One of the prominent challenges facing healthcare services is the high rate of occupational stress that leads to turnover and the intention among professionals to leave the profession. The increased healthcare needs of an aging population, the need to adapt to technological advances, the financial constraints of the healthcare environment, and workforce shortages result in high patient loads and long work hours. Healthcare professional exhaustion, cynicism, and decreased productivity can lead to diminished quality of care, negative healthcare outcomes, reduced patient satisfaction, and considerable increases in healthcare costs.

There are different terms applied to this constellation of events and the impact on healthcare professionals. Compassion fatigue is used to describe the “cost of caring” when healthcare professionals are exposed to repeated interactions requiring high levels of empathic engagement in life-altering situations for patients. Moral distress, where a healthcare professional knows the right action but is unable to act on it, can lead to moral injury. Moral distress and injury over a period of time will lead to the stress, anxiety, and depression associated with the sense of professional burnout. The healthcare literature identifies a pressing need to study and evaluate healthcare professionals’ satisfaction, as turnover and burnout have far-reaching consequences to safe and effective patient care.

Similar to other healthcare professionals, physical therapy professionals are not immune to compassion fatigue, moral distress, moral injury, and burnout. High patient loads, long work hours, salary stagnation, and educational debt have been identified as contributing factors. A systematic review by Burri et al. separated physical therapy risk factors for burnout into unavoidable and avoidable risk factors. Although not conclusive, a majority of the studies reported that a younger age, fewer years of experience, and fewer years of employment were linked to a higher risk of burnout, potentially leading to leaving the profession. The avoidable risk factors were separated into structural/organizational, psychological/emotional, environmental, and sociodemographic. The most frequently cited factors to burnout were unsatisfactory work relationships, high workload, inadequate resources, lack of support, and organizational structure. The information from studies on occupational stress and burnout provides an opportunity to support physical therapy providers with a resource to gauge and address both personal and professional aspects of well-being.

FSBPT has developed resources such as the Healthy Practice Resource that can be used to address components of compassion fatigue, moral injury, and practitioner burnout. The Healthy Practice Resource is a healthy practice self-inventory developed by the FSBPT Continuing Competence Committee and Healthcare Regulatory Research Institute (HRRI) with researchers Alyssa Gibbons and Gwenith Fisher. The anonymous and free Healthy Practice Resource  went fully live in the third quarter of 2025. The Healthy Practice Resource is designed to support the well-being of healthcare professionals by addressing various aspects of their personal health and practice environment. It includes modules related to individual emotional, mental, social, financial, and physical well-being, as well as modules related to the practice environment. Practice environment modules include work-related well-being, work role support, benefits and wellness, practice climate, and compassion. The modules are designed to be completed in eight to ten minutes, and the healthcare professional can choose any combination of all ten different modules.

After answering questions in a module, the healthcare professional is provided with a report and links to resources that support deeper understanding and application to that specific personal or practice component. Importantly, results are only shared with the healthcare professional to support anonymity and ensure candid responses when completing the questions. The Healthy Practice Resource therefore provides two key components for an effective workplace well-being strategy: a self-inventory of the healthcare professional’s current state and resources to bolster their personal and professional well-being.

Research supports the benefit of interventions to improve personal and workplace well-being. A systematic review by Cohen et al. demonstrated improvements in well-being, gratitude, self-efficacy, psychological stress, work engagement, and work performance through a variety of programs and resources. Organizational support through well-being activities also reduces the intention of healthcare professionals to leave their organization and the healthcare workforce. The promotion and utilization of the Healthy Practice Resource  by jurisdictional boards, employers, and educators seems to align with the peer and organizational support that will improve the well-being and retention of healthcare professionals, ultimately providing safe and effective physical therapy care for the public.

In the event that a physical therapy professional is considering stepping away from the profession due to work or individual factors, FSBPT has created a resource that guides them about the potential implications of a lapsed license as well as protocols for re-entry. The document “Licensee Information about Lapsed Licenses and Re-Entry” is publicly available on the FSBPT Resources webpage. The document expands on potential practice restrictions and skill erosion that can occur after letting a license lapse. The resource also provides potential reinstatement steps that jurisdictional boards typically require for healthcare professionals with a lapsed license. In addition to the physical therapy provider, FSBPT developed the “Reentry of Physical Therapy Providers: A Resource for Regulatory Boards” to support our jurisdictional boards that are considering re-licensing a provider who chose to take an extended leave of absence from licensure and active practice. This jurisdictional board resource includes multiple components with an ultimate focus on the responsibility of the jurisdictional board to protect the public and determine if the individual seeking to re-enter active practice demonstrates the skills and knowledge for safe and competent practice.

Regardless of the terminology used, healthcare professionals are facing increased rates of occupational stress related to the increasing healthcare needs of an aging population, the need to adapt to technological advances, the financial constraints of healthcare employers, and workforce shortages. These occupational stressors impact the well-being of healthcare professionals and ultimately the safe and effective care for patients. It is important for regulators to be aware of and promote tools, such as the Healthy Practice Resource, that are available through FSBPT and HRRI to support physical therapy professionals and students in delivering safe and effective care.

References:

Sorenson, Claire, Beth Bolick, Karen Wright, and Rebekah Hamilton. “Understanding Compassion Fatigue in Healthcare Providers: A Review of Current Literature.” Journal of Nursing Scholarship 48, no. 5 (June 28, 2016): 456–65. https://doi.org/10.1111/jnu.12229.

Burri, Sabrina D., Kaleigh M. Smyrk, Mostafa S. Melegy, Melanie M. Kessler, Nadim I. Hussein, Brandi D. Tuttle, and Derek J. Clewley. “Risk factors associated with physical therapist burnout: a systematic review.” Physiotherapy 116 (February 5, 2022): 9–24. https://doi.org/10.1016/j.physio.2022.01.005.

Cohen, Catherine, Silvia Pignata, Eva Bezak, Mark Tie, and Jessie Childs. “Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review.” BMJ Open 13, no. 6 (June 29, 2023): e071203. https://doi.org/10.1136/bmjopen-2022-071203.

Roitenberg, Neta, and Noa Ben-Ami. “The Mediating Role of Physical Therapists’ Satisfaction with Helping Patients in the Relationship Between Work Support and Intention to Leave Their Current Employment.” Physical Therapy 105, no. 5 (May 2025). https://doi.org/10.1093/ptj/pzaf026.