Sunday, July 31, 2011


It's been a tough week to escape the federal financial debate, no correct that, "Debacle". The country is less faced by a debt ceiling than by a leadership deficiency. At the heart of every conversation is the issue of entitlements. Nearly half of Americans pay NO taxes, but all want what is "entitled" to them... think social security, medicare, medicaid. The federal government more than doubled since 1965 - of course state and local governments have also grown. None of this is a surprise. The financial implications of baby boomer retirement has been well documented for decades by the Menniger Foundation and foretold by Kotlikoff in his book The Coming Generational Storm (2004). But somehow the inevitable is conveniently pushed aside.

There is another entitlement issue. It is one faced by nearly every physical therapy practice in the country. It is the entitlement of compensation driven by labor shortages but supported by third party reimbursement. Over the past 2 decades, I have had the pleasure of working with over 100 hospital systems, and several hundred private practices. Interestingly, I've never found a hospital based PT service that knows what its profit margin is - yes they know how they compare to budget with all its arbitrary and rationalized allocations but not whether they in fact are creating economic value or even covering their own expense. Likewise, it is rare indeed to find a private practice PT owner that can simply answer the same two questions. Then there are employed PTs... are they creating financial value for their employer and for their own job security? Is that value proportional to their compensation? 

The US federal government will be paying over half of the entire US health bill by next year - that's even before national health insurance (2014). Do you think that the federal government solvency might impact Medicare spending? Do you think Medicare spending might impact PT provider reimbursement? Do you think PT provider reimbursement might impact PT compensation? 




Are you entitled? Think again!

All The Best!


(c) Copyright 2011

Friday, July 22, 2011

Trial, Error and the God Complex

Wednesday, July 13, 2011


Every professional runs into issues from time to time, forcing uncomfortable confrontations. This happened to a client of mine recently. Here was my advice...

  1. Attack the issue not the person. Doing this reduced defensiveness and enables alternative endings other than win/lose.
  2. Make your points in questions rather than statements. Doing this keeps you off the defensive and support #1 above.
  3. Approach the issue as if you were discussing it on behalf of someone you care about rather than yourself. Doing so reduces your emotion and positions you to speak on behalf of what is fair, just, and right.
Don't avoid confrontation when it is necessary; instead position it for success.

All the Best!


(c) copyright 2011