Key Considerations for Changing Positions in a Clinic Setting

Alan Fredendall // #LeadershipThursday // www.ptonice.com

In today's episode of the PT on ICE Daily Show, ICE Chief Operating Officer Alan Fredendall discusses three things to consider when changing positions: transparency, pay, and communication.

Take a listen to the podcast episode or check out the full show notes on our blog at www.ptonice.com/blog.

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EPISODE TRANSCRIPTION

INTRODUCTIONHey everybody, Alan here, Chief Operating Officer at ICE. Thanks for listening to the P-10 ICE Daily Show. Before we jump into today's episode, let's give a big shout out to our show sponsor, Jane, an online clinic management software and EMR. The Jane team understands that getting started with new software can be overwhelming, but they want you to know that you're not alone. To ensure the onboarding process goes smoothly, Jane offers free data imports, personalized calls to set up your account, and unlimited phone, email, and chat support. With a transparent monthly subscription, you'll never be locked into a contract with Jane. If you're interested in learning more about Jane, or you want to book a personalized demo, head on over to jane.app.switch. And if you do decide to make the switch, don't forget to use our code ICEPT1MO at sign up to receive a one month free grace period on your new Jane account.

ALAN FREDENDALL Good morning, PT on ICE Daily Show. Happy Thursday morning. We hope your day is off to a great start. My name is Alan. I have the pleasure of serving as our Chief Operating Officer here at Ice and a faculty member in our Fitness, Athlete, and Practice Management Divisions. Today is Thursday, Leadership Thursday. We talk all things small business management, practice, ownership, and management. But more importantly, it is also Gut Check Thursday. This week's Gut Check Thursday, coming up on Memorial Day weekend, we have Murph, the infamous hero workout performed by CrossFitters and functional fitness enthusiasts across the planet. This is a very long, grindy, aerobic bodyweight workout. If you've done this workout before, I don't really need to tell you anything about it. a one mile run, 100 pull-ups, 200 push-ups, 300 air squats, and then finish with another mile run. You can't manipulate the order of the mile runs at all. You can change and partition or not partition the pull-ups, push-ups, and air squats in the middle any way you want. As long as you get 100 pull-ups done, 200 push-ups done, and 300 air squats done, you are good to go with that work that you get done in the gym. Typical times are going to be 40 to 60 minutes and obviously a little bit slower if you wear that 20 pound or 14 pound vest. A lot of different ways to approach this workout. We have a lot of scaling options over on the Gut Check Thursday post on our Instagram account. But there are numerous ways to modify and scale this to get a really good workout in on Memorial Day before you head off to hopefully celebrate some barbecues, some beers, that sort of thing. Today, Leadership Thursday, what are we talking about? We are talking about things to look for if you are considering changing your job position. So we're gonna talk about transparency, we're gonna talk about pay, and we're gonna talk about communications and leadership presence.

JOB CHANGES ARE NORMALBefore we talk about the three things we think you should look for, the first thing I want to say is to understand, and we can have a lot of reservations about this, we can get in our head a lot about this, it is completely normal to change your job, and even to change your job on a regular basis. Bureau of Labor Statistics. It's a government agency that posts a bunch of data about really a wide variety of topics related to working and the workforce. They have data that shows the average person will change their job 12.4 times between the age of 18 in 54. So the average person is changing their job maybe as frequently as every year or maybe every two to three years. So I think that's really important to understand that it's normal to move on for whatever reason that you feel like it's normal to move on. Often we can encounter a lot of shame, a lot of pushback of I can't believe you're going to leave, who's going to treat all of these patients, so on and so forth. But we need to recognize That is not your problem and that it is normal to want to move on again for whatever reason you feel like you need to move on. A different schedule, more flexibility, less work, more work, more pay, different location, whatever. It is normal to change your job positions. About 30% of all Americans change their job each and every year. And then why do we look at that? All the reasons that we think about in the profession of physical therapy are the same across other industries. 80% of people leave a position because they feel like they are burned out. 70% feel like work is overtaking every aspect of their life. They're losing that balance between work and personal life. and then about 50% leave because they believe they are overworked or underpaid or both. And certainly, in the profession of physical therapy, we can relate to that.

GET IT IN WRITING Before we talk about transparency, pay, and communication, the other thing I'll say is that as we get into these topics, it is in your best interest, and I cannot reinforce this enough, that whatever you discuss, whatever is told to you in words, should go into writing, and any unwillingness about specific details of your job tasks, of productivity, of pay, of time off, of other benefits, so on and so forth, anything related to the fine details of this position you might be considering should go into writing. And unwillingness or hesitancy or any sort of mystery about that should be immediately a beige flag, I would say a red flag in your mind that already you're thinking, why would I accept this position if it is not willing to be put into a contract? that I will be promised these things in writing, that I am being promised verbally. So, that's always front of mind, that if it's not in writing, it's probably not going to happen, and you'll just find yourself likely, eventually, in the near future, thinking about changing job positions again.

TRANSPARENCY IS KEY So getting into our first point, the most important thing I believe related to perceiving a job position to be a good fit is transparency. That in the profession of physical therapy, in the field of physical therapy, whether it is being a frontline staff clinician treating patients, whether it is being in a management or ownership position, there is no secret to what we are doing. There is no mystery formula. secret technology, government secret for national security that we can't talk about, that transparency rules the day, especially in a profession like ours. A healthcare profession, a medical profession, a graduate level, doctorate level profession. Transparency should be there in all things. How are people paid? What are they paid? We should not go home every night and wonder if someone is making more or less money than us for whatever reason because I am a female and they are a male or vice versa. We should have very clear cut transparent lines of how does pay work and where does the strategy and where does the logic for that come from? How does productivity and time off and benefits Again, all the stuff that you would care about and all the stuff that you would want to see in writing, where is that at? It should be there. It should not be hidden. It should not be something that is not told to you. We live in a day and age. It's 2024. We know how much we are charging. We know how much we're receiving. We know how much we're getting paid. It should not be a big mystery. Any reluctance there, any hesitancy to share? First of all, regarding what the clinic gets paid in 2024 is illegal. As of 2021, we have to have our rates published on our website or somewhere posted publicly that patients considering care with us can find it, right? That's the no surprises act of 2021. So we should at least have an understanding of how the clinic and what the clinic is making for revenue and understand how our pay is calculated, how our productivity and everything that kind of follows downstream from that. So there's no secret that we have to hold on to. Certainly if you work at NASA or something, I could see that being a little bit secretive is important, but in the field of physical therapy, that just does not make sense. You should, again, never go home and have to fester about this stuff. Am I being underpaid for whatever reason? Am I being asked to do more work for whatever reason? All of that goes out the door when you work in a really transparent workplace. PAY MATTERS The second point is pay. High quality leaders, and I will take this to my grave, high quality leaders recognize that pay is very important when you want high quality folks to join you at your business and help you grow your business. No one is happy when it is National Physical Therapy Month and you work in a hospital or some other big group clinic and instead of a bonus or an extra day off, what comes through the door? Some old, stale, gross, soaking wet Jimmy John's sandwiches, right? That really just makes everybody upset. You don't feel like you were awarded. You don't feel like you were valued. Pay is one of those things that is just Part of going to work, whether you're going to work for somebody else or somebody else is coming to work for you. Several high quality papers exist now. We've talked about several here on the podcast. The most notable one is Killingsworth and colleagues back from 2023. establishing an objective database link between pay and satisfaction. Job satisfaction, life happiness. We know that human beings fall into buckets. Not everybody is motivated by money, but most people are at least somewhat motivated by money. That paper is really profound to me knowing that there is about 33% of the population who does not really seem to care about money beyond having their basic needs met. That being said, the majority of the population, therefore, is motivated by not just enough money to have food and a place to sleep, but having enough money to start a family, buy a house, retire, all the other stuff that we do with our money. So we know there's a middle portion of the population that sees a linear increase in happiness up to and beyond $100,000 a year of household income. And there's also another a third of the population, another 33%, that sees an exponential change in the relationship between their pay and their satisfaction up to and beyond $100,000 a year. We've said it here a thousand times, we won't beat the horse too much here today, but pay matters, and in specific, if you're not getting a raise every year, you are taking a pay cut. So pay should be one of those things that's included in transparency, and it should be a big factor, and it should not be a thing that is a mystery when you're looking for a new position. You're not quite sure how it works. And again, everything related to pay should be put into writing. We talked to a lot of people who are presented a salary or an hourly or a per visit or whatever pay scale that then find out later, Oh, by the way, that's based on X productivity. And because you did not hit X productivity, you are now being paid Y instead of Z. We see this often related to a percentage of arrival, that if only 90% of your patients showed up this week, you only receive 90% of that promised salary, for example. So be really careful, ask a lot of questions about pay, and make sure that stuff goes into writing, because if it's not in writing, again, it's probably not going to actually happen when you accept that position and you begin working. COMMUNICATION IS CRUCIAL And the final thing here is communication and presence of leadership. I think communication is really important. I think we can over communicate. We can have a lot of meetings that are maybe seen as wasting time. But I also think a lot of workplaces, a lot of communication between owners or managers and staff clinicians does not happen often enough. There is no inclusion of the other people that work at the facility of hiring somebody else. Is that person not only a good fit for the clinic, but is that person a good fit with everybody else who works at the clinic? And so having open communication, having the ability for folks to ask questions, Again, not necessarily over communication, just to communicate, but making sure that when decisions are made, as much as possible, everybody else who works at that clinic should at least know what's going on. Maybe it's not relevant for them to have a say in, you know, that you switch toilet paper brands or something like that, but at least the option to have that open line of communication should be included. And with that comes the presence of leadership. I truly believe that to run a very successful business and to have a staff that works really well together, the people in charge should probably be there on a somewhat regular basis. Very often we hear that clinic owners are living in the Caribbean or across the country at their second house. They haven't been seen for weeks or months, and they're primarily just collecting their ownership distribution from the business at that point. It's really difficult to feel connected to the business side of your job when you are not even sure who is in charge and what they're doing. We see this in our bigger clinic groups across the country, that the people that own the company are not even physical therapists. They've never been a physical therapist. They've never treated a patient in their life. an investment banker or a stockbroker or some sort of real estate mogul. And the physical therapy business is just numbers on a spreadsheet to them. It's just profit and loss. And it can be naturally very difficult to feel connected to that position, to feel like you're doing meaningful work, and to also feel like you're being rewarded for that meaningful work when there's not that communication and there's not that presence of leadership going on. SUMMARY So, what are three things that you can very quickly use to screen in and out a good position? Making sure that everything that is talked about is put into writing. Focusing on transparency of understanding why and how the business is run and what those decisions and how those decisions are arrived at. Knowing that pay is very, very important. We need to recognize both that from the ownership and management side of the equation as well as those of you seeking a new position. It would be, Not a great optimal decision to change positions for a lateral promotion or even a decrease in pay unless it meant living in your dream geography or something like that. And then the final point, communication is important. Having open lines of communication with ownership, with leadership, both ways. Having a say in important decisions or at least being able to voice your thoughts on the matter. and having active presence of your leadership and ownership in the actual business. When is the last time the clinic director or the clinic owner has maybe even been in the same state that their clinic is in? Those are all important things to consider. So we hope this was helpful. We hope you have a wonderful Thursday. Have a fantastic Memorial Day weekend. Have fun with MRF. If you're looking for more business practice ownership information, if you're looking to start your own practice, whether it's insurance based, cash based, you're not sure based, check out Brick by Brick, our practice management course. The next cohort starts July 2nd. Have a great Thursday. Have a great weekend. Bye everybody.

OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.