So you're a burnt out clinic owner?....Join the club
Why the normalisation of burnout is creating an unhealthy acceptance of an abnormal state of being. My personal journey through languish…
Burnout is a well-documented, real condition within the Physiotherapy profession. It applies to both clinicians and business owners and is especially prevalent in the private practice sector. Considering the current challenges clinic owners face in the middle of this pandemic, burnout is especially relevant.
The term “burnout” tends to be thrown around a bit. It’s a broad concept that is used both colloquially and clinically. A definition provided by the 11th version of the international classification of diseases describes burnout as “an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed, causing energy depletion, mental distancing, negative or cynical thoughts and reduced professional efficacy”
Throughout the course of my 22 years as a clinician and private practice owner, my colleagues and peers within the Physio community would regularly say they were “burnt out”. Looking back, I probably always used the term just to highlight the fact I was stressed, tired, lacking energy, feeling depleted and overwhelmed…. Languishing!
I’ve since transitioned into the life coaching space with my niche interest in coaching people through the midlife years or a point in their life where there is pain, indecision, and lack of clarity. Not surprisingly, many of my clients are suffering career related burnout that effects their emotional well-being, relationships, career, business management and health.
Reframing the norm
I’ve read deeply about burnout since exiting a clinical practice that I owned. I had a desire to understand more about a ‘state of being’ that lead me to leave a career and a business that I loved and served for over 20 years with absolutely no idea what was next. All I knew was I could no longer tolerate where I was. The term burnout is so widely used it is becoming normalised, almost a rite of passage in a well-earned career. What I experienced felt far from normal. Was it really something that I needed to go through? Does it represent the battle scars of a well fought professional life? I felt it needed reframing given a new identity. I’ve reframed the term as “languishing” so we can create new curiosity and meaning to a state of being that is far from normal.
Languishing refers to a state that sits somewhere between depression and flourishing. This in-between state is characterised by a malaise. Not quite burnout or depression. There is still some energy. The feeling is somewhat joyless and aimless and probably more a sense of stagnation and emptiness. It feels as if you’re muddling through your days, looking at your life through a foggy windshield. Exactly what I felt during the end stage of my career. I often ask myself how many of us are sitting in the state of languish, not depressed but certainly not thriving. I’ve also identified that the more prolonged this state is, the more likely you are to be heading toward the wrong end of the spectrum. Languishing is a frustrating state that effects one’s capacity to do their job and as a clinic owner this is especially true.
Most of the research conducted around burnout in the physiotherapy profession, assumes that the clinical nature of physiotherapy work is the prime driver. Through my personal experience, I recognise clinical load is not an exclusive contributing factor for clinic owners. I believe there are unique drivers of burnout that are separate to those who are purely in a clinical role. There is little or no research around burnout specifically in Physiotherapy clinic owners yet one only needs to ask any private practice owner about burnout, and most will have a story to tell about their own experiences languishing in the fog of where to, what for and why?
So, what are these common drivers and solutions?
I’ve scoured the multiple groups I’m a member of and looking at past posts and conversations on this as well as doing some external research, it seems the following things are especially relevant to clinic owners;
Wearing too many hats (clinician, parent, business owner and community man/women) and the effect this has on the quality of the job we do as any of them
Financial pressure
Time management issues
Poor self-care habits
High achiever traits (high self-expectations, perfectionism, Self-doubt and self-competitiveness, weight of self-expectation to prove it to yourself)
Difficulty in “switching off”
Difficulty letting go – delegation
Staff related issues
Decision fatigue from micro-managing
Lack of business vision and therefore direction
Little or no time off
Working to the agenda of others
Economic and industry lockdowns
Uncertainty
Profitability
Fear of failure
PLUS, if you are consulting, then add in all the usual issues associated with clinical work
Client expectations
Consultation length pressure
Difficult patients who aren’t improving
Self-expectation
Compassion fatigue
Client numbers
Mental fatigue
Here’s some widely circulated management techniques for burnout:
Develop a self-care plan
Perform rituals / routines for well-being
Exercise frequently
Practice mindfulness
Set boundaries around your time
Be aware of unhealthy coping strategies (drugs, alcohol)
Leave work concerns at work
Seek help
Immerse yourself in “flow”
Learn stress management tools
Do work you find meaningful
Remove the triggers for stress
Why all these things don’t work in the long term and what to do
Most of the above ideas are great symptom relievers but they don’t go very far in addressing the root cause, nor do they suggest stopping for a moment to reflect on choices. This is not normal, nor should it be tolerated. You’re a clinic owner. You’re burnt out or languishing. What are your choices?
Stay as you are – do nothing and see what happens
Implement some of the above short-term strategies and hope like hell you don’t relapse
Stop, re-set & revitalise by getting clear on your own personal life vision including how your business fits within this
Attempt to scale and grow your business – eg work more on the business as an owner, and less in the business as a multitasker
Leverage your experience and skills and transition to a new vocation.
Options 1 and 2 aren’t recommended but would probably be the most common among Physio clinic owners. Options 4 and 5 are a strong chance for sustainable change BUT only when combined with option 3. Interestingly by the time you become a clinic owner it’s likely the idea of leaving the profession won’t appeal to you as much as it did in the first 5-10 years of your career. Option 3 will probably get overlooked unless someone presents it to you as a viable option but really, it’s the first thing we need to consider.
How many of us have stopped to consider our career as a piece of our overall story? Personally, I’ve been great at setting career goals and moving forward with both clinical and business achievements but over time many of these goals turned out to be hollow victories because they came at a cost. Usually to my family life and personal freedom. How does becoming a clinic owner serve you and encourage the best version of you each day? How does being a clinic owner allow you to live you best life? If you are familiar with your personal life purpose, then how does being a clinic owner fit within this?
A personal vision for your life includes a vision for your business. Only by gaining clarity around all aspects of your life can you truly create a business vision that fits your circumstances. Many of us have a lack of clarity and a foggy fatigue that sees us unable to ascertain exactly what the problem is and even less likely to know how to fix it. Thus, the symptoms of burnout and languish occur when your life vision and business vision are poorly aligned. Interestingly, even if you haven’t clarified either, your gut will tell you when there is a mismatch. Things feel off and shouldn’t be tolerated.
The immediate call for help is usually directed at business coaching. Whilst business coaching is helpful for many, it is most helpful for those who are clear about their personal vision. Most coaches will agree that the biggest influence on a client’s results, lays heavily on their ability to get out of their own way. So much so that some business coaches will not take a client on unless they display a certain mindset or a clear vision of what is required.
There has been much talk around the difference between high achievers and high performers in relation to business success. High performers have purpose, you press pause on your triggers, you are fiercely protective of your time, you have filters and rules around your decision making and you have a long-term focus in all you do. In short, you are clear about your life vision and how to get it. There is no such thing as a high performer in business and not in life generally. You are either a high performer or not. If you aren’t there’s a good chance you are/will experience burnout from lack of clarity around your life vision.
Here’s the 5 steps to stop languishing and burnout if you’re a clinic owner.
Create a life vision: Write down what good looks like in every aspect of your life. How would that feel? What things govern your decision making?
Set some intentions for your vision: What needs consideration for your vision to thrive? What things do you need to do more and less of?
Bring your vision to life: Set some actions that will bring your intentions to life? What daily habits, routines and rituals will you engage in to serve yourself and others. How will you manage each area of your life so that your vision is successful?
Get out of your own way: What’s stopping you? What are your limiting beliefs and how can you reframe them to become empowering beliefs?
Prepare for difficult days: Form a plan for when things get tough. What life skills will you need to navigate this? How can you stay on track with your life vision?
Coaching myself and others through the steps above, I have found great results in transitioning many from languish to flourish, shifting the thinking from problems to possibilities. What’s on the other side? Joy, happiness, fulfilment, and life on your terms exactly the way you design it.
As a previous Physio clinic owner, I set myself a vision. This vision sees me guiding other clinic owners through a journey of personal evolution from surviving to thriving in all aspects of their life, including their business. I feel the journey I have been on is one worth sharing. It’s all in our control, we have the power and choice to determine the life we wish to lead. I’m grateful for choosing the journey to flourish, it’s not easy but it’s worth it!
Yours on purpose,
Ben & Josh (The Purpose & Flow team)