What Employers and Employees Wish You Knew

For a couple months now, we've been running this series called "Dear Employees... Dear Employers..." The content came together from an open letter anonymous survey. Today, we wanted to share with you even more of the survey results in what employers wished their team would know, and what employees wished their company managers could be aware of.
Warning: If easily offended, just watch the video. Otherwise, if ready to help elevate the profession... read on, below!

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Dear Employees…

I wish you knew…

• How many things I deal with as a manager behind the scenes so you don't have to.
• How much it really cost me to employ you & how much of a sacrifice in revenue I am making to allow you to have a structured mentorship program. I truly wish you knew the value of healthcare benefits. I wish you knew what a luxury it is to treat 1 person at a time.
• How hard it is to be an owner.
• How tough it is to meet payroll and keep the lights on.
• How thin margins are in healthcare.
• That Ben Fung and Greg Todd are seriously misleading you. Their salary calculations don't consider ALL the cost associated with a practice, and telling you that you deserve 50% of all produced charges is a lie, they do not calculate all cost related to the practice that you are in. If you want to negotiate salary, fine, but be educated, and understand the true fixed and variable cost of a business, to tell me you should make $100K a year simply because you exist, is not good enough.
• The pressures I have on me about productivity, and contribution margin.

—Sincerely, Your Manager

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Dear Employers…

I wish you knew…

• That you are sacrificing your quality of care with your stupid double and triple booking mandates.
• How physical this job is.
• How stressful my job is.
• What working a full day in today’s work environment is like. You haven’t treated patients in years. I wish you knew how it makes your employees feel less important when you arrive to work after me and leave before me almost every day. We feel small and unimportant when you look bored when we praise each other.
• How much I resent colleagues who don’t work as hard, and that you let them get away with crappy pt care.
• That the pay is causing me financial struggle.
• How much I hate my job when I have to see 4-5 new evaluations every day.
• How valuable my skills are.
• How important it is to make your employees feel appreciated and valued. Happy employees work harder!
• How unhappy and frustrated  your employees are due to the poor organization, lack of respect, limited interest in feedback and openness to change.  
• How to be a better leader, not just managing systems and people. I want an example and I want enthusiasm
• How much my patients appreciate the care they get here.
• That Your micromanagement adds work to my day making me less productive. That I “break” protocol to do what is actually best for my patients.

—Sincerely, Your Clinician

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Dear Employees…

Right now, I'm really struggling with...

• Changing the mindset of getting referrals in the door and not waiting to call them.
• Finding the best way to get you up to speed to have you be a productive member of my staff. I want to make the transition as smooth as possible to mitigate the anxiety of all the responsibility you now have.
• Finances and keeping up with PT expected salaries/rent, office expense increase vs income coming in
• keeping the basics of the clinic together.
• Getting PTs to have their patients complete their course of care.
• The future of PT. ironically the travel companies, and recruiters, those that make a buck off your hard work, have you convinced that going to work in a SNF or POPTs is a good career choice, you're being pimped out for them to make big bucks. It seems from the post I see, that OPPT seems to have a negative connotation, that working hard to be independent and help Pt is a bad thing.
• Getting help and answers on our denials.  

—Sincerely, Your Manager

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Dear Employers…

Right now, I'm really struggling with...

• Your asshole personality and closed-mindedness.
• Too many hours--not enough balance.
• Training the new guy and not being guided appropriately.
• Apathy of my manager. How do I reach someone who doesn’t care about me personally or professionally. How do I give feedback to his manager when in the past it hasn’t been given much weight?
• Fatigue, feeling unappreciated, and feeling underpaid.
• Making ends meet.
• Not feeling burnt out. And not being proud of my care when I can’t get my returns in for a minimum for 3 weeks after an evaluation.
• Only being valued for how many units I can bill. No one seems to care or notice that since I've begun working as a PT this clinic has doubled the amount of referrals and my patients give very good feedback about their progress.
• Not having clear answers regarding my job description, productivity.
• Patient management due to the poor organization, feeling taken advantage of for simply having a PT license, lack of respect, motivation to continue working for you and be productive and contribute to the company.
• Leaving work on time.
• Understaffing, high census and having projects that have deadlines. You before deadlines but don’t give time for projects

—Sincerely, Your Clinician

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Dear Employees…

I want to know why...

• You don't want to double and triple book your schedule to meet your quota.
• Upper management expects us to skip lunch to fit pt's in when I already work 10 hour days.
• "I have to ask you to communicate with me in deadlines. For example, I need you to reply to me that you got my email with my employment offer. I need you to reply to my offer in 3 days, because when we talked, you said that this was the place you wanted to work, but some of you drag the decision on forever."
• Everyone expects employers to do all the work for them to get higher salaries.
• You feel entitled to raises larger than I've ever given to any employee during my 25 years of being a business owner.
• We need to have productivity standards.
• OPPT, which brought you, the push for direct access, autonomy in practice, increased manual skills requirements, etc, is now not a desirable place to start a career as a true professional, but working for a POPTS or being a minion @ a hospital is a good career choice worthy of a $100K education.
• Many clinicians expect their employer to carry the full burden of their continuing education expenses.  

—Sincerely, Your Manager

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Dear Employers…

I want to know why...

• You think that double and triple booking will improve the patient experience.
• I get paid what I get paid.
• There isn't a better orientation and training protocol.
• then later trying to back pedal and hire new people.
• It’s ok for some PTs to break rules and demo poor ethics and keep their jobs. Why some PTs can “WNL” and “WFL” their way through evals and that is somehow acceptable as assessing ROM.
• You re-did my contract.
• You don’t say enough is enough and stand up to your bosses.
• There does not seem to be opportunity to advance leadership skills and taking on responsibility.
• You don’t respond to some of my emails and just ignore some of my concerns.
• You say you want feedback, but when given information you either argue why XYZ can’t be changed or disagree with how I feel.  I want to know why you make empty promises. You talk, but don’t walk or put into action the changes. It seems like there are excuses as to why  things can’t be better.
• The office manager is always hard to talk to about problems or ways to improve the patient experience. Probably easier for you because of your status in the organization.  But what can I do, other than filter through you?
• Rules, hierarchy, and existent systems prevent my ideas from being implemented and improving clinical operations.
• I can be crabby and easily frustrated when you don’t acknowledge how hard I am working.

—Sincerely, Your Clinician

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Dear Employees…

I'd love to pay you more, and will, if we're able to...

• Increase patient volume.
• Turn a profit, and you are generating enough revenue to pay for your salary, benefits and your portion of the overhead costs. If the company succeeds, so will you.
• Increase income.
• Justify it.
• How to better engage your patients.
• Have you function as an autonomous professional, develop the skills to allow you to attract and retain a client base, understand the true mechanics of marketing and business, and like any other professional be willing to share the risk, i.e. bonus or incentive plan based on your ability to contribute to the bottom line.
• Improve upon our denial rate.

—Sincerely, Your Manager

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Dear Employers…

I have a great suggestion about...

• Improving efficiency based on client territory.
• How managers interact with their employees. First, reflect on yourself and what energy you bring to meetings and interactions. Be fair , as possible. If a person is well liked by staff, and patients, there is a reason. Try hard to keep them.
• Increasing awareness of our office.
• Asking my input about PT operations. I have great ideas but there is no time to share them when I'm always treating patients and documenting.
• I wish you paid me more...or at least provided insight into how to get promoted or why you can’t give pay raises. Your answers of “that’s just how it is” or “we haven’t given raises in 5 years”, those are not good answers and raise red flags.
• Having a low key welcoming party for newcomers. If open to new ideas, have an entrance interview vs an exit interview (e.g. what would you like to see in your work environment happen, what improvements would you make from previous employer, etc.). And I’m not talking about the job interview.  This is on the first day of employment, maybe first week!
• A lot of things, which get thrown to the wayside.
• I work hard and do so much extra outside of work or stay late without getting paid.

—Sincerely, Your Clinician

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Dear Employees…

I’m thankful that you...

• Are flexible with your schedule.
• Took the opportunity to listen to what my company could offer you as you start your career.
• Work hard as a team to build the business.
• Are willing to have a frank discussion about this.
• Take great care of your patients.
• Love what you do and treat all your patients as if it was your family.

—Sincerely, Your Manager

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Dear Employers…

I’m thankful that you...

• Let me treat how I see fit.
• Pay me well.
• Give me the days off that I ask for. Always.
• Are trying to keep the doors open.
• Keep 30 min one on one treatments a priority.
• Listened to me.
• Are a smart and thoughtful individual and I know you are in a tough job.
• Value me as an employee.
• Are way more laid back than my last boss.
• Gave me this opportunity as a new grad and I appreciate the compliments you have shared regarding the potential you see in me.
• Back me up and support my clinical decisions and treatment style.
• Understand I want to do my own thing after a year at this clinic.
• Have knowledge over the business aspect that I am just beginning to to understand.

—Sincerely, Your Clinician

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Obviously, there are some areas that could benefit from clear communication — things like wage literacy, revenue transparency, and how the operations as well as supply chain of any company behaves... none of these are mission critical business secrets. AND, if they are... is a SEVERE red flag warning. There are also some more conversations to be had in the topics which seem to be concerning only one "side" or the other.

A most important consideration is this: If you haven't been hearing these thoughts, it's very likely the people you work with are terrified to speak them... or, even think them.

Other things, such as production value vs. production volume... these are things each company needs to decide and WE ALL need to come together on in terms of the health and future of our profession. There is no industry on this earth where higher production volume leads to higher production value; however, there is an equilibrium of volume vs. value that contributes greatest total economic value to society.

Perhaps the biggest opportunity is learning to be more aware of each others struggles until we can identify them all as OUR struggles.

Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. Live cases, webinars, lectures, Q&A, hundreds of techniques and more! Check out Modern Manual Therapy!

Keeping it Eclectic...