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Hire Ground

Recruiting and retaining a skilled therapy team forms the foundation of a successful practice.

Management Focus

When operating a physical therapy private practice, the decision on whether to add to your administrative or clinical team is not one to be taken lightly. Is there a need for new staff? Here are some questions to ask yourself: Do I have a waiting list? Do new patients have to wait at least a week to get an appointment? Am I losing business because I can't provide the customer service my patients are accustomed to? Is my billing going out daily or weekly? Is my A/R exploding?

If the answers to the above questions are yes, then you need to examine what you need to solve your problems. Here are a few more questions to ask yourself:

Do I really know what position I'm hiring for? Do I have a job description? Do I need a part-time or full-time person? What hours will best meet the needs of the clinic? With reorganizing, could current staff absorb some or all of the additional responsibilities? Finally, is it time to consider technology upgrades to improve staff efficiencies, manage time and meet compliance guidelines?

Hiring is expensive. There needs to be a return on your investment. If you need help, consider a consultant or other professional to assess your needs, help you hire the right person, reorganize your staff or help with implementing new technology that will allow you to improve your processes and eliminate the need for additional help. Here are some step-by-step strategies for the hiring process.

Advertise. When deciding on where to place your ad, be creative. Where will you get the best audience? Ideas include Internet outlets, professional organizations or special interest groups, universities, other employees, friends and colleagues, consultants/contract recruiters, and employment agencies.

Make sure your ad specifically describes the job responsibilities, skills, education necessary, and hours. Don't make promises you can't keep. Identify the type of personality you are looking for-energetic, athletic, organized, a multitasker; and education required, license required, etc. List the benefits including growth opportunities. State to whom and where to send a cover letter and resume.

Since a resume can only give you limited information on a candidate, look for ones that best relate to the position you're hiring for, the job specifications, and those that appear to have potential for learning. Note education requirements, job history, and the presentation and grammar of the cover letter.

After reviewing resumes, choose those you would like to contact and interview. Be prepared-know the essential job functions so you can clearly explain them. Begin by calling candidates to set up a time for a telephone interview. This allows you to get a first impression when they answer the phone and begin a conversation. The goal here is to weed out those who cannot meet your needs.

Tell them about the job they have applied for: job responsibilities, experience and skills necessary to do the job. Explain hours of work and amount of travel. Ask about salary requirements or salary history (let them know you don't want to waste their time if you are miles apart). Plan for possible candidates to come in for a personal interview. When they arrive, have them complete a job application. When they are finished, while you look over the application, have them review the job description.

When you finally get them in for the interview, ask whether they have any questions regarding the job description. Give them some history about the company and the benefits of working with the organization. Ask questions that will reveal their past experiences. Give them scenarios that you know they will experience if they get the job and ask how they would handle such situations.

Listen to the answers. An interview is to find out more about the candidate; not to reveal more about you. You can also ask questions about people they like to work with and don't, what their short and long term goals are, and why they think they should be considered for the job. Go over salary, benefits, start date, hours, and orientation, and review any confidentiality and/or non-compete issues.

The best indicator of future performance is past performance. Ask questions that will help you gauge their actual past performance: What were your key responsibilities at your last three jobs? What was a typical week at your last job? Have them describe a bad day and how they were trained. Finally, what are their career goals?

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You can always ask a candidate back for a second interview to discuss the job position in more depth and go over the orientation and training they'll receive. Once you've made your decision to hire a candidate, check references first, and then call and make them an offer. Go over what you have previously discussed and confirm salary, benefits, start date, hours to be worked, orientation process and, if necessary, the confidentiality and/or non-compete issues. Follow up with a letter confirming the above and ask them to acknowledge their acceptance by signing and returning the acceptance letter.

Job descriptions are a valuable tool in the hiring process. Think of a job description as a "snapshot" of a job-a plain language tool that communicates clearly and concisely what responsibilities and tasks the job entails and also indicates the key qualifications of the job-the basic requirements (specific credentials or skills). Categories of a good job description include title of the position, department/office, accountability/reports to (to whom the person directly reports), qualifications (necessary education, licenses, skills and experience required), job summary and essential functions.

Ask for references-name, addresses, and phone numbers-and check them thoroughly before offering a position to an applicant. Ask for former managers (they may not be able to give you current one) and co-workers. Have them sign a statement giving you permission to contact the references. Call references before making an offer.

When you call references, give them a brief description of the job the candidate has applied for. Ask whether they think the candidate would be well suited for the job you have described. Confirm the dates of employment and ask whether there is anything else they would like to tell you regarding the candidate.

Spend lots of time with the new hire. An outcome-driven orientation program should include who will be doing the training, what the training will involve, and the time frame in which each function should be accomplished. Introduce them to all staff and show them where everything is, including the lunchroom, restrooms, first aid kit, etc. Have them complete employment documents including an I-9 and W-4 form, computer and confidentiality statements, and benefit applications.

Orientation periods are typically three months. This gives you ample time to get to know one another and to determine whether it's a good fit. Discuss the orientation period and what will take place over that time. Establish both your and the employee's expectations. Review performance standards and the time in which you expect each function to be accomplished. Stick to your orientation plan-it will help ensure their commitment to your organization.

Performance reviews should be an ongoing management function and include observation of performance and results, assessment of performance related to expectations and standards, and written or verbal feedback. Conduct performance reviews during orientation, at 30, 60 and 90 days, and then yearly afterward. Hold staff accountable by using the performance reviews to set goals that will help move the company forward. Each staff member should do a self-review before their annual review. This will help you understand what the employee believes they've accomplished over the past year.

To keep staff motivated, introduce new staff to your referral sources and the community. Get staff involved at all levels so they feel part of the team. Ask for their help in establishing new programs and services. Recognize anyone who makes an extra effort to improve communications and deliver quality care.

Creating a positive environment takes a powerful leader. Share your vision and mission. Show you are a true team leader. Be open to new ways of doing things. Plan staff meetings to keep everyone up to date on what is going on in the practice. Listen and learn. Change can be difficult for many employees, but a strong leader can ease the stress of change and, in fact, even make it desirable.

Your leadership, encouragement and strong employee relationships are essential to protecting the investment you have made in your staff. Set the bar high-continually encourage participation to reach your goals. As success finds you, you will be able to give back to those who helped get you there. 

Diane McCutcheon is president of DM Business Management Consulting Services, a rehabilitation management consulting company in Hopedale, MA. She can be reached at

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