In this solo YouTube talk, Kelly Alhooie examines why many pelvic floor physical therapists (PTs) and occupational therapists (OTs) feel burned out. She argues that burnout stems not from the patients themselves but from a fundamental mismatch between the effort clinicians invest and the rewards they receive, especially within insurance‑driven, brick‑and‑mortar clinic models. Alhooie shares her personal journey of running a traditional clinic while also building PelviBiz, a cash‑based business aimed at broader impact and financial freedom. She describes how the limits imposed by insurance reimbursements, caps on patient payments, and the endless cycle of clinical notes create a financially and emotionally draining environment. The talk contrasts this with the cash‑based model, which removes the insurance middleman, offers higher earnings potential, and aligns more closely with clinicians’ purpose of empowering women’s health. Alhooie emphasizes the importance of recognizing when the current path no longer serves one’s calling, making a decisive shift, and seeking coaching to clarify next steps. She concludes with a strong call to action for clinicians to stop waiting, take control of their careers, and pursue a model that delivers both fulfillment and financial sustainability.
Chapters
Pelvic floor PT and OT burnout. Let's talk about it. The real reason why you actually feel depleted, and it's not because of patients or you know what you think it is. I believe most of us in this field feel burnt out because the reward that we actually get compared to what we're actually doing is not. Acceptable for many of us. Some people it is, most of us it isn't. And that is when burnout comes. Or burnout comes as well— I think this word burnout is kind of overutilized. Like, do you really burn out? I don't believe people really burn, like physically burn, right? I think people burn out— the true definition in my head of burnout is when, like I said, the what you are expecting to receive from the outcome that you are wanting isn't met and you're not getting it, then I believe people burn out. So, um, I've been in this place in my life where when I was running my clinic and running PelviBiz, um, where I had to choose because I was getting to a burnout state, meaning the reward for what I was doing was not as fulfilling compared to what I was doing at PelviBiz. You know, I've changed as a human, and I really wanted to impact women. Now, I was still doing that in clinic physically. I was impacting them, but I really wanted to elevate and change people's lives, um, overall, not just from a physical perspective. That was one aspect, but I wanted to massively impact their life with money and time. And so I can do that through PelviBiz. I could not do that as much through my brick and mortar. And so I started to realize there was more out there, and I started to become almost resentful of my brick and mortar because it was slowing me down compared to what I could impact with PelviBiz. And then that comes a point where you just have to— you have to choose. And you could get to a burnout state when one thing is pulling you down because the reward that you get from that is not what you're looking for. That That is a burnout state, yes. And that's when you need to let things go. That's ultimately, you know, I sold orthopelvic because I needed to get out of the situation I was in of being in Virginia. It wasn't my clinic; it was the situation that I was in of being in an absolutely horrible place that I did not want to be in. And you know, it was a whole that's a whole other topic. But you know, that is true burnout, and I think. Yes, like I was just talking to someone there seeing 23 patients a day. Now that yes will burn you out 100%, and she became like the director, and like she's like, "Yeah, I'm starting to see that like there really is no other milestone to get." I'm like, "Yeah, like it's just stupid what you're doing right at this point. It's stupid." Um, and so, but she's not willing to invest yet, so I'm like, "It's even more stupid." Because if she invests, she'll go from here to here. But she's just too scared. She's not willing to do that right now. And I'm like, so you're going to stay at 23 patients? Well, that's just going to burn you out if you're not already. And I hear a lot of these new grads coming out. They're like, after 2 years, I'm already burnt out. Well, no, the— well, maybe that's true. I'm not saying that's not true that they feel that. But what's happening is that they're understanding that that $85,000 to $90,000 salary Does not suffice to live in this environment and to have a physical job for 8 hours a day treating multiple patients at a time. It just isn't worth it. There are other things in today's world that you can make $5,000, $6,000, $7,000, $8,000 from a month that you don't have to physically be in front of someone. You don't have to manually be doing things, and you can help them, these, anyone, Like just as much. And so people are realizing that. And so that is when burnout comes because they're like, well, what kind of life is this? If I got to go pee, I can't even go pee because I got patients staring at me like, hello, you're going to come work on me? Or you can't even do notes and then you go home at night, can't do notes there because they're looking at you like, are you going to work on me? Well, when you go home at night, you got another 2, 3 hours of notes to do at night. And then guess what? The next day you're like, yes, I completed it by 9 o'clock at night. Next day comes around, guess what? Those notes start back up again. It's like the ever, the never-ending, like nagging thing. And it's like they might as well just worked another 3 hours at another job and got paid for those hours. And, you know, actually be able to make more money. And there's a cap. Like we don't even talk about that part. There's always a cap because the patient can only pay so much and the insurance company is only going to pay so much. So like the company can't even pay you more because again, it's not the company's fault. I'm not blaming the company. I'm blaming the system. This is a system problem. So it really none of it makes sense. I feel like we all got sold a lie, and it's just not right. You know, which is why I coach people to actually go cash to take out the middleman because it makes no sense with insurance company. You're getting played. You're getting played. So are you gonna be part of the— are you gonna get played like your entire life? Some people are okay with that. I don't know how you're morally okay with that. So if you're one of those people are like, man, I just feel so freaking burnt out, it's because burnout to me means you're not living your calling. You're not actually living what you know you're meant to be. So internally, and I felt this too when I had two companies. Internally, I believe that I was meant for more. I believe that I knew that there was different levels to this game as I started to get into it and realize that I want to play those different levels, and that my interests that I had were not as strong as my other interests over here, and that's okay. And I wanted to pursue these other interests over here, but I couldn't fully pursue these other interests over here because I was always being, you know, had to have attention on my brick-and-mortar as well. Like, I can't just— you have to have attention on both when you have 2 companies. And so anyways, um, there gets a point where you have to decide, are you going to take the risk and go for something that you have more interest in and more passionate about and feel fulfilled? Even though that's not the thing that was making me the money? Or are you going to just stay with the money to stay with the money? For me, I just can't stay with the money. It's not about the money. It's about doing things to impact and fulfill and have a fulfilled life and living your true authentic life. So, or if you are working for someone else or you're stuck in insurance, or maybe you're a business owner that has insurance and you know you're meant for more and not just what the pennies are, Left over at the freaking insurance company, then freaking make a change. Do it now. Make a freaking change. Stop waiting and say, "You know what? I'm gonna take back my freaking life." And you know what, guys? Financially, it may not support you right away, but I can tell you this: if you hang in there and you stick with it long enough, it will actually. Be the thing— if you, if again, if you hang in there and you just stay on the path, stay on the path, don't get sidetracked, okay? It will actually be the thing that actually is allowing you to have freedom, and you'll be fulfilled, and you will not feel burnt out. But burnout to me just is like the little red flashing light that's like, hello, this isn't it. It's just a sign. It's telling you this isn't it. You may still be able to do the same thing, but maybe you do it a different way. But are you willing? That's the next question. Are you willing then to go in the different direction? Are you willing then to take that risk? Are you willing then to be brave enough to jump? Most of y'all are not. I wish you were. But like, that's the thing that like we help people with. We help you make these decisions. We help you understand what you're feeling. We help you internally digest what is happening. So if you're someone that feels burnt out, guys, please reach out to us because I've been there. I have 100% been there. But it actually got better when I took the steps and let go and thought, you know what, I'm just gonna have to control this whole situation. I'm just gonna keep pushing through. I'm gonna power through because that's who I am. No, it got 10 times better when I started truly living Who I knew I was meant to be, and my full purpose. Okay? It got ten times better. But you got to be willing to let the other thing go, and it's okay. You didn't fail. Priorities change. You change. Your brain shifts. Your interest shifts. That's okay. But I'm asking you today, if you're listening to this, to start taking action on that. That's what I'm asking you. Start to do something about it. Ask questions. Jump on a call with me. Ask questions. Hey, like, what does this mean? Okay, well, let's talk about it. What is your gut saying? Like, this is what I do. I help you understand and try to get a clear path on what is your next steps. Because you know you're feeling something, but you can't verbally say it, or you can't get clarity from it. But when you talk to someone else, it's a wider out lens. It can actually bring clarity to your situation. So like, my advice to you today: stop waiting. Stop. Like, go take action now.
