I was talking with somebody the other day and the topic of burnout in therapy practice ownership came up.

He runs a private therapy practice and has 15 clinicians that work for him. He’s not involved in daily practice anymore. He manages the business and the 15 clinicians deliver the direct patient care services in the practice.

Anyways, he began by telling me that there’s a lot of stress, almost to the point of burnout. Obviously we’ve been coming out of just the time with the pandemic and now heading into what may be a pretty significant recession if the numbers play out the way they’re predicted to.

That type of economic environment causes stress, especially to practice owners worrying about payroll, overhead, and billing issues.

He also needs to fill a couple open positions, and it can be difficult to recruit, retain, engage clinicians. Now I’ve done an article and a couple podcasts on recruiting and retaining clinicians. You can find the article here, and here are the podcast episodes part 1 and part 2.

Here’s a video rundown of this article:


What to do to combat burnout as a practice owner?

This practice owner tells me that he’s just feeling burnt out. He doesn’t know what to do. He thinks about selling the business. He thinks about how he can walking away from this headache. He’s thought about trying to find a manager to run the practice, but he just didn’t know what to do.

During our conversation, I thought some of the things that we discussed and potential solutions we came up with and brainstormed seemed like something that’s applicable to anybody dealing with burnout while running their private therapy practice.

So I decided I’d share them here.


7 Ways to Beat Burnout & Become Re-Energized as a Practice Owner


What I’ve got is 7, maybe 6, because two of them could be merge into one…

So 6 or 7 solutions or decisions you could make as a therapy practice or clinic owner that could help you regain some kind of engagement or fulfillment in running your practice. Basically avoiding becoming somebody that cries a little bit inside when you hit the alarm clock in the morning.

Let’s dive right in.


7 Options for Re-Engagement


I’m going to share all seven burnout antidotes with you, and then we’ll get, go into each one individually.

  1. Sell the business to leave burnout behind
  2. Take inventory of your daily tasks
  3. Look for opportunities to innovate within the business, or challenge and grow your organization or your team
  4. Reconnect with your purpose
  5. Merge
  6. Work as a clinician again
  7. Expand or create a new service offering or clinical specialty

As I explore each item on this list, I’ll try to provide some details and practice steps to implement it if you feel it would help you in your practice. Not every item on this list will be relevant to you and your particular business or practice; but they hopefully provide a good starting point for thinking about this in more depth.


1. Sell the business to leave burnout behind

If you’re not engaged anymore, you may want out of the business. You may be tired of running the day to day tasks and worrying about payroll every couple weeks. Or maybe the stress of making sure you’re keeping census at a certain rate keeps you awake at night.

Sometimes in those cases, it makes sense to simply sell the practice and walk away. This makes more sense especially if you’ve got some kind of project or work on the side. The practice owner I was talking with mentioned to me that he’s already doing some real estate work; buying and flipping houses and so on.

What he really wants is a way to keep doing that. So in that situation, where you’ve got a business that is profitable and that could be sold for some kind of multiple of net earnings, it might make sense to sell the business and use the funds from the sale to finance, whatever the next venture is.

I know some people that have sold their practice and started another practice in a different specialty area or sold their practice and moved across the country to open up another practice in their new state. That’s an option as well.

The reality is when we build businesses as clinic owners or healthcare entrepreneurs, we forget often that while this thing that we’ve built is providing cash flow and is financing our lifestyle, it is still an asset. Pieces and components of that business that can be parceled off and sold to capitalize or to realize the value that you’ve created in this business, especially if you’ve been doing it for 10, 15, 20 years. You may have some significant equity to sell.

If you’re interested in selling your practice, primarily in the PT/OT/SLP space, we’ve done an interview with Michael Piekutoski, MPT from Physical Therapy Brokers. I’ve done a little bit of the advisement in this area, mainly around valuations, but Mike is the guy that I point people to if they’re looking to sell their business or get their business ready to sell. He’s done a lot of very big deals and has worked on both the buy side and the sell side. He’s somebody to talk to if you’re looking at potentially selling your business or investing multiple businesses in the PT space.


2. Take inventory of your daily tasks to prevent burnout

Now, I did this myself in the business. I advise my clients to do this all the time. If you think about what happens, especially as a private therapy practice owner where you don’t have this big corporate structure behind you doing all the back end work with organization charts and standard operating procedures and all that kind of stuff, you often find yourself slipping into a state of reactivity. You find yourself reacting to everybody’s questions or problems or concerns about the business or practice and what’s going on. Or, you fall into a state of doing jobs that other people should be doing.

I think this is an area that we as practice owners always have to reevaluate. I made a commitment to do this once a year. Now, this idea came about for me because I read a book titled Essentialism (find it on amazon here).

The main premise of this book centers around doing less but more. Focus on doing less activity or investing less time in the work or work activities, but getting more benefit or creating more value out of that time by directing your work and energy to only the most essential tasks and functions. Oftentimes, at least I’ve experienced this as a practice owner, I find myself getting pulled into a lot of things that are not my highest and best use.

So what I did, and what I’ve encouraged a lot of clients to do, is at the beginning of the year sit down and take stock of what you do and what you should be doing.

Taking stock of your work efforts to combat burnout

I created a spreadsheet. This spreadsheet contained 5 blocks which each contained 3 columns:

  1. The hours of the day broken into 30 minute segments
  2. Task or work activity
  3. Comments or notes

Each day of the week had its own block, each containing these three columns. I then simply tracked my work for a week. Everything that I did within my normal work hours went on that spreadsheet. And not only did the activity or the task itself go on the spreadsheet, but my own notes about it were entered. Sometimes it included a note to myself; something like, “I don’t want to ever do this again”. Sometimes the note read “okay, I did this task because somebody called out, but this is not a typical activity for me”.

What to do after you track a week’s worth of work

At the end of the week I sat down and I had a breakdown of what I actually did at work for the past week. I then created another page on that spreadsheet and filled out the times/day/tasks with activities that I knew I absolutely had to do or what I wanted to do. Some of that included marketing, lead generation, consulting work with clients, or business management tasks. But, I filled in that sheet with what I would call my “ideal” work week.

I then compared that idea week to what I had documented over the last week. I noticed patterns. For example, I really like doing my writing at 9:00 AM on Monday. I then took note of what was taking my time at 9:00 AM on Monday. I highlighted all the areas where my ideal differed from my actual. I asked myself, “Is this some something that I’m already paying somebody to do? And if it is, let’s get it over onto their daily task sheet. Or is it something that I need to find somebody to do or is it something that’s not even worth my time and I shouldn’t be doing it all?”

This process helped me weed out those tasks that were time-wasters for me. If you take a look at what you’re actually doing in a given week and then comparing that to what you know you need to be doing or what you want to be doing, you often find that there’s a very big discrepancy. You spend time doing tasks that you shouldn’t be doing. And you probably have a list of things that you know are priorities that aren’t getting done.

Find a way to reconcile those two things and you’re going to wake up feeling peaceful and avoid burnout because you will be doing the work you know you need to be doing. You also experience less stress. Those random things that come up and take your time away become easily identified and removed from your work day.


3. Look for opportunities to innovate or challenge yourself or the business and grow

I’m not saying that expansion or ever-expanding businesses are ideal or something that you should be interested in pursing at all times. However, as an entrepreneur or somebody that went into business in healthcare, part of the most exciting time (also, maybe some of the stressful time) occurs when you’re building something. You institute new policies, you explore or experiment with new business development ideas or new marketing ideas or new service delivery ideas. The list is endless.

When you’re building something, it uses the creative side of your brain to problem solve. That in and of itself is much more engaging work. It makes you feel like you’re actually doing something of value. And, it keep burnout at bay.

I always ask clients, “If you’ve been kind of stagnant in the business and you’re just done, you’re stressed, you don’t wanna run it anymore, when was the last time you innovated in your practice?”

Looking for opportunities for innovation and growth connects you to creative work that is fun and exhilarating or that challenges you in a way that you feel is worth putting in the effort, and prevents burnout.


4. Reconnect with your purpose to prevent burnout

Now, this might sound a little cheesy. I hear it all the time and I’m one of those people that when I hear talk about mission, vision, values, purpose, all that kind of stuff, a lot of times I find it to be very superficial. It sounds great on paper, but what does it really mean?

For me, when I talk to clients about this topic in particular, reconnecting with your purpose is not just about writing it on the wall or the whiteboard and talking about “what it means to be…” When I say reconnect with your purpose, I mean take time to think about what made you choose healthcare as a career, as a profession, or a vocation or a calling.

Then look at what are you doing in your daily work. If you’ve done an essentialist work list and you’ve tracked your daily tasks, what on that list of daily tasks is in any way directly connected to what got you into healthcare as a profession? Maybe you chose healthcare because you wanted to help people, and maybe practice ownership was the vehicle that allowed you to do that. Sometimes it’s just a matter of reconnecting with that original purpose.

This might not involve you making any big, drastic, dramatic shifts at the business or your daily workday, but sometimes just connecting the dots mentally is enough to beat back burnout and make you feel reinvigorated in your work. It helps you see that the work that you’re doing is actually valuable and meaningful in the world.


5. Merge?

Now, this could have been lumped in with sell the business or practice. However, the outcomes for the business owner are drastically different whether you sell the business or whether you merge. If you sell the business, potentially there’s some kind of service commitment. Maybe you become tied to an earn out, or you enter some kind of standing service commitment that after the sale you work with or for the company that bought your practice for X number of years, months, etc.

But then after that time, you walk away. You may negotiate an employment agreement or a consulting agreement that happens afterward the given time. But other than that, there’s really no ties to you and the business in the long term. It may last a couple years and then ends.

When you merge, you explore bringing on partners. The merger may also include you doing some of the other things on this list. It likely includes expansion. It likely includes exploring new service areas or opportunities or new service offerings. It likely involves reconnecting with your purpose, your mission, vision, values. It will totally challenge what you’re doing on a daily basis. All of that combats the effects of burnout. 

Effect of Merging

So merging could affect all of the, the items on the list previously mentioned. One of the benefits of merging includes getting back into that entrepreneurial “building something” phase. Again this taps into the mental and the creative work that tends to energize us. It also increases the opportunities.

You likely add a lot of equity or a lot of value into the business that you’re now building with these new partners. You also likely expand your geographical reach. Again, sometimes just the challenge of something new is enough to get you reinvigorated about work.

It may be one of those things that you’ve always thought about doing in the back of your mind that you haven’t done. Perhaps you run a physical therapy practice and you’ve always thought about maybe adding speech language pathology or occupational therapy or connecting with a chiropractor or massage therapist. The act of merging gives you the opportunity to add those clinical specialties. Perhaps you merge with an occupational therapist and now you can see double the patients potentially because you’re now adding another discipline to the patients that your clinic already serves.


6. Work as a clinician again

Now, when I’ve mentioned this a couple times to a couple different clients they immediately react with, “I don’t wanna do that!”

Hopefully the business is running in such a way where you’ve got systems and processes in place so it’s not going to fall apart without you walking away for a little bit (if you’d like to learn how to build your practice to run without you, grab a spot on my calendar here). Simply put somebody in charge to run the practice while you go back to full-time (or part-time) clinical work. Many people find that adding a day or two in the clinic, reconnects them with that purpose, the mission, the vocation; the calling of healthcare.

It also gives you great insights into how your business is running. You likely discover areas that can be improved. Maybe you see processes that need to be outlined or more clearly defined.

Maybe working as a clinician allows you to get to know frontline staff and clinicians in a way that you can’t simply do when you’re in the office running the business. One time, I talked to a practice owner and they were apprehensive about working as a clinician again because they didn’t want to get sucked into all of the requirements of being a frontline clinician. However, they discovered that they really enjoyed working with their frontline staff. They especially enjoyed mentoring new entry level staff, many of which they had never met because they had hired so many so quickly.

This person loved getting back into the clinic and becoming a mentor to new staff. They now keep a slot on their schedule for in-services and trainings and clinical rounds to provide that opportunity to interact with and mentor new, younger clinicians.

Sometimes, simply stepping back into the clinic gives you a vision of what your day could look like, or one of those things that maybe you took for granted that you really wanna do again.


7. Expand or create a new service offering or clinical specialty focus

As I mentioned previously, the simple act of building or creating something new targets different parts of your brain. You use your creative side for problem-solving. It often feels like really meaningful work. I’ve written an article that’s on the website called What Now: How to Position Your Practice for Growth and Expansion, which outlines a very simple process for crafting a strategy for expansion or innovation.

So, how do you go about doing it? You use a Venn diagram of 1) your clinical expertise 2) the market potential 3) and how it fits into your mission, vision, values. I won’t bore you with the process. Go read the article to get a better idea of how it works. If you want to have me help you and your team chat your strategy for growth or expansion, reach out and we can get something on the calendar.



Maybe one of the items on this list sparks something in you that you can take and implement in your own practice. If nothing else, I always encourage people, just to look at your daily tasks. Look at what you’re actually spending your time on. Then compare it to what you want to do or what you know you need to be spending your time on. That step by itself helps to reinvigorate you in your work.


For more informational reads, check out our Insights Page to see all the articles we’ve published to date, recent podcast episodes, and links to past webinars and videos. Or if you want to develop a system to attract, acquire, engage, and retain more patients to increase your clinic’s revenue, learn how Rehab U Practice Solutions can help  here! You can also schedule a call with Rafi to discuss your clinic or organization’s situation and learn here. Check out my latest book, Better Outcomes: A Guide to Humanizing Healthcare, on Amazon!

Rafael E. Salazar II, MHS, OTR/L (Rafi) is the Principal Owner of Rehab U Practice Solutions and the host of The Better Outcomes Show and the author of Better Outcomes: A Guide to Humanizing Healthcare. He has experience in a variety of rehab settings, working with patients recovering from a variety of injuries and surgeries. Rafi has worked in a variety of settings, from orthopedic and musculoskeletal rehabilitation, to academia, and even healthcare consulting. He spent the majority of his clinical experience working at Charlie Norwood VA Medical Center, where he was the lead clinician and clinical education coordinator for the outpatient specialty rehab program. In this role, he treated many veterans with chronic pain and helped to establish an interdisciplinary pain management program. He has worked on projects ranging from patient engagement initiatives to marketing communication campaigns to a multi million dollar project assisting the State of Georgia’s Department of Behavioral Health and Developmental Disabilities transition individuals out of state institutions to community residences. His work on Telehealth has been discussed in Forbes. He also has experience as a core faculty member at Augusta University’s Occupational Therapy Program, as a Licensed Board Member on the GA State OT Board, and he serves on the Board of Directors for NBCOT. He works to help healthcare clinics and organizations deliver uniquely impactful patient experiences by improving service delivery, increase revenue, and deliver better outcomes.

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Medical Professionals RafiIf you’re ready to craft a strategy to help your organization bring in more clients, retain them throughout their course of care, and create uniquely impactful patient experiences, then reach out. We’d love to talk with you about how Rehab U Practice Solutions can help.

What we can help you do:

✅ Train your staff and clinicians to be able to confidently communicate the value your organization provides…

✅ Leverage best practices, new technology & telehealth, and marketing/messaging to maximize patient engagement & retention…

✅ Develop a system that keeps patients & clients happy, engaged, and satisfied throughout the entire process of care…

We help you not only craft marketing messages & campaigns that build that know, like, & trust value you need to convert leads into scheduled clients; but we also work with your clinicians and staff to make sure that, once a patient decides to schedule an appointment, you have a system setup that keeps them happy, engaged, and satisfied throughout the onboarding, treatment, and discharge process.

In short, we help your whole organization become focused on the most important thing in healthcare: people – the people who work for your organization, and the people who your organization treats and serves.


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