“When should we hire?” 

“Who should we hire?”

These are both very common questions I get asked as practice owners are growing their business & there is a method to the madness, even during a time when it is hard to find the right person with the correct qualifications. 

If you sense you are ready to hire a front desk person, office manager, billing person, marketer, physical therapist, chiropractor, or whatever position you want to hire next, the decision steps are the same for every position.

1. What is your Vision?
2. What measurement tools can we use?
3. Overcome your fears!

What is your Vision?

Vision is a statement of what you hope to achieve in the next one to three years while delivering daily on your business mission. Recall that a mission tells clients and staff “who you are, what you do, for whom.” A vision identifies a dream, a hope, or an aspiration that you as the owner and your staff team can get excited about achieving. 

Another way to think about vision is to answer these questions.

• What is it that I’m trying to do or accomplish? By when?
• Where is it that I’d like to see the practice go in the next few years?
• Do I want to maintain the size of my practice or see it grow? Why? When? Where?

If you don’t have a vision that excites and inspires you and your team, then you may be getting ahead of yourself on the decision to hire more people. For example, if you want to maintain the size of your practice over the next three years so that you can keep your current team employed, help them grow their skills, and allow yourself more time for leisure activities, your vision might be “We will maximize our effectiveness so that each team member achieves their professional potential, so that I as the owner can enjoy more leisure time, and so that our clients are receiving our best possible services each time they are here with us.” You and your team will know that you have achieved this vision when utilization is consistently at 90 to 95 percent; your team is able to handle the administrative functions that you’ve been handling, and you find yourself with more leisure time. All of these achievements may be possible to accomplish without hiring more staff. 

Let’s look at a few more examples of Vision and how different visions for your practice can affect your decisions to hire. The two visions that follow are different, so you’ll see that the advice I offer is different.

Business Owner A: Business Owner A says “We’ve gotten pretty busy. In the next year, I’d love to have another PT. Right now it is only me and one part-time assistant.”

My Recommendation: Use your financial dashboard and the Utilization metric. When you begin to hit between 90 and 95 percent utilization, start to look for another therapist to hire as a full-time team member and determine whether your part-time assistant can become a full-time team member. Because if you’re already at 90 to 95 percent utilization and striving for 100 percent utilization, you’ll soon discover that this workload is not sustainable. Sometimes the only way to get to another level of business is to have more patient slots available.

By the way, I love working with full-time people because they are generally more committed to and engaged in the practice than part-time people. We have found that one full-time assistant can support two full-time therapists.

Business Owner B: Business Owner B says “Right now I have one part-time assistant in addition to myself. In the next year, I’d like to have two clinics with each clinic having at least two full-time PT clinicians. And, I want my schedule to be 80 percent spent on leader, entrepreneur, and owner roles because there are other opportunities I want to explore. I still envision spending 20 percent of my time involved in the day-to-day treatment of clients whom I choose to work with.” 

My Recommendation: Let’s say business owner B is at 75 or 80 percent utilization. Should they wait to be at 90 or 95 percent utilization? No. This owner needs time right now to start putting together a detailed vision and supporting action items to achieve the opening of a second clinic. Time is your most precious ally and if you wait to implement the details of your vision (location, lease/buy, equipment, supplies, hiring staff), time is going to fly by. To protect your time, immediately determine the activities that are consuming your time so that you can identify who else in the practice can take over these activities, leaving you time to focus on your vision and its achievement. 

In this case, I would suggest hiring someone immediately to free up your schedule so that you can begin implementing such things as marketing strategies that will generate referrals, and documentation of your systems so that you can repeat your successes in the second clinic.

Measurement Tools – What measurement tools can we use?

What are the tools we can use to measure our current volume of business in order to make sound hiring decisions? Measurement tools are used in support of your vision to determine when is the right time to hire your next “A” Player. The place to begin is the Financial Dashboard which includes such things as your practice’s utilization rate.

• Utilization: Identify whether you are close to 100 percent utilization of your time, space, and staff. If so, it is time to identify what steps you will take to manage the success of your practice.
• Support staff to Clinical staff Ratio: We have found that one full-time support or administrative staff person can support two full-time clinicians. 1:2 – Remembering this ratio helps to identify when it is time to hire more support staff.
• Urgency: Assess how quickly your practice will need staff. Looking back at owners A and B, owner A can take a moderate to slow pace regarding hiring. However, owner B has a “second practice in one year” vision that will require an immediate assessment of what positions are needed and when the hiring needs to occur.

Overcome Your Fears!

No matter your vision, beware of the fears that can overtake you and prevent you from making your vision your reality. Here are some of the typical fears I’ve heard from practice owners over the years.

• If I hire these additional people, how will I afford it?
  • Use your financial dashboard to figure out your practice’s formula.
• Where do I get the money to float this effort?
  • Use your financial dashboard, to determine whether you’ll need a loan. Explore options with your accountant and banker.
• How will I know that business will get busy enough to support the hiring I do?
  • This is a marketing and client acquisition opportunity!
• How do I know that work is going to be consistently and repeatedly done?
  • This fear comes from not having documented your existing practice processes. (See prior blog. 
• What if I don’t have the time to do everything needed?
  • Determine what activities you will stop doing, which activities you can delegate, and which activities only you can complete. You are the one who must protect your time.

By not having a clear and written-down vision of what you want, you make it impossible to make decisions right now and leave room for fears to creep in. Spend time focusing on what you want, on what you desire for the business, and on describing what future you want to create. Write down your ideas for your practice vision statement. Talk with your team members to see what they think of the vision and learn whether they will stay engaged in your practice. Work together to use the right measurement tools and to overcome any fears that arise. Your vision will determine your next move – your next hire – right now.

Ready to explore your vision for growing your practice? Anything that I can clarify? Let’s get into a discussion. I’d like to engage with what you have to say. If you’d like to have a conversation, please fill out the PT Practice Quiz.