Blog Four Methods to Prevent Burnout in Physical Therapy By Palak Shah, DPT, 09.18.18 FacebookTwitterLinkedin Palak Shah, DPT and head of Physical Therapy Services at Luna, kicks off the first in a three-part series on topical matters that impact physical therapists. Dr. Shah and Luna provide their thoughts on redesigning the physical therapy experience to elevate the industry. We hope you enjoy the thought leadership. It’s a pleasure to share this blog with like-minded upstarts that seek to drive innovation and provide support to our community of clinicians. Luna, like Clinicient, is bringing tech to modernize the clinical experience. In my position, I have the ability to speak with hundreds of therapists. Through those conversations, it has become evident that the field of physical therapy is comprised of amazing practitioners devoted to helping others in need but who face a considerable amount of burnout. Burnout, or the encroachment of burnout, is a key issue in the field and is one of the reasons why some therapists consider leaving the profession. One study from 2008 report upwards of 85% of therapists experienced burnout in nursing homes [¹ Alexandria, VA, 2008]. Burned out therapists feel psychologically stressed and taxed beyond their adaptive capacity. They are less equipped to provide the high-quality care that patients demand and deserve. A recent study from the Journal of Health Psychology showed that burnout and depression manifest similarly. Untreated burnout can manifest as poorer quality of care, increased medical errors, and attrition. Another study from 2009 listed the following consequences of burnout: “These outcomes include burnout, turnover, sickness, absence, and work-related musculoskeletal disorders. Job stress has been linked to medical and psychiatric conditions, including depression and cardiac disease. In health care workers, job stress has been linked to reduced quality of patient care.” For the sake of our patients and our own well-being, we need to steer the PT field in a direction that allows us to do what we love: helping others. We’ve identified four methods on how to restore not just work-life balance, but better work-life integration. First Method: Adopting an Optimistic Explanatory Style Martin Seligman, a pioneer in the field of Positive Psychology, suggests that if you’re feeling burnt-out, there is a high chance that the way you explain bad situations to yourself is highly pessimistic. What does a pessimistic explanatory style look like? Bad situations are explained in three separate entities: Long-lasting Universal Your fault For example, you meet a patient who is furious that their treatment is taking too long and not working. You may think to yourself: “This patient will be with me forever.” “All my other patients must feel the same.” “This must mean I’m a bad physical therapist.” This type of mindset strongly correlates to burnout. In order to combat workplace depression, we must actively strive to approach our life and work with an optimistic style. An optimistic explanatory style tells us that bad situations are: Transitory Specific External When using an optimistic style, the scenario above would play out much differently: “This patient has always been tough, and it’s not my job to make everyone happy always; luckily he won’t be with me much longer.” “Thankfully, the majority of my patients are quite happy with my care and we enjoy our sessions.” “He must be in a really challenging spot in his life.” Be kind to yourself and treat yourself with care. While pessimism has a time and a place, you must strive to be optimistic in explaining bad situations. What did your explanatory style look like during your last negative experience at work? If it was pessimistic, how could you flip the situation and explain it optimistically? The takeaway? Bad situations are not long-lasting, specific to a particular situation, and not your fault. Second Method: Give Yourself the Gift of Purpose You may think that one of the reasons for your workplace apathy is that you are working too much. The Longevity Project by Howard S. Friedman, PhD, and Leslie Martin, PhD, actually showed that some of the happiest and most fulfilled people work incredibly long hours, but these people are highly engaged in purposeful activities that have meaning. As Friedman told the Monitor: “There is a terrible misunderstanding about stress. Chronic physiological disturbance is not at all the same thing as hard work, social challenges or demanding careers. The Longevity Project discovered that those who worked the hardest lived the longest…especially if they were dedicated to things and people beyond themselves.” Having a purpose that serves the greater good of humanity or your organization is a clear way to combat burnout. You’re not a cog in the wheel, with quotas on patients to increase revenue. You’re a vital and important piece of your patients’ lives. Mr. Seligman also recommends using your signature strengths on a daily basis within your career. Signature strengths are unique characteristics that are essential to who you are as a person. Consider your top three strengths and reflect on how you can utilize them at work. If you’re optimistic and have a patient who tends towards pessimism, how could you use your optimism to positively influence their outcome? What situations at work would best call upon your signature strengths? How would you go about implementing them? The takeaway? Utilizing your signature strengths, in conjunction with adding more purpose to your career, will be an effective counter-measure to keep from burning out. Third Method: Celebrate your Strengths with your Friends and Peers Isolation is a strong characteristic of depression, and unsurprisingly, isolating yourself when you’re dealing with burnout can be very harmful. Mihaly Csikszentmihalyi, a leader in Positive Psychology, told Time: “Almost every person feels happier when they’re with other people…It’s paradoxical because many of us think we can hardly wait to get home and be alone with nothing to do, but that’s a worst-case scenario. If you’re alone with nothing to do, the quality of your experience really plummets.” Seligman adds that the happiest and least-depressed people have “strong ties to friends and family and commitment to spending time with them.” The best way you can combat burnout is to make an effort to spend more time with friends, peers, and loved ones. Consider how much time you normally spend each week with these people and set a goal to increase it. If you want to spend time with peers in the industry, websites like Reddit and SomaSimple have thriving online communities of physical therapists that can offer encouragement and support. Reach out to the APTA and find the closest community gathering. Facebook and LinkedIn have thriving groups with active discussions (check out the LinkedIn PT & Rehab Compliance group managed by Clinicient here). Even if access is limited, you can still reach out and connect with people who care. We’ve all heard the announcement on the plane to put your oxygen mask on before you help others, and this mantra rings true: to help others you must help yourself first. By turning into an optimist, finding meaning, using your signature strengths, and reaching out to peers, you can beat burnout and have a vital career with passion and purpose. The takeaway? Fight your urge to isolate yourself and increase your amount of time with people who care about you. Fourth Method: Find a Career that Supports the Above Interests Optimism, purpose, and community all help to drive ambitions and keep you from burning out. Without all of these, physical therapists—like any other professional—are destined for burnout. Unfortunately, the current market landscape for the PT profession lends itself to not having the time or resources to sustain the above interests. Variable reimbursement rates, high overhead, and a push for healthcare optimization at the expense of patient care all challenge these vital components of your career. Whether you are practicing in outpatient orthopedics, inpatient care, SNF care, or Travel PT (among many others), there is always a battle of “I didn’t have enough time,” or “insurance mandated that care be stopped.” The market must change. Our conventional perception of what PT care is must change; for the better of our patients, and ourselves. Luna provides a platform for PTs to make excellent pay (double the hourly rate of some positions), have scheduling flexibility to make their own hours, and champion their own brand. Because of the flexibility that Luna enables—providing an hour of optimal care to each of our patients—your work can be your own catalyst for maintaining optimism and purpose, as well as having more free time to do the things you love. Regardless of where you choose to work, it is imperative that you find a position that champions the importance of optimism, purpose, and community (both within your career and allowing personal time with friends and family). Know that you have incredibly marketable skills and deserve these things. Find a position that can balance these interests, or move on. As the research on burnout demonstrates, your career depends on it. There are opportunities for you to take advantage with supportive, modern technology like Luna to deliver convenient care without burning out. — If you are interested in either full-time or supplemental work opportunities in the Bay area, please contact us at www.getluna.com/own-your-career Luna’s team of therapists, technologists, community-builders, and customer service experts examine every aspect of the clinical relationship. Luna is introducing ways to remove overhead and enable technology that empower therapists and patients to stay informed for ease of giving and receiving care. Want to see more content like this? Subscribe to our blog digest to get future blogs from Clinicient delivered straight to your inbox. Unlinked sources: Physical Therapy Workforce Project: Physical Therapy Vacancy and Turnover Rates in Skilled Nursing Facilities. Alexandria, VA: American Physical Therapy Association; 2008.