Prompt recently conducted a survey to better understand why physical therapists and other rehab clinicians are leaving outpatient care for non-clinical roles.
Why? Staffing is the number-one challenge facing rehab therapy businesses, and we hear more stories about it each day. The reduced candidate pool makes the hiring search increasingly competitive for understaffed practices.
In our survey, we asked clinicians who have transitioned out of the traditional care setting or are considering doing so why they are deciding to make a change, among other things. We’ve summarized the findings below.
Table of Contents
- Survey methodology and key findings
- What are the top reasons rehab therapists are leaving traditional care roles?
- What do/did they like most about traditional care?
- What roles are they transitioning to, and what would influence a decision to return?
- How can practice owners address this trend in clinic retention?
- Conclusion
Survey methodology and key findings
Prompt conducted this survey from May 14-24, 2024, and collected 215 responses. Respondents were members of The Clinician Transition, an online community for rehab therapists (PTs, OTs, SLPs) who are either considering a nontraditional role or have already taken one.
Key Findings
Lack of growth opportunities (85%) and insufficient salary/benefits (73%) were the top two reasons* clinicians gave for transitioning out of traditional care
*Respondents were allowed to choose multiple reasons
68% of all respondents said emotional burnout is a top reason for leaving traditional care
79% of respondents under age 30 said that excessive workload was a top reason for transitioning
The top roles* that clinicians are transitioning to are customer success (52%) and product/project/program management (50%)
*Respondents were allowed to choose multiple roles
Clinicians with 5-7 years of experience represent the largest group seeking nontraditional roles
24% of those surveyed indicated they’d consider returning to traditional care if they had a leadership role
Who took the survey?
Survey respondents were predominantly female (83%), followed by male (16%) and non-binary (<1%). The largest age group was 30-39 (62%), followed by 40-49 (20%), under 30 (13%), and 50-59 (5%). Responses were distributed evenly across levels of experience, ranging from 1 year to 15+ years in traditional care. Respondents were split fairly evenly between still having a role in traditional care (52%) and having already transitioned (48%).
What are the top reasons rehab therapists are leaving traditional care roles?
When asked for their primary reasons for leaving the field of traditional care, clinicians reported lack of professional growth opportunities, desire for higher salaries, burnout, and difficulty balancing work and home life. Note: They were able to choose multiple answers.
The top reasons clinicians are changing careers
- The top reason clinicians cited is lack of professional growth opportunities (85%)
- The second is insufficient salary/benefits (73%)
- 90% of the 30-39 age group – the largest age group represented in the survey – say that pay is a top reason they are transitioning
- 95% of providers under 30 report “lack of professional growth opportunities” as a top reason
- 75% of providers age 40-49 also say “lack of professional growth opportunities” as a top reason
Many respondents called out declining/stagnant reimbursements rates, low reimbursement payers, and the profession’s overall reliance on insurance reimbursements for adequate pay as frustrations with traditional care.
What clinicians are saying about their top reasons for leaving
In their open-ended responses, clinicians went into more detail about topics that contributed to their decisions to leave the profession. They shared their thoughts on limited career growth opportunities, insufficient pay for their work, and a lack of respect from leadership, among others.
Greater respect for my time and professionalism - I was underpaid and overworked in a large institution wherein it seemed they cared more about the "name" and their own ranking than they did caring for their own people.
The lack of respect from the managers and higher-ups. I should be paid way more than I make for the amount of work I do. I basically manage myself. I never receive the therapy equipment I request. The demands are unrealistic and there is no reward.
I think if there were more paths to grow – even as a regional lead with certain expertise, mentor for young DORs, or more project improvement opportunities. I just got bored with the work.
There needs to be a structural reorganization of the entire system. Specifically in rehab, requiring a doctorate without increase in pay or opportunity to grow is an abhorrent way to treat our therapists.
The biggest problem is that pay is not keeping up with inflation. Because of the financial squeeze, companies are squeezing therapists and trying to make them do more with less.
Additional reasons clinicians reported for leaving
- 68% of total respondents list emotional burnout as a top reason, making it third overall
- 61% of total respondents list work-life balance as a top reason
- 79% of respondents under 30 also say that excessive workload was a top reason
- Some responses point to “increased focus on numbers over quality of care,” “difficulty in getting PTO,” and “lack of mental health support” as challenges they faced
What clinicians are saying contributed to their burnout
Clinicians reported unrealistic work demands, less focus on patients, documentation struggles, and frustrations with inefficient technology as burnout contributors.
Outdated software with too many unnecessary/irrelevant fields that need to be filled in. It impacts my interest in leaving traditional care because it adds to my workload. Documentation outside work poses a huge work-life balance issue and having to use software that doesn’t support user functionality only elongates the completion process and takes away valuable time from both patient care and my time outside of work when I need to work on notes.
Healthcare is not patient-first anymore, there are too many elements of the job that become obstacles on a daily basis.
Having to deal with productivity demands every day when the “service or product” we’re selling is treating patients. Patients aren’t machines and can cancel or no show. I can’t control that.
Reduced documentation burden would have made all the difference. Doc was what ruined my work/life balance. The other problems would have been tolerable.
Documentation software is extremely slow, often loses connection working in the field even if laptop/phone has connection, does not do enough to reduce redundant tasks, not enough autofill (fill out forms regarding CLOF, goals, etc. and still have to type out a narrative summary based on the exact same information).
What do/did they like most about traditional care?
When asked “What do you/did you like most about traditional patient care?,” many respondents shared their positive experiences getting to know and helping patients, as well as building connections with their team.
I do love building trusting relationships with my patients and seeing them accomplish things they never thought they would be able to do. I also love working in a collaborative environment with my coworkers.
I like the population - older adults or geriatrics. It is fascinating to hear their stories and connect with them.
My coworkers, interactions with patients, helping others be and feel successful even during physical and emotional challenges.
Solving the problems that people thought were unsolvable.
What roles are they transitioning to, and what would influence a decision to return?
Customer success and product/program/project management are the top fields that rehab therapists are transitioning toward after traditional care.
The top 5 alternative career paths mentioned* were customer success (52%), product/project/program management (49.75%), healthcare quality (38%), sales (30%), and data analysis (25%).
*Respondents were allowed to choose multiple options
When asked the most appealing aspects of non-traditional roles, “time flexibility,” “ability to work remotely,” and “better growth/pay potential” were often mentioned.
89% of respondents are detractors of the profession (reporting 6 or less out of 10 on the question, “How likely are you to recommend a career in traditional care?”)
34% of respondents who have already transitioned away from traditional care reported they are highly unlikely to return to a traditional care role in the future.
What clinicians are saying would improve traditional care:
In clinics
Respondents shared some suggestions for how practice leaders could improve their businesses to help retain clinicians. These included building more time into provider schedules for unique projects and career development, and a greater focus on quality over quantity of patient visits.
I never understood why therapy clinics wouldn’t hire part time. It was either full-time or PRN. But for so many, PRN doesn’t work especially if you need a set schedule. But full-time burns you out. If I knew I could have a set 15-20 hours a week in a clinic, I’d most likely go back and then pursue my passions/own business venture on the side! Just having more options with that would be huge!
Listen to your staff, try to be transparent about business needs and how the team can meet those needs AND get what they need as well.
Identify pathways to build additional administrative "downtime" (for mentorship, projects, development, etc.) into therapist schedules alongside tenure for better employee retention in hospital settings.
It is important to have clinicians on non-clinical/corporate teams. We have firsthand experience with the clinical world and can provide a unique perspective to these teams.
Shifting the focus back to quality patient care and less focus on pushing therapists to see 18-25 people per day in OP.
At the industry level
Clinicians also offered some ideas for improving the rehab therapy industry as a whole. These included a desire for less dependence on the reimbursement model and more general business education in school.
It is time to find a way to move away from insurance and go direct-to-employer. Remove fee-for-service and get into contract-based coverage. We will treat your employees for $X and can show reduced utilization of healthcare benefits, etc.
Nationwide licensing (not state-based). True direct access. The “direct access” we have now is anything but that. It’d be great if hospital policies let therapists practice at top of license. Even when allowed in practice acts, policies, procedures, and cultures generally don’t give permission for therapists to do so.
I'm concerned about the characterization that therapist pay is bound by reimbursement rates. There are many administrative and management positions in healthcare that do not bill insurance and still receive adequate pay.
Educate the general population better about the importance and significance of rehab on long-term outcomes.
I think there needs to be a movement to improve reimbursement and respect for clinicians. I think in a money grab in PMP, we lost a lot of respect and expertise. The reimbursement for the amount of training therapists have is really poor.
I love therapy. I see the benefits and have seen all the good in it. I wish we had received more education on business aspects, entrepreneurship, consulting, and non-clinical roles.
How can practice owners address this trend in clinician retention?
There are some pressing themes from these answers that are hard to ignore – and for the future of PT, owners and decision-makers across the industry need to address them. Consider the following:
Clinicians need to be paid more
Practice leadership teams need to be creative in finding ways to overcome reimbursement struggles. Running more efficiently, ensuring error-free billing, and scheduling out patients more intentionally can help battle margin compression and offer higher base salaries. Incentive-based structures could also be considered for rewarding high-performers and giving them a sense of upward mobility.
It’s worth considering that providers in the 30-39 age group reported compensation as the biggest issue for them, while those below 30 and over 40 reported “lack of growth opportunities” as their top reason for leaving.
Staff burnout needs to be more openly talked about and addressed
Owners and managers should stay aware of the possible mental toll their teams are experiencing. Leadership should create open-door policies to discuss issues, and provide resources and job flexibility that can benefit the well-being of providers and support staff alike. They should also solicit feedback about work demands or aspects of the business that contribute to burnout and work together on solutions. Find tips for preventing staff burnout here.
Modern equipment and technology should be a priority in practice budgets
They help create a foundation for operating smoothly, maximizing reimbursements, and eliminating common headaches in provider tasks – which can not only lower stress but allow clinicians to help more patients and maintain a sustainable work-life balance.
Conclusion
Thank you to The Clinician Transition group for partnering with us on this survey, and for all the respondents who took time to share honest answers.
We are committed to a brighter future in rehab therapy, and offering technology that can help clinics deliver better care is just one part of that.
We look forward to the positive impact(s) this report can have across the industry.
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