FAQ: 6 Personnel Problems in Your PT Practice (and How to Solve them for Maximum Efficiency)

Introduction

Every private practice leader wants to build and manage an exemplary team. After all, gold-medal-deserving employees can seamlessly and automatically collaborate, sharing their skills and expertise and helping each other provide the best treatment and create the best patient experience possible. But recruiting—and more importantly, retaining—those cream-of-the-crop employees can be difficult. That’s exactly why Brian Gallagher, PT, MEG Business Management President and Founder, and Dr. Heidi Jannenga, PT, DPT, ATC, WebPT Co-Founder and Chief Clinical Officer, teamed up to host an hour-long webinar covering exactly how to build and maintain a killer team. During the webinar, they received too many questions to answer in the time allotted, so we compiled and answered the most commonly asked ones in this FAQ. Don’t see the answer you’re looking for? Leave us a comment at the bottom of this post, and we’ll do our darndest to get you the information you need.

Recruiting

When it comes to hiring top talent, how can smaller clinics compete with larger practices that are able to offer better salaries and benefits?

When you’re a leader in a smaller clinic, you have the advantage of being able to build personal connections with your team. You are able to acknowledge, mentor, and validate them in ways that simply aren’t possible in larger organizations. Make sure you clearly communicate that benefit during the recruiting and interview process. Additionally, try to look beyond the usual pool of candidates. This may help alleviate some of the competition with large employers. Extend your efforts beyond your local market. For example, you may try advertising open positions in different locations or smaller job markets where there’s less competition.

What is your advice for promoting or advertising our open positions and job listings? How can we make sure we are getting seen by top candidates?

First, make sure you ask each person you hire how they found out about your clinic and the open job role. Beyond that, hit up other therapy professionals in your local market and/or personal network to find out how they found their latest position or their most recent hires. If you practice near a university with a physical therapy program, try to build relationships with professors and program directors—or perhaps even offer up your time as a clinical instructor. Finally, ensure you have coverage on the most-used national job boards—including Indeed and LinkedIn.

Interviews

If our clinic is still doing mostly video interviews, how can we allow applicants to “mingle” with other therapists during the interview process?

This may be a little difficult. You may have to block time on the appointment schedule for therapists to meet these prospective employees virtually. You don’t have to reserve much time—just a few minutes here or there. It won’t be exactly the same as a casual in-person meet-and-greet, but it will at least give your therapists and prospective hires a chance to interact and feel out whether joining forces would be a mutual culture fit. Alternatively, you could try to schedule your official interviews when your therapists have a little down time between patients so they can hop on those video calls with you.

How many interviews do you recommend scheduling with a candidate before making them an offer?

Unfortunately, there isn’t a single tried-and-true answer that applies to all candidates at all clinics. According to Gallagher, clinic leaders must find the cadence that works specifically for them. If you like conducting multiple interviews—and you’re not losing candidates because your hiring process moves at a slower pace—then by all means, go for it. That being said, Gallagher suggests keeping a tight schedule whenever possible. “I have found that the speed in which you operate is relevant—especially in smaller markets,” he said. And for that reason, he likes to conduct most interviews in one day’s time. 

In order to ensure an efficient interview process, it’s critical to ask questions that cut to the heart of a prospective employee’s work style and personality—and you can do that by asking questions that stimulate emotion. For example: “What did you hate about your last job?” Or: “What do you love most about being a physical therapist?” Of course, as Gallagher mentioned during the webinar, if you want to dig more into a potential employee’s tangible skills, then you’ll likely need to book them for multiple rounds of interviews. 

Jannenga also recommends being upfront and transparent about the interview process—including how long it will take. This will help you build trust and rapport with prospective hires. 

How long should the interview process take in total—from the first interview to the offer?

This varies from clinic to clinic and market to market, but Gallagher recommends prioritizing speed so you don’t lose top talent. He prefers to complete the interview process within one day’s time whenever possible. And when you know a candidate is a good fit for the role, don’t delay in sending out an offer. 

Employee Onboarding

Where can I find resources to help me streamline my employee onboarding process?

There are a plethora of resources available online. In fact, these are five different resources we found by searching “employee onboarding PT resources” and “employee onboarding resources” on Google. Beyond that, we recommend reaching out to MEG Business Management for some really excellent resources!

How long should it take to fully credential an OT or PT? It takes us around 30–90 days; is this a normal turnaround time? We’ve heard it only takes two weeks for some of our competitors.

Based on our research, credentialing takes 64 days on average, so it sounds like your timetable is right on the money. We’re not totally sure how your competitors are credentialing their providers so quickly—but we can offer some tips and tricks to help you speed up your credentialing process. Check out these articles. 

How do you ensure competency after a new hire completes their onboarding and training?

You’re right to be concerned about potentially hiring an employee only to learn that their skill set doesn’t align with your staffing needs. However, if you’ve ever been through an onboarding process that left you feeling underprepared and underwhelmed, then you know how frustrating and isolating the experience can be. For both of these reasons, it’s absolutely essential to meet with new employees at regular intervals throughout their first year of employment. For example, you could make it your standard practice to meet with every new hire at the end of the onboarding process, after their first 90 days, and again after their first six months on the job.

It’s also extremely important to approach these meetings as an opportunity to assess the effectiveness of your hiring and onboarding processes rather than strictly evaluate your employee’s competencies. After all, you are just as essential to your employee’s success as they are, and you should leap at the opportunity to improve and refine your onboarding process to ensure every new team member has what they need to hit the ground running.

How can I get a copy of the onboarding checklist Brian showed during the webinar? What about the employee status sheet?

We’ll provide all webinar attendees with instructions for accessing these materials as part of our regular recap email. However, you can also obtain the onboarding checklist and the employee status sheet by reaching out to MEG Business for a free practice assessment.  

Employment Maintenance 

What is the average length of employment for a PT/PTA or OT/OTA?

While we can’t speak to average employment tenure for rehab therapists, specifically, according to this article (which cites Bureau of Labor Statistics data):

• “The median tenure for workers age 25 to 34 is 3.2 years.
• The median tenure for employees age 65 and over is 10.3 years.
• Workers in management, professional, and related occupations had the highest median tenure (5.5 years).
• Workers in service occupations had the lowest median tenure (3.2 years).”

What is a performance improvement plan?

A performance improvement plan (PIP) is an action plan you can employ when one of your employees doesn’t meet the clinic’s minimum performance or behavioral standard. These plans typically span several weeks, and the employee must meet (or exceed) specific benchmarks over certain periods of time in order to retain their employment at your clinic. These plans give your employees a chance to redeem themselves if you’d rather not terminate them immediately. 

Do you have any recommendations for staff satisfaction surveys we could use?

At WebPT, we’re big proponents of leveraging Net Promoter Score® (NPS®) to track patient and customer loyalty. But NPS® surveys are also great for tracking employee loyalty. (In fact, it’s the main way we gauge employee happiness at WebPT.)

When using eNPS® (that’s employee NPS®), you simply ask your team members the following question: How likely are you to refer a friend or family member to our practice?

The employee will respond using a scale between 0 and 10, with 0 being “extremely unlikely” and 10 being “extremely likely.” If you’d like, you can leave a space for the employee to explain the reasons for their score.

As with patient NPS, your “promoters” (i.e., employees who select 9 or 10) are your biggest advocates; “passives” (i.e., those who select 7 or 8) are satisfied but not necessarily loyal; and “detractors” (i.e., those who select 6 or below) are highly dissatisfied.

Metrics

What front office metrics do you recommend tracking?

When measuring the success of your front office staff, keep in mind that these team members aren’t just there to collect copays or schedule future appointments—they’re responsible for making first impressions with new patients. As such, it’s crucial that they view themselves as patient advocates. While many evaluations of customer service rely on subjectivity, there are a few objective metrics you can use to get a pulse on the level of attentiveness your front office staff displays. These include:

• average check-in time,
• outstanding amounts due,
• percentage of kept appointments versus cancellations, and
• percentage of appointments rebooked after cancellation or no-show.

How do you track things like patient satisfaction, experience quality, and other less tangible PT performance aspects? 

If you can see it, you can measure it! In fact, those two categories (i.e., patient satisfaction and experience quality) are both perfectly measurable—you simply need to tap patients to get the numbers you need. By sending out a patient satisfaction survey—or even better, an NPS survey—you can measure exactly how happy patients are with your care and how loyal they are to your clinic. The better the quality of your staff PTs’ care, the higher your patient ratings—and vice versa. 

Alternatively, more traditional metrics like productivity and patient load can give you a hint as to the quality of your PTs’ care. If they’re billing an exorbitantly high number of units or seeing an extraordinary number of patients, then it may indicate that they’re not giving each patient adequate attention and time. Keep in mind, though, that these metrics won’t give you the whole story, and it’s important to keep investigating and trying to find metrics that accurately represent the information you’re looking to obtain.

How can we incentivize/measure performance for clinic directors? What metrics should we use?

Beyond traditional business metrics like revenue and P&L (profit and loss), we recommend considering:

• patient satisfaction and loyalty (via NPS);
• employee satisfaction and loyalty (via eNPS);
• average star ratings and review quality (e.g., via Facebook and Google reviews); and
• patient retention/dropout rates.

What tools should clinics use to track metrics?

This will vary from clinic to clinic. For smaller practices, Gallagher recommends the budget-friendly DIY option: Google Sheets. He says a custom-built system that’s user-friendly can be an excellent way to track your metrics in a single place with a unified format. 

For those who don’t have the time or mental energy to custom-build a metrics-tracking system, we’d recommend checking out WebPT EMR and WebPT Outcomes. Our EMR comes with a built-in business analytics tool, and Outcomes helps clinics track functional progress and patient satisfaction. 

Compensation

How do we move from salary to a salary-plus-bonus or pay-by-performance compensation model? Any suggestions on metrics to use?

We’ve actually written a whole blog post about this!

How do we have a conversation with our staff therapists about moving to a pay-by-performance model? 

Gallagher recommends picking a pay-by-performance model wherein therapists feel as though success is attainable (i.e., one based on things like quality, efficiency, and excellent patient care). He also urges clinic owners to make the parameters of the new pay model totally clear and transparent. In an ideal situation, your best therapists should be able to see that if they keep up their same level of performance, they’ll actually make more money. Bottom line: It’s critical to approach this conversation in a way that makes people feel like their livelihood isn’t in jeopardy—and that the bar to earn a good salary that covers their costs is perfectly attainable. 

If you tie therapist compensation to productivity, can you legally specify the units billed per patient on the contract? Does this get the company into legal issues with dictating care?

With these types of compensation models, you’re not making billed units a condition of receiving a paycheck or maintaining employment. Remember, therapists do not bill. Therapists document the care provided, and that documentation dictates the number of units billed. When you have conversations with your therapists about productivity, you should simply urge them to provide an abundance of care commensurate with patient needs. The ultimate goal is delivering high-quality care and an excellent patient experience. Secondary to that is finding opportunities to be more efficient—by completing at least some documentation at the point of service, for example. If the therapist does those things, high productivity will naturally follow. We’d recommend shooting for approximately 85% efficiency, which simply means that 85% of the therapist’s work hours are dedicated to providing billable care.

Miscellaneous

How do you suggest dealing with therapists who seem overwhelmed by seeing more than one patient per hour, even when they have access to highly qualified extenders?

Try working to improve the relationship between the therapists and the available extenders. When therapists hand off patients, the quality of the patient’s care is no longer directly in their hands—which may create some concern if they’re invested in their patients’ outcomes (which they should be!). When you nurture trust between therapists and extenders, therapists will see that their extenders can provide equally excellent care—and that both parties can collaborate to create an even better patient experience. 

How would you address someone in an administrative role who is advocating for their own professional growth and a fair exchange agreement?

Contrary to popular assumption, administrative roles come with a lot of opportunity for career growth and advancement. Your best move is to gauge the direction in which your administrative employees want to move. Do they want to move from the front desk to the back office and become expert billers? Are they interested in learning more about running a business and progressing into a managerial role? From there, you can begin to craft a growth path and offer resources (e.g., training courses or mentorship opportunities) to help them along the way. 

Have another question for us? Feel free to drop it below, and our team will do its best to whip up an answer for you!