I’m a new grad, but I’m pretty motivated. My interest has grown in the business side of PT and I like taking a look at the numbers and see how they relate to measuring a PT's job performance. Looking at the numbers has given me a better idea of how a PT business runs and why certain decisions are made. What I’ve also realized is that there are some intangibles to the business, that can’t be measured as easily as dollars in and dollars out.
With this in mind I decided to interview my final physical therapy clinical instructor (and private practice owner) as he “walked the walk” and was more than happy to share his experience and knowledge with me.
Providing fair raises and bonuses requires knowing how to measure a PT's job performance.
When it comes to the yearly (or quarterly) review, there are a few different ways to look at it. Evaluating performance can be broken into subjective and objective categories. You don’t always want to look at numbers alone because there are other factors that can be just as important and add value to the company. You want to look at the whole picture.
Subjective measures of a PT’s job performance.
- How is this person involved in the community?
Are they volunteering at local events? Do they go beyond normal patient hours? More importantly, have they been willing to do it or am I having to ask every time for them to get involved? Have they been flexible in their hours and are they willing to pick up hours or change shifts when needed?
- Consider their attitude and mindset.
How have patients been responding to them? Do patients like them? (This can be measured by no-show rate)
- What are their goals?
Do they have plans and goals for the future and are they making steps towards reaching them? The goal itself doesn’t matter so much as long as they are taking steps to reach the goal.
- Finally, how has their appearance been?
Do they at least look the part of a PT? When you work with an older population, the little things such as shirt being tucked in and ironed can make a bigger difference than some younger clinicians may realize. And, as we all know, patient satisfaction matters in our industry.
Objective measures of a PT’s job performance.
- Their cold, hard numbers.
This includes their no-show/cancellation rates, how many evaluations they’ve done, their overall productivity, and their money in versus money out.
This can be analyzed quarterly and annually.
- How accurate has billing been?
If you know your charges and numbers as a therapist, you will absolutely generate more for the clinic. That also goes along with charging times. If you are watching them walk in from the parking lot that can count as gait analysis and the time you take to observe them can be charged. Obviously you shouldn’t get carried away with this, but valuing your time and skills appropriately is important.
Different companies track productivity differently, but one common way to assess productivity is simply number of patients divided by hours worked (productivity quotient). So if a PT sees 55 patients/40 hours a week their productivity quotient is 1.38, whereas a PT seeing one patient every hour would be at a 1:1 ratio. 55 patients per week averages to 11 patients a day, which is a very reasonable productivity rate.
The nice part about this is that in the outpatient setting it can give you an overall idea of how the PT forms relationships and how much value patients see in their care. I’ve been told that about a 10% cancellation/no show rate is what many owners see as an acceptable number or goal.
Then you can look at the billing practice of the therapist and see if they are billing their worth. So if this same PT is seeing 55 patients per week and billing a total of 165 units, their billing per pt is 3 units (165/55 = 3). In this scenario, evaluations are viewed as 2 units. Given that this PT is seeing 1.38 patients per hour on average, this is appropriate billing.
So, this is a gives you a general idea that they are tracking their time well, and that they are keeping busy. But then you have to examine what units they are billing.
For example if a PT is billing only manual therapy (hopefully not), that means that at a rate of $18 dollars per unit they will be bringing in $2970 per week (using 165 units per week as a base.) However, if they are charging all therapeutic activity, at $27 per unit, they will be bringing in $4455 per week.
Unfortunately for you manual therapists, this means that you probably won’t be bringing in as much revenue as a more exercise-based PT. There are a number of other ways to track productivity but the big three remain patients seen per week, units billed per patient, and charges per week.
Parting shot of wisdom: the hardest part of running a clinic is HR. The easiest is running the numbers (besides treating).