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Knowing when it’s time to hire that next physical therapist can be challenging. If done incorrectly, you could wind up paying more in payroll than you are getting in return for the services being delivered. You also risk having too few clinicians to admin staff or vice versa. Keep in mind, the ideal ratio of clinical to admin staff ratio is 1:1 (2:1 at most). Having a proven hiring system that tells you when and who you should hire based on the numbers is key to successful and strategic hiring decisions. Stop guessing or hoping that your new patient numbers will sustain the new therapist you just hired. You should be driving those patient numbers and hiring based off a sequential plan of growth that you are in control of.
The Hiring Sequence
The Hiring Sequence is the formula created to prevent hires that are solely influenced by the group saying it’s time to hire. This sequence is detailed and ties back to your weekly patient visits and the maximum number of treatment slots available in your schedule.
Your staff hiring should occur in a sequential order that allows for your clinic to remain net positive while you hire new clinical and admin staff members. The exception to this may be startups who are still in that growth phase.
Your weekly patient visits will not only inform you if you are overstaffed but also if you are disproportionately staffed between clinicians and admin staff members. Using a mathematically based methodology of hiring ensures your staffing needs are met in a timely fashion. In order to support the success of your hiring sequence system, consider these factors that must be in place:
- The 5 phase hiring process
- Position by position bonus system
- A Proper onboarding process
- Established post stats and targets
- Know how to work the production center formula
Once these factors are in place, you can develop your annual marketing program into two month long campaigns to drive in the number of New Patients necessary to grow the practice. As you develop your marketing campaigns to drive the number of new patients, you’ll utilize your weekly patient numbers as indicators for when the next new hire needs to come onto the schedule. So long as you are able to sustain greater than 85% of max efficiency for a minimum of 3-4 weeks, then that is when your new hire should be walking in the door. This is the 85% rule.
The 85% Rule
The 85% rule was perfected by a fast-growing physical therapy group in the mid to late 1990s. To this day, it is still the best approach to determine when and how to add clinical staff. When that new hire walks in the door, you will want to pass along as many patients as you possibly can onto their schedule and fill them up first. The Clinical Director/Owner may be dropped down to about a 35% efficiency, however, they should not take on new patients until the new hire is at 85% efficiency.
It should be the owner/Clinical Director who rides the ups and downs of the schedule, not the clinical staff. Once the owner/CD drives the numbers up to 85% efficiency and maintains 85% efficiency for 3-4 weeks, it is time to bring on another physical therapist to allow for growth. This physical therapist will immediately take on 50% of the owner/CD’s caseload, so he/she can focus on driving the new patient numbers to increase patient volume to get the new hire to 85% and then himself/herself to 85%. Once they are both consistently at 85% for 3-4 weeks the next clinician hired should be a physical therapy assistant.
In order to ensure your staff is effective, delivering exceptional care, focus in on the quality of care (measured by success stories), the percentage of kept appointments, are they above 85% efficiency and are they maintaining an average of 3.75 or greater billable CPT codes? If so, you can expect to grow and expand your team at a healthy rate while maintaining the care delivered to the public.
Learn more hiring tips and best practices by checking out our on-demand webinar on Hiring Best Practices.
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Brian Gallagher, PT is the founder and CEO of MEG Business Management, LLC. He has more than 27 years of experience in the field of rehabilitation and 19 years in business and specializes in Physical Therapy practice management and executive coaching nationwide. As a licensed business management consultant, Brian has helped hundreds of business owners nationwide improve their business operations through proper restructuring to achieve improved systems of efficiency and productivity as well as marketing and sales with effective public relations which have proven results for double-digit growth year-over-year with businesses around the country.
