Problem 8 Time Based Billing: Reduced professional enjoyment

 In POGO Partners™

Following on from my last post about the seventh problem that the traditional time based physiotherapy model of care produces (higher physiotherapist attrition and burnout) the 7th problem ties in closely.

To read more about how time based billing can result in greater therapist attrition and burn-out (Problem 7 Selling Time in Physio series) click HERE>>

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One of the greatest drivers I believe for a therapist’s reduced professional enjoyment is the accumulative pressures that result from the model of session to session service delivery.

I believe that over time the pressure of meeting (and hopefully) exceeding the client’s expectations can take an progressive toll on the well-being of the treating therapist. This toll can manifest as either full blown burnout and industry attrition (worst case), or a reduction in enjoyment (best case) of a physiotherapy role.

When the pressures of practice life rise, it is not atypical for the enjoyment of the therapist to reduce.  It is possible to be pressured as a therapist and also enjoy professional life. It is one satisfaction I have enjoyed- the pressure of delivering on a client’s expectations of their treatment/ consultation. However by the end of a session to session back to back day the enjoyment level while still there can certainly wane.

Meeting deadlines: a clinical reality

Clinical life comprises of meeting client’s expectations every session. My wife a General Practitioner (Dr Cris) jokes that every consultation is akin to meeting a project deadline. This it really resonated with me. It made complete sense. No wonder at the end of a clinical day after seeing a dozen or more clients my exhaustion levels were high, and enjoyment levels could wane.

We have all experienced the stress that comes from meeting a project deadline.

Think back to what it was like submitting a university assignment on time. I know I was normally pretty fatigued by the time the assignment was submitted. In fact I would often feel very fatigued and physically quite ‘spent’ after often a late night cramming the work trying to honour the impending deadline.

Clients: 3D Projects

Now extrapolate those feelings across the clinical landscape where the ‘assignment’ is a real person-the ‘client’. The client just like the project has a deadline. They require (and expect) that their deadline will be honoured at the allotted end of their consultation.

What’s more the client needs to be emotionally connected with and communicated with empathetically and effectively. They are more than a task on a piece of paper. The client ‘project’ has feelings, emotions, and a real need for effective communication.

Attention to client’s needs takes energy, concentration, and dedication.

This 3D nature of client care places greater demands on the therapist submitting the ‘assignment’ on time, at the end of the 30, 45, or 60 minute consultation. In some practices consultation times of even less than 30minutes are the norm, adding even more pressure to the therapist in honouring the end of appointment ‘deadline’.

Other factors that can reduce therapist enjoyment levels

Therapist enjoyment alone is not derived entirely from the pressures of delivering on client expectations and results with session to session physiotherapy care. There are many layers that contribute to a reduction in physiotherapist enjoyment levels.

Other contributing factors that can contribute to a reduction in enjoyment can include:

  • Practice culture-if the culture of a practice turns negative, not unified, poorly led than this can have a deleterious effect on therapist enjoyment levels.
  • Client mix- treating clients that are not in alignment with your ‘sweet spot’ or niche can be less enjoyable (but still rewarding).
  • Alignment or otherwise to the practice’s goals and vision-if you feel like you are contributing to your team or practice’s overall success it feels good-everyone likes to be on a winning team. Conversely if you are experiencing the opposite -questioning does your contribution to your practice matter, than your professional enjoyment levels will be less.
  • Relationship with team members-if there are relational strains enjoyment will suffer.
  • Not feeling safe in your practice environment: this is one of the most important roles of a practice leader/owner. If you feel unsafe in your work environment you will obviously not enjoy it.
  • Not being recognised for your contribution from your practice owner, manager, and/or your clients. We all like to feel appreciated. Starve someone of appreciation for too long and enjoyment levels will take a nosedive.

A solution to bolstering professional enjoyment

While client expectations and pressures will always exist I have enjoyed a deeper satisfaction and greater enjoyment in practice since the launch in 2016 of our Finish Line™ Programs. The heightened enjoyment comes from the delivery of gold standard best practice treatments devoid of restrictions to access that exist with traditional session to session time based billing models of care.

Having the greater contact time with the Finish Line™ Program client across more sessions than the traditional session to session model allows for, allows me as the therapist to slow things down and do things very well without missing anything vital to excellent clinical outcomes.

Take for example being able to strength test an injured client in the gym to establish baseline strength measures and identify and potential contributory injury factors that relate to strength. By testing a client like this I will get better overall results, and the client doesn’t feel like they have missed out on any key treatment in the rooms due to strength testing taking time.

The reduced stress is the byproduct of not being pressured to fit everything into a single treatment, but rather enjoying the sequencing of key treatment elements at the best time as afforded by the greater access to services under the fixed fee unlimited access Finish Line™ program model.

I believe that this shift away from the pressures of session to session care is a positive for the physiotherapy team I lead, and further afield the physiotherapy industry.

Learn more about our Finish Line™ Programs

  • If you’re a physiotherapist feeling the pressures of practice life, yet still caring about your profession I encourage you to learn more about Finish Line™ Programs.
  • For more information around the journey we underwent to launch our Finish Line™ Programs click HERE>> (Challenging the Way the Physiotherapy Industry Charges) to listen to a podcast interview.
  • For an example of how POGO’s Finish Line™ programs achieve great client outcomes click HERE>>  (Finish Line™ Case Study-Tom Bowie) to read Tom’s story of overcoming debilitating lower back and sciatic pain.
  • In the meantime if you are physiotherapy practice owner looking to get more respected results through heightened trust levels with your clients be sure to subscribe for our POGO Partners™ updates HERE>> POGO Partners™ Launch.


  • If you are a physiotherapy consumer looking to benefit from the best in treatment outcomes schedule your initial appointment (Discover Recover Session) HERE>>.


Coming Up:

I will explore how session to session billing can result in clinicians being underpaid and undervalued.


On my 10th physiotherapy anniversary I sat down to reflect on 10years of my career and noted the top 10 learnings to that date. Here they are My Top 10 Lessons Learnt Through my First 10 years as a Physio

Physio With a Finish Line™,

Brad Beer physiotherapist gold coast

Brad Beer (APAM)

Physiotherapist (APAM)
Author ‘You CAN Run Pain Free!
Founder POGO Physio
Host The Physical Performance Show

Featured in the Top 50 Physical Therapy Blog

pain free performance Gold Coast physio

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