1 in 5 O&P Clinicians Are Walking Away. Burnout Is Telling Us Why.

The study is observational. It doesn't ask why clinicians leave. But anyone who has worked in or around an O&P practice can fill in the gaps.

Clinicians don't typically walk away because they stopped caring about patients. They walk away because the system around the patient stopped working for them.

It looks like this:

• A SOAP note that takes 45 minutes because the template wasn't built for O&P
• An LMN cycle that loops back three times before a payer accepts it
• A WIP list tracked across sticky notes, inboxes, and someone's memory
• A denied claim that surfaces 60 days after the device was delivered
• A referral that arrives missing the very documentation that determines whether the case will get paid

Multiply that by a full caseload, five days a week, for five and a half years.



This is the math behind a 20 percent exit rate.

At Nymbl, we've said it before, and the Kistenberg research reinforces it: burnout in O&P and CRT is systemic, not personal.

It doesn't begin in the treatment room. It begins in the inbox, in the documentation queue, in the back-and-forth with a payer, in the gap between what a clinician was trained to do and what their software actually lets them do.

When the workflow drains time, energy, and attention away from patient care for years on end, attrition is the predictable outcome — not a surprise.

And here's the part practice owners can't afford to miss: every clinician who leaves takes with them years of training investment, mentorship hours, established patient relationships, and a referral network that doesn't transfer easily. The cost of attrition isn't just a vacancy. It's a compounding loss across financial performance, patient access, and institutional knowledge.

A 2.66 percent annual attrition rate, compounded across a 16-year window, is how you end up with the staffing cliff the industry has been talking about.

The good news in all of this: practices that have already started rebuilding their operational foundation are positioned very differently than those still patching legacy systems.

Sustainability doesn't mean asking your remaining clinicians to absorb more. It means designing systems that absorb the work for them — so that the 5.5-year mark becomes a moment of professional growth, not the moment they update their résumé.

That's the standard Nymbl was built to meet:

Documentation that doesn't outlast the visit. Nymbl's AI-powered Clinical Notes system listen during the encounter and generate compliant, structured documentation in real time. Clinicians review, edit, and move on — instead of taking notes home.

"AI Notes gets us 90 percent of the way there. We just make a few quick edits. We're capturing far more detail than when we relied on memory, and we're more focused on the patient, not the keyboard."
— Ryan Russell, Reseda Prosthetics and Orthotics

Intake that catches problems before they cost you. Automated checks confirm that referrals are complete, authorizations are in motion, and required documentation is tracked from day one — so revenue isn't held hostage by missing pieces discovered weeks later.

Task management that doesn't live in someone's head. Rule-based workflows assign, escalate, and surface what needs attention. No sticky notes. No "who was supposed to handle this?" No silent backlog.

Real-time visibility for the people leading the practice. Dashboards show where the bottlenecks are, which payers are slowing down, where caseloads are imbalanced, and where revenue is at risk — while there's still time to act.

An RCM partner when in-house billing isn't sustainable. Workforce shortages aren't limited to clinicians. Billing staff turnover sits above 20 percent annually industry-wide. Nymbl's Revenue Cycle Management services give practice leaders the option to outsource the functions that are driving their team into the ground.

If you lead an O&P or CRT practice, this research is more than a data point. It's a deadline.

Three questions worth bringing to your next leadership meeting:

1. Where in our workflow are clinicians losing the most time to administration? If you don't know, ask them. They do.
2. What is our actual cost of a clinician departure — recruiting, training, lost productivity, patient continuity, referral relationships — and how does that compare to investing in the systems that could prevent it?
3. Are we operating on software that was built around our workflow, or are we still bending our workflow to fit our software? That single distinction is showing up in attrition numbers across the field.
   

Twenty percent leaving is not a fact of life. It's a result.

It's the result of a workforce that has been asked, for too long, to compensate for systems that weren't designed for the complexity of O&P and CRT care. It's the result of treating burnout as something individual clinicians should be tougher about, rather than something practice leaders can engineer out of the day.

At Nymbl, we believe O&P is one of the most meaningful corners of healthcare — the kind of work that restores mobility, independence, and dignity. Clinicians shouldn't have to leave to keep loving it.

The Kistenberg study is a wake-up call. The response is up to the field.

If you're ready to look at what's draining your team, and what a system built for O&P and CRT can do about it, we'd love to show you.

Source: Kistenberg R. "Early to mid-career attrition and employment outcomes among prosthetists and orthotists in the United States: An observational cross-sectional cohort study." Prosthetics and Orthotics International. As reported by The O&P EDGE, May 14, 2026.