Category: Boss Blog

If we had just walked to the garage and grabbed another ball, we’d still have been able to play– Instead, we had a broken bat and some explaining to do. So many times, in my physical therapy career I observed similar happenings. Watching as physical therapists tried to make do with what they have instead of taking a moment to utilize additional resources. 

Growing up, my friend Sam lived down the street by the Little Calumet River on the southeast side of Chicago.  He had a great big backyard that sloped gently away from his house toward the water. The back of his garage was solid tan brick it worked perfectly as a backstop for playing homerun derby.   

One glorious day after several days of rain, we reignited our friendly competition. Amid our trash talk, we found a ball and strolled around to the back of the house. That the days off did not sit well with my arm, my first pitch was fortunate to not get evaporated by Sam’s bat.   It went right past his wild swing for a strike. The second pitch was thrown just as accurately and just as hard. However, this time the swing was not wild —it connected perfectly. Greg Luzinski would have been proud. 

The homerun cleared the evergreen hedge and took two giant hops before rolling into the river.  It was the deepest home run either of us had ever hit, but it also cost us our only baseball.  The game ended in a first-inning walk-off. 

However, we were resourceful kids there was no need for us to go buy another ball from the store. It didn’t take long for us to find the gravel at the river’s edge– We realized we could hit these rocks almost as easily as we could hit any ball.  Soon the rocks got bigger and shortly after that, the bat broke. 

As a physical therapist , I observed similar happenings. We start with resources that serve us well, but then something happens. Whether it’s continuing education, mentorship, online tools or even equipment–we start to make do with what we have instead of being committed to using additional resources.  

As our clinic begins to wear down and our equipment is no longer suited for optimal care we just roll with it instead of repairing it. How many PT clinics have you seen that have broken equipment or continue to use tables with cuts in the fabric?  Or that have adjustable pieces of equipment don’t adjust anymore?  

I had a multitude of assumptions when I was treating in the clinic about resource scarcity.  Most of those were false stories I was telling myself. I thought I was helping by NOT spending money, in reality I was failing to invest in places where Alliance was eager to help.  

We convince ourselves that we must make things work in their inferior state. We fall into the trap that there is humility and resourcefulness in making do with the resources we have. of Whether we think it’s cost savings or convenience, it’s not okay. Complacency is a killer and the patients are the ones who end up paying for our mistake.

The commitment to providing excellence in the delivery of care includes being committed to making sure we are not allowing bad habits to take root out of convenience. Controlling costs does not mean cutting corners. 

Having a partner like Alliance can help you not only identify things you’ve stopped seeing but also help you prioritize getting back on track.  

Don’t accept less. Stop hitting rocks with a stick—take the time to go back and get a ball 

It seems that every time we turn around, there is a new requirement for documentation, education, reporting, or delivery of care. As therapists, we often find ourselves wondering who continues to dream up these excessive and draining restrictions, and why they would add one more thing to a plate that’s already full. As the poet Taylor Swift once said, “It’s me. Hi. I’m the problem, it’s me.”

In the ‘90s, my first job was working as a rehab tech at a large hospital near Chicago. I helped transport patients to the gym for rehab or wound care. Prior to getting the patient into a wheelchair, we pulled paper charts for the nursing staff to verify the patient’s medical status hadn’t changed and nothing would keep them from attending therapy. A common physician note for a patient encounter was “Afebrile.”

We’d joke about how useless the commentary was, as it provided next to nothing about the patient’s condition other than the fact their temperature was normal. We would then bring the patient to therapy and write their PT note. If you treated in the 1990s, you could likely tell me what it said:

S: No new c/o

O: See Log

A: Tol well

P: Cont.

If there is something I’m embarrassed about in my patient care journey, it’s that I wrote this note. It was pervasive and in common use in all settings. It was horrifically nonspecific and added nothing to the importance of documenting patient progress or representing the skill of the physical therapist in the delivery of care. We felt we didn’t have to justify our services to anyone, so we didn’t.

It was an unfortunate reality that was no support for the value of the service we provide, no justification for the expense, and no concern for continuity. We delivered the most exceptional care in the medical world at the time, but were such poor historians that we were unable to defend ourselves when insurance companies called us out.

When purse strings tightened, medical reviews and denials moved into the forefront. Then compliance became the new profession within the profession. Our own failures allowed payers and regulatory agencies to set standards for us because we failed to demand more of ourselves. Honestly, I’m thankful they stepped up where we didn’t. The profession needed accountability and an objective bridge between delivery of quality care, the definition of quality care, and the verification of delivery. We should have done it, but didn’t, so they did.

Fast forward to today, there may be a lot of grumbling about compliance and talk of “extra” work to meet all the requirements. As someone who lived through it, all I can do is assure you that — as a profession — we did this to ourselves. The people who guide us in compliance are helping us prove our excellence and our value by bringing us up to the objective standards we should have had all along.

We have moved academically and professionally into a doctoring profession. We need to stop doing the minimum (as defined by the payers or legislators) and be exceptional. Compliance professionals are our gauge for that. They help us increase access while we stay within the parameters of quality care. Appreciate them. Lean into their expertise before there is an issue.

Compliance is not a dirty word. It is not a punitive element of what we do. It is a natural outflowing of the optimal delivery of care followed by proper billing and documentation practices. If we want the recognition we deserve as a profession, we need to acknowledge the errors we’ve made. We need to be collectively better at rectifying the impression we’ve left. 

We need to be proactive about providing and proving value until our default behaviors are maximally compliant, and Compliance professionals can start looking at what we’re planning to do instead of what we’ve done. Taking back ownership of our profession from both a reimbursement and compliance standpoint hinges on our ability to be as undeniably excellent as we truly are.

First and foremost—Thank you for reading; I appreciate the opportunity to help people learn from my mistakes and even my successes. Though, I can’t take all the credit — these blogs typically start with inquisitive questions from our marketing team. I must admit, the most recent question put me on pause. 

“What were things you did to keep the culture fun while building partnerships between the staff at clinics?” 

I basically blue-screened.  

Many memories flooded my brain, overflowing my capacity to sort them out.  I’ve been blessed with lots of good times.

During my practice days, we established a tradition of closing for lunch every Monday. We went anywhere the staff wanted. Caught up on each other’s lives and decompressed. This one small act of community completely changed the tone for the rest of the week.

In my subsequent role as an Outpatient Rehabilitation Manager at a large hospital system, committees were dedicated to arranging parties and get-togethers. Therefore, the fun I implemented fell more into the daily workload by encouraging my team to latch onto an area of specific interest. Together we would work on a plan to integrate that interest into their week. The team pursued a variety of passions: Some delved into post-surgical care, others embraced Tai Chi and community education, and some explored pet therapy. We dedicated four hours each week for team members to devote to their passion projects. As a result, several individuals willingly extended their work week to 36 hours to make room for this creative and fulfilling time.

At Advent Physical Therapy, (an Alliance Physical Therapy Partner) I gravitated toward food as a bonding tool. The chocolate-covered apple fritters from a local bakery are a culinary treat best shared with a team. The same was true for Grand Rapids Pizza Delivery (GRPD), which is famous for being the pizzeria that named its pizzas after cop shows. Pizza buffets quickly became a regular occurrence at my clinic. 

In addition to culinary comradery, I implemented themed music based on the day of the week. Soulful blues would fill our clinic on Monday; Tuesday was dubbed 1992’s day; Western Wednesday followed; Throwback Thursday offered a dose of nostalgia. The week was then ushered away by casual Friday featuring Hawaiian shirts and current pop music. This routine kept things light, and the variety was refreshing.

So, what truly sustains a fun work culture? 

After reflecting on my experiences and everything I can think of that built a positive work culture — the best and most influential thing I can recommend to fellow clinic directors is: Ensure you hire well. 

This might not align with some expectations, but it’s the undeniable truth my experience has led me to understand.

No level of lightheartedness can cheer up someone persistently downbeat. Endless pizza can’t make up for the struggle of a top performer enduring a less dedicated colleague. Even the culinary excellence that is Ida’s fritters cannot reduce the friction caused by a bad hire.

Hiring can make or break an organization’s culture. The Talent Acquisition team at Alliance is truly exceptional, lending their expertise to the hiring process. The team at Alliance streamlines the hiring process through their hands-on approach. Participating in the screening and interviewing of candidates, ensuring the procedure is both efficient and effective. 

When lacking the support of a partner like Alliance, my advice is to pay close attention to how your interviewees interact with your front office staff. Take note of their behavior when they’re unaware of observation. When it comes to interviews, don’t be afraid to ask challenging behavioral questions. For example, ask them to share a situation where they had difficulty getting along with a coworker. Or, inquire about an instance when they collaborated with someone whose background, experiences, or lifestyle differed from their own. Such probing questions make it hard for the candidate to hide who they are under a blanket of ‘correct’ responses.

The one easy, yet sometimes challenging step, is to hire truly exceptional individuals. Such people can foster enduring relationships. These relationships infuse the workday with a sense of fun and camaraderie that extends far beyond the lunch hour. 

My friends and I are passionate about fishing. So we all chipped in and bought a classic boat, a 1978 Lund with a console drive and twin 35HP Evinrude outboard motors; it was my wife’s grandpa’s walleye boat. It was a classic, but not one of those nice classics. It needed some TLC, but if we each took on a little bit, we could have this boat ready quickly. After some painstaking upgrades, including cupholders, rod holders, a trolling motor plate, and a fish finder, we took it fishing all over Michigan.

The fun lasted all of one year. The following summer, I was on vacation with my family for the first time in a while. When I put the boat in the water, the left engine wouldn’t start. I got the right one rolling and figured I’d idle to the cottage we were renting and fix it there. Halfway, the forward gear in the right lower unit let loose again and trashed the right engine. I beat on the starter of the left motor, then finally used a pull rope to get it started and limp it to the dock. When I finally made it to the cottage, my foot went through the rotten floorboard while I was stepping out to tie it off.

I spent the majority of daylight hours those few days fixing what I could and zero hours relaxing or fishing. I didn’t have the resources I needed, and I didn’t have my friends along to share to work. Owning that boat went from epic to headache so fast it made my head spin. Eventually, we towed it back and this winter my friends and I are refurbishing the whole thing. It’s a very fun and very positive experience.

Owning that old boat reminded me of how it sometimes felt to run a physical therapy clinic. At first, you’re engaged in your passion, but eventually, the maintenance and repairs catch up with you. That’s when you need allies, partners, and people who share your passion.

Alliance is not just a company but a group of people who love physical therapy and are dedicated to helping each other succeed. They know how challenging it can be to stay up-to-date with the latest techniques, regulations, and patient care while also managing the day-to-day operations of a clinic. That’s why they offer support, resources, and a community of like-minded professionals who can help you navigate the challenges and keep your clinic running smoothly.

As with owning that old boat, owning a physical therapy clinic requires collaboration and teamwork. We all have different areas of expertise and need to rely on each other to keep our clinics thriving. Whether you’re struggling with insurance billing, patient care, or hiring new staff, Alliance is here to help.

So, don’t give up if you’re feeling overwhelmed and out of your depth. Reach out to Alliance and discover the power of partnership. We’ll help you right the ship and return to doing what you love: providing top-notch physical therapy care to your patients.

Attending physical therapy school at the University of Illinois in Chicago during what is now referred to as the late 20th century, was an eye-opening experience for me. As a high school and undergraduate student, academic work came easily to me, except for calculus. I coasted by relying primarily on my gut instincts and intuition. However, I found the academic expectations at PT school much more intense. I also found myself surrounded by much more intelligent and harder-working students. Though it should have been, this alone did not motivate me to push myself further. I needed someone to hold me accountable.

Dr. Jules Rothstein, my department chair, was a renowned physical therapy researcher, educator, and editor of the PT Journal. Although he was known for his incredible contributions to the field, he was not known for his gentle approach to students. He challenged his students and was not afraid to point out their shortcomings. In my first interaction with our cohort, he described how eight of us wouldn’t finish and how “that was a shame because people who could have made it through were denied spots in the program to make room for us.” It was challenging to be in his presence, so I decided to admire him from a distance.

When I had an opportunity to talk to Dr. Rothstein one-on-one, he was quick to tell me that I needed more than my intuition and ability to fill in gaps at this level. He paid me several compliments and said he admired my skills but that gut feelings were insufficient at this level, and he was sorry that no one had ever taught me to prepare academically. He said he wouldn’t insult me by explaining what I needed to do to succeed because I already knew. He was “taking a moment to free me from the burden of thinking no one knew I was still winging it.” Though challenging to hear, his words were a game-changer for me. They pushed me to hone my academic skills and utilize the resources around me.

Working with Alliance Physical Therapy Partners gave me the same feeling of being seen. I was doing enough to get by and could fill in the needed gaps, but I knew there was room for improvement. If left alone, I was unlikely to have the resources and motivation required to make those improvements. Working with people who can see your blind spots, pinpoint what you’ve been neglecting, and help you realize your potential is invaluable.

Alliance Physical Therapy Partners gave me that push and invested in my success. If they invested in me, I can confidently say they would invest in you. Although it can be hard work, retaining your identity while moving forward into areas you used to avoid is liberating. They will give you the tools needed and prepare you for the next level of success. Freeing you from the limitations caused by thinking no one knows you’re winging it.

If you’re looking for a physical therapy company to help you realize your full potential, look no further than Alliance Physical Therapy Partners. Our experts can help you see your blind spots and point out areas for improvement. Contact us today to learn more.