Unless the deal completely falls through for some reason (not likely), I’ll soon be signing a lease for larger space for my physical therapy clinic in Austin and starting the search for my first staff PT!
I had toyed with idea of a “cash practice incubator/fellowship” and having a new therapist/practice-owner start their practice within mine each year, but decided I really didn’t want to consistently deal with that type of turnover. So I’m going the employee route and will soon be posting the job in various locations.
The reason for today’s blog post is to show you what I’m planning on posting and ask for your feedback.
If you ever dealt with employee searches and hiring process, and feel the job post I’ve created could be improved in any way, I would love to hear about it in the comments below.
(Please note: I purposely made the job posting quite long [compared to most]. I want to weed out potential applicants who are not willing read a bit and really pay attention to a number of details.)
With that said, here is what I have so far…
Hi, I’m a physical therapist and own a cash-based PT clinic in the Central Austin/Westlake area.
If having a full hour of one-on-one time with every patient sounds like a wonderful way to spend your day in the clinic, read on.
I’m ready to expand my practice and build a fun team of professionals who love treating patients and are pumped to be able to treat them the way they know is best (Not the way insurance dictates!).
I’m first looking to bring on a superstar Manual Physical Therapist, but before I start asking you questions, let me tell you a bit more about myself, my practice and treatment philosophy so you can determine if this position is likely to be a great fit for you …
I earned my DPT about 10 years ago and shortly thereafter earned a Manual Therapy certification (Both via University of St. Augustine). Treating patients with my hands has been the primary focus of my career but I never discount the importance of therex, and all of my patients are taught a HEP to support what we do in the clinic.
I never have patients doing things in the clinic that they could be doing on their own at home or in their gym … people don’t like to pay much out of pocket for that approach.
Due to legal limitations, I do not treat a great deal of Medicare beneficiaries though I do have a handful of Medicare patients here and there.
Patients pay in full at the time of service and are provided a receipt with the necessary codes/info to send in self-claims to insurance if they so choose. ($150/hour-session)
Documentation must be inline with the State Practice Act and be sufficient if legal issues arise, but much of the insurance-based paperwork requirements do not exist in this clinic.
Sound exciting so far? If not, no need to read further. If so, let me tell you more about who I’m looking for.
Clinically, I’m looking for a stellar manual therapist. Having solid training in manual therapy beyond what is taught in PT school is advantageous. Having a natural ability with your hands is a must. I’ve known PTs who have taken significant continuing education in manual therapies but lacked a natural ability with their hands. Some things can be taught and some things unfortunately cannot. I’m looking for that person who has always been told they have “great hands.”
So you will bring your own skill set but I’ll be teaching you a large number of manual techniques and ways to optimize patient interactions and experiences. I’m a fan of having a big clinical “toolbox” and do not subscribe to any one approach to physical therapy as being the best or fixing everything. So get ready to learn!
Part of your job responsibilities will include occasional reading of not just clinical-related books/articles but also business-related content. Especially when I’m training you, you will be recording a lot of that training via video as well as text. Having to take on these responsibilities during training will help to reinforce the knowledge and skills I’m teaching you.
If it’s not clear already, I’m looking for someone who is passionate about learning and wise enough to know there will always be much more to learn … regardless of age or experience. And in our clinic, it will not only be about improving clinical skills but also about improving the creation of an incredible experience for every patient.
Whether you work in an insurance-based clinic or a cash-based clinic, “selling” the value of what you provide is hugely important and must be a priority in every treatment session (and especially so in the cash-based model). If the idea of selling makes you feel a little uneasy, you are not alone! But I assure you that selling doesn’t require being “salesy.” I will teach you how to ethically and effectively sell your services to those who need them, keeping your schedule full and earning you larger paychecks.
On a similar note, at least for now, you and I will be processing/taking payment from patients at the end of treatment sessions. How will feel asking patients for $150 for an hour of your time? Your current/former employers routinely ask insurance companies for much more than that for an hour of your time. You ARE worth it. But now YOU will be asking for that much directly from the patient, which can take some getting used to.
Great Physical Therapists change people’s entire lives for the better. We are extremely well educated and help people get back to the things they need, want and love to do … that is worth a lot!
If the idea of “selling” or collecting $150 from each patient at each session makes you feel uncomfortable, that’s okay; but if those things make you want to throw up, there’s probably no need to read further or to apply for this position.
Some other things to help you decide if this is a good fit:
If a primary joy for you in the field of PT involves being able to treat elderly patients, this may not be the best clinic for you since we will be limited in which Medicare beneficiaries we can legally accept as patients. At the moment, this clinic’s population is quite diverse and evenly spread among gender and age up to 64. Plenty of high school athletes, weekend warriors, desk jockeys, and middle aged people trying to stay active. Due to the cash-pay business model and the fact that I don’t market to orthopedists, the clinic doesn’t see a lot of post-op rehab patients (nor is the clinic outfitted for much of that … no large gym space with lots of equipment).
If you have aspirations to have your own private practice someday, please do not apply. I’m looking for someone who is happy with an awesome daily work experience and good pay for the long-haul.
Again, you need to have a good relationship with money and be okay with asking for it and making a lot of it. I know that may sound a little strange to say on a job description, but there are a lot of people who subconsciously (or consciously) don’t value themselves and their skills highly enough to be completely comfortable asking for fair compensation. They set a ceiling to what kind of wealth they can attract in their life, and that mindset can be very damaging to a private practice like this one.
Compensation will include a low base salary with a very high per-patient hourly rate. I’m not listing exact numbers here but it’s the kind of hourly rate you won’t typically find in outpatient orthopedics (even prn positions) and you’d likely need to be working home health home to rival it … but you won’t be driving all over town between patients nor will you be instructing patients on how to do quad sets and straight leg raises.
If you’re willing to work hard, learn from me, follow my lead and help me market your services, your take-home pay will likely be far above the salaries offered in other outpatient clinics.
We will offer customized orthotics and have a massage therapist as well. Both services will also offer commission possibilities that can substantially add to your take-home pay.
Because you’ll be making a much higher than the average PT hourly rate, and this is a very small company, health insurance is not offered. However, as far as vacation goes, you can take up to 5 weeks paid-time-off. I want my staff to be happy, rested, and never feeling burned out. I place an enormous value on time off and time doing what you love, and that is reflected in this vacation policy.
On the “burn out” note: I request that you open your schedule for a minimum 30 hours per week of patient care. You can of course see more patients if you want to make more money, but I’ve decided to keep the schedule very manageable for the above-stated reasons. There will be other regular (paid) marketing tasks (blog/video creation, community/athletic/injury-prevention events, etc.) you’ll be responsible for but certainly not enough to add 10 hours to your workweek.
This position will be perfect for someone who has great manual skills and a compassionate joyful outlook on life, who is looking for an environment where high quality care is truly the top priority (not just part of a mission statement) … where you are not rushing from patient to patient all day and then buried in a never-ending pile of paperwork … where your employer is not nagging you about the type and number of codes you’re billing … where the harder you work the more money you make, but the minimum necessary schedule is quite relaxed.
If all the above has made you excited about this job, I’d like to know more about you. Please don’t simply reply with your resume. Please provide answers to all the questions below in the order they are given.
- What is your favorite hobby?
- What is your favorite way to spend the weekend?
- Tell me about your family.
- Why did you become a Physical Therapist?
- Do you feel that you’ve had the experience you originally expected to have via your career in PT? Why or why not?
- How would you describe your overall approach to patient treatment … your “treatment philosophy”?
- Share with me your favorite patient story … your favorite experience with a patient.
- How would your coworkers describe you?
- How would your family and friends describe you?
10. What motivates you to do a good job and perform at the highest of your capabilities?
11. What is most important to you in your day-to-day work setting and work duties?
12. Please describe your current or most recent job scenario.
13. What do/did you like about it most?
14. What do/did you least like about it?
15. Have you ever thought about starting your own practice PT? Why or why not?
16. What is the craziest/funniest thing you’ve seen happen in a PT clinic?
17. What about the job description in this job posting makes you want this position?
18. In one page or less please describe why you think you are a great fit for this position.
You will obviously need to send your resume’ along with your responses to all the above, but please also include 3 work references.
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Again, if you have any suggestions or feedback, I’d love to hear it via the comments below. I’ll be tweaking and reusing this job posting for years so please feel free to post your comments at any time in the future too. Also: if there are any in-person interview questions or tactics you’ve found really useful, please share them too!
And if a job at my clinic is something you’re really interested in (or anyone else you know), please contact me here with responses to the above questions (you won’t be able to attach your resume but I can reply to ask for it if needed).
Thanks everyone!
Looks great! If I was still stuck in an out-patient clinic and if I didn’t already love what I was doing, I would apply! May you find the perfect fit.
Thanks Liz!
Jarod, Wow! Who out there would not LOVE to work with you in your clinic. I think you will draw a lot of interest. I wanted to share with you a hiring strategy we use at the private “insurance based but looking at possibility of cash based” clinic where I work. We are a manual clinic, mostly musculoskeletal (a good amount of dry needling done also), but I do vestibular and neuro which is totally one on one also. Our owner grew from 1 to 9 PTs in the last 10 years. He has acquired most through having them as students. Greg developed a brand of care which not only involves certain manual techniques and disciplines but also attitude and personality characteristics. High on his business priority list is to protect and preserve the integrity of his brand. So, in short, we have a strict interview process for intersted DPT students in their final rotations, and if they pass the interview then bring them on for clinical instruction with very tight reins during the rotation. I would say they are more closely supervised than in many clinicals. But they learn A TON! They also do pro bono treatments. So we treat each clinical as a 2-3 month trial period for possible employment. A number of students have just not worked out like we expected them to from the resume and interview. We determine if they fit the culture and have what it takes skill wise to maintain the level of excellence in our clinic. Greg spends a good chunk of change on continuing education and certifications for his staff. He decides though what those are so there is unity between therapists in the clinic. Of course there are other CE that everyone spends their own $ for too. Because he invests so much in their training then he requires a non compete contract. I am a 28 year veteran PT but new to his clinic and developing the neuro and vestibular side of it. So my arrangement is a little different. I know this isn’t exactly what you asked for but I thought I would share it since it is working very well for us.
Thank you so much for sharing Sarah. GREAT ideas and advice! I’ll definitely incorporate it and really appreciate you taking the time to comment.
Jarod,
I am somewhat surprised that you have decided to adopt a business model based upon a practice owner-employee relationship. I am very interested to know why you would not bring someone on, exactly the type of person you have described in your job posting, in a limited partnership of some kind; sharing expenses, with each responsible for their own revenue stream. It just seems that the type of person you really want, is not likely to remain satisfied as an employee for very long. Why would anyone with that much skill and drive want to build someone else’s practice with no hope of ever owning a piece of that investment?
It seems that most other health care professionals, outside of hospital systems, enter into practices in partnerships, not employer-employee relationships.
I have thoroughly enjoyed your blog posts and pod casts and respect your bold approach, and your pride and confidence in our profession. I look forward to hearing what you think about my perspective.
Alison
Good points Allison. To consider bringing on a partner, I would have to know that person very well and know that we work well together. That is something I will learn after working with someone for a while (as my employee). So future partnerships are a possibility in my practice but that’s not something I would advertise to potential candidates before I knew them well. I wouldn’t want someone taking a job with me expecting that they’ll be made a partner because not everyone I hire will work out to be someone I would want to partner with.
Well done! That is the most awesome job posting Ive ever seen. It is very direct and clear on what you are looking for and it offers as incredible learning curve /resource in you as well as what we all value- time with pts, time with family, time to follow passions and well compensated. I had been in management and sometimes the best hires in terms of on paper skill set with good personalitities turn out to be a dissapointment. Do some hands on clinical skills on yourself as part of the intervewing process- it gives a good feel of their pt handling skills, communication, comfort level ,education as well as manual skills- soft hands vs rough hands, techniques and why chosen, what expected outcome from this visit etc
Great suggestions. I have some injuries and aches that need some treatment anyway!
Jarod,
Congratulations! This is a an awesome job description and a huge next step, one live been considering seriously myself.
My feedback is:
1) make a hands-on interview a must. That’s how it was always done when I applied for jobs as a massage therapist. I think it’s the best way to know how a person treats a patient and to get a feel for their touch and hands-on skills
2) make it a requirement to email you with a very specific subject line and weed out the responses that don’t get that right. You can do that using an email filter or even start with another gmail address and only forward correct responses. This is an automated screening system for the first test.
Good luck!
Thanks Aaron! Definitely planning on getting some free treatment out of the in-person interviews. Just kidding! But yes, hands on checking of their skills is on the agenda.
Hi Jarod, sounds like a great position. First thing I thought of was that this was a contracted position, as this PT will be collecting the $150 from each client. I was a bit confused as I read on because of the talk of salary, but it became clear that it was an employer-employee situation and that this PT would not be receiving take home pay of $150/hour. What makes it seem a bit tricky is that this PT will know exactly what you get per client per hour versus what they are making per hour…..whereas in a traditional clinic, this is usually an unknown. Perhaps your generous salary takes precedence over that knowledge because it is way better than they could ever make in a traditional setting, so it’s a moot point. Anyhow, just an observation. Congrats on the opportunity to expand your practice.
Thanks Tianna, I’m rewording to make sure the charge per patient and take home hourly pay are more clearly delineated.
And yes, in a cash-pay clinic there’s no getting around the staff knowing exactly what is being collected for their services.
Jarod,
Very thorough and direct, and you’ve received some excellent feedback already. I am confused by 1 thing in particular…you state that you do not want individuals to apply who aspire to be private practice owners in the future…why? You’re asking for applicants who who have manual skills and will be taught your techniques…you’re expecting this individual to read clinical as well as business-related material, that is “passionate about learning and wise enough to know there will always be much more to learn…” How can you expect any individual in this scenario NOT to want to be a business owner? And then 1 of your questions to them is “Have you ever thought about starting your own PT practice?” So that’s either a trick question, or a contradictory one, in my opinion. I just can’t imagine anyone working under your tutelage to not have an entrepreneurial mindset. If you truly want to be able to step away from your business and have it run smoothly when you’re not there, I can’t imagine having a “staff PT”–you want someone who can think on their feet and is a go-getter!
I also agree with Caren and Aaron about the hands-on aspect…give them a diagnosis (if you have neck pain, for example), then give them 15-20 minutes to work up a brief history, eval, and then have them do a meaningful change (treatment) in whatever they feel comfortable doing.
The other consideration I would have is to have the individual present a 1-page write-up of their ideal scene–ask them to write out their ideal position, including exactly what they’re looking for…and to be honest…write what they actually want, not what they think you want to hear.
Lastly, Alison makes a valid point about a partnership…waaayyyyy back in my earlier days (I was about 7 years out of school) I interviewed for a position where the owner was looking to bring on a partner–minimum of 3 years before he would decide whether to make an offer. So it definitely would have a time frame, since this is YOUR business that you worked very hard to build…not saying that this is the way to go, but a consideration that may dissuade someone from wanting to break off and go out on their own.
Looking forward to seeing how this plays out!
Best,
Dave
Can’t thank you enough for the detailed response Dave.
Yes, my fear of having someone learn from me for 2-3 years and then leaving to start their own practice definitely colored the job posting. Awesome suggestion about making it clear that partnership may be a possibility but would be a few years before deciding whether or not it will happen with any employee. I’m totally open to the idea of partnership, but I would definitely need that time to determine who might fit as a partner.
Jarod,
I am so enjoying this exchange of ideas; I hope you don’t mind that I have more questions than suggestions for your job posting. I have been a PT for 35 years and have seen the profession change dramatically, in many ways that are discouraging. What I love about your practice is that you are preserving the integrity of the profession and providing the kind of care we used to provide in the private practice outpatient PT setting in the context of the third party payer system.
My questions about bringing someone on as an employee may not relate to your situation as a one person owner in a cash-based practice. Here goes anyway:
1. What happens to the “intellectual property” of your staff PT when they leave or are asked to leave? For instance, if they develop a specific treatment approach, protocol, programmatic element while employed by you does that remain yours or theirs? Will they be asked to sign an agreement that outlines this aspect of employment?
2. Will you ask them to sign a non-compete agreement? What might that look like?
3. Will there be a probationary period of employment such that, just in case your hire is not the perfect fit, you will be allowed to let them go or they will be allowed to leave without obligation on anyone’s part?
My perspective may be entirely unfounded but it is based on the notion that the kind of person you rightfully seek is likely to be entrepreneurial, creative, independent, and willing to give a great deal to the practice, the profession, and ultimately the investment in their own future. I just wonder if that person will be satisfied as an employee in the long term, with even the incredible opportunity you provide: your mentorship, salary + “commission” (which is a genius idea), generous vacation and continuing education.
I very much look forward to seeing how this works out for you as I expect it will become a new model for the rest of us to consider, just as the cash-based practice has.
Thanks for your dedication to our profession and the patients you treat.
Alison
Hi Jarod,
First off, I believe whoever has the good fortune to work with you will be a very lucky therapist!
Have you considered having the P.T. be an independent contractor, who as such would cover their own malpractice, taxes ( FICA, etc..) but still work as a P.T. under your “brand” maybe taking 50% or so of the reimbursement of the treatment they actually provide?
This certainly would assure your profitability and incentivize the therapist at the same time.
Good luck with your search..
Best Regards,
Darren Williams, P.T.
Hi Jarod,
This posting will only get you the perfect professional clinician that fills your criteria. I can’t see there being any confusion or inferior talent going through the process of reading this.
Shoot I’d consider it if I Weren’t seeking my own business growth and lived in Texas. lol!
I like your approach and wouldn’t change any of it.
Best of luck finding superstar talent!
Hi Jarod
I was so excited to read your post – I am a solo practice manual therapist in a similar position, as you up here in WI, looking for a larger space and more staff. I am NOT cash-based yet but have been reading your posts and am heading in that direction. I opened my doors 1.5 years ago and started taking insurance to get myself up and running. I have a contract with my biller so I will stay insurance-based for one more year. In the meantime, I am considering a much larger dedicated space, and want to hire a PT or a PTA. I loved your straight forward approach and compensation idea and your interview questions which are very similar to mine. My husband is an executive search recruiter and I am having him take a look at your post as well to see if he has any advice for you. We were just recently putting together ideas of how to market my need and one of my personal dilemmas is trying to determine if I should start with a manual trained PTA, vs a PT, then later add a PT. Have you thought of doing that and if not, can I ask why? Maybe its the cash-based reason, which of course makes total sense, since customers may not pay the full $150 for a PTA – but since I am insurance-based, it may make good financial sense as I get my larger space up and running. Of course, it would be even more important to find the right fit of a PTA with the talents and the passions you describe above but if indeed one is out there, the advantage may be that he or she is less inclined to open their own practice considering their limitations in working under a PT. I do provide Pilates for Neuro- reEd as well and finding a PTA who is Pilates-trained is a priority for me. Meanwhile, I do agree with the above comments on the type of PT you are looking for (who describes me to a T, by the way) but as stated above, I do think you would be hard-pressed to find one not considering their own practice in the future. I am 29 years out and just a year and a half finally started my dream of owning my own practice. I have 7 kids and the timing was never good until now. I was always more content working part time and learning all the manual skills I could. That being said, you may have better luck finding someone like me about 15 years ago who has a family, would be an awesome PT, but wouldn’t have the time to be full time or consider a practice on her own. I would have answered YES to your question above #15., however, but it would have been a TIMING – issue due to family. You could’ve had me as an employee for a good 10-15 years. I would’ve learned a lot from you and would be very interested in a partnership down the road. Or, as I have now, would’ve gone on my own if the opportunity didn’t exist……just some thoughts for you to consider.
Good Luck – I will continue to follow this post! THANKS SO MUCH!