For about 7 years of my young life, I worked at Sam’s Club. It was here that I learned about business.
I started as a cart guy and quit not long after I was named employee of the year 7 years later.
I learned how to interact with people. How to serve people. How to be a leader and a strong work ethic.
This place gave merit raises for those that went above and beyond, and over the years I earned many merit raises. Within my first few years, I was making as much as those with over 10 years served.
This is what we need in PT. More employees taking on the ownership mindset. Doing what needs to be done to take care of the patient’s needs.
Sam Walton, who I had the opportunity to meet before he died, had a “10 foot rule” at Sam’s Club. This means that whoever you come within 10 feet of within the store, you stop and ask them if there is anything that they need. This slowed down the work that was on the to do list, but it instilled the value that without the customer, there is no business.
This holds true in PT also. Without the patient there is no business. There are great clinicians in this field and like any bell cure, they are matched by bottom-feeders. Those that are only looking to make money in the profession will place the patient lower on the hierarchy of care than the business.
This is not my belief. Some will disagree with this, but this has been my personal ethos for at least the last 6 years of my career. It may change…no, I’m sure it will change as I gain more experience and my priorities in life change.
As the owner of the company, it was my personal responsibility to ensure that all of the priorities before me were taken care of. This means that I had to ensure that patient’s were being cared for and were satisfied with their care. This doesn’t always mean that patient’s improved with PT, but it does indicate that patients understood what was happening to their bodies and they understood why Physical Therapy wasn’t helping them.
If patient’s are taken care of, it helps the business run more efficiently. Ensuring that the business is profitable goes beyond taking care of patients clinically. The front desk has to be trained to set up expectations and start to build the relationship with patients. Expectations and therapeutic alliance are two characteristics that can make or break a business. If the business doesn’t set up the expectations surrounding the PT experience and doesn’t prime the patient for results, either positive in terms of complete resolution of symptoms and return to function or an inability to change symptoms and referring the patient to a provider that may be able to help the patient achieve his/her goals, then the PT experience may not go well.
I say this over and over, but here we go; when I was doing a lot of public speaking, I polled one of my audiences and 30 out of 31 patients surveyed would not return to PT again after their first episode of care. In the end, their expectations weren’t met and the alliance wasn’t built. These have to be established by all partners of the clinical and non-clinical team.
The third rung of the ladder is taking care of the employees. This means making sure that the employees are able to provide best patient care. This involves empowering the staff to become better at their position through training. It also means empowering the staff to take the time to build expectations and alliance. This is a tight rope to walk because too much time building relationships may cost more money than can be afforded, but not enough time to build the relationship and the patient becomes MIA, which correlates to lost revenue and negatively impacts the business in the short and long term.
Finally, the owner is last on the rung. I believe that my job is to serve. I have a minimum number that I need to make in order to survive. Going above that number is bonus, but going below that number is unacceptable. If we can’t achieve the number that I need to survive, then the pyramid tumbles. This has resulted in cutting costs in the past, which reduced staff size and put more responsibility on my plate. Although it was more work, it was the only way at the time for me to hit my minimum number. This was blamed on CoVID, but really it was based on me not understanding expectations that were happening during the pandemic and my inability to navigate the rapidly changing landscape of CoVID.
As I am leaving ownership and returning back to being an employee, my pyramid may shuffle a little, but only time will tell.