The Best Person for the Job


Create the right environment to keep your exceptional employees on board.

By Stephen Anderson, PT, DPT, and Lori Dillon, MPA

As private practice owners, we continuously navigate turbulent waters. Reimbursements and expenses fluctuate, regulations change, treatment approaches evolve, patient needs and demands grow. We rely on different resources to achieve success (at minimum, sanity and stability), the most significant being our valuable team members. Arguably there is nothing more important than skilled and loyal employees and partners.

We all know that sometimes employee turnover is positive. If you are seeking a culture change, dealing with a disgruntled underperformer, or your business needs evolve, you might intentionally devise a turnover plan to reach your ultimate goals. Most often, however, the turnover we experience is not in our control and has a devastating impact on our business. Much research has been done on the costs (direct and indirect) of employee turnover. Estimates are 1 to 12 months’ worth of an employee’s pay, depending on the role and experience spent to replace that person.1 Losing a good employee takes a toll on us and our business financially and emotionally. To avoid this, we try to proactively hire the right people.

The Right Seat on the Bus

Most of us have heard Jim Collins’s reference to getting the right people on the right seats on the bus2 in relation to great business practice—ensuring that the skills and experiences of our teammates align with their roles and our business needs. This is what makes recruiting so important—and time consuming. Though not foolproof, at our company, we have found that investing time and resources at this stage in the process reaps rewards. Ten years ago, we hired a dedicated recruiting specialist to facilitate this process. You may not have the resources for that, but there are other things you can do. Set aside time in your schedule to dedicate to these tasks, or delegate to a skilled teammate and ensure that they have time to focus on this work. Add hours and recruiting responsibilities to a current employee’s schedule—especially if it is someone you are mentoring to be a leader for your organization. Acknowledge when and how to use an outside recruiting company (perhaps for temporary coverage, or to maximize your exposure if you are in a rural area), but know that you and your teammates are the best spokespeople and relationship-builders for your business. You are poised more than anyone else to define the seats on your bus and attract the right people for them.

When it comes to interviews, do not rely on just one point of contact, especially for key positions.

  • Consider multiple meetings. Maybe start with a Skype call so that you can get a feel for each other’s personalities without the full investment of an in-person interview.
  • Have trusted team members interview candidates in addition to your interview.
  • Invite the candidate to shadow in the clinic for part of a day.
  • Use the interview process to observe and confirm behavioral patterns. Anyone can present a persona in one interview; it is more difficult to fabricate behavior over multiple engagements.

Get deeply curious about what drives your top candidates so that you can craft an enticing offer. Of course, pay and benefits are crucial to meet basic life needs. However, we know that our practices often run on thin margins and relative to other industries and settings, our base pay ranges will likely not be at the top of market scales. We have to get creative. At our company, we offer programs that attract the kind of motivated people we want to hire: a structured one-on-one mentoring program, Orthopedic Residency, and a 4-level Leadership Development Program designed to build leadership skills in every employee, at every level of our organization. We encourage all employees to develop a personal education plan, and we support their goals with continuing education dollars (sometimes even for learning endeavors not directly related to their role, but purely to enhance personal growth). We attract many entrepreneurial people to our company because of our equity ownership model, the opportunity for a motivated therapist to become a clinic and company owner one day. Your clinic may not be in a position to offer what we do but you will benefit from identifying what makes you unique. Figure out how to maximize those qualities for new hires. Think outside of the box and beyond the pay and benefits that your market competitors offer.

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Research has repeatedly shown that money is not a primary motivator for most people.3 The promise of camaraderie, support, trust, and respect in the work environment is what draws people in (and keeps them around). Take the time to demonstrate this to your top candidates. Connect with them beyond the interview process: send a thank you note following an interview, email links with resources that you think they might enjoy, offer to connect them with other people in your clinic (or even past employees) who can share personal stories and answer questions. If you have not seen Simon Sinek’s TED talk “How Great Leaders Inspire Action,”4 we highly recommend it. In it, he argues that people are motivated to take action—make a purchase, seek services, choose to work somewhere—not because of the details and data, but rather because of why the company exists. People want to be a part of something inspiring. Show them why you are great.

Whatever you do, do not hire out of desperation. We have all done it . . . and it never works out well. Waiting for that right person can pose short-term pains but almost always leads to far surpassing long-term gains. Good companies are picky. Hire slow and fire fast. If you weed out people who do not fit, that is good turnover. And the ones you end up hiring often turn out to be legacy-building teammates.

Keeping the Right People Engaged

After we have the right person hired, our work has only just begun. Avoiding negative turnover relies on strong leadership and fostering a positive clinic culture. Thanks to resources like Daniel Pink’s book Drive, we know that an ability to direct our own pathways, to learn and create, and to support and advance ourselves and those around us are profound human motivators.5 Likely these factors are at the core of why you got into private practice in the first place. The people who make your company great are those who seek a culture that allows them to have autonomy, achieve mastery of something, and live for a greater purpose. Give them opportunities to continuously have these things.

The best way to do this is through regular conversations. To really understand the needs of your team and truly support them in meeting those needs, you cannot rely only on an annual review. The best leaders dedicate time to these kinds of dialogues. Often what we discover in these talks not only helps us support an individual employee, but also uncovers other opportunities to celebrate or investigate in the clinic. Additionally, we know that millennials (the generation that many of us are hiring nowadays) want coaching, mentoring, and frequent feedback. We have found that even a few minutes of daily check-in and acknowledgment of a job well done can go a long way toward their satisfaction and loyalty.

Mentoring has become a buzzword within our profession. We believe that true mentorship is building skills, but more than that, it is about building leaders. Innovative companies recognize that successful leadership development for the future relies on the collaboration of diverse individuals who bring different perspectives, giving individuals ownership over their own development plans, and encouraging “vertical” versus “horizontal” development.6 Horizontal development is skill-building (to use a metaphor, it is filling a glass with water). Vertical development is supporting an individual through the stages of how they make sense of their world (transforming the shape of the glass of water entirely). Vertical development is when problem solving and complex thinking evolve. We know that the health care landscape is complex, and the future of our profession relies on innovators who will be able to work collectively to seek out, explore, and solve problems that may not even be on our current radar. Cultivating these skills in our teammates not only retains good people, but grows our profession. Our company encourages vertical development through investment in a yearlong development program for our directors. Annually, a new group of directors meets once per month with a facilitator to discuss and strategize challenges and opportunities in their roles. This program has not only grown participants’ skills, self-awareness, and confidence, but has also positively impacted our overall company culture. None of this is easy. It takes time and consistent work. It requires us as business leaders to do our own self-reflection and energy recharging. But if we can get these things right, those turbulent waters that we navigate on a regular basis will feel a lot more manageable.


1. Accessed April 2016.

2. Collins, J. Good to Great.

3. Accessed March 2016.

4. Accessed March 2016.

5. Accessed March 2016.

6. Accessed March 2016.

Steve Anderson, PT, DPT, is chief executive officer of Therapeutic Associates and past president of the Private Practice Section. He can be reached at

Lori Dillon, MPA, is director of professional development for Therapeutic Associates in Seattle, Washington, and can be reached at

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

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