If you’re a clinic owner, you know that building the right team of physical therapists is key to your clinic’s success. A good PT is dependable, shows integrity, and makes your patients feel safe and cared for. She is committed to learning and plays a critical part in the culture you’ve worked so hard to build.

That’s why it’s so scary to imagine your best therapist leaving for greener pastures. The good news is that even when a therapist is considering leaving, it’s not too late to turn things around and keep her on the team.

Here are some signs that your top PT might be a flight risk—and what you can do about it. Bear in mind that any one of these on its own is typically not a cause for concern, but if you see multiple signs concurrently, you might want to do some damage control—STAT!

1. She updates her LinkedIn profile.

Now, a simple one-time update is nothing to worry about. People dust off their resumes from time to time, and they do the same with their LinkedIn profiles. A simple profile update isn’t a big deal, especially if your prized therapist just earned a new certification, title, or promotion. She might be eager to share the news with her network, or perhaps she’s simply the type to “update her files” as soon as she accomplishes something new.  

But if you’re starting to notice frequent profile updates—or if she’s continually rewording and rephrasing her achievements—it might be time to worry. Pay attention to her activity, too. On LinkedIn, you can see what types of articles members of your network “like.” If your top therapist is starting to like or comment on articles with titles like “My Boss Doesn’t Appreciate Me” or “What to Do When You’re Frustrated at Work,” then you certainly have a reason to be concerned.

What to do:

This is a touchy situation. If you bring up noticing her profile activity, you’ll look a bit creepy, like you’ve been checking up on her (which—let’s be real—you have). But, there’s a way to broach the subject without coming across like a sneaky spy.

One approach is to say, “I’ve noticed you’ve been making frequent updates to your LinkedIn profile. It looks great! But, I also saw that you’ve been commenting a lot on articles about job frustration, and that concerns me. I don’t want you to feel like I’ve been spying on you, but I want to ask you directly how you’re feeling here. My job, as your manager, is to make sure that you feel good about your work, and I’d like to make sure that you believe this is the type of place where you can grow. I can’t help but wonder if you’re looking for new jobs—and, if that’s the case, whether there is anything we can do on our end to address your concerns.”

2. He is less engaged.

Your top therapist might stop volunteering to take minutes during the staff meetings, or he might stop volunteering for, well, pretty much anything at all. If your star PT used to run the booth at the local 10K every year and suddenly seems uninterested in helping out on race day, it may be cause for concern—but don’t panic quite yet. There are plenty of reasons why he might be stepping back a bit. If he has a new significant other, child, per diem job (we’ll get to that in a moment) or teaching role, or other type of increased commitment outside of work, that’s plenty of reason to stop giving up his weekends for the good of the clinic.

Lack of engagement shows in other ways, too. What if your prized PT isn’t stepping up to accept students? Or what if he is taking students, but simply lets them do all his work as he fulfills the bare-minimum mentoring requirements? And what if he’s no longer asking you, the front desk staff, or anyone else about their lives outside of work?

What to do:

A steep decline in a therapist’s level of engagement is one of the biggest giveaways that he’s looking elsewhere, or simply feeling burned out. He may be emotionally separating himself from you and the rest of the team so it’ll be easier to part ways when the time comes. One of the best ways to remedy the situation is to address it upfront with genuine concern. Say you’ve noticed that his enthusiasm isn’t what it used to be, and see if there’s anything you can do on your end to improve things. For example: “John, I’ve noticed you haven’t volunteered for the last few 10Ks, and you’ve stopped taking the meeting minutes. Is everything OK? Is there anything on my end that I could be doing to keep you invested in the role? You’re an incredible therapist, and I want to make sure you’re happy.”

Perhaps you’re not doing enough on your part to thank him for going above and beyond. Are you enabling him to flex off on a weekday to make up for these additional work-related commitments? If not, you’re essentially expecting him to work for free. If that’s the case, he might be getting frustrated and burned out—and understandably so. Nobody likes to go above and beyond for years on end without being rewarded for it.

3. She is taking more time off for dentist and/or doctor’s appointments—or simply calling in sick more often.

Your once healthy-as-a-horse therapist is suddenly ill every other week, or maybe she’s attending a series of dentist’s appointments. Depending on the size of your clinic, this may or may not even be evident or problematic. People have medical and dental issues all the time, and they deserve to be treated with privacy and respect during what could be very challenging times. Your therapists have no obligation to tell you, or anyone else, what is going on with their health.

That said, if you’re noticing a dramatic uptick in all sorts of appointments—or the therapist who once hoarded her PTO is suddenly planning week-long vacations with abandon—you might have cause for concern.

What to do:

Before you start worrying that she might quit, the obvious first consideration to make is that something is going on with her health. As her manager, your first priority is to be there for her without being intrusive. There is a fine line between demonstrating concern and appearing to pry, but you can always approach her and say, “I noticed you’ve been requesting more PTO and time off for doctor’s appointments than usual. You’re certainly not obligated to tell me what’s going on, but if you do need support at any time, please let me know.” Unfortunately, even if she is planning to make her move, this is one situation where you really need to just step back and let her do her thing. All you can do is show genuine concern and hope she’ll tell you if she has been interviewing elsewhere.

4. She starts leaving right at 5:00 PM sharp—when she never did before.

Is your prized PT known for staying late to finish meticulous documentation, complete productivity logs, help other therapists with their schedules, and straighten up the clinic for the next day? If so, how nice of her! In fact, have you ever taken the time to thank her for going above and beyond? Because if you haven’t, your superstar PT might be eyeing other clinics as you read this article. In reality, behind that superstar facade there could be a very frustrated PT—one who feels that her efforts are not being rewarded.

It’s easy to forget how physically and emotionally demanding patient care can be, especially for those therapy professionals who are no longer treating full time. But your therapists have lives outside of work, and when their responsibilities require them to work additional, unpaid hours, you run the risk of burning them out.

What to do:

Pull her aside and say something like, “You know, I noticed that you’re leaving right at 5:00 PM these days, and I confess that I should have acknowledged all the extra effort you put in long ago—and rewarded you for it. If you’re feeling disengaged or frustrated, I’d like to address those issues. I don’t expect you to stay late and put in more time than the other therapists, and if you do opt to do those things, I’d like to discuss ways that we can do a better job of acknowledging and rewarding you.” At this point, it’s up to her to tell you what she needs.

5. He takes a per diem job.

There are plenty of innocuous reasons for picking up a second job. Unfortunately, working an additional per diem job is sometimes necessary to pay off loans, so you don’t need to panic if your prized therapist does start taking extra shifts at another facility. Also, some therapists do this simply to broaden their skillsets. For example, if you’re in an acute care or inpatient facility, your top therapist might be looking for an opportunity to work in a different setting—one you simply can’t provide, such as outpatient. If that’s the case, there’s really nothing you can do.

What to do:

If your cherished therapist picks up a per diem role, you do want to consider his reasoning. For example, if he needs additional money to pay down loans, you might want to take a closer look at your pay. Are you providing a competitive wage? Are you giving him opportunities to earn bonuses by picking up additional certifications or writing blog posts for the website? Are you providing incentives for therapists to participate in marketing endeavors? A physical therapist’s value stretches far beyond his or her billable units, and if you reward your PTs for taking initiative, you’ll be far more likely to retain the true go-getters.

At the end of the day, some of your top therapists will leave no matter what. It could be that they need variety, or perhaps they merely want a shorter commute. But, you can sometimes retain your best employees by making it a point to communicate with them regularly—and thinking outside the box for ways to keep them engaged. Different employees are motivated by different things, and a good manager will understand each employee and manage him or her accordingly.


Meredith Castin, PT, DPT, is the founder of The Non-Clinical PT, a career development resource designed to help physical, occupational, and speech therapy professionals leverage their degrees in non-clinical ways. Meredith is also the co-founder of NewGradPhysicalTherapy and works as a freelance writer and editor for a variety of publications.