Physical Therapy. Robert is now a Jones Strain Counterstrain Certified Instructor (JSCCI) who’s dedicated to presenting Counterstrain the way Lawrence Jones, D.O., advised his students to do at his final course offering. Robert applies the philosophy of Counterstrain to all clinical settings from the outpatient orthopedic clinic, acute care hospital, and ICU to the nursing home and hospice industry. When he’s not practicing in the Black Hills of South Dakota, Robert can be found writing, fishing, hunting, or riding his motorcycle.
Larry Ham graduated from the University of Southern California in 1978 with a Master of Science in physical therapy. He took his first Counterstrain course in 1986 after Lawrence Jones, D.O., treated him and successfully eliminated all back and sciatica pain. He’s now certified to teach Strain and Fascial Counterstrain courses for the spine and extremities and the viscera, respectively. In addition to teaching Counterstrain in the U.S. and Australia, Larry has served on the sidelines of over one thousand sporting events as a Certified Athletic Trainer. Though nearing retirement, Larry still practices in Spokane, Washington, and enjoys spending his free time with his wife, sons, and grandchildren. You can catch him scuba diving with sharks, remodeling his home, or hydrofoiling on the lake.
Greg Zadow has been a self-employed physical therapist since 1998. He earned a Bachelor of Applied Science in physiotherapy from the University of South Australia and Doctor of Physical Therapy from the Rocky Mountain University of Health Professionals. Greg is the owner and clinic director of Green Ridge Physical Therapy and Wellness, his Oregon-based private practice. In 2011, he became certified in the Strain Counterstrain (SCS) technique and continued on to complete a mastery program with Counterstrain Academy and become a Jones Strain Counterstrain Certified Instructor (JSCCI) of Fascial Counterstrain (FCS). Greg has been using Counterstrain ever since his first introduction to the technique in 1991 and now holds over 20 years of continuing education experience in the field of manual therapy.
Kyle graduated from San Diego State University in 2010 with a bachelor’s degree in kinesiology and earned a Doctor of Physical Therapy from the University of Miami in 2014. Kyle immediately started his private practice and became certified with The Jones Institute after witnessing the powerful effects of Counterstrain on his patients. Kyle currently lends his expertise to the Doctor of Physical Therapy programs at both San Diego State University and the University of Miami. Since joining The Jones Institute as a lab instructor in 2015, Kyle has taken on additional roles in managing the company’s domestic headquarters, developing the curriculum for a new anatomy program, and teaching Anatomy Dissection as the lead instructor.
Eryn Milian earned a Bachelor of Science in chemistry and environmental science from William Smith College along with a Doctor of Physical Therapy and PhD from the University of Miami. Her doctoral work focused on anatomical sciences and measurable outcomes which inform her current clinical expertise in orthopedics and sport physical therapy. Since joining the University of Miami’s faculty in 2013, Eryn has expanded her role as assistant professor to become a course master for neuroanatomy and instructor for both pelvic anatomy and the university’s orthopedic, sport, and neuroscience residency programs. Her research interests lie primarily in knee injuries and the development of reliable and valid measures of assessing ACL risk in adolescent athletes via musculoskeletal ultrasound.
Tim Hodges has worked in the field of physical rehabilitation since 1996. Since joining The Jones Institute in 2004, he’s assisted Brian Tuckey, PT, OCS, JSCCI, in the development of several Fascial Counterstrain techniques and taught numerous Fascial Counterstrain courses as a certified instructor. Tim continues to apply his knowledge and expertise through Counterstrain Academy—a mastery program designed for licensed Counterstrainers throughout the country. In addition to developing the program’s curriculum and overseeing its mentorships, Tim is currently practicing at Counterstrain Portland, his Oregon-based private practice.
Brian Tuckey, a magna cum laude graduate of the University of Maryland School of Physical Therapy, became board certified in orthopedics in 1995. Under the tutelage of Lawrence Jones, D.O., Brian became one of only four physical therapists in the world to be certified in the Strain Counterstrain (SCS) technique. He was also the first practitioner to recognize Counterstrain’s impact on the fascial system which led to his development of Fascial Counterstrain (FCS) with over 800 anatomically-specific techniques in addition to the FCS Cranial Scan—a proprietary assessment that identifies dysfunction in all systems and regions of the body. When he’s not teaching, Brian is treating complex patients at Tuckey and Associates Physical Therapy in Frederick, Maryland.