Everyone assumes it was payer headaches that pushed me out of the clinic. It wasn't.
I loved being a clinician for sixteen years. What I loved even more was everything that grew up around it.
I was the physical therapist who actually looked forward to community events like local schools, running clubs, and small businesses, because it meant more people I could help, or point toward someone who could. People started asking me things that had nothing to do with a prescription: which doctor should I see, which coach actually keeps their athletes injury-free, what do I do about this pain that won't go away. I loved being a clinical instructor even more, teaching new graduates not just how to treat a patient, but how to own their schedule, their reputation, and their patients' trust, and how to think like the business owner they actually were.
None of that showed up on a productivity report. I made room for it by staying late, working weekends, letting my own patient load slide. That kind of trade-off quietly costs you somewhere else.
Then a corporate group acquired the practices I was managing.
The changes came fast: how we treated patients, where staff got sent. People got shifted around the metro area to cover gaps wherever the schedule was thinnest. On paper, coverage improved. In practice, it broke the relationship each therapist had built with their patients, and with the neighborhood they served. That's the thing I actually cared about. Care became an assignment instead of a relationship.
“Care became an assignment instead of a relationship.
That's what took me out of the clinic. Not the prior authorizations. Not the reimbursement pressure. Not patient volume, not the things every clinician usually says pushed them out. For me, it was watching connection get engineered out of care in the name of efficiency.
I didn't have language for it at the time. I just knew something I valued was gone, and I wasn't willing to keep doing the job without it.
I've spent every year since trying to put that connection back, first without knowing that's what I was doing, and eventually on purpose.
What's something that got "optimized" out of your work that you're still trying to get back?