Creating a workplace that rehab therapists want to work at and would never dream of leaving is becoming more and more difficult in this increasingly competitive market. Harder still, a considerable number of rehab therapists are considering leaving clinical work altogether. Our 2022 State of Rehab Therapy report unearthed some startling data on this topic:
- The employee turnover rate in rehab therapy soared to 9% last year—comparatively, the current healthcare turnover rate is at 3.7%.
- In addition, more than 27% of the rehab therapy workforce is considering a non-clinical career move, or thinking of leaving health care altogether.
In past articles, we have given some helpful tips on how best to attract the best and brightest in rehab. Looking ahead, however, it’s just as important that practice managers understand what’s really driving staff retention in this current climate—and how they can keep their best clinicians in the clinic, doing what they love.
The workplace has changed—and so have employee expectations.
Delving deeper into the industry report—and really, what seems to be at the center of these turnover issues—is that there is a disconnect between what employers view as the best staff retention strategies and what employees are actually seeking from their employers. For starters, the top retention strategy the executives and practice owners used last year was to offer flexible schedules. By contrast, not only did the “desire for more flexible schedules” rank as one of the lowest reasons for employee resignations last year, it’s not even among the top three factors employees make when weighing new job opportunities. These include improved work-life balance, company culture, and income stability.
To be clear, we’re not saying that offering flexible schedules is no longer important. Rather, this discrepancy points to a greater issue in the healthcare workforce: the misalignment between therapy leaders and rehab therapists, which ultimately comes down to generational differences. According to Gallup, the two youngest working generations (Gen Z and Millennials) now make up 46% of the US workforce. From that survey, both generations wanted their employers to care about their wellbeing, and both followed with a secondary measure of wanting ethical leadership.
Understanding the drivers of these two generations is not an option, it is a necessity. As Larry Benz, DPT, OCS, MBA, MAPP, FAPTA, President and CEO of Confluent Health stated in our report, it’s essential for leaders “to enhance their communication to understand the perspectives of their PTs." Therefore implementing these strategies—among others—will be an imperative for employers who desire to put staff retention at the top of their list of company priorities.
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1. Create a better work-life balance by recreating the flexible schedule.
As mentioned, the concept of offering flexible schedules has been a popular one for some time now. But, offering flexibility can also mean looking to change the paradigm of putting in forty hours of patient care a week. Think about it: forty hours of patient care is a grueling expectation for all generations of rehab therapists—especially once you factor in the extra time required to actually document the care you’re providing. As such, carving out time for your therapists to document, market to their patients, or perform essential patient follow-ups beyond the visit within the work day can prevent your therapists from burning out and promote greater productivity in the long run.
This is a good time to mention CMS’s decision to create remote therapeutic monitoring (RTM) CPT codes for rehab therapists, enabling them to provide quality care when patients aren’t in the clinic—and get paid for it. As Mike Willee explained in this blog post, “Rather than filling your schedule with in-person treatment, you could devote two hours of your day to checking on RTM patients, at a cadence of roughly four per hour. Instead of seeing 10 patients a day in-person, you’re cutting that number to eight—all while doubling the number of patients you have meaningful interactions in a given day.”
This is a great example of using the resources on hand to lighten the number of in-person appointments for your therapists (while still retaining your profit margins), and allowing them the necessary time to catch up on the administrative part of their work.
2. Use small gestures to improve culture.
Making work fun and giving employees a sense of belonging is certainly easier said than done—especially in the midst of a public health emergency with short-staffed clinics and rising overhead costs. But, doing nothing really isn’t an option considering what today’s employees value from their work environments. Plus, a number of affordable options still exist. To recap what we covered in this blog post, small things like having an open door policy, being transparent on company goals, and celebrating individual and team accomplishments can go a long way to foster trust and communication in the clinic. Additionally, sprinkling in a paid lunch or allowing staff some time to decompress and detach from patient care can also make a big difference in a long day.
3. Explore non-traditional compensation models.
Even if it is not a top one or two priority for clinicians in today’s workforce, income stability and salary will always have a seat at the table. Especially when we look at the most recent student debt information stemming from our report. Sixteen percent of rehab therapy students will graduate with more than $150,000 in debt—a 5% increase since 2018.
While we know that all clinic owners want to give their employees what they deserve—especially those paying off high student loans—it can be a hard metric to achieve. This is particularly true post-COVID, when financial and labor expenses are greater than ever. But, alternative compensation models, like revenue sharing and performance-based models, can provide greater autonomy and flexibility, ensuring that therapists are getting compensated based on the value they deliver while also safeguarding clinics against future losses.
Promote staff’s understanding about the business financials.
Non-traditional compensation models can also provide therapists with a greater understanding of where their salaries fit into a practice’s overall budget. Because these plans are based on employee performance, setting productivity targets (e.g., total billed units, monthly visits, revenue per visit, profit per month), therapists gain more exposure to really drives revenue and success for the business. As such, it makes it easier for therapists to understand where their salary comes from—and where it fits into the organization’s overall budget. Additionally, this approach can also encourage more accountability and autonomy among your staff, which brings us to our next point.
4. Engage staff in growing the business together.
As rehab therapy managers evolve with the changing landscape, involving clinicians in this metamorphosis can increase staff engagement and—perhaps more importantly—give staff a sense of purpose and belonging. Promoting intrapreneurship in practice can be a great way to do this, and help further strengthen your therapists’ ties to the business.
At its core, intrapreneurship is the practice of identifying ways to fully engage your staff with your business goals and encourage them to take more ownership in their work. This requires establishing a trusting workplace environment in which people feel comfortable voicing where their interests lie and where they’d like to continue improving. It will also require clinic leaders to ensure their staff is equipped with proper practice guidelines and the resources they need to make sound decision, thus promoting autonomy and improving employee morale in the long run.
Brian Gallagher, PT, Founder and President of MEG Business Management provides a lot of useful information on how intrapreneurs in a private practice can be a mutual asset for the company and the individual—and how clinic leaders can foster this in their organizations.
5. Provide opportunities for personal growth and development.
Our industry report also shed light on the desire incoming clinicians have for more clinical training and residency opportunities, a natural byproduct of our industry’s shift to evidence-based practice (EBP) principles. This recent study found that physical therapists felt EBP was important and they valued its place in health care, but barriers to successful EBP included lack of time and lack of support from employers. Mentorship programs for newer clinicians—or those looking for guidance in general—can help propel a practice for long-term success while making the clinician feel valued by the employer. Staff are looking for quality over quantity, and employers who offer it will succeed.
Taking this one step further, more companies are beginning to offer in-house residency programs, which can be an attractive staff acquisition perk for clinicians looking to gain specialty certifications. From a business standpoint, upleveling your therapists’ skill sets can not only improve the quality of care they’re providing, it can also instill them with greater confidence—which is important step to increasing retention in your organization. As Gallagher stated in our report, “great employees need to be made, not hired, and this takes an internal learning management system that most small practices owners don’t have.”
Leveling up clinical education is achieved through the creation of clinical excellence programs (a.k.a. career ladders) that reward growth in the profession through tiered benchmarks for success accompanied with monetary and personal incentives. Show clinicians that their expertise—and expensive education—are not only valued, but encouraged, to better strengthen the bonds between staff and leadership.
There is a common saying in health care that the only way to grow professionally is to change employers, but I think we can work together to change that narrative. Rehab managers can spearhead staff retention by proactively engaging staff, providing opportunities for growth, and encouraging greater autonomy. It may take a bit of creative thinking to find strategies that work for your practice, but it’s possible—and well worth the effort.