Clinician Advancement and Avoiding Burnout

As a practicing clinician for 7 years, I have been thinking about my future and how I want it to look. I have been working as an outpatient orthopaedic physical therapist for the same company since I graduated from my DPT program. I have every intention to continue working in that capacity in patient care, and I love direct patient care. However, I do want to continue to grow as a professional and continue to put other skills, knowledge, and passions I have learned to use in my daily work.

Over the years, I have developed clinical skills and non-clinical skills through various continuing education courses and service opportunities. I have pursued an orthopaedic board certification and additional training in physical therapy for temporomandibular dysfunction (TMD) and disorders. I have maintained involvement within the APTA and began work as an adjunct faculty member with my former DPT program. With these clinical and non-clinical opportunities, I have really continued to develop my interest and passion for continued clinical expertise and development, advocacy, leadership, and innovation within physical therapy. I certainly have opportunities to explore those areas, but I wish to find opportunities to bring these interests and additional skills into my work environment and relate them to my work responsibilities.

As a staff physical therapist, what is my next step? A common next step for practicing clinicians is into management. While that is a logical step, and that likely makes sense for others, I don't know if that is something I want to do or if that would be the best fit for me and my skill set. I could imagine that other clinicians may feel the same way and perhaps feel stuck like I do sometimes. Is this just the model we work within? Or is this just a personal dilemma? How can we as a profession unlock some unused potential in clinicians and let them incorporate those other skills, knowledge, and interests into their day-to-day work and allow them to be recognized and compensated appropriately for that non-traditional work? We often view those who work in clinical roles as having the responsibility and duty to treat patients. Often, clinicians are compensated and rewarded for productivity, patient outcomes, etc. But what if there are other things that a clinician can bring to the table, such as advocacy knowledge and action, expertise in a clinical area, innovative practice ideas, community service, that could ultimately bring value and benefit to their workplace. Is that something that a clinician can be provided time and resources to pursue, and also get compensated and recognized for, as a part of their current clinical job? Sure, lots of clinicians do things like that already that better themselves, on their own, and during their own time, but wouldn't it be great to let them bring that into their workplace to directly influence and impact their peers, their clients, and their employer? It seems too often, the better a clinician becomes the longer they have worked, they are loaded up with a larger caseload or management tasks that might not, by themselves, fully tap attributes and skills. Of course, there are non-clinical roles and other settings that a clinician could venture into, but I think it would be great if there can be a balance of clinical work and other valuable non-traditional work in a clinical role that would potentiality keep people engaged in the profession and ultimately grow and advance the profession.

An APTA article shared the results of a survey of physical therapists in Texas, the majority working mostly in direct orthopaedic patient care and in either private practice or a hospital setting. It stated, "Higher feelings of autonomy and competence were associated with lower risk of burnout."1 Lead author of the study, Rupal Patel, PT, of Austin, Texas stated, "We found that a feeling of autonomy in the workplace is important." "That includes having the freedom to decide how jobs are completed, receiving awards for taking initiatives, and feeling valued for one's perspectives. The literature shows that employees who perceive that their supervisors support them being autonomous in their jobs leads to less burnout, and discussion to help facilitate this should be initiated by managers." An article in APTA magazine describes how two employers have acknowledged and addressed burnout in their workplaces.2 One employer created a career pathway for clinicians to understand how to advance in the company and made changes to its continuing education program. Another completed an interdisciplinary project that involved physical therapists, along with other healthcare providers involved in total joint replacement care, that showed employees their expertise was valued.

While these are just a few ideas, both discuss engaging and using clinicians beyond direct patient care, something I think would benefit clinicians and give them opportunities to grow and advance, but also allow clinicians, to show their value to their workplace/employers and other stakeholders. As clinicians, let's continue to explore new knowledge and involvement in new arenas. Consider the possibilities! Offer to start a project, like a journal club, that could provide new information to other clinicians or suggest a workflow change to pilot in the clinic. Maybe you're active in legislative advocacy for the profession and can share updates with your peers.

  • Let's demonstrate how we can use our knowledge, skills, involvement, and service outside of the clinic to provide different services to our employer.
  • Let's start conversations with those with whom we work and for whom we work about our interests and ideas.
  • Let's consider discussing this with employers so they could consider the above survey and article and ask their physical therapists about their interests and passions and inquire about activities outside of the clinic.

Ask these clinicians for input on decisions and offer opportunities for involvement in tasks and projects needed for the benefit of the workplace. Perhaps there are ways to assess clinicians' skills and interests and find meaningful ways to bring those to their work, provide support and resources to do so, and acknowledge and reward doing so. I would imagine that in doing so, clinicians, myself included, would continue to feel satisfaction with their work and have a desire to continue to do that work.


  1. Review | Survey of PTs Finds Feelings of Autonomy and Community Could Lower Burnout Risk.
    APTA. Published January 4, 2022. Accessed June 10, 2023.
  2. Understanding and Avoiding Burnout. APTA. Published November 1, 2020. Accessed June 10, 2023. 

Author Bio:

Natalie Novak is a Board Certified Clinical Specialist in Orthopaedic Physical Therapy with practice in the treatment of temporomandibular dysfunction (TMD). She currently practices in the outpatient setting in Pittsburgh, PA. Natalie is currently professionally involved in a variety of roles in the APTA Pennsylvania (PA) Chapter and Academy of Leadership and Innovation (ALI). She serves as the APTA PA Political Action Committee (PAC) Treasurer and coordinates social media for the Southwest District. Within ALI, she serves as the Member Services Committee Chair and Social Media Subcommittee Chair. Natalie also organizes and oversees social media for the Pitt PT program.


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