Work. We do it day after day and rarely pause to consider why. The obvious reason is to provide for the basic needs in life. But in work that satisfies there is always something deeper. For most healthcare workers, like myself, we are looking for a kind of work that brings reward.

I have experienced the various rewards associated with my job as a physical therapist; helping people meet functional goals daily, engaging with co-workers and other professionals, getting new certifications, mastering the technical parts of the job and realizing a gradually larger paycheck. I have also witnessed the opposite of reward with frustrating patients, co-worker conflict, seeing burn out in others, and the challenges with getting change from middle/upper management. Through it all I have learned that the true rewards in my profession come from focusing on each patient encounter, not the outcome of the encounter.

At a course several years ago Brian Mulligan made a statement I will never forget, he said:

“the trouble with you Americans is you always walk around at the end of the day sad and pouting about the patients you did not help. I focus on the ones that I did help and what I did to make them better.”

On the surface the statement seems to be focused on outcomes, but it is not. It is focused on what he did during the encounter to help, and then enjoying the fruits of the successful encounter.

Many physical therapy outcomes are predictable. As professional confidence in diagnosis, prognosis and treatment improve there are probable and likely outcomes for many conditions. Outcomes are very important. More and more our profession is being judged and scored on the quality of the outcome. We should always strive for good outcomes, but not seek our rewards here because successful outcomes do not always happen. Outcomes can be fickle. Often patients have uncontrollable environmental variables in their lives and present with past social and medical histories that simply make outcomes unpredictable.

A therapist who finds their reward in outcomes will no doubt struggle over time.

While a positive and successful outcome is always the goal, it should flow out of a focus on each individual patient encounter. Variables associated with a quality encounter, like building therapeutic alliance with active listening, warm body language and instilling hope, encouragement and motivation, are almost always controllable.

We spend a large amount of our life at work. It is sobering to see how much of our time is actually spent there. The Bureau of Labor Statistics outlines it well in the below chart.

How and what we seek as rewarding can profoundly influence our career longevity, satisfaction, and success. Rewards are designed to motivate, stimulate, and perpetuate behavior and action over time. We must be wise in the rewards for which we labor.

Seeking reward in the land of healthcare can be challenging as there are strong and dramatic contrasts in the current macro and micro environments. The macro environment is one of shifting policy wrought with heated emotions about the future, as those in power seek the best path forward. The micro environment is where most of us work. We have the privilege of interacting with unique patients all seeking the best care at a reasonable price. As a healthcare professional seeking rewards in your work, I encourage you to find reward in each encounter, and not the outcome of the encounter.