Founder Letter: Why Company Culture Matters More Than Ever

I’ve written quite a lot about the PT profession’s struggles to keep up with the evolving healthcare landscape and patient expectations. We haven't kept pace in our use of technology, our approach to promoting ourselves as essential and cost-effective providers, or our ability to develop a more diverse workforce pipeline to meet the growing demand for rehab therapy. And if I’m completely honest, I also worry about whether we’re keeping pace with the changing demands of our current clinicians. 

Long gone are the days when the only thing that mattered in the hiring process was who could offer the best salary. Providers are looking for more from their careers than just a paycheck; they want purpose, a sense of belonging, a tangible career path, work-life balance, and to feel valued by their employer.  That’s a lot to try an improve on and offer in an environment in which reimbursements are declining, a clinician shortage exists, and profit margins are being squeezed The only way we can meet these new expectations is to make company culture a priority and have buy-in from every employee as to what it means to be part of your company or practice..  

Fortunately, I think we’re in a good position to face this challenge head-on. As rehab therapists, empathy and listening are part-and-parcel of the job; we just have to turn those skills towards our own teams. 

Creating a strong culture starts with defining a set of values that underpin the company culture and guide employee behaviors, service level expectations, decision-making, and engagement. It’s an essential step in new company formation to have the values and expectations defined prior to starting the hiring process, and for established practices, it’s a good idea to review company culture and the defined values to make sure leaders, decision-makers, and all employees continue to honor and are true to the values as defined. Let’s dive into why company and clinic culture must continue to evolve and remain essential to the success of any business.

We’re still dealing with a staffing crisis. 

No breaking news here: rehab therapy is having a hard time adding, growing, and retaining clinicians to keep up with the demand for our services. Unlike in other professions, artificial intelligence and humanoid robots are not taking over our PT jobs completely anytime soon. However, due to burnout, financial limitations, and declining enrollment of DPT students, the PT shortage remains a high-priority issue, as the demand for PT services continues to rise. We’ve got the numbers to show just how stark the staffing problem is within our profession.

• According to WebPT’s 2024 State of Rehab Therapy report, just over 9% of clinicians resigned in 2023, and a little more than 40% were thinking about leaving clinical care in the near future. And those numbers are down from previous levels! 
• Along those same lines, the APTA Benchmark Report: Hiring Challenges in Outpatient Physical Therapy Practices found a 16% overall vacancy rate among surveyed practices.

We all know the problems that come with being understaffed. Patients have to wait longer to get in for an appointment as they continue to deal with pain. Your providers have to work longer hours and see more patients, pushing them ever closer to burnout and to that 40% who think of leaving your clinic—or the 9% who actually do it.  Improving the efficiency of clinical operations will be key to meeting the patient demand. 

Therapist turnover is costing us precious time and money.

Clinic profit margins are being squeezed by the relentless payment cuts coming from CMS and private payers.  As you know, clinic revenue is generated by patient volume, which is determined by therapist productivity or the number of patient visits completed by clinicians per day. With therapist turnover, a clinic that might already be struggling to turn a profit must endure a loss of income, add increased patient load onto the remaining therapists, have to cancel or delay patient visits,  and incur additional marketing and recruitment costs to replace the resource. It can be painful for the entire practice—especially smaller businesses that may not have additional therapists to fall back on.  But this is the reality for many practices right now every time a therapist leaves. 

It’s hard to quantify exactly the cost of turnover—no two staffing situations are going to be exactly the same—but our friends over at UpDoc Media have done some math and found that the cost of replacing a therapist can run between 45.88% and 123.53% of their salary. That accounting includes the revenue you’re losing between the time they leave and the time you’ve hired a replacement, recruiting costs, and the time and money it takes to onboard a new therapist. And as anyone who has tried to hire recently can attest, it’s not a quick process; in UpDoc Media’s 2024 Talent Acquisition and Retention Report, 51% of respondents said it took them anywhere between three months to a full year to replace a departed provider. 

Given the current tightening financial situation within rehab therapy, it would be easy for practices to feel like they’re stuck in this hiring/re-hiring cycle—but that’s only the case if you’re approaching hiring and retention as a strictly financial equation.   

With the stress of losing a therapist,  don’t lose sight of company culture; today’s clinicians certainly aren’t. 

Have you ever had a job you truly hated? At a certain point, you probably decided that no amount of money was worth the misery you were going through every day. That feeling, along with a loss of a sense of purpose,  is one that more and more employees today are struggling with when it comes to their healthcare career decisions—which is why company culture is a critical part of attracting and retaining employees..  

The 2024 Talent Acquisition and Retention Report had some interesting numbers on what employees value today:

• 55% of respondents would take less money if it means working with good people and a supportive supervisor
• 69% would take less money if it means their work-life balance is improved
• 52% would take less money if it means they’re held to a reasonable productivity standard

A survey done by Glassdoor in 2019, where 77% of people said that they consider a company’s culture, and 79% said that they consider the company’s mission and purpose before applying fuels the importance of focusing on more than just salaries and bonuses

Unfortunately, culture often gets the short end of the stick when it comes to company initiatives. If a practice is struggling financially, leaders are often looking to prioritize the things that bring in money in the short term at the expense of things that might need a bit of cultivation before yielding dividends.  A culture that includes a sense of purpose, a path to both career and personal development, and a connection to the community is essential to employee satisfaction and, in turn, the growth of your business.     

Company values and culture are the foundation of every business. 

A great company culture starts with a set of tangible and lived core values that underpin every business decision and accepted behavior in the practice.  They must be infused into everything that you do as a leader and matched to the values of every employee. When bad hire decisions are made, it usually equates to a poor match to the values of the business and no accountability to those values.  Clearly defining your values, leading by example, and taking the time to hire employees who live those values are valuable steps to solidifying a great company culture.

Find your company values and let them be your north star. 

There is no better time than the present to revisit your defined company values to make sure they are still holding true to the business. If they are not clearly defined or no longer truly representative of the business, then it’s never too late to start creating or refining them. They don’t have to be grandiose or sound like you’re trying to change the world, but they must be a reflection of what you want your practice to accomplish and how you want everyone involved to approach every interaction. For example, here’s what we created at WebPT:

Service: Create Raving Fans

Our goal is to exceed expectations with every interaction, both with our Members and with each other.

Accountability: F Up; Own Up

Innovation is key to our success, so we embrace failure as a learning opportunity in order to push the status quo. Showing ownership, staying humble, and sharing learnings define our individual responsibility to ourselves and each other.

Attitude: Possess True Grit

We attack challenges with tenacity and the creative problem-solving necessary to right the ship and get back on course.

Personality: Be Minty

When you’re minty, you are a team player: it’s about supporting each other and winning together.

Work Ethic: Be Rock Solid

We value smart work— innovative, creative, and brilliant work that’s done by trustworthy, dependable, and honest people willing to do what it takes to make things happen.

Community Outreach: Give Back

We make it a point to pay it forward as volunteers, philanthropists, mentors, and advocates, in the hopes of creating a better community for everyone.

Health & Wellness: Live Better

We promote, support, and educate our WebPTers in making healthy choices for their minds, bodies, and souls. We prioritize creating a safe work space for every WebPTer to grow both personally and professionally.

Resource Efficiency: Do Más With Menos

We never want to lose touch with our scrappy, start-up roots—which is why we hire smart people, using data to plan up front to reduce the potential of future waste, automate manual processes, and recycle whenever we can.

The key here is that they are unique and meaningful to us as an organization. It’s not enough to write your values down, though; it’s about putting those values into practice every day, reinforcing them to your team regularly, and following them yourself in every critical decision you make for your business.  

Collaborate with your team to refine your culture.  

Culture has to be organic; it has to live every day in what you’re saying and doing, but it also has to adapt and evolve as needed. Your goals at the outset of your business can change as you grow and expand, and your culture can change as well as you add more employees, more locations, and more services. The values of the business, however, should remain static and every new leader and employee should be held accountable to them.

Part of creating a harmonious working environment must include gathering feedback from your team to gauge the lived experience of the company culture and job satisfaction on a regular basis. Casual, face-to-face conversations are beneficial, but there must also be avenues for more structured, focused conversations—and the opportunity for anonymous feedback as well. Similar to sending regular Net Promoter Score surveys to your patients, Employee Net Promoter Score surveys can provide an honest, real-time view of your culture based on current things that may be causing disruption or cohesion, unlike an annual survey that reflects only that one time of year. Showing that you’re listening, giving it serious thought, and potential action will go a long way.  

Culture might not show up on your ledger, but building a strong culture can be just as important as your ability to offer competitive salary and benefits when it comes to attracting new talent. Don’t get too wrapped up in dollars and cents to recognize other areas where you can build the value of your practice.