Two years after graduating PT school, I found myself in my first outpatient director position. I had picked up some operational skills along the way from working in a small business setting, but many of the issues in clinic management I encountered were new. My doctoral program did provide administrative coursework. We had a semester long “Build Your Own Clinic” project, where groups develop a name, vision statement, and a business plan. But what happens once the doors open?
What do you do when an aide calls out? The dryer breaks? The electronic record goes down? Your staff members don’t get along?
I realized that my deficit in knowledge came mostly in operations. Creating an optimal patient experience and clinical care is what grows your clinic, and keeps the flow of new patients going. Operational dysfunction creates an environment of low staff morale, which in turn will create unsatisfied patients.
At that time, one of our favorite TV shows to watch at home was Bar Rescue. For those of you that have never experienced an episode, here is the basic formula:
- A bar is failing.
- Jon Taffer does surveillance outside and watches an awful display of customer service.
- Jon enters the bar and screams at the manager and/or staff.
- Jon identifies the problem areas and his team works to fix them.
- A new bar is created to optimize customer experience and sustain the business.
The more I watched, I discovered that some of the issues discussed are issues that come up in PT clinics. I don’t want to conflate the two industries, but lessons in customer service and experience are universal in business. Here are my most useful takeaways.
1. EVERYTHING is the manager’s fault.
A major downfall I saw in managers is blaming employees for poor outcomes. For example, if drinks are not being made fast enough by a bartender, customers get angry and leave. Is this the bartender’s fault? The answer is no. The problem is the manager. This is why. The root cause of why the drinks aren’t being made fast enough must be identified. If it’s because there isn’t enough glassware or bottles available, the manager should have more. If it’s because the bartender is not trained for efficiency and quality, the manager should have trained the employees. If it’s because the orders are not reaching the bar, the manager should develop a better system.
Any problem that is negatively affecting a business comes back to the manager. The first step is admitting it. Reflect on the issue and what could have been done in prevention. Perhaps the cancellation rates are high because patients aren’t getting reminder calls, or the cleaning products ran out because you didn’t put in an order in advance. The ability to anticipate problems allows for the creation of effective systems that will minimize the risk of failure.
2. Systems. Systems. Systems.
Did someone say systems? Systems are integral to the success of any PT clinic. When does a system start? It starts the moment a patient calls on the phone to schedule. Everything from that first conversation with the front desk staff to the discharge plan when a patient is done with PT must be reviewed and systemized in order to achieve a high level of patient satisfaction.
The same way that long wait times for food and drinks will make people leave a bar, long wait times in the clinic will destroy productivity. This can involve anything from a patient waiting too long for their evaluation to start, waiting for instruction on an exercise, or waiting to schedule more appointments at the front desk. These things happen due to lack of foresight of patient need and lack of systems to make a clinic run efficiently. These things also are what decrease your quality of care and make patients seek other clinics.
3. Relationships are key.
As much as Jon Taffer breaks people down, it is only done when necessary. His goal is to build people back up so that they can perform and prosper. Once the initial storm has calmed, Jon sits down with the management and staff to find out what is really going on. Managers acquire the most useful information when they listen. If there is an underperforming employee, listen to that person. Everyone has struggles in his or her personal life that may be affecting work quality. Empathy and shared understanding opens the door to trust. Your employees need to trust you in order to perform at their best.
Imagine our bartender example. She knows she can’t get drinks out fast enough to make the bar profitable, which is escalating her stress about paying the mortgage and keeping her job. In that scenario, the manager must understand that (1) the breakdown is his or her fault, (2) develop a system, and (3) work with that employee to build trust. No matter what the industry, employees are people that are not perfect and go through ups and downs. Your employees should know that you are approachable when something is wrong. It’s easier to proactively hold a staff meeting or forums for discussion before a solvable problem progresses to a staff member quitting. Satisfied employees will go above and beyond to promote the patient experience.
4. Handle the curveballs.
A common thread to any clinic is that there will always be unforeseen daily problems. The ceiling is leaking. The internet is out. A snow storm is coming. The ability to think on the fly to solve problems in the moment is pivotal. Even with the best systems, you can’t account for everything. The manager has to be ready to jump in and use available resources to minimize operational dysfunction with an unforeseen change. If the cook at a bar burns his hand and has to leave suddenly, the bar manager has to step in and start grilling burgers. This willingness and flexibility is absolutely essential.
If your front desk staff suddenly becomes ill and has to leave work, you need to be ready to assume that role. If your dryer breaks and you’re out of towels, start Googling laundromats. It’s the same principle, which can only be accomplished by knowing the ins and outs of every operation from front desk to cleaning.
Drawing Physical Therapy Lessons From an Unlikely Mentor
The image that is often drawn of Jon Taffer is screaming and throwing things. What is missed is the part where he takes people that are broken, businesses that are broken, and helps them find within themselves the ability to succeed. He brings business back from the brink through education. The bars that succeed in the long term are the ones that are willing to accept their faults and learn. When he teaches bar managers about how improve, he is also teaching managers watching at home. For that, I am grateful.
The pillar of my journey is to strive to make your employees a priority, which will in turn empower them to make the patients the priority. Set your staff up for success. There is no way to predict all of the twists and turns of daily operations. However, having efficient systems, open communication, and a positive work atmosphere all will tip the odds in your favor for positive outcomes. Most importantly, trust the process and try to have some fun!