The PT Burnout Problem: Why Therapists Are Leaving Outpatient Care and What Keeps Them

Ask a room of outpatient physical therapists how their week went and you will hear some version of the same story. The schedule was full before Monday started. Two patients were double-booked. Notes followed them home. By Thursday the work they trained for, figuring out why a patient moves the way they do and helping them move better, had been squeezed between visits and paperwork.

That story now shows up in the data. Almost half of U.S. physical therapists in one national survey said they were burned out. Outpatient clinics report open positions they can't fill, and more PTs are cutting their hours or leaving the field. This is happening while the need for physical therapy keeps growing.

Demand is up. The bench is thin.

The U.S. Bureau of Labor Statistics projects employment of physical therapists will grow 12 percent from 2025 to 2035, much faster than the average for all occupations. It expects about 13,400 openings each year. Many of those openings come from replacing therapists who change careers or leave the labor force, not from new positions.¹ Offices of physical, occupational and speech therapists are the largest employer, with about 36 percent of PT jobs.¹

Outpatient owners are feeling that gap directly. In a 2022 benchmark survey of outpatient practices, the American Physical Therapy Association and APTA Private Practice found a 16 percent total vacancy rate across PTs, PTAs and support staff, with more openings for PTs than for anyone else. Most practices (56.9 percent) had more openings than before the pandemic, and 40.8 percent said turnover was higher than two years earlier.²

The exits add up. APTA's 2023 report on the pandemic's effects on the profession cites Definitive Healthcare data showing that 22,032 physical therapists, or 9.8 percent of the workforce, left in 2021. That same year, 12,074 new PTs graduated.³ Some of those who stayed cut back. The share of PTs working full time fell from 86 percent before the pandemic to 78 percent in fall 2022. In APTA's 2022 Fit for Practice survey, 44 percent of PTs and PTAs planned to reduce their patient care hours over the next two years, while only 9 percent planned to add hours.³

Nearly half of physical therapists in a national survey said they were burned out.

What's driving therapists out

A cross-sectional study of 2,813 U.S. physical therapists from every state, surveyed in December 2020 and January 2021 and published in 2023, found that 49.34 percent described themselves as burned out. Therapists in home health and skilled nursing settings had the highest burnout scores.⁴

Clinicians name the same causes again and again. In WebPT's 2022 State of Rehab Therapy report, more than a third of the rehab therapy workforce said they were burned out. High patient loads and long hours were the top reasons, and clinicians ranked heavy documentation third.⁵ When outpatient staff leave voluntarily, APTA's benchmark survey found relocation was the most common main reason (37.3 percent), followed by pay (25.4 percent).²

None of this says PTs have stopped caring about the work. The 2023 APTA report found that most PTs and PTAs said their pride in their career had held steady or grown.³ The problem is how the work is set up: too many visits in too little time, documentation that spills into evenings, and new graduates left to figure out complex caseloads on their own.

What keeps them: the evidence on mentorship

The 2023 burnout study points to a fix that clinics control. Therapists who received formal mentorship had significantly lower burnout scores than those who received none. Therapists who gave formal mentorship also had lower burnout than those who didn't. Self-efficacy, meaning a therapist's confidence in handling daily and stressful situations, had a moderate negative correlation with burnout. Higher confidence went with less burnout.⁴ The authors recommend that organizations measure burnout, invest in mentorship programs and build their clinicians' self-efficacy.⁴

Because the study is cross-sectional, it can't prove that mentorship prevents burnout. Still, it gives owners something concrete. Mentorship costs mostly time, it helps both the mentor and the person being mentored, and it is the same thing early-career PTs say they want when they look for a job.

For therapists: questions to ask before your next job

If you're burned out, the problem may be the clinic rather than the career. When you interview, ask:

• Who would mentor me, and how much time is protected for it each week?
• How many patients per hour would I see, and how often are visits double-booked?
• When is documentation time scheduled, and how often do clinicians finish notes after hours?
• How long have your PTs stayed, and why did the last few leave?

The answers tell you more than a job title does. Clinics that answer clearly tend to be the ones that keep their people.

The bottom line

The profession isn't short on purpose. It's short on clinics set up so therapists can last. Demand will keep growing for the next decade. The practices that fill their schedules will be the ones that mentor people, set reasonable caseloads, and protect time for both patients and paperwork.