Here’s a quick list of 6 things I would have liked to have known before specialising as an MSK outpatients Physiotherapist. These points wont apply to everyone, and will of course differ greatly from department to department. It’s just a few things I would have found helpful had I known before embarking on my career as an MSK Outpatient Physiotherapist.
1. Burn out is common.
“Sixty per cent of subjects [recently qualified physiotherapists] were found to have moderate to high levels of emotional exhaustion, the key characteristic of burnout.” (http://www.sciencedirect.com/science/article/pii/S0004951414604256 )
I burned out pretty quickly. I was so focused on being the best physio I could be and impressing my colleagues and patients. I took it upon myself to go over and above. I kept saying YES.
“Yes, squeeze in an the patient who failed to turn up on time yesterday.”
“Yes, I’ll work later on Thursdays”
“Yes, Ill make a presentation in my own time for the band 5 development meeting”
“Yes, I’ll be on the respiratory on call rota over night, and if I’m called out (say for 4 hours overnight) then of course I will start work again at 8:30am as usual despite getting 3-4 hours of sleep”
“Yes, I’ll spend a few weekends working on the stroke unit and medical unit in addition to my normal 37.5 hours a week”
” Yes, I’ll drive in traffic to a different clinic (for and extra 50 mins a day) to fill staff shortage once a week “
“Yes, I’ll get in to work at least 20 mins earlier (unpaid) to get ready for the day” ( If I arrived at my allotted time I would run at least 10-15 mins late for my first first patient and this would have a knock on effect throughout the day. ( I know unpaid overtime seems to be the norm these days – but it wasn’t ideal )
“Yes, Ill attend a course to add to my CPD which will take up an additional 3 weekends over a 3 month period.”
“Yes, I’ll try and juggle a part time masters along side all of the above”.
(I want to stress that my colleagues on MSK were amazing and were not to blame.)
My own drive to be the best physio I could be, meant that I failed to look after myself properly. Physio became my entire life. Eventually it all caught up with me. I started resenting going to work. I felt stuck in rut. I suffered from emotional exhaustion and depersonalisation. I craved a way out. It wasn’t long until I quit my job and moved on to a different specialism.
So PLEASE take it easy. Take those admin slots. Say ‘NO’ more often. Look after number one.
Not only will you benefit but your patients, partners, colleagues will also benefit too.
You will never be on top of all your work
There is always more that you could be doing.
For me, being on MSK outpatients (unfortunately) felt a little working on a Henry Ford production line.
“Assess, treat, advise, arrange next appointment, complete notes …..over and over again”.
Everything is set on a very tight time schedule. You rely on your patients to show up on time. You pray for a day without any hiccups.
Of course, things rarely work out like clock work, and it’s not uncommon for patients to arrive late to their appointments.
Despite having a duty of care, and wanting to provide the best service possible for your patients. You strangely start to feel elated when patients fail to attend their appointments. It means that you can catch up on other tasks like ; finishing yesterdays notes within the 24 hour time frame, writing reports to the GP, handing over patients, asking for advice form seniors, looking at scan results, sending referrals, reporting damaged equipment, chasing up a patients who fail to attend multiple times, returning patients phone calls/answerphone messages, reading articles with the latest evidence.
Whilst you are working, it doesn’t feel too bad. Everyone is in the same situation, and you just tend to get on with it. By the end of the day however you are exhausted. The only thing you want to do after a days work is to lie down. The last thing you want to do is speak to anyone.
3. Keep your profession secret for a peaceful life.
Family, friends,… people you have only just met. You will get asked medical questions all the time.
If you can leave a party without being asked for a massage, consider it job well done.
4. Managing expectations
A large percentage of your time will be spent educating and managing expectations. Its not all assessing and treating.
” I waited 4-6 weeks for my initial appointment ” – Sorry, I really wish I could have seen you sooner. It really is the best we can do with current funding.
“Why can’t you get rid of my pain immediately?” – You have had your condition for 5 years… it wont magically go away after one treatment session.
” Why has my pain not improved? “- I gave you a 4-8 week exercise program to follow, and you haven’t completed it. What more can I do?
” I thought Physios only gave massages” * face palm*
5. You will never get rich working as an outpatients physio
From a money perspective , the the pay isn’t too bad. It will allow you to live fairly comfortably.
You will by no means be rich. But, you shouldn’t have to worry too much about being able to pay the next gas bill.
6. You have the power to help change peoples lives for the better.
This blog was by no means focused on putting people off becoming an MSK physiotherapist. It can be very, very, rewarding. There is no better feeling than playing a key role in changing someone else’s life for the better.
The job keeps you on your toes. You will forever be learning and challenged. The profession is continually evolving and progressing which is exciting. You will meet and establish relationships with people from all walks of life, and this in itself keeps the job fun and interesting.