I could probably write a small book about all the things I learned at the Private Practice Section 2012 annual conference, so I’ll at least have to do a three-part series on my highlights.

Performance-Based Pay for PT

Mike Danford PT, OCS, MTC presented on “performance-based pay” for Physical Therapy businesses. I obviously can’t cover all the details of his presentation, but his PTs (and he himself as well as the other practice partners) get paid based on their performance and work output. They have a base hourly rate that is a little below the area norm, and that hourly rate can increase based on a large number of factors (% of time billed per patient treatment time, certifications/fellow credentials, having a DPT or tDPT, participation in specialty programs, and the list goes on.)

There is a belief among most people that the longer you work in a job, the more you should be paid. I can understand this sentiment, but only to a point.

Having more experience should make you a more productive and valuable employee, in which case it makes sense that you would earn more than someone with less experience and/or time in that position. However, we all know that it isn’t always the case that more-experienced employees produce more for a company than less-experienced ones do.

Mike’s practice does give a small hourly rate increase each time they accrue a certain amount of hours worked in their clinics, but there isn’t a “since you’ve been a PT for 25 years, you start out this job getting paid more than the new grads” component. If his clinic were to hire someone with 20 years as a PT, and in that time they have acquired certifications and a DPT, then they would start out making more per hour than a new grad hire. It’s the same system for everyone. If you want to make more per hour, then get a good certification (higher level ones like MTC, SCS, etc), make sure you’re billing for all the time you’re spending with patients, get your tDPT, etc. There is also a profit sharing component designed to further motivate high performance both as an individual and as a team of practitioners at each clinic.

It’s a transparent and highly motivating system that drives employees and owners alike to be their best and continually strive to improve. No “coasting” allowed unless you’re okay with making less money. There are a number of other important details of their system that I can’t cover here, but you get the general idea.

At the conference closing dinner/party (which was at an incredible club – “Surrender” at Encore), Mike was kind enough to spend a good amount of time speaking with me about his presentation and a number of other topics. He had really great advice about planning for the long-term and considering a number of things when analyzing decisions of whether or not to hire PTs or bring on a partner. I’ll be forever grateful for his time and generosity.

If I decide to add staff PTs in the future, we will undoubtedly be on a performance-based/commission pay scale system; and call me crazy, but I imagine that if this were how most PT clinics went about compensation, our profession as a whole would greatly benefit … there would be so much more motivation to continually improve your skills and produce great results, which would inevitably improve the average experience that people have with PT and the average public opinion of our profession and services.

Hiring considerations

Looking at the topic of adding staff in my clinic, he also made me realize that when I’m so happy with the current set up and headache-free status of my business, “what’s the rush?” I think a lot of people, myself included, have a tendency to think that small businesses should be consistently growing. This of course is not the case, and many factors need to be carefully considered when analyzing expansion and adding staff. These factors are not simply financial ones, but also lifestyle considerations and answering the question “will this change be in line with what I want my average day to be like?”

Do you have staff at your clinic? What are some of the things you had to consider (or wished you had considered) during the hiring process? Also, what do you think about the performance-based pay model? Let us know in the comments below and share this post with your colleagues to get them in on the conversation.

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