Let's be honest, insurance reimbursement is stagnant at best right now. There are various opinions about the future of PT and healthcare, but those opinions don't earn you money right now. If you want to earn enough money to pay off your expensive pieces of paper that say "DPT" and "Licensed PT," you're going to have to work a little bit harder and demonstrate value to your employer.
However, using alternative methods to bring more money and value to a clinic can benefit both you and the clinic owner.
Demonstrate value to your employer
Demonstrating value to your employer is essential, no matter where you are in your physical therapy career. You must be able to show your importance and value to your workplace if you'd like to achieve any of the following:
- Land a raise
- Change your schedule or workplace hours
- Accrue more more PTO
- Move into a leadership role
Here are some strategies to help you demonstrate your value and earn extra $$$ for you and your employer.
1. Become known as an expert in your niche.
More specifically, become an expert in a treatment technique that people actually want. Being known for providing a unique talent can be a huge asset to a clinic.
Assuming you are half decent at this treatment, they will tell their friends and family as well, building your network. Providing high quality care in a niche is not something to be taken lightly.
Some examples of this I have seen include:
- Bike fits
- Dry needling
- Vestibular rehabilitation
- Hand therapy
- Running analysis, gait retraining, or coaching
- Concussion screening/treatment
- Women’s health or pelvic health
- IASTM treatments
[easy-tweet tweet="Don’t doubt the power of referrals in physical therapy." user="@covalentcareers" hashtags="#referrals #physicaltherapy #PT #PTFam #FreshPT"]
People are much more likely to believe their family and friends and will take the time to travel to where you are, even if you are in an already rural area.
2. Work on your rapport and establish relationships.
When patients request to work with you, it's not just because you're skilled. In most cases, they actually enjoy your presence and look forward to seeing you during appointments.
If you can’t establish a connection with a patient to at least some extent then why should they see you over anyone else?
While there are self help books that are highly rated (Dale Carnegie's "How to Win Friends and Influence People" seems to be highly regarded), it might be even more simple than that. There is a journal article by a nurse who temporarily lost her voice and found it actually improved her communication!
Obviously it would be fairly difficult to provide patient education without saying a word. It’s a very interesting read but the main points are to focus on non-verbal communication (body language), listening, silence, touch, and a combination of presence, intuition, and empathy. If you’re able to access the full text, I highly recommend reading it to get the full story.
This can be looked at from an object perspective by examining your no-show and cancellation rate. Certain factors can't be controlled, of course, but over the course of a few months to a year you can look at how you've done. Comparing to other therapists is a good way to judge your success, as well as start a friendly competition!
3. Have a side gig that benefits your employer, as well as yourself.
Maybe you like coaching athletes, maybe you teach yoga, or maybe you do bike fits. If it makes sense, use the clinic for your after hours classes or training. This is an excellent time to really work on a passion of yours that can help you earn a couple bucks.
This can work to both you and your employers benefit for several reasons:
- You keep the money flowing between you and your employer (instead of using a gym’s space for example). So while you get paid, your employer gets a cut for using the space and equipment.
- It gets people in the clinic. They become aware of the location, what you actually do for a living, and maybe they tell a few other people. Establishing a broader network of relationships could be more valuable to your clinic than a cut of your profits from teaching classes.
- It allows you to use equipment you are familiar with and can make the whole process easier. Instead of searching an unfamiliar location for yoga blocks or bike pumps, you have more time and less stress when you are preparing.
I have seen PTs use their time after work to:
- Teach yoga
- Host strength classes for runners
- Coach athletes one-on-one
- Teach workout classes
- Teach dance
- Lead spin classes
- Perform bike fits and bike performance analysis clinics
- Coach rugby
- Teach continuing education courses (training personal trainers, for example)
- Lead injury prevention classes (strength training)
- Provide medical supervision at sports events
- Perform throwing coaching, goalie coaching, etc.
- Teach Crossfit classes (mobility, technique, etc)
At my prior clinical rotation I know of multiple patients who would drop in to a yoga class (or running class or strength training) and would end up receiving physical therapy care later on when they received some education on an ache or pain they had going on.
For example if you're coaching hockey and you don't have a hockey rink in your clinic you probably won't bring them in. However, when one of your players inevitably hurts themselves, you are probably the PT they know the best and trust.
Being known as a PT in the hockey (or sport of your choice) community can be a great in as well. It shows that you know the demands of their sport and how to get them back to what they need to do while also possessing the in depth physical therapy knowledge.
4. See more patients.
It sounds so simple it’s stupid, but if you get to the point that you are comfortable seeing more patients either per hour or with longer hours, then simply seeing more patients is a viable option to demonstrate your value.
Of course, your employer has to be willing to pay you more for it and ideally you won't sacrifice any quality of care. Be aware that you will spend more time at the end of the day typing notes as well.
Streamlining your note system by creating templates based on the body part can also save time. This is especially helpful for evaluations in EMRs that are either A) a lot of blank space to type in or B) drop down menus with lots of clicking.
This can be a touchy subject and some people may feel that seeing higher volumes of patients actually devalues PT as a whole. Ultimately, it dependent on your choice and your practice values to make that decision.
Seeing more patients is also market dependent.
If you are constantly booked out 6 weeks then this could be pretty easy to pull off. However, if you are barely hitting 6 patients a day then this might not be appropriate. Sitting down with your higher up and having a frank discussion about what you are willing and not willing to do could work out well. Communication is key!
5. Be a mentor.
From what I have seen, a high amount of PTs in the workforce are willing to put in extra time and effort to mentor young clinicians. Equally important, the vast majority of young clinicians seem more than willing to receive it. Mentoring can have all sorts of benefits to a clinic and can range from increasing positive outcomes, decreasing no show/cancellation rates, improving the treatment atmosphere due to confidence, and can draw passionate clinicians to your clinic.
Taking on students can have a positive financial impact on a clinic as well, especially in an outpatient setting. I know some people are upset about clinics profiting off of students free labor (rightfully so). I am also by no means suggesting you load a student up with 10 pts a day on their first day.
However, trading mentoring, supervision, and education can result what is essentially a doubled productivity.
That being said there are certainly risks to taking on a student and you should not do it unless you are comfortable. At the least there is a greater time requirement to review their notes, discuss progress and areas to improve.
6. Take a position of responsibility.
There are many ways to take on additional responsibility at your clinic, and they all help you demonstrate your value to your employer.
Just a few of them include:
- Reviewing billing practices
- Auditing charts
- Taking on clinic manager duties
- Mentoring students or new employees
There is a good reason clinic managers are paid more, for example. Many managers work anywhere from 50 to 60 hours a week, although this can vary greatly. There are also more responsibilities, including HR tasks for smaller clinics. This is also an excellent way to gain experience managing a clinic, a useful skillful for future practice owners.
- Kacperck L. Non-verbal communication: the importance of listening. British Journal of Nursing. 1997;6:275-279. https://www.ncbi.nlm.nih.gov/pubmed/9155278