“It’s ten past eleven at night… where is Peter?” Alicia asked herself as she woke up from dozing in front of the television with her daughter, Jessica. She was pleased to hear the sounds of a door opening and Peter entering. He looked exhausted but was happy to get Jessica to bed. After all, it was Saturday and she should have had the day off.

Alicia was proud of her husband. She worked tirelessly without counting hours, evenings and weekends, in order to achieve her goal of having her own practice and giving Alicia the freedom to dedicate herself to raising her two children and continue with her MBA. .

Peter opened his practice two years ago and built his business from the ground up. The referrals were growing rapidly and he was now receiving 100 patient visits per week. He recently hired a PTA in addition to his administrative staff to help with his growing caseload. His passion was treating patients, but his current priority was developing his practice. Peter was telling Alicia that in a year or two he could earn over $600,000 a year, perhaps earning $6,000,000 in ten years.

“Pete, Jessica was so upset that you missed her soccer game again. All the other dads were there.” Alice said disapprovingly. Peter worked every night and weekend for the last 3 months. “I don’t understand why you spend every night and weekend at the office,” he said. “Aren’t your staff supposed to do most of this work while you’re in treatment? Do they stay late to help you?” she asked.

“I really don’t need this extra stress right now,” he replied. “I can’t pay them overtime to help, and I can’t really sit there and watch what they’re doing all day.”

“You know, Peter,” Alicia pressed, “it’s clear to me that you’re not managing your staff properly.”

Peter felt as if he had been punched in the stomach. He wasn’t going to challenge Alicia. For the past two years, he’s managed to take care of Jessica while she pursues her MBA. Pedro starting a headache.

“You are all day with your head down treating patients and not paying attention to what is happening with your staff.” she added. “Last month, she had to replace her front desk person and two months ago, she replaced her biller.”

“You’re paying your administrative staff $12 an hour and you just hired a PTA for $45,000 a year, but you’re still doing most of the work.” Alicia continued, becoming more and more agitated. “You have to be losing money due to turnover and salaries, and on top of that, you’re never home again. If you’re going to see 100 patients a week and then spend every night and weekend doing business administration, why what to have staff at all?” Alice asked.

“Good question, I don’t know” Peter replied grudgingly.

Katherine called the other day. Alice said.

Peter went to college with Katherine. They graduated together and were good friends. Katherine opened her practice 4 years ago and was in the process of opening her fourth location. She was averaging 800 visits a week.

“We didn’t talk for long because she was about to take her golf lesson, but in the few minutes we talked, an idea occurred to me,” Alicia said.

I couldn’t even consider taking a day off to play golf, Peter thought to himself. “Okay Alicia, what did you come up with?” Peter relented.

“You know, she pays her staff based on performance. Let’s start with some facts. Employee salaries vary in three ways: type of service, years of experience, and location.

There are four types of basic compensation: hourly, monthly, base salary plus performance bonus and profit sharing, or pure commission,” Alicia said, handing the table to Peter. “Employee compensation is a cost of doing business. If you didn’t have employees, you’d eliminate that cost, but if you spend time greeting patients and pursuing insurance claims, you don’t have time treating patients and managing referral relationships. So to grow, you need help. “

“So you hire staff to treat patients, to greet and schedule their visits, and to chase insurance payments. Motivation is the problem. Can you tell me what the costs of unmotivated front desk staff are?”

“Well, Alicia,” Peter said, “a sloppy front desk person could make patients angry, forget to collect co-pays, not follow up on a missed appointment. It could also make other office staff angry because they won’t be working.” together as a team The cost of an unmotivated front desk person could increase patient burnout, affect cash flow and ultimately the bottom line The cost of an unmotivated hire is much more expensive than a few dollars more per hour…”

“So Alicia,” Peter quipped despite the lateness of the hour, “should we find more qualified front desk staff and pay $15, or maybe $18 an hour?”

“Not so fast.” Alice said. “If you pay more per hour, you’ll reduce turnover because fewer practices will compete with your compensation, but you’ll still have the same motivation issues regardless of whether you pay $12 or $20 per hour. Tell me, what’s the problem with paying wages per hour? hour to staff who need people interaction skills?

“Now I understand!” Peter didn’t realize his voice was rising. “Front desk staff are responsible for patient loyalty and referrals. Working with people requires attention to detail and an interest in their problems. Especially when working with injured or sick people. It’s hard work, people feel So compensation and incentives should recognize their results, such as new referrals, fewer missed appointments, fewer missed co-pays You could structure your front office salary so they are paid a minimum for standard work and a percentage of revenues for incentivize them to increase referrals and keep patients compliant with their care plan Since more referrals, fewer missed appointments, efficient co-pay and balance collection increases charges, they could work harder and earn more than the highest paid staff!

“Right,” Alicia said, “and not everyone is going to be ready for this kind of compensation. But that’s okay, too: why waste time hiring the wrong person for the job and then finding out they lack the skills and the motivation to do the hard work?” to work?”

“So what about the PTA? Should I pay them a bonus too? But for what?” Peter asked.

“Sure, they don’t want to pay you for downtime when you don’t show up, and they do want to pay you proportionally to the number of patients you see and for better care plans. That’s called profit sharing,” Alicia said.

“…or commission,” Peter continued his thought. “Okay, I get it: commission and bonus help people to focus on the result of their work and not on its difficulty. The compensation structure helps to motivate my staff and improve teamwork, avoiding problems and contributing more to my bottom line.”

“Then why don’t we move all my staff to commission?” Peter asked.

“That’s the right business approach,” Alicia replied, “except most people don’t have the self-confidence or productivity to work on pure commission. For example, would your biller agree to work on commission from the 100% of her insurance collections?She most likely wouldn’t, because she needs to pay her mortgage and other fixed costs and can’t make her income dependent on her patient flow and insurance companies.Do you have forms measure your performance?

“Today, I pay him regardless of his performance in practice. That’s not a healthy relationship,” Peter lamented, “it’s hurting the business.”

“The good news is, like Katherine’s office, there are companies that work on commission-only arrangements,” Alicia said, “outsourcing their billing would make more sense because a specialized billing company would have processes to manage the performance of their employees, including the correct incentive methods. Actually, if you talk to an outsourcing company, always ask them how they compensate their employees. Are they all on commission? Otherwise, you’ll end up with the same problem with even less control.”

“In reality, no matter how large or small my practice is, all of its parts need to work together to be successful. If the administrative staff allows too many cancellations and doesn’t help with referrals, patient visits will suffer and revenue will decline.” “, said. To fart.

“A Pay-for-Performance salary scale rewards staff who produce and penalizes those who don’t. As a practice owner, I’m always on the Pay-for-Performance salary scale. You get paid less when company revenues are low. Why shouldn’t staff income be on the same path? Tomorrow, I will change my compensation settings for my employees,” Peter sounded very excited.

“Slow down, Peter,” Alicia said. “Before making any changes, review them with a Compliance and Human Resources specialist for good advice,” Alicia warned. “We don’t need a lawsuit because we didn’t meet a legal requirement to make the changes we want.”

What do you think? Is Alice right in her reasoning?

Do you know of a PT-specific staffing system that could make Alicia and Peter’s dreams come true?