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The Experience of Providing Physical Therapy in a Changing Health Care Environment

R Blau, PT, MS(PT), is Staff Physical Therapist, Brigham and Women's Hospital, Boston, Mass
S Bolus, PT, MS(PT), is Research Assistant, Beth Israel Deaconess Medical Center, Boston, Mass
T Carolan, PT, MS(PT), is Staff Physical Therapist, Kessler Institute for Rehabilitation, West Orange, NJ
D Kramer, PT, MS(PT), is Staff Physical Therapist, New England Rehabilitation Hospital, Woburn, Mass
E Mahoney, PT, MS(PT), is Staff Physical Therapist, Boston Medical Center, Boston, Mass
DU Jette, PT, DSc, is Professor and Program Director, Program in Physical Therapy, Graduate School for Health Studies, 300 The Fenway, Simmons College, Boston, MA 02115 (diane.jette{at}simmons.edu).
JA Beal, DNSc RN, PNP, is Professor and Associate Dean for Nursing, Graduate School for Health Studies, Simmons College

Address all correspondence to Dr Jette

Background and Purpose. The changes in the health care environment during the last decade have had an impact on the roles and responsibilities of all health care professionals. The purpose of this phenomenological study was to describe the experience of staff physical therapists during a time of systemic change within a large urban academic medical center. Subjects and Methods. Participants were 5 physical therapists working in various clinical settings within the medical center. The participants were interviewed and asked the question "Over the past 4 years, there have been major changes in your work environment. What has it been like for you working as a clinician during this time of change?" Interviews were recorded, transcribed, and analyzed to find thematic patterns of responses. Results. Four common themes emerged in which participants described experiencing loss of control, stress, discontent, and disheartenment. A fifth theme showed that despite these negative feelings, participants were able to "find the silver lining" in their daily work lives (ie, they were able to find positive aspects of their professional lives despite the perceived unpleasant changes with which they had to cope). Discussion and Conclusion. This study provides insight into the experiences of a group of staff physical therapists during a time of systemic change in their work environment. Although the themes reflect largely unsettling and negative experiences, there seems to be an underlying ability to find affirmative aspects of work.

Key Words: Health care environment • Merger • Physical therapy profession • professional issues