Human Resources

By Stacy M. Menz, PT, DPT, PCS

I’m not sure about the rest of you, but the first thing I think of when I think of human resources is my onboarding process for my first hospital job. I had a lot of paperwork to fill out, a lot of tests to take, a few long days of orientation (during which I struggled to stay awake), and then finally I could start doing the job I wanted to do. I never even thought about Human Resources after that initial process because all of my other interactions were with my supervisor or director.

As a business owner, I have realized that human resources is more than a department. However large or small your Human Resources team is, whether just you or a team of people, the function is key to your practice’s success. Being in a service industry, our primary asset is the people that deliver the service. Given that, the dollar and resource investment you make in this area is paramount.

While there is a wonderful resource on “how to do it” via the PPS Human Resources Compendium (see page 74), I have found, that since your team is made up of individuals, an individual approach is needed while also maintaining consistency. Luckily there are systems you can put in place to help provide the consistent policy and procedures. Within the systems you can individualize so that the needs of your team members and your organization are being met as well as ensuring they are meeting the expectations and needs of the organization.

This issue includes some pointed articles on the topic of human resources. I was excited to read “How to Drive the Journey of Change” in this issue, as it provides a systematic and evidence-based way to bring change to your organization. Change is often one of the hardest parts of managing people and a business. This article provides some great insight…I will be reading this one again!

I was also intrigued by the idea of decreasing the formality of performance reviews. We do reviews two to three times a year but they are time consuming and while I find that taking the time to put my thoughts onto paper can clarify things for me, I often wonder if the time investment translates into meaningful feedback for the employee as the formality of the “review” at times seems to limit true dialogue. If they can be done in less time and be more meaningful, this is definitely something I want to explore.

We hope that this issue of Impact brings about thought and you spend some time pondering your most important resource and asset—the humans!


Marketing Field Trip

By Lynn Steffes, PT, DPT

Summer is a great time for your practice to take a field trip. How about taking a marketing field trip in your community? So often we limit our external marketing reach to traditional medical referral sources and ignore opportunities for business-to-business (B2B) marketing. Small businesses in your community that serve similar demographic targets may be a great place to take your marketing message!

8 Steps in Planning Your Marketing Field Trip

Step 1: Begin the process by identifying your primary patient target market for expansion.

Step 2: Define the geographic range that patients typically travel from to your practice. It will vary greatly depending on if your practice is urban, suburban, or rural. Your practice management software may be a great place to run a patient zip code report to assist in setting your geographical parameters.

Step 3: Divide your practice up into teams that will do a field trip in a certain area around your practice location. Perhaps you will have two to four teams of individuals who will actually agree to drive through the neighborhoods surrounding your business and identify small businesses that serve your primary patient marketing targets. Businesses that are related to health, wellness, fitness, and sport are often great targets, but don’t forget a local coffee shop, salon, or shoe store.

Step 4: Each team should identify at least five possible targets and rank them by location (closer is better), affinity for your practice (to serve women’s health), and familiarity to the practice (someone in your practice patronizes the business).

Step 5: Each team member then selects a business or two to research via website and visit.

Step 6: Team members outline a strategy to approach the business and connect on similarities, identify a co-marketing or mutual referral system, and plan their B2B call.

Step 7: Once a successful B2B connection is made, create a specific plan to cultivate cross-referrals, cohost events, create social media exchanges, and share advertising opportunities.

Step 8: Track your results and remember to express gratitude to your team and to the small businesses you visit and build on each other’s successes!

Steffes-Lynn-2016 Lynn Steffes, PT, DPT, is president and consultant of Steffes & Associates, a national rehabilitation consulting group focused on marketing and program development for private practices nationwide. She is an instructor in five physical therapy programs and has actively presented, consulted, and taught in 40 states. She can be reached at

Spell It Out

By Tannus Quatre, PT, MBA

You are going to spend 50 to 60 cents of every dollar on your staff. They are expensive because they are worth it, but if you don’t manage their time correctly, you will soon find that your bottom line is a little closer to the bottom than it should be.

It’s a plight business owners are all familiar with—getting the most out of our labor dollar.

We spend a lot of time focusing on the “P” word, productivity, and while strategies to optimize productivity are of paramount importance, not every moment on the clock can be measured with a billable unit.

What about project management, administration, training, and business development activities, which are much harder to track with traditional productivity measures? How do we ensure our investments in these areas achieve a positive return for our companies?

Many of us will be drawn toward quality or efficiency metrics which can (and should) be used to measure time spent by staff in these areas; however, it is what you do before the time is spent that is key to the wisest use of staff time. How clear are you being about how your staff’s time is to be used? It is the owner or manager’s job to ensure that staff know exactly what is expected of them and how their performance will be measured. Without this, how can we truly expect that their time on our clock will be used in a way most aligned with our business objectives?

Clarity takes a bit of work, but it’s worth the effort. Try these tips to ensure you are getting the most out of your staff.

  • Be specific. Ever require a member of your team to go out and “market” to referral sources or small businesses in your area? How much latitude did you provide them in how this was to be accomplished? Sure, your top marketers will have this dialed in, but if you expect the same from everyone without specific instructions, you will be sure to incur payroll expense that isn’t rewarding your business. Instead of saying “go out and market,” be specific: “I’d like you to share our pelvic wellness packet with five women’s health physicians within the area.”
  • Measurement. What gets measured gets managed. Without a specific measurement, it is impossible to know if one’s actions are in alignment with the business objectives. If you have asked your lead clinician to make recommendations for improved throughput of patients, define the measure that will be used to drive their work. “I’m looking to reduce our average time spent in the waiting room from 10 minutes to less than 3 by improving our patient throughput.”
  • Deadline. Without a deadline, everything is a priority. More specifically, without a deadline, nothing is a priority. Deadlines put needed pressure on projects and activities by letting your team know there is an actual finish line, and that you will be there to watch them cross it. If you have asked your office manager to train a new receptionist, let him or her know that you expect the new employee to be fully effective in their role within X number of days of the hire.

Being absolutely clear with your requests of staff time—actually spelling it out—is critical to the effective use of the most important investment we make in our businesses. It takes some discipline, but it’s worth it.

tannus_quatre Tannus Quatre, PT, MBA, lives at the intersection of physical therapy and entrepreneurship, spending his time helping physical therapists build and operate successful practices through his company, Vantage Clinical Solutions. He specializes in marketing, finance, and business planning, and authors and speaks regularly for the APTA and PPS. He can be reached at

Jarod Carter, PT, DPT

Dr. Jarod Carter is the president and founder of Carter Physiotherapy, PLLC, in Austin, Texas. He can be reached at

Practice, Location: Carter Physiotherapy, Austin, Texas | Practice specifics: 1 location, 3 employees, 6 years in business.

You are clinic owner of Carter Physiotherapy, book author of Cash-Based Physical Therapy and Medicare: A Comprehensive Guide, consultant for cash-based physical therapy practices, and a podcaster…. Is there an area that you find particularly rewarding/helpful to develop your business?
The most rewarding are certainly the clinic and the podcast. I really enjoy interviewing people because I am always aiming at finding the one thing I did not already know. The practice has been just awesome. I am spending an hour one on one with every patient. In terms of revenue streams, the practice is my biggest earner, but that may change over time as I grow them all congruently. It has been a fun crazy ride so far.

Most physical therapists in private practice cite reduction in payment as their number one business challenge. You operate an entirely cash-based practice, so reduced second payer payment is not an issue. What would you declare your top challenge for keeping your business viable?
One of my biggest challenges is setting up systems to always stay top of mind with all previous customers and to maximize the lifetime value of every customer. There are a lot of cool ways technology wise to do that.

What has been your biggest business mistake and how did you correct it?
I wish I would have taken the time to document everything that goes into making my practice run the way I want it to. Now I am in the process of doing that for the new full-time admin I am about to hire amidst the mountain of work that is all part of growing a practice. This transition could be a lot smoother and less stressful if I had written it down along the way.


You have traveled and studied around the world, and you are a lover of all things business. What is the best business resource you have found?
This is a tough one because there are so many resources out there. For me, the best resource is having a practice of learning how to focus so that I can efficiently and effectively utilize all of the great resources I have come across over the years. My advice: Work on developing your own ability to focus in the moment, and do not be distracted by thinking of the future. For me, that focus comes from a meditation practice.

Do you have any recommendations for the private practice owner on achieving a work/life balance?
Never stop a regular exercise practice. It is easy to get obsessed with the business, but if you do not do a little exercise each day, the rest of the day you will not be as effective. There is no excuse for not taking the time for it.

What is in the future for and Carter Physiotherapy?
On, I just finished the second e-book on Medicare and cash pay, which was a five-year project. Now that it is out I can focus on expanding the clinic. I just hired a full-time physical therapist and am hiring a full-time admin. I would like to expand to two or three more physical therapists and into a bigger space over the next few years.

What is the number one thing you think therapists today need to understand about owning their own private practice?
Make sure your business is well diversified. Whether that means having cash-based services or referral diversification, it is important to start looking into that now. Things are going to change quickly, and it can be too late if you have not come up with Plan B and C for revenue. Make sure the direction you are heading is a safe one.

They Need You


Engage with candidates this campaign season.

By Alpha Lillstrom Cheng, JD, MA
August 8, 2016

It is August in an election year. While many things are uncertain in this incredible election cycle, one thing is for sure—candidates are pounding the pavement, knocking on doors, kissing babies, and eager to meet as many constituents as possible in order to earn as many votes as they can. This presents you with many opportunities to engage with those running for office while he or she is in campaign mode.

During campaign season, people running for office host events such as town hall meetings, rallies, and listening sessions. These public events are often well publicized and are the perfect opportunity to introduce yourself to the candidate and their staff. Often the local papers or news stations report on upcoming events, but the most efficient way to find out when and where an event will take place is to sign up for notices on his or her website. The process is similar for anyone running for office, but the mechanisms differ slightly because of differing levels of organization and resources a given candidate might have. Campaign websites vary widely in their sophistication and ease of use. The easiest way to find a campaign website is to search for the full name and the candidate and “campaign” in a search engine such as Google. For candidates challenging an incumbent legislator, it is often most efficient to call or stop by their campaign office and ask for the best way to get on their event mailing list. In the case of incumbent members of Congress running for reelection, there are two places to look—their campaign website and their official congressional website. Generally a sitting senator’s official website uses the following naming convention: www.senator’; for an incumbent representative it will be www.representative’ If your legislator has the same last name as another member of Congress, use their first name too; for example is Speaker Paul Ryan’s official congressional website. Another way to make sure you learn of upcoming events in your area is to reach out to both the incumbent’s district and campaign offices and ask to be added to their event mailing list.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.