Managing Change—in our Practices, Profession, and Personal Lives

For me, adapting to change—both personally and professionally—has been incredibly rewarding, but that doesn’t mean change is easy; I’ll be the first to admit that I’m slow to adapt. I often need time—and space—to process change. Many of us do. After all, even small changes can trigger big fears. And while change often sparks challenging conversations and questions, it also opens productive dialogue, whether that’s within a relationship or across an organization. WebPT is an incredibly fast-growing company, so we know a thing or two about adapting to change. And yet, change can still throw us off-guard occasionally, which is why we’ve trained our teams on change management—an incredibly valuable skillset for anyone to possess, and a crucial one for individuals in leadership roles.

Given the changes that the physical therapy industry is facing with respect to payment, care delivery, and the overall healthcare reform effort, it’s safe to say change has become an integral part of our profession’s culture as well. That makes this the perfect opportunity to discuss not only the change that’s happening, but also how we can deal with it in a way that’ll yield the most positive results.

The Change Cycle

My mentor recently told me that the difficulty we humans have with accepting change is so universal that there have been millions of books written on the subject, all offering advice and strategies for coping. You may already be familiar with Elisabeth Kubler-Ross’s work on change: in the 1960s, she identified five stages of emotion that people progress through following significant changes that they perceive to be negative. Contemporary researchers have whittled down Kubler-Ross’s five stages into four (which I’ll cover in a moment).

First, though, let me say this: these stages are normal, and there is nothing to be concerned about if you find yourself or anyone else in the throes of shock—or even anger. While none of us can circumvent the process altogether, there are things we can do to make moving through it a bit more comfortable—both for ourselves and for others.

Change management image


Image adapted from this EBA article.

Stage 1: Shock and Denial

When change happens, shock and denial often are our go-to reactions. Feelings of instability or uncertainty about the future can give way to panic and anxiety. At this point, we may even pretend that the change isn’t happening or draw far-fetched, worse-case scenario conclusions about what the change might mean for us. This often is where rumors start.

Leadership Tip

During this stage of the cycle, there are several things you can do to help reinstate feelings of security—like providing clarifying information and realistic answers about the effects of the change. In other words, address the need for more information.

Stage 2: Anger and Depression

Once the shock has worn off and we can no longer deny the fact that the change is happening, we may get angry, lose trust, feel helpless, or even lash out at those we believe are responsible for the change. In a work setting, this can negatively impact morale, collaboration, and productivity.

Leadership Tip

During this stage, be sure to keep the lines of communication open, so people can voice frustration and feelings of hurt. If you have an open-door policy, this is a good time to remind staff about its existence. If not, consider implementing one—or at least making yourself available in a similar fashion. 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

Finally, this stage is where the anger and depression lift, and the fun begins. During the exploration stage, we begin to experiment with new ideas and thoughts about how we can make the change work for us—in other words, how we can adapt. We may even begin to imagine new possibilities for how the change could benefit us.

Leadership Tip

During this stage, provide guidance and create opportunities for staff members to get involved. That way, they’ll be better able to understand the potential benefits of the change and how they can use it to their advantage.

Stage 4: Acceptance and Integration

In the last—but certainly not least—stage of the change cycle, we accept the change and integrate it into our lives. There are two types of acceptance:

  1. Compliance: accepting something because you have to or because you are being told to do so.
  2. Championing: embracing, understanding, and advocating for the change while also helping others progress through the change.

Leadership Tip

During this stage, be a source of encouragement; celebrate and embrace all that you’ve accomplished—together. You all deserve it.

Looking to the Future

I’ve been through a lot with my team, as I’m sure you have with yours. So, no matter what else changes—and more will—take comfort in the knowledge that you’re going to get through it together. And you’ll all be even better off for having done so. The same goes for the PT profession—and all of the changes we stand to face. 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. Now, it’s time for all of us to leverage our experience to effect even greater change and land physical therapists a prominent seat at the healthcare decision-making table.


Now that’s what I call successful change management.

About the Author

Heidi Jannenga PT, DPT, ATC/L is the president and co-founder of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi leads WebPT’s product vision, company culture, and branding efforts, while advocating for the physical therapy profession on a national scale. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has since guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.

An active member of the sports and private practice sections of the APTA, Heidi advocates for independent rehab therapy businesses, speaks as a subject-matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. In 2014, Heidi was appointed to the PT-PAC Board of Trustees. She also serves as a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice rehab therapy professionals.

Heidi was a collegiate basketball player at the University of California, Davis, and remains a lifelong fan of the Aggies. She graduated with a bachelor’s degree in biological sciences and exercise physiology, went on to earn her master’s degree in physical therapy at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her doctorate of physical therapy through Evidence in Motion. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.



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