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What I Learned From 14 Years of Hiring Physical Therapists

by Keith Mahler, PT, MPT, CEAS, CCI

I'll be the first to admit it: I am picky about who I hire. I run a small outpatient physical therapy clinic in San Diego, and much of my career has been devoted to ensuring its success. Our patients are loyal, and most of our referrals come from word of mouth or other forms of "success stories." I spend nearly no money on marketing, and rely on excellent care and patient outcomes to keep the clinic afloat.

I’ve hired many physical therapists over the years, including the years I spent at other clinics before launching my own practice. I have learned a great deal from hiring and working with these clinicians, and I value them as colleagues and friends.

I'm writing this article to help you make the right hiring decisions for your own needs. Hiring the right physical therapist takes patience, and I have found that there are certain make-or-break traits of clinicians that can truly impact the health of your business and the morale of your team.


1. Hire a proactive physical therapist, not a reactive one 

A proactive therapist fills needs that you might not even know exist. A reactive therapist needs to be asked or reminded to step up to the plate in times of need. 

Consider your clinic's size and needs. As I mentioned, my clinic is small, so I need a therapist who recognizes the importance of answering calls if the front office manager steps out for lunch. This type of therapist will take the initiative to clean up after himself or herself and ensure that I'm aware if we're running low on hand sanitizer. He or she will schedule a patient without being asked and thinks to help me carry the bags of dirty linens to the car on laundry day.

While these are clearly needs specific to a small clinic, a proactive physical therapist is essential in any size of organization. Do you run a large chain of clinics? A proactive therapist will think to hand out business cards at CSM and mention if you're hiring. On the other hand, a reactive therapist will need to be reminded to pack a shirt with the company logo to wear over the weekend. 

If you manage a hospital, these traits are key, too. A proactive physical therapist will contact a doctor when there is a question about whether to mobilize a patient with a DVT. This type of therapist will take action to resolve scheduling issues that arise at the end of the day, rather than scurrying out the door "because it's 5 PM!"


2. Choose a passionate physical therapist

You've probably heard the expression, "Attitudes are contagious. Is yours worth catching?" It's so very true in any workplace, and can be especially true in healthcare settings, which can be emotionally draining on some days. Passion for patient care is vital to keeping your team inspired and motivated to become the best therapists they can be.

Physical therapy is, by nature, an extremely selfless and giving profession. If you opt to hire someone who has a "treat and go home" philosophy, his or her apathy can quickly rub off onto you and the other employees. This is the fastest way I know for patient care to go down the drain. 

I don't expect my therapists to be studying until midnight each night after work; far from it. But I do expect that they ask me questions, challenge me when needed, and remain passionate about patient care. When my employees attend a continuing education class, I expect an inservice afterward, and I’ll want them to discuss the comprehensive body of research on whatever topic they covered at the course, not just the sources cited by the course’s presenter. A passionate, proactive physical therapist will do these things naturally, as it will be in his or her blood.


3. Make sure you hire someone who is hungry for knowledge 

Many clinics stress out over whether to hire a new grad or not. New grads do not concern me. In fact, they have historically been my best clinicians, as they are passionate, excited, eager to learn, and not set in unhealthy treatment patterns.

The key words here are “eager to learn”; what really matters is whether your hire plans to continue to learn, no matter where he/she is in the career cycle. Think about PT in the 80s and 90s. We have made tremendous strides since then, and we rely on continuing education courses, staying up to date with research, and our colleagues' input to continue to stay abreast of emerging treatment philosophies.

Many clinicians out there simply give up on learning. And this is not a problem exclusive to "old school clinicians." In fact, I have met my fair share of new or recently graduated clinicians who are simply checked out. They complete the bare minimum of online continuing education courses. There may be a place for this type of clinician, but it is not in my clinic, and hopefully not in yours.


4. Opt for someone organized 

Disorganized clinicians are a liability, plain and simple. Sure, you might run into some sort of “House” style PT who can diagnose better than anyone you've ever met. For this rare unicorn of a clinician, it MIGHT be worth dealing with the hassle of disorganization for the sheer genius of his/her clinical prowess.

But this is doubtful.

A disorganized clinician can cost you a fortune in lost reimbursements or penalties during audit season. Disorganization is contagious and causes other employees' work to suffer. Other clinicians might resent having to pick up the slack for an organizational nightmare, as they surely will have to do so when covering for that therapist's vacation days and sick days.


5. Ask the right questions in the interview

You can easily weed out many types of applicants during the interview process. To save yourself time, schedule a short phone interview before you block out time from your schedule for in-person interviews. Some questions I like to ask include the following:

  • "Describe the last 2 continuing education classes you took and what you learned from them."
    This can weed out the apathetic clinicians quickly. Red flags include stammering about financial woes, being too busy, and other excuses for being lazy. The truth is that anyone can attend continuing education classes. Even if finances truly force them into online courses only, it should be temporary and the applicant should have LOTS of classes they've taken online in the recent past.
  • "What is your biggest weakness as a clinician, and what are you doing to change that?"
    My, does this ever help weed out the arrogant, know-it-all types. Everyone can say they're a perfectionist, but it takes an introspective person to have an active plan to address their weaknesses.
  • "How do you make sure that you stay organized throughout the day?"
    This can help you weed out the disorganized, lazy, and inconsiderate therapists who plan to coast on by and collect a paycheck.
  • "What is the next continuing education class you want to take, how do you plan to make it happen, and what do you plan to take home from the course?"
    Again, this topic will highlight clinicians who are hungry to learn. Passionate, hungry, curious clinicians are greedily scanning through continuing ed catalogs the moment they arrive. They're scouring youtube videos for helpful hints, and they're following PT influencers on social media to learn everything they can about how to promote the PT profession.Beware of the physical therapist who only wants to attend a continuing education class to get some letters after his or her name or learn a hot new treatment technique. As a director, make sure that you discuss the ramifications of certain treatments and how they might impact the clinic. The legality of physical therapists performing manipulations is a topic too big for this article, but if one of my therapists injures a patient from an improperly executed manipulation, I cringe at the thought of the fallout. Can your clinic afford the legal bills if something goes wrong? And can you sleep at night knowing that a patient was injured at your clinic?
  • "In what cases would you refer a patient out?"
    This tells me a lot about a therapist. It can highlight his or her clinical reasoning skills, ability to interface with other practitioners, willingness to ask questions, and overall tenacity or lack thereof. There is no right answer here, but you will learn so much from your applicant's answer. Listen carefully.
  • “Name two topics of research that you have studied that are not offered in a continuing education course.”
    The reason I ask this question is that, as I alluded to above, many clinicians take continuing ed classes to learn hot new techniques or become “disciples” of one of the many treatment philosophies. One of the reasons my clinic is so successful is that my therapists and I take the time to understand the whole picture of any diagnosis and choose our plans of care accordingly. For this reason, I like PTs who approach continuing education classes as an avenue to improve their understanding of how they treat patients, rather than those who wish to adhere to a particular treatment philosophy.
  • “Tell me about a mistake you made as a clinician, and the steps you took to correct the mistake.”
    Unless your potential hire is perfect, he or she has made a mistake as a clinician. If it’s a new grad, probe for mistakes during clinicals. This question tells you whether your candidate has the self-awareness, humility, and safe practices required to care for your patients in the manner that you’d like.

While I realize that my expectations are high, I do not think they are at all unreasonable. I built this clinic from nothing, and my name is on the line. Think of your hospital, clinic, or department. Do you want a negative, reactive, apathetic hire aboard your team, even if they are experienced and skilled? Or do you want a clinician who seems born to treat, eager to educate, and passionate about promoting their profession? 

One last piece of advice for you, as a physical therapy employer: Once you have taken the steps to hire a passionate, organized, self-starter with initiative, get out of their way.

After all, nothing will stifle an excellent clinician like micromanaging them when you’ve hired them for all of their wonderful qualities.

Also, consider using Eyesoneyecare.com to hire PTs and staff for your office!


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