As the old saying goes, the only constant in life is change. Yes, it’s a bit cliché, but it’s true nonetheless. And for those working in the healthcare space—including private practice PTs, OTs, and SLPs—change is an especially prevalent aspect of day-to-day operations. After all, the whole point of all this healthcare reform hullaballoo is to change the manner in which providers deliver—and receive payment for—their services. So, whether they like it or not, practice leaders must find ways to adapt—if they want to stay in business, that is—and in many cases, that means deviating from the status quo. With that in mind, let’s take a look at the four stages of the change cycle and discuss techniques for managing change effectively during each stage.

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Stage 1: Shock and Denial

When change comes our way—especially unexpectedly—we naturally tend to fall into a state of shock. Then, in an effort to combat the ensuing feelings of panic and anxiety, we often move into a state of denial. We may even refuse to acknowledge the change—instead continuing along with our lives as if nothing had happened. Alternatively, we may begin to concoct outrageous—and highly unlikely—worst-case-scenario visions of how the change will affect us. And many times, those misguided speculations end up igniting the rumor mill. In a work setting, that can quickly create a toxic environment.

How to Manage It

As a leader, it behooves you to nip feelings of unease—and any resulting rumors—in the bud before they fester. To do that, you must help your team feel secure about the impending change—by providing ample (and clear) information as well as honest answers to any questions.

Stage 2: Anger and Depression

At some point, the initial shock will wear off, and we can no longer pretend that the change isn’t happening. This is where the real emotional turmoil sets in: we get angry, feel helpless and betrayed, and may take out our frustrations on the people we believe are responsible for the change. When this happens in an office setting, it adversely affects employee morale, gets in the way of team collaboration, and drains productivity.

How to Manage It

Nobody likes confrontation—which is why many people avoid having hard conversations with their staff and colleagues. But at this stage of the change management cycle, communication is crucial. If your team members are upset, they need an outlet for unloading their feelings of hurt and frustration—otherwise, their negativity could infect your entire office. If you have an open-door policy—and if you don’t, you definitely should consider implementing one—this is the perfect time to encourage your team to take advantage of it. Making yourself available to your employees goes a long way toward promoting open dialogue—and that, in turn, may help alleviate some of the discontent brought on by the change. As Heidi Jannenga, PT, DPT, ATC/L, co-founder and president of WebPT, writes in this blog post, “When I had the opportunity to talk through some recent changes in my own life, I realized that my fears about those changes were rooted in my fixation on what I was losing, rather than what I could gain. This was an eye-opener for me, and it made me appreciate the power of open dialogue even more.”   

Stage 3: Exploration

Once we stop thinking about how much we dislike the change that’s happening—and our feelings are a little less raw—we can let go of the anger and depression that were clouding our assessment of the situation during the previous stages. In this stage, we start to think about the possibility inherent to the change—that is, how it could actually work for us rather than against us. Essentially, we plan how we will adapt to the change and consider the many ways in which those adaptations might benefit us.

How to Manage It

Keep the positive momentum going by involving your staff in the change-planning process. Furthermore, provide them with guidance on how to adapt their own individual processes to the overarching shift away from the status quo. That way, they’ll feel confident in their ability to not only handle the change, but also use it to their advantage.

Stage 4: Acceptance and Integration

Once we’re on the positivity train, we can ride it all the way to the final stage of the change cycle: accepting the change and integrating it into our lives. As Jannenga explains in the above-cited blog post, there are two forms of acceptance:

  1. Compliance, which means you accept something because you have to or because someone else is telling you to do so.
  2. Championing, which means you not only embrace and understand the change, but also advocate for it and help others progress through the change cycle as well.

How to Manage It

Congratulations! You made it through the most treacherous parts of the change cycle. Now, it’s time to celebrate everything your team has accomplished—together.

Managing Industry-Wide Change

Successfully managing change in your individual practice means doing whatever you can to maintain staff unity and morale. The same goes for managing change at the industry level. “By embracing the changes that have befallen us thus far, we’ve been able to help our patients, positively impact the physical therapy profession, and create a community dedicated to empowering our industry,” Jannenga writes.


And for the rehab therapy community to overcome the challenges ahead—and more importantly, take advantage of the opportunities hidden within those challenges—therapists must band together and commit to proactively addressing healthcare change and reform. If they do, they have the opportunity to claim a more prominent seat at the healthcare table and thus emerge even stronger than they were before. Now that’s a change we can all get behind.

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