Game Changers - Productivity (Part 2 of 3)

To repeat where we left off...


While external factors have had their impact on productivity, there have also been critical internal factors at play – education and training, infrastructure investment, management priorities, and matters of professional comfort and convenience.


Despite the elevation of entry level education to the doctoral level for PTs, most enter the profession with little if any business orientation; this despite the fact, that healthcare accounts for 1/6th of the US economy.


Most therapists also arrive with little if any structured training or experience in delegation to support staff – even to staff who are credentialed professionals (e.g. PTAs). Task stratification, work assignments, and supervised delegation are cornerstones of productivity but remain under leveraged at best and unleveraged at worst within the profession. The result is underperformance and unnecessarliy constrained capacity within practices and the profession as a whole.


Infrastructue investment has been another internal detriment to productivity. Simply stated there has been too little. There are also matters of investment with good intentions but disappointing results. A prime example of that is the current rush toward the perceived need for electronic medical records in rehab with too little regard or understanding of productivity and return on investment implications. (more about that in another post).


It is extremely rare to find practices strategically and systematically investing in making their people more productive. That despite the fact that practices are service based with labor the single largest expense. Optimizing staff productivity and capacity through training and infrastructure investment should be the primary expense management strategy of practices but seldom is!


Too often productivity improvement is no more than owners, administrators, or managers periodically mounting their bully-pulpit or soap-box to threaten, admonish, cajole, plead, or beg staff to work harder or longer or to bill more units. Staff without adequate understanding, training, systems, resources, performance standards and accountability are not to blame, and thus are not the primary solution.


Productivity begins with purpose, leadership, strategy, and investment. It begins with an end in mind and is executed with passion and attention to detail. Only then can the benefits of productivity be harvested and respect for individuals be protected.


That is not to say that front line clinical professionals are not a critical part of the problem and of the solution. Professionals are afterall people first. All people have a tendency to do what they perceive to be in their own best interest. Work related comfort and convenience are important.


Change takes energy and comes with uncertainty. Lives are busy. One-on-one services packaged in one hour appointments for all patients, without delegation responsibilities are comfortable and satisfying for the professional on multiple levels. But, it is neither a clinical or business model that is financially stable, sustainable, or scalable! That’s the simple truth.


Let’s be honest and respectful with each other – it’s the way professionals relate. There is a significant culture of comfortable productivity that dominates the rehabilitation profession. That culture is protected and perpetuated whenever the quality trump card is played in productivity discussions.


Why does it have to be quality or productivity? Why not quality and productivity? It is where quality and productivity intersect that value is created, patients and communities benefit, professions are advanced, and future opportunities are secured. Professional advancement, job security and financial prosperity is dependent on value creation as measured by clinical and business outcomes – not one or the other, but BOTH.


Only by enhancing productivity and value (i.e. providing better results for more people at less cost) can professional security and prosperity be expanded. The simple reality is this: the need for health, rehabilitation, and fitness services is increasing rapidly and will continue to do for several decades. Those who expand capacity and value will be well rewarded. Those who don't will eventually be replaced. It is the way of the market. There is no place to hide. It is true for professionals, practices, and the profession. Evolve and adapt or go extinct.


Productivity is a measure of contribution, relevence, value, and vitality. Productivity is a matter of professional pride and possibility. Productivity means potential and prosperity. Productivity is a Game Changer!


Leading practices are Changing the Game today! They are doing so from the inside out while they have time. They are not blaming others and are not waiting for the inevitable. They are listening to the worries, needs, and preferences of the communities they serve. They are responding with new services provided in new ways with enhanced value to more people. And, they are being recognized and rewarded. They are sparking a revolution.


It was during the American Revolution that patriot Thomas Paine said, "Lead, follow, or get out of the way!"  And so it is today with productivity in healthcare...


To be Continued...


All The Best!


Bob

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