Burnout in the healthcare realm is a legitimate phenomenon, and the profession of physical therapy is not immune to it. While physical therapy often ranks very high every year for job satisfaction, there is still ample amount of burnout that occurs. Is it inevitable? Perhaps for certain circumstances. I would argue, however that it is largely preventable, provided that we understand all that we can about the nature of this beast in conjunction with understanding the locus of control we afford ourselves in the process.

If you’re a new PT grad, being aware of the condition of burning out and then adopting strategies to counteract it or prevent it from happening can be a critical move. This will help ensure you keep the fire burning strong for what you love (and signed up) to do as a career.

The insight I offer in this article is presented in a way that will hopefully challenge you to look inwards and reflect upon some key issues. A little bit of introspection can go a long way when it comes to knowing yourself, mastering yourself and creating an uncompromising desire when it comes to fulfilling and living your dreams.

Key points of this article

• Key point 1: Above all else, avoiding burnout starts by you being aware of the need to protect your passion at all costs in whichever ways this may be. This can be challenging for new grads who are fresh out of school and feel the need to accept a job anywhere they can get due to being a new grad and/or in order to begin paying off debt.

• Key point 2: New PT grads should think about striving to work in the clinical environment or speciality area that they are most passionate about if they’re not currently working within it. The option to work in their dream setting may not be immediately available to the new grad, but always striving towards the dream goal should be immediate from day one.

• Key point 3: Avoiding burnout will likely involve the need for you to be bold and take chances. Being bold enough to leave one facility behind for another; being bold enough to tell your employer that you need some time off; being bold enough to sacrifice some income in order to not get worn down in the clinic every single day for eight or more hours per day, etc. This is challenging for any PT, but even more so for a recent graduate.

• Key point 4: Being bold is not being selfish. Knowing what you truly want and being willing to strive and grind to make it happen is anything but selfish. This very process is what will save you from burnout – it will allow you to continue to provide passionate and effective treatment to your future patients who otherwise never would have been treated by you since you weren’t willing to set up a job more inline with what you longed for.

• Key point 5: Willing to be bold and take action signifies that you are adopting an internal locus of control. This means that you are choosing to believe that your job satisfaction, its inherent meaning and your passion for what you do are all largely within your control and that external influences do not have the final say as to whether or not you burn out.

• Key point 6: As a physical therapist, you must recognize that you must look after yourself in ways that permit you to recharge your physical, mental and even spiritual batteries. PTs (as with other healthcare providers) are notorious for caring about people to such an extent that they continually put their patients needs before their own personal needs. This results in the PT being chronically depleted physically, mentally and even spiritually.

Key point 1: To avoid burning out as a PT, you MUST protect your passion for what you do at all costs

Before I go off on a bit of a passion-soaked tangent, here’s a couple of things to keep in mind if you’re a new PT grad:

• You’ve just spent six or seven years of your life and a small mountain of money to become a PT. You have therefore sacrificed a substantial portion of your biological life and your financial life to get to this point. As a result, protecting your passion for this career you now wish to sustain should be at the top of your priority list. This is not a selfish move. This is a life-giving move.

• You likely signed up to become a PT so that you could help others and make a meaningful impact on their lives in some way. If you’re burnt out, you won’t provide your best care and service to others. You’ve now just lost the whole reason for why you became a PT. Therefore, protect your passion at all costs.

Tell me that these two aforementioned points are not important to you and I will tell you that you’ve made a monumental mistake in choosing to become a PT.

Assuming that you believe these two points are indeed important (and extremely important at that), it would then make sense to protect them both however need be.

You likely won’t come out of the graduation gates making heaps of money, and if you’re in upper five-digit territory or have cracked the six-digit category of student loans to pay back, you won’t have much of a return on investment if you only last a few years in this profession. This is all the more reason to protect your passion for what you do.

Not every day in the clinic is going to be a walk in the park and a basket of roses, even in the type of practice that you’re most passionate about. We must indeed acknowledge this. But when you start noticing the number of bad/miserable days more and more outweighing the number of good days, you can be sure that burnout is slowly working its way into your life.
Protect your passion and you’ll practice for a lifetime.

Key point 2: Where we as new grads often first begin to compromise on protecting our passion

It’s not easy being a PT when you’re a new graduate. The final year of school is filled largely (if not entirely) with unpaid, full-time clinical rotations, often at clinics far from home. Money in the bank account has long been non-existent by this point and student loans for DPT school have already been accruing interest for three years since taking out the first round of loans back in year one.

So, we graduate with excitement but also a semi-hidden desperation to find employment as quickly as possible. Any new grad within the right frame of mind would indeed be keen to start getting some pay checks and is willing to understand that the dream PT environment/job may not be feasible at this point in time. Take what you can get for now, right? And so we sign up with a clinic that will help us begin to right the ship of financial strife.

And it’s at this particular point where we haven’t necessarily done anything wrong per se, but just that we’ve now left the door open for the potential for burnout to begin creeping into our lives, and we need to be aware of this. We need to get a job, yes. But if it’s not the one we’re after – the one we truly long for – then we need to continually strive, seek and ask ourselves what it will take to get there.

This is the point where we need to be ever present to the voice within ourselves asking and reminding us as to what it truly was that we wanted to get out of becoming a PT. Maybe your dream was to make meaningful connections with patients and deeply inspire them, but you now find yourself working for a clinic that pushes as many people through the doors as quickly as possible. Maybe it was to work in a geriatric-based setting but you are now serving a completely different population.

Sometimes we have make ends meet (especially when first stepping foot into a new career), and a less-than-ideal PT clinic may be the means to that end. But, we need to realize that the door for letting in burnout symptoms may begin to creep open wider and wider if we choose to stay within that environment without any real plans to work our way towards the type of practice that our heart truly longs for.

We must also be wise enough to realize that a dream practice may change on us or not be what we expected. If so, we must plan for an eventual exit strategy“

You may not be given the best hand of cards to play, but a good card player knows that they can always walk away and change tables.”

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It’s also critical to have the awareness towards not being fulfilled at a clinic that we first deemed to be ideal or were led to believe as ideal. If we find ourselves working in a clinic or practice where we no longer find a deep fulfillment or perhaps only find excessive amounts of stress, we must realize that this scenario becomes a ticking-time bomb with burnout being the point in time at which the bomb goes off.

The bottom line: If you feel that you’ve ended up at a facility, clinic or practice where things are not how you dreamed of them to be, and that there’s no chance for it changing and that you’ll be working there indefinitely, then I would encourage you to ask yourself if you need to begin devising a plan to get to where it is that you truly want to be.
Which, leads me into my next key point…

Key point 3: Avoiding burnout will likely require the need for you to be bold and take chances

If you’re not happy with how things are going at work, and the change you long for isn’t going to take place at your work environment, you may need to begin to live bold and take some chances.

Maybe you’re burning out from being forced to shovel patients in an out of the clinic on a rapid basis, or you’re tired of dealing with insurance companies. Maybe you’re truly overworked and underpaid. Maybe there’s too much stress going on in an unhealthy work environment.

These are all indeed burnout seeds that get planted in such environments and they will take root in the soil of your heart if you don’t do something about it.

No one would stay in these environments if they could instantly snap their fingers and begin working in a clinic more inline with their dreams. But often we tend to stay since the fear of stepping out of the familiar becomes too great for us. There’s a fear of leaving security, of leaving a pay check, job benefits, and so on.

And if comfort outweighs the lack of fulfillment or extra stress you find yourself enduring on a daily basis at work, then by all means you can stay put. But burnout has a way of rearing its ugly head when the lack of fulfillment and copious amounts of stress outweigh the comfort, especially when we choose to stay put.

There’s no boldness in this latter scenario. There’s only a whole lot of what you never signed up for. Yes, these situations get complicated when you’re supporting a family or have others depending on you for income and there’s no immediate options for finding work elsewhere. I don’t have answers for you if you find yourself in this category. But I’d be willing to venture that deep down your heart does. If you fall into this category and are feeling like burnout is breathing down your neck, take some time to quiet yourself and listen to what you feel called to do.

Key point 4: Being bold is not selfish.

When you strive to make changes that are more inline with your dreams and desires, it’s a far cry from being selfish. If you think otherwise, you’re believing a lie.

You are not being selfish – you are being bold. These are distinctly different in terms of not only what they require, but what they’re after. Being bold takes courage. Being selfish is the pursuit of your own desires at the expense of (or without at least considering) others.

Being bold is done so as to ensure you spend your career giving the best care possible to those whom you treat, which you can’t do if you’re burning out or burnt out completely.

Continuing to work in a PT environment in which you’re miserable (despite having the option to go elsewhere or further work on your dream) can better be seen as the selfish move. Your submission to the fear of taking a chance elsewhere comes at the expense of providing passionate, best-effort care to patients who are depending upon you.

Key point 5: Willing to be bold and take action signifies that you are adopting an internal locus of control – that change is within your reach and not dependent on others

“The people who succeed in this life look around for the circumstances that they want, and if they can’t find them, they create them.”

– George Bernard Shaw

Perhaps George Bernard Shaw said it best. There’s profound beauty in his statement, and in unpacking it a bit, we discover that it contains a mindset rooted in adopting what’s known as an internal locus of control
Locus of control, in the world of psychology, refers to the extent to which an individual adopts the belief that they themselves have control over situations, factors and outcomes that control and affect their lives.

An external locus of control is one in which we feel that we have no control over the situations and outcomes within our lives – they are all beyond our control and we are at the whims of however things choose to play out.
You made it all the way through undergrad and PT school.

• Willing to be bold and take action signifies that you are adopting an internal locus of control. This means that you are choosing to believe that your job satisfaction, its inherent meaning and your passion for what you do are all largely within your control and that external influences do not have the final say as to whether you burn out or not.

Key point 6: PT’s can easily invest more energy into others than others invest into them, leaving them chronically depleted physically, mentally and even spiritually.

The most important person in a rescue scenario when someone is drowning in a lake is not the person in the lake. The most important person is the one who will be conducting the rescue. This person must take appropriate action to look after themselves in the rescue process or else there will soon be two people drowning in the lake.

Healthcare workers in general are well known to routinely invest more time and energy into their patients and their job on a daily basis than they get back. I believe this is largely in part to the fact that healthcare workers (including PTs) genuinely care about those whom they’re treating; we as healthcare professionals have hearts that truly want the best for others.
This in and of itself is a beautiful thing. But if we’re not careful, we can run into burnout and then we are no longer going to provide effective treatment to our patients, either because we’re too exhausted or because we’ve walked away from the profession entirely.

Insurance and bureaucracy within the profession and workplace are notoriously brutal for this passion-draining phenomenon, and they are but a few examples.

Being mandated what you are required to treat on a patient, or how much time you can spend treating it, and receiving low reimbursement rates are just quick and easy examples of how physical therapists can get burnt out rather quickly. This is likely a theme that physical therapists young and old have heard of or even experienced.

As a physical therapist, you must recognize that you must look after yourself in ways that permit you to recharge your mental and even spiritual batteries.

You are not much good to others when you haven’t looked after yourself and are completely and utterly burnt out as a result.

Looking after yourself largely ties back in with key point 4, in that it is not selfish to want the best for yourself and to look out for yourself. After all, if you don’t look after yourself, you can’t do your job of looking out for others (i.e. treating patients as a physical therapist).

There are a multitude of ways to ensure you look after yourself. This will come down to some individual thought and planning on your own part, and it might even take time to effectively implement these strategies. Much of it may begin by trial and error, but it will be worth it.

Booking regular time for yourself throughout the week in which you can pursue activities that are meaningful and enjoyable to you is but one such idea. Having a qualified councillor or individual whom you trust and can open up to can also be very life-giving (take it from me, who has talked with councillors over the years in order to keep myself uplifted and strong).

Remember that burnout is inevitable if you are constantly pouring out more energy (physical, mental and even spiritual) into your profession (PT or otherwise) than what you are receiving and are able to take in.

Concluding remarks

The world will always need physical therapists, but what it doesn’t need is therapists who are broken in mind, body or spirit from burnout as they try to heal others. ESPECIALLY when it was largely preventable. This is not to say that we are not expecting everything to always be perfect or for stresses of our profession to be completely absent. Every profession will always have challenges and fluctuating degrees of struggle and seasons of stress.

I would argue, however that we are expected to be acutely aware enough of the passion-draining situations we can find ourselves in when we stop striving for what our dream goal truly is, or when we give into the belief that all aspects of our happiness within our career are truly dictated by means outside of our own control.

We must not give into the belief that we are stuck working at a facility or clinic forever if our hearts are not content with how things are going within it. We must be brave when we find change inevitable within where we’re at; we must be willing to pursue new environments if that’s what it ultimately comes down to.

We must also employ a combination of approaches when it comes to avoiding burnout, not just for the sake of our own selves, but for the sake of our patients as well. When we as therapists begin to burn out, it’s our patients who can suffer the consequences, not just ourselves as PTs.
Staving off the effects of burnout is an active process, and one that takes continual strategies and effort when it comes to keeping our passion burning brightly.

It’s ok to look after ourselves as we press onto and pursue our careers. Passion is a beautiful thing, and we must protect it at all costs. This means that we must always stay in tune with what our hearts long for in regards to our ideal work scenario, being bold enough to act out on it, knowing that its within our control to make a change and that doing so will benefit not just ourselves, but our patients as well.