What Happened to Us – Burnout or Demoralization? You Decide

When you have been in the field as long as I have, you have the opportunity to bear witness to burnout among therapists, as well as a professional obligation to discuss it. From my vantage point, burnout was typically synonymous with therapists who have been in the industry for a long time. Therapists whose mantra is “Off my knees by 50 please”, therapists who voiced a cumulative high degree of mental, emotional and physical exhaustion, often accompanied by a low sense of personal accomplishment, and always compounded by years of work. Yet after COVID, study after study has shown the highest rate of what is being called “burnout” is among the younger staff.

I am coming to the conclusion that what is being labelled as burnout may actually be demoralization, disenchantment and disillusionment. When our patients become demoralized, they express a sense of helplessness and loss of purpose. When therapists become demoralized, maybe they are mislabeling their dwindling faith in the medical system as burnout.

Therapists provide therapy services with the sustaining belief that our efforts will make a difference. We work together with our clients to “fix what is broken” and make it better.  However, during COVID, therapists and other health care workers saw a health system that failed and fell apart and1000s died each day. Even when the deaths slowed, the disillusionment persisted. COVID caused the biggest disruption of the healthcare system and also in our lifestyles. Maybe it gave us all pause to reflect on the professional paths we have chosen. Perhaps younger therapists realized that they don’t want to work in a system that does not offer enough social support or recognition, where expectations may be unrealistic or unclear and the prospects for upward mobility in professional growth, pay and acknowledgment is murky at best.

It feels like therapists are aware of these new realities but are the leaders of our profession blissfully unaware? We should be in the middle of a healthcare revolution and using the disruption to fuel reinvention or at the very least, a huge reset. Instead, right now we see shrinking enrollment in therapy schools, payment structures that continue to devalue what we do and therapists of all disciplines leaving clinical care, while demand is soaring. The results? Unfilled positions across every type of clinical setting, and waitlists for services across the country.  Are there efforts going on from the top down or will change happen from the bottom up?

My hope is that ALL THERAPISTS focus on the future, look to the longevity of our fields and trends we can get behind; care delivery outside of the hospitals, care that is digitally enabled and technology that can improve our abilities to communicate with our clients in their full health care journey, especially as more and more clients live with chronic diseases. If my generation of therapists are stepping down and the new generation of therapists are not stepping up all while the demand for services is skyrocketing, we could be setting ourselves up for “service substitutors” to come in and do the work we no longer want or are willing to do.

This was written by me, not ChatGPT!

Iris Kimberg, MS PT OTR