skip navigation
Welcome! Orthopedics Resources Neurology Resources #PTDOS Physical Therapy Pulse Contributors Store

On Burnout: Recognize and Revitalize

08/24/2013, 10:15am EDT
By Josh D'Angelo, PT, DPT

Let's Talk about Staying Cool

APTA Student Assembly President 2012-2013

On Burnout: Recognize and Revitalize


Three months in, I know health care provider burnout is real.

I realized my passion for physical therapy about seven years ago and instantly began dreaming of practicing PT – of using my unique set of knowledge, hands-on skills, and strong communication to improve patients’ lives. Along the journey to becoming a PT, I expressed my passion through service and advocacy, which better prepared me for my role as a provider.

After nearly a decade of study and countless professional activities to supplement my education, I have finally arrived, ready to contribute as a practicing physical therapist.

So why, at the end of every day, do I feel completely exhausted? And what is this creeping cynicism emerging in our office? Why do I hear providers’ focus shifting from quality care to reminding themselves that they can “make it through the day, only 4 more patients to go?”

After a quick google search, I realized that what I’m seeing is actually quite common. Termed “burnout,” this sense of depersonalization and emotional exhaustion affects 50% of students, new professionals, and experienced doctors alike1-2. While burnout stems from providers’ personal feelings, it has been demonstrated to directly affect patients, as it reduces quality of care1-3.

Since reading these articles, a few questions have been gnawing at me: how do we stave off this nagging exhaustion? How can we avoid this dangerous mindset of treating patients as numbers rather than individuals? Better yet, how can we be sure that we are giving our best to every single patient that walks through our door?

Here are a few ways I have started to nourish myself and answer the above questions. My hope is that you can add to the list in the comments below and together we can work toward defeating these feelings of distress, ensuring we provide quality care. A few areas I am exploring:


{C}{C}1.      Open Discussion. One of the best tactics I have found is being honest in the clinic. When I notice an area we could do better, I discuss the idea in a professional manner with co-workers, friends, and even family. Everyone has generally responded positively, along the lines of, “let’s talk about how we can make this better.” Getting my thoughts out in the open prevents my frustrations from building and hearing others’ responses have been one of the most valuable methods of positive reinforcement.


{C}{C}2.      {C}Empathy. Studies have shown a correlation between burnout and low empathy4-5, and as Dr. Larry Benz so clearly explained, empathy is critical to quality of care. Dr. Benz cites studies that demonstrate simply watching a movie or reading literature that evoke empathy and compassion can lead to gains in empathy, and therefore potential gains in the clinic.


{C}{C}3.      The Environment. From the little things such as functioning computers and smiling co-workers, to the bigger challenges of mounting documentation and responsibility, our environment shapes the way we practice and has a huge impact on our personal state of mind. I have become a stronger advocate on clinical and legislative levels, working to create a more positive environment.


Confronting feelings of distress will push us to create good habits, treat each patient as an individual with unique pain and impairment, and set a strong foundation for the rest of our careers. Our discussions will serve to develop a more positive atmosphere within our clinics and profession, one that is focused on what we can do to ensure we are providing high quality care for all patients.

What other ideas do you have to overcome provider burnout? What have you seen done in clinic? I'm looking forward to reading your comments and insights. 



1. Dyrbye LN, Massie F, Eacker A, et al. Relationship between burnout and professional conduct and attitudes among us medical students. JAMA. 2010;304(11):1173–1180.


2. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358–367.


3. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302(12):1294–1300.


4. Thomas MR, Dyrbye LN, Huntington JL, et al. How do distress and well-being relate to medical student empathy? A multicenter study. J Gen Intern Med. 2007;22(2):177–183.


5. Shanafelt TD, West C, Zhao X, et al. Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med. 2005;20(7):559–564. doi:10.1111/j.1525-1497.2005.0108.x.


Josh D’Angelo currently serves as APTA Student Assembly President and as a member of the DC Chapter Membership Committee. In the spring, Josh was awarded the Mary McMillan scholarship award for scholastic ability and potential for future professional contributions. He is now practicing in the outpatient orthopedic setting in Washington, D.C. 

Tag(s): Physical Therapy Pulse  All Articles  Josh D'Angelo, DPT