Quality of Life vs Burnout: A Real Healthcare Dilemma

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When thinking about what you’d want more – improved quality of life vs feeling burnt out, the answer is almost always very clear. A better quality of life, of course. Nobody wants to feel run into the ground, under appreciated, underpaid, etc. to the point of hating or quitting their job. That’s common sense. But what if I told you there are actually issues in emphasizing this superior quality of life mentality?

While there are pros and cons to all companies, it’s pretty astounding to me that improving employee quality of life could actually cause issues within a healthcare system. Hear me out on this one.

I feel honored to have worked in a variety of facilities within the last 3.5 years of practicing as a PT. Specifically, I have worked in larger hospital systems on both the east coast (Norfolk, Virginia) and the west coast (San Diego, California).

If you know anything about the differences between the east and west coast, just know this one- California values quality of life way more than any other place that I have lived. The labor laws entitle employees to multiple paid breaks throughout the day, a need to take a 30 minute lunch break or get paid extra, staffing ratios are way better (especially with nursing!). In Virginia, you don’t get these paid breaks throughout the day, staffing ratios are lower, and there is much more demand for productivity when treating patients. Again, these are specifically comparing these two states that I’ve worked in, but I imagine it carries over to multiple other states as well pending labor laws and culture.

Reading this, you’re probably thinking – okay, so how could it be a bad thing that staffing ratios are up and employees are entitled to breaks!? That’s crazy! Well, this isn’t across the board with all facilities – it is definitely dependent on the health system you’re in, but I can say I have some experience with a few of them now.

Recently, I left a facility that I had heard AMAZING things about even when I lived on the east coast. “The benefits are great!” or “My aunt works there and she loves it!” I heard endless good things and decided I had to check it out once I moved. I was hired and worked in one of their facilities for 8 months before I decided I couldn’t do it any longer.

So what happened?

I had a 15-20 minute commute, I had been given free scrub tops for my position, they gave me multiple free things throughout the year, the hospital had a bunch of free workout sessions at lunch, a gym that I could use… what’s not to love?

Well, from the beginning, I noticed everyone was pretty relaxed at the facility. That chill Cali vibe. I figured I could get used to it. My first 1-2 months were focused around figuring out the documentation, finding my way around/between the various floors and settings.

The things I began to notice around month 2:

  • Everything I did was communicated to the “lead therapist” who then contacted the physician. Or I talked to the nurse. I had never been introduced to a physician, NP, or PA. I didn’t even know where the phone list was. Why? Because that’s not a thing at this facility. Staff PTs hardly ever spoke to the physicians or mid-levels directly. Yep, that means little to no autonomy. And yep, that means when the physician/NP/PA walked in the room, they definitely did not acknowledge who you were or show much respect (I know this happens everywhere depending on the person, but definitely more emphasized here). This also meant that whenever a lead therapist wasn’t present, the staff therapists claimed it wasn’t their role to call the physician because it wasn’t “part of their job,” at times leading to a delay of care.
  • Patients wouldn’t get seen/treated because people just didn’t want to/needed breaks. And it was pretty unlikely for another therapist to help another out, because most of the time, they wanted to leave early. Oh, and the priority to see patients was based on “who we got paid more for” not who needed it most based off diagnosis and presentation (YIKES).
  • Poor evidence-based care. Everything seemed very behind the times. I’m not sure the reason for this, but I have a few speculations:
    • Most of the employees come to work for a paycheck, they highly value their home life more than work. And don’t get me wrong–this is SO okay!!! BUT – in a healthcare profession, when your job is to advocate and assist patients, this can be harmful to patients if you’re not at least somewhat dedicated to your role.
    • Related to above, the bare minimum is done because nothing more is expected of the workers – and management doesn’t necessarily encourage more education and more progression. Employees didn’t take students, and when volunteers came to observe, nobody wanted them either. Many times when I asked why something was done a certain way, the answer was, “well that’s how we’ve always done it.” **NEWSFLASH** Healthcare is ALWAYS changing – if you are doing something because that’s how you’ve ALWAYS done it- chances are you are very outdated.
    • When I brought up the need to see certain patients at a higher frequency due to certain neuro diagnoses, evidence, and patient response, I got feedback such as, “we’re not staffed for that, so can we decrease the frequency of those patients?” And “We don’t get paid as much to see them, so we only see them 3 times a week.”

*slowly begins to pull hair out*

I know these may seem silly, but being in a profession where we get PAID because of having these patients as our “customers,” some of this boggled my mind. The employees are getting treated better than the patients! Yes, I understand we need employees to be healthy to treat patients, but there is a very delicate balance that needs to be found. And YES I understand patients will come based on how you treat them – but to me, not providing the best, evidence-based care, is harmful and a true disservice to our patients. It’s truly not hard to treat the patients well AND provide evidence-based care, especially if you have a dedicated team of employees who work together to provide this.

We can’t keep delaying patient care because we don’t feel like doing extra work. I understand you can’t do extra work every single day, but sometimes we just have to go above and beyond – we need to advocate for our patients and stand up for them, not treat them like a dollar sign.

We can’t keep doing the same thing over and over – that’s a disgrace to the profession and healthcare overall. Be open to new ideas, change, and evidence, learn to progress with the profession and stay on top of your continuing education in a variety of realms. This is a profession with never-ending learning, don’t forget that.

I can walk out of the hospital. I can choose the hours I want to work so I don’t get burnt out. I can change my job. (Trust me, I know this is hard because of student loans, I have PLENTY). These patients can’t change how you treat them, the care they receive, the knowledge behind what you are doing. Treat them how you would want to be treated, they need you. End of story.

If you are feeling burnt out, find an alternative. What can you do that you love? Can you change your position around to make you happier? Will your manager help you re-organize this? Can you find a new position that requires less working hours so you can give it all you got for a few hours and then focus more on home? By doing the bare minimum at work, not only are you suffering from not wanting to be there – but the patient is suffering, those around you are suffering, and the profession is suffering. We need to keep moving forward, help yourself to help others. It is hard work changing jobs and searching for one that best suits your needs, but to make you overall happy – that work is 100% worth it. (I fully understand that this is difficult especially when there are financial barriers, really, I get it).

So back to my rant of how this improved employee quality of care can be harmful.. For me, it hurt me that I was consistently going above and beyond and working harder than almost everyone around me. I felt like I was trying to drag other employees forward to be better, trying to inspire a group of people who did not seek motivation or inspiration. I truly cared for my patients and wanted the best for them. I noticed many patients who were not able to advocate for themselves and therefore were pushed off to the side. They weren’t given the appropriate chance because they didn’t have the financial means of others, or they weren’t able to progress as quickly so others didn’t have the patience and want to take their time with them.

I know this sounds heartless and a bit of a direct blow coming from me, but if you aren’t fully dedicated to this profession, you are harming this profession. As physical therapists, we need to advocate for what we do, show our importance, educate others on how we can help them. By falling into the norm, you are allowing our profession to regress while other disciplines keep moving forward.

Next time you head into work, I hope you remember why you’re there, why you got into this profession. Life happens all around work, but for just a few hours, you are there to make a difference in someone else’s life. A difference you were educated and trained for, and a difference that nobody else can provide. Dedicate yourself for those few hours, help those patients, remember what you are there for. That being said, don’t beat yourself up if you slip up now and then. Just keep trying to do the best you can, for your patient. The reward you will feel internally for helping others will be much more than a free water bottle or a phone case. It will reside with you for years. Search for that type of gift from your work.

If you are ever in a position where you don’t feel like your current job is helping you improve yourself, improve the profession, or even worse – just not listening to you. Don’t be afraid to get out. Listen to your morals, follow your ethical compass. You are wanted and needed. And don’t forget one of my favorite quotes, “If you’re the smartest person in the room, you’re in the wrong room.”

Get out there, find what you love, and use that to help others! I know if you are able to achieve this level of success, you won’t feel burnt out.

Feel free to reach out or provide any comments, suggestions, or alternatives you can think of! I try to stay as open-minded as possible 🙂 Find all of my contact info here.

Until next time,


Check out my other blogs including Simple Ways to Save Money, Observing a Japanese Day Rehab, and Life as a Small PT!


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