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How to “Fool-Proof” Your Physical Therapist Hiring Process

Welcome back! Recently, we’ve been discussing how to hire amazing staff for your private physical therapy practice.

So far, we’ve learned the difference between good and bad staff, the idea of working yourself out of job one position at a time, and which clinical responsibilities need to be delegated to reliable employees and PT's.

Today we’re moving on to when you should hire new employees, and how to create a killer hiring process. Keep reading to take the next step in building your dream team and growing your business.

When to Hire

Getting started, how are you supposed to know when it’s time to hire new employees?

To answer this, it’s important to ask yourself two questions:

  1. In what areas do you spend most of your time?
  2. Are these areas the most productive use of that time?

On day one of Harvard Business School, they ask all the new students a question:

If Bill Gates were walking down a hallway and saw $100 bill on the ground should he take the two seconds it takes to bend over and pick it up?

What was your first instinct?

I know mine was that yes, he should obviously stop to pick it up. However, the correct answer is in fact, no. Due to his success in his business, his time is worth more than $100 per second, so in order to be most productive, his time would better be spent elsewhere.

The same principle applies to you and your practice. In our last post, we made a list of the areas owners often spend too much of their own time. These are the areas it would be more productive to hire an amazing staff member to perform those tasks for you.

Take the time to write down which responsibilities you’re managing in these areas (reception, personnel, internal marketing, finance, etc.) and determine how much each of these responsibilities is worth.

Answering phones – $14-15/hr?

Cleaning the clinic – $12-13/hr?

Providing PT services – $60,000-$70,000/year?

After determining how much each task is worth, you can begin to start taking them off of  your plate, allowing more time in your schedule for the tasks that will make your business most productive.

But when is NOW a good time to hire?

I know what you’re thinking…

“How can I possibly add more staff to my payroll when my profit margins are only $X dollars a month?”

I used to think like this too. That is until I realized the more time I spent on areas where I was most productive, the larger our profit margins became.

For example: I hired another PT to free up my time for marketing and our business saw a steady increase in patient numbers. With this improved consistent stream of patients, our profits, even with the salary of the added therapist, were greatly improved.

The key here is to look at potential production value compared to the cost of the employee. While you may pay a new therapist around $7,000 a month, you have to consider that he or she also will bring in about $90 per visit at around 50 visits per month. That’s $18,000 in production value compared to the $7,000 cost! Not to mention it frees up your time, allowing you to spend more time on productive tasks like learning about running a business or hanging out with your family!

To make a long story short, if you feel bottle-necked with tasks and are unable to maintain consistent growth, it’s probably time to hire another therapist.

When it comes to other staff like PTA’s or administrative staff, I find hiring is best dictated by patient numbers.

If your PTs are consistently seeing 50-60 visits a week, it is probably time to hire a PTA or aide.

If your accounts receivables are through the roof, your billing staff are performing at a high standard, and they are already at 40 hours a week, it’s likely time to hire another billing person.

Two Choices in Hiring

There are two choices you have when hiring: outsourcing or employment. In reality, you could utilize either to fill all the positions you need.

For me, tasks performed by anyone who owns their own business but also works with me are outsourced. This means I outsource tasks like transcription, legal work, and bookkeeping.

Positions where there is a clear employer-employee relationship, I hire for employment. These are my PTs, PTAs, receptionists, billing staff, marketers, and office managers.

Creating Your Killer Hiring Process

A great hiring process is necessary to attract good staff. Hiring good staff up front will lead to good managers down the road. In short, the more time you put into your hiring process now, the more benefits you’ll see later on.

Let’s talk through the process step by step.

1. In present tense, physically write down who your ideal hire is.

An example might look like:

“We have an awesome PT. He is involved in the community, has an active license to practice in my state, is a great communicator, enjoys growing the practice, cares about our patients, uses evidence-based practice, is a problem solver, and is an advocate for the physical therapy profession.”

This is a personal statement that will be different for everyone, so make sure to shape it to best fit your practice.

2. From the above statement, write out a long-form ad.

The secret to this is that it should highlight what YOU want, not what you think a potential hire wants to see.

While that may sound simple, most jobs are written showcasing what is in it for the employee, essentially attracting the wrong type of person. The employee you want to hire is the one who shares similar values to you and fits your standards.

3. Where to post your ad? The simple answer is, everywhere.

Have you ever heard that what you put out into the world is what you receive back? Go ahead and give it a try. Put out EXACTLY what you’re looking for, and you will more than likely find just that.

Post on facebook, craigslist, in print ads, your patient newsletter, and on educational sites like the APTA or JOSPT.

4. Pre-employment Testing

When an applicant comes in, we always have them perform an aptitude, skills capacity, and IQ test. We use an online software that costs around $40 a month and it gives us a TON of information.

From personal experience, there have been times where I had a good feeling about an employee who performed poorly on one of these tests. On a few of these instances, I ignored the results, went with my gut instinct, and hired the person anyway. Let me tell you… it never ended well. Our instincts about people are not always accurate. Invest in some software.

5. Interview with qualified applicants

Those applicants who pass the pre-employment tests then qualify for an interview. This is the time to really find out what the applicants' expectations of the position are.

We like to ask applicants to provide a one-page write up of their ideal position. We tell them to write the position as if they could have anything, but ask that they don’t just write what they think we want to hear.

Even just asking for a write up gives a lot of information about the person. Did they take the time to type it out? Hand-write it on looseleaf in a rush?

We then proceed with the interview by having the applicant read their ideal position aloud. Were they honest, or just writing what we want to hear? Did they give a genuine effort or was their response half-hearted? This is a good time to probe a bit and ask them to expand on their statements. Someone writing what they truly want should be able to provide details as to why.

6. Observe the work area during high flow

What better way to see if someone is a good fit in your clinic than to literally put them in your clinic.

They should at least stick around to watch one or two treatments to get a feel for how a normal day might flow when it’s busy.

Additionally, it’s important for them to interact with other staff members without you there. Are the interactions easy or forced? Does their personality seem cohesive with your current staff?

7. Discussion of potential benefits and compensation

This is an area in which we do not negotiate; we simply tell our hires what we have to offer.

We have had PTs who are unhappy with our offered salary in which my rebuttal is always, “What would you like to make?”

If they request notably higher pay I discuss with them that they’re able to make that type of pay, but that it comes with a much longer list of responsibilities.

If this remains a problem, this candidate will not be a good fit for the company.  They are clearly only concerned with what they’re getting out of the working relationship and not what they can contribute to the company.

8. Work Interview

This part of the process differs slightly depending on position.

For our PTs, we do a mock evaluation and treatment. This includes 15 minutes for an assessment and a treatment to make a meaningful change. This is a great way to determine if they have good clinical decision-making skills, are comfortable putting their hands on people, and can essentially “walk the walk” of what they’ve told you thus far.

For PTAs, we hire them for a short 4 hour period where they perform treatments under observation.

For administrative positions, we hire them for four to eight hours where they will be performing whatever tasks match the position they are applying for.

9. Offer in writing

If everything checks out in the work interview, we give an offer in writing that is signed by all parties.

9. Set Start Date

The start date should be agreed on, and announced to all staff so everyone is prepared for the changes that are coming.

Making a new hire feel welcome makes for a much smoother transition to the team and can be done in several different ways.

We like to have our new hires tell us fun facts about themselves while performing their favorite PT exercise at their first staff meeting. Just something silly to make them feel like they’re a true part of the team now.

10. Disney 2-Phase Training

You can’t expect someone to come in and hit the ground running. Disney has a great two-phase program they use for new employees and it definitely works.

Phase 1: Our new hires will observe someone performing necessary job tasks for as long as they need to, to feel comfortable.

Phase 2: Once they’re comfortable with their responsibilities they will then be observed performing them.

Using this training system, you can be certain employees are performing at the standard you expect, allowing you to gradually work yourself out of a job one position at a time.

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