Next Gen PT Masterclass: Prevent PT Burnout

All right, guys, well, welcome to our master class of next gen. We are so excited to have you here. We have a number of people I'm sure that will be joining us as we get going, but we don't want to punish the on time because of the late. So we're going to get started right away. And man, am I excited about today. We are going to spend some time continuing our discussion in this master class series that we started a while back on PT burnout. And man, is that a problem. The PT burnout thing is real. Everyone knows that's there. And as this group comes together, this group is a collective, just so you guys know, of students and new grads and business owners. It's both sides of the equation. And the reason that's important is because I believe firmly there's a number of business owners, many of which are here today, that have figured out what causes the burnout in a real tactical sense and what to do about it. And if we can help the next generation, the next gen of pts, navigate their career in a way to where they're not overwhelmed and they're not burned out, then we've done our job by promoting the legacy of our, of our industry. And so I'm just going to open it up as an early conversation to everyone here on this call and we'll keep the discussion fairly light as we go. But first of all, what do you guys feel at this point are the main causes of burnout? What do you guys see as the most influential, you know, instigators of this problem?

I think a big one Will is. And this is not unique to our profession, but it definitely applies to our profession is I think pts don't always have an optimistic view of where they're going to be in the future. And if they get in positions where they are optimistic about where their future is going, that's a huge. And that's. That's shown by a lot of research too, that people are much less likely to suffer burnout. And there's a lot of reasons. I think another big reason is, you know, the financial pressures that are on our industry and on a lot of students coming out of PT school today where they don't feel like their. Their salary matches their student loan. It's not justifiable. And so I think a lot of students are probably. Or new grads are probably taking positions that maybe they're not really passionate about, but they feel forced to take them because of financial reasons or maybe they're just working a bunch of overtime or PRN hours. And it's burning them out because of. Just purely because of schedules.

Man, that is such a great insight. You know, Chris looks like he's about to say something, so I don't want to get going. Chris, what are your thoughts?

Well, I. I absolutely agree. I. I think in a similar way is. I. I don't think that the new grads realize that they have, as Orit talked about when she was on last time, control and. And that's control and making decisions up front in terms of understanding what they want to do and then getting themselves in the situation, as Blaine suggested, where they're passionate about something so that they can enjoy what they're doing, they can have some control over what they're doing, and they can also dot their I's and cross their T's so they can pay their student loans and issues like that.

Yeah, it's interesting how you guys are highlighting these components of expectation. And then there's the real physical, like, down, like, the gravity of having so much debt. And I think, obviously we've seen a huge spike in people feeling burned out. And it's gotta correlate with that thing called exchange, where people are coming in, having a certain expectation of it, but they're not getting exchanged with in a way that feels fair. It creates emotional pull and trauma. For, for example, I don't even care what I'm doing if I'm doing standup comedy, even if everyone's laughing at it. But I can't. I don't have enough money to eat. I'm going to feel really stressed about what I'm doing. Conversely, if I'm getting paid a lot of money to make people laugh and I can't make anyone laugh, I'm going to be really stressed because I'm standing on stage and people are just staring at me, which is a real thing I've experienced. When I used to do standup comedy where I stood up and no one laughed, it was the worst feeling on earth. So I think there's that exchange component that both of you guys hit really well about it. So, you know, like, so for today, I want to get really deep into that. Like, what can we do about it? But it's so important we identify the causative factors. So we have. We have student loan debt. We've totally hit that. I like Blaine's hit on, like, just optimism. It is really a pessimistic market out there. And are. You're kind of shaking your head on that? Do you agree with that slash? Have other Ideas as to what some of these influential factors are that are causing this burnout.

Well, I think you guys have just hit it. I don't, I'm just sort of like, yes, it's all the things. We have some young wonderful techs in our clinic right now and I've heard through the grapevine because they both came in super passionate about going into PT and I've heard through the grapevine that they're both considering not whoa. And I haven't had a chance to sit down with either of them and have that discussion. But what has come about has been the discussion. There's been discussion around what it's going to cost to go to school and then whether or not the salary is going to match. And I think the thing that's always important to remember is that we're playing a long game when we come into our field. Our field still has a very high.

Job satisfaction rate for most people that come in and do pt. And so I think that we have to remember there's that long game, but the ability to have some control over your destiny and your path as a clinician. If you come out feeling like you've got this, you know, crazy amount of loan debt and you can only take the highest paying job that's going to work you to death, feel like you have control over that, then yeah, you're going to make decisions based on that and then in of itself is going to bring you in a certain direction from a stress standpoint.

Yeah. It's like instead of following the passion and the purpose, we're following the path of least resistance and trying to avoid the fear or burnout. It's, it sets us up for failure from the beginning. I love it.

And even, even though I'm, you know, I went back to school, I went to school from 80 to 84 and, and although it was only a bachelor's degree to become a PT at that point we were still borrowing $20,000 a year, so. And 1980 to $84, that's $80,000. So I don't want to minimize the numbers because they are big numbers yet. But I think that in and of itself that's not a reason to not go into it. I think it can be well managed and the profession does provide lots of opportunities to allow people to make a living, to pay their bills, including their student loans, and actually do quite well.

Yeah, I think would be cool about today's call too is talking about strategies to prevent burnout. And maybe we could talk, we could talk globally. We could talk in a lot of directions. We could pick one of these factors, student loans being one of them. Right? Professional development being another one. Another area that you guys have hit upon is that no one, the universities are doing better, but they really don't do a sufficient job of educating pts on how to professionally develop. Like how do you interview, negotiate salaries, find the right fit and then progress in leadership. Because if, if all we're doing is getting our license, that's the, that's the base level entry into our profession. There's no development or support in helping us grow as leaders. Even if. And leader doesn't mean clinic director, leader could mean specialist, could be educator back at the universities. I strongly believe that there is no reason why anyone here in. In physical therapy shouldn't be making as much money as they possibly can ethically and truly. Most pts could if they just were given that to me. I'm going to throw in there another factor I just thought of which is mindset. I believe pts from the day one of PT school, we indoctrinate them to think about money as bad. You know, if you want, it's bad to make a lot of money at pt. And so it shows up in our, in how we negotiate contracts as owners, right? Like we have to embrace the fact that like, if we're making a lot of money, maybe it's because we're doing a lot of good physical therapy for people, but we're. I remember when I was a PT student back in. I don't know, I'm not going to say when, but I was as a PT student decades ago. And like for real, I remember people shaming me. I remember, I remember being confused by the fact that I was like day one of PT school going, yeah, I want to own a practice one day. And people like, so are you just in it for the money? And I'm like, not just, but I sure am. Like I want to. Why can't it be both? Why can't I change people's lives and make their worlds, help them walk again and go home to a nice lifestyle that supports my family. And people always like talk shamefully like, well, I don't want to have like a nice car or anything. It's like, why not? I'm not saying you should be showy about it and like be unethical, but that's the thing. So we got a chat here from Aaron. I love this Aaron. In response to Chris, the cost of living has gone up relative to inflation, so debt in the 80s can't be directly compared. Yeah. You know, to your point, Aaron, I bet there's even things in the last, like, two years that are hard to compare because of inflation. Just real quick, Aaron, while you're commenting, where are you at in your stage of your journey? Are you a PT student, new grad, PT owner? Where are you at?

I am about to graduate in May.

Yay.

How do you feel?

I'm really excited to be through with the didactic portion of PT school and, like, coming back to the real world. It feels like I've been under a rock.

Yeah, yeah, yeah.

But I'm also looking at job offerings, and I'm. And I'm frankly like, oh, shoot, these are like five, ten grand less than what I was hoping they would be starting. Starting out, so.

Got it.

Relative to debt and everything else.

Yeah. And if you're okay, I'd like to talk with you a little bit and create tons of value for you since you were. You were here today. And I. I really hope that. I definitely don't want to ask anything that's too personal, but anything you can share is useful just for the sake of being the education in this space, because you are the realest in this room. You're the exact person we're trying to help. Right. So you're coming out of school in May. You're realizing that salaries are coming in five to $10,000 less than you're hoping.

And do you have. And is that your. Is that a common experience with your classmates as well? Like, do you guys talk about it?

Yeah, we. We talk about it. And I talked a lot with the class before. Me too. But it seems like somewhere in the 70s, even if it's like 80,000, but I'm in the Pacific Northwest, so cost of living in the Seattle area to have a doctorate and make $80,000 a year is like, you. You don't have enough money to save with that.

Do you know Ori?

No.

Okay, sorry. Norit's in the Pacific Northwest, and she kind of waved when you said that.

I'm like, oh, nice.

There's a bunch of friendships going on I don't know about. Okay, so. So you're. Yeah, I get it. I get it. And yeah, by the way, when I came out of school, Aaron, do you want to know what starting salaries were in. In 2002?

Yeah. What were they?

Mid to low 70s. Like, there was just very, very. It hasn't changed very much, at least. So inflation's gone on. What's up, Chris?

Back in 1980, they were 16, 18,000 or 84. They were 16, 18,000.

Oh, geez. A year. So I'm glad I wasn't a PT back then.

Well, you got paid more than I did coming out of school. I graduated in 2000, and my first salary in a hospital setting was 54,000.

Wow.

When I moved out to Seattle a few years later, it was about the same.

What was your debt? Or eat. What was your debt?

I was. I had a hun. Oh, I remember. $125,000 for PT school.

Wow.

In 2000, which is a lot. It was a private. It was a private institution, and I took out loans for. I took out loans for living expenses on top of my degree. So I. It was tough. I was thankful that I had a partner, but he was also going through school at the same time. And, you know, so what Aaron says is real here. The price, you know, the salaries are there. There's, you know, it's high living expenses in the. In the Seattle area. For sure.

Yeah. Aaron. So what do you guys talk about in terms of strategies? I'm curious, from. From your perspective, what are the strategies that you guys is. First of all, let me ask you this. Do you think that the student loan debt is the primary contributor to this burnout and stress that. That pts in the industry face?

I think it's a big contributor. I don't know if it's the primary, but I think, like, you were talking about the exchange, like, showing up to work and then feeling like you're well compensated. I don't think that.

Is. I think, like, the satisfaction is there working with patients, but financially, I think we're like, just below the satisfaction level for a lot of folks. And the thing that keeps people in the profession is, like, loving the job. And a lot of pts are like, very compassionate people. People.

Yeah.

So.

Yeah, I think. But what. Like, the more I've understood it, it's like, it's tricky from the business owner side because it's not like you're making it huge. Like, you're not, like, wildly successful and holding money away from your PT staff. Like, you just, you. Like, the reimbursement is too low to really be able to pay people more than the. Yeah. The bare minimum to keep them to stay.

Yeah. So first of all, that gives me a lot of hope that you just said that, because that means that your generation, if you're representative of this generation, is understanding the bigger problem at play. You know, back in the day, when I owned my practice, I was, you know, my employees oftentimes thought that I was rolling in money because, you know, they would see what they were billing. And I had, you know, up to one point I had four locations and 50 employees. And so in their minds they were like, gosh, that's like $4 million. And it was, we were grossing about $4 million a year. And some years it cost us $4 million to make $4 million, which meant I made nothing as an owner other than what I paid myself, which would fluctuate based on, on how profits were that year. Some years I'd pay myself less than my therapists dramatically. And I was working six, seven days a week. Like it was one of those things where, you know, but my pts would think that I was making money. So in your case, you kind of get the bigger problem that industry wide, the national average for GROSS Profit is 8% for PT practices. And to put it in perspective, 0% means no profit. Mean that company isn't even, the company isn't even worth anything. And most financial experts say that you need to be at a 10% profit range just to make sense to even do a business. So our national average as, as a, as an industry is 8%. And I think that really speaks to the bigger reason why at least PT salaries aren't going up, reimbursements are down. I just wonder how much of that correlates directly as a, a mover into what therapy some PT owners do, which is they raise the volume of expectation. I also wonder, Aaron, do you think that I want to ask the owners and this I'm going to ask.

The owners and Aaron, like, I think there's a discrepancy between volume expectations as well. Like, and I think it's growing. I think PT owners, I don't think PT owners are wanting their PTs to see more and more patients every year. I, I don't really, when I talk to pt, I don't think they're out there saying, okay, now this year I want you to see 65 visits a week. And then this year I want you to see 70 visits a week. But I do think there's more and more students coming out of school, being taught in school, that it needs to be one on one for an hour. Like that's something that I see can is more and more. So Marie, what are your thoughts on that?

You're muted, I think.

I know I'm super opinionated about this, right?

Oh, here we go.

So why did I open my practice? Right? The real, the, the, the main reason that at the time that drove me to open my practice was to do one on one for one hour sessions.

Got it.

I went through school back in, you know, late 90s, early 2000. I graduated in 2000 and I went through school and I had this mindset at that time that there was quality of care in the timepiece, that the more time I could spend with patients, the better their quality, the quality of care that I could give them. And so that was my whole focus. So it kind of made me cry when a couple years ago we switched to 45 minutes. And I've been crying ever since. But the, the thing that's been really interesting for me is I think you're absolutely correct that most, most of us who are in private practice are trying to figure out how do we keep providing this high quality care. And there's different way that owners are going to handle that. Some owners are going to say, yes, we're going to make visits smaller. And I know that that is the case in, in Washington. We've had, we have some clinics that are doing 40 minutes, we have some clinics that are doing 30 minutes, we have some clinics that are double booking. But I'm like, how do I get back to one hour? Because I want my team members to see less. So I think that the question that has to be asked by all of us, including those who are coming out and, and hiring and interviewing the potential owners, is to say, okay, well, what are you doing to offset this problem that we know exists? We know that as time goes on, reimbursement is decreasing. So what are we doing to offset that? So I know, like in Chris's case, and he can speak to this, right, it's cash pay practice in our clinic. We're starting to bring in cash pay services. We're going to open up a fitness program, we're starting to do some classes, we're starting to do more, more stuff that we feel still adds value and allows us to feel that, you know, general satisfaction and helping our community. But we're not going to cut those visit times down because it's a slippery slope. But that's how I'm approaching it as a business owner.

Love that input. Aaron, what do you think about that comment? What do you think?

Well, I don't have a ton of personal experience except for working as an aide, but I, I have seen how when we have like Medicare patients.

Or like the lower paying, like United Health. Sorry to throw them out, but yeah, anyways, when we have lower paying health care providers, there's like a higher chance of double booking those patients.

And I think when it comes to like, time with a patient, like, the quality matters. But if you're. Even if you have like a longer time with them and you're not good at like staying focused, if you have a second person at the same time, I don't know, just the, the to have like a successful business where you have one hour long or even 45 minute long sessions. You. In, in this area, you can't accept all of the different providers because some of them have such a low reimbursement rate. So then you have to be choosy and that means you're excluding a ton of people. And then that's where my, like, ethical.

You know, I'm like challenged ethically with like, looking at which PT clinics I would want to work with.

Yeah, I get it. It's really hard because this is where the mindset really starts to shift because we have some unique problems. Orit mentioned in a chat, she just said, aaron, we accept many of them, but we just dropped UnitedHealthcare. So like, there's, there's a lot of, there's a lot of frustration that we all experience in this industry that has nothing to do with any of us. We did not create the industry to this point with the crappy reimbursement that's there. We did not create the culture or the mindset shift of like, seeing money as a bad thing and not seeing it for what it is, which is a tool, you know, but we are in a position now where we're dealing with the cause of all that. So we are, you know, the impact of all those things. So as owners, they're working with really low reimbursements, very thin profit margins. Students are coming out with tons of student debt because our industry decided to promote being doctors of physical therapy before we fought for, you know, a fair exchange of compensation, which I think the doctor thing is great. I think we should have done it in a different order. I think we should have protected our financial worth and then become doctors. But regardless, we're here. You've got the student loan debt of being a doctor, Aaron, and, and reimbursement's worse than it was when you started. And so now we're all in this position of just trying to cope. And I think, I think that has everything to do with the burnout, is that it's not like students are coming out of school and there's anyone who's not already feeling the burn. I've never met a PT owner. That's not true. I know a number of PT owners who are actually very chill, but they're at a certain stage, they usually have three to five clinics, because at that scale, they have figured out leadership concepts. They've also figured out how to negotiate insurance contracts. They've also figured out what works for them to be able to pay their people at a rate that keeps them engaged without burning them out. And so at the end of the day, truly, we all have to come together, owners and students. And I think as you're. As a student coming out of school, I think who you decide to work for, Aaron, has everything to do with your burnout a hundred percent. I think who you work for determines all of that.

And the one thing you control, Aaron, besides who you decide to work for, is getting really clear that the only way to overcome all the burnout and the financial stress that your, your generation is going through is through leadership. Leadership is the only answer. It's a real broad term, but, like, whether that's rising as a leader within the clinic or rising into a leadership term in terms of specializing or whether that's becoming a leader in a way that, like, you have your own business. I met, I had lunch with an amazing new grad. She graduates next month. On Monday, I had lunch with her. She's a student. She's graduating. She just passed the boards. She's been developing her social media presence in physical therapy. She has a couple 10,000 followers. And what she's doing is that she's going to go out and independently contract, and then she's going to sell programs to patients directly. And our profession just doesn't promote that. But that's the. That's the answer is there's actually a huge opportunity and a lot of money to be made while we help a lot of people. But it's just not as, like, straightforward as coming out of school and working.

Blaine, I'm wondering, from your perspective, what do you, with your team, how do you help them deal with burnout on any level, whether it's the financial piece or, like, what do you do to help as you work with people? How do you help mitigate that burnout?

Yeah, great question. I'm just gonna. Before I answer that question, I'm just gonna echo what you say is like. Like where you choose to work and your ability to develop into a leader will dictate everything. But back to your question. So I, I do really strongly believe that knowing where you're going and having an optimistic view of where you're going will largely determine what if you burn out or not. And so in Our clinic, you know, every PT has different goals. Some really want to develop, you know, special certifications. Maybe you want to become an OCS or. Or maybe you want to become a pelvic health specialist. And some PTs are more. Maybe have more dreams of becoming a clinic director or an owner. And so I think the important thing is to really find people that you align with and make sure that your owner understands what your dreams are and that they're going to facilitate that you can get there. And so some things we do in our clinic, we have a. We have an unlimited con ed budget. And so students that are new grads that come work with us have that freedom to develop, develop how they want to. And we try to have, you know, frequent conversations, monthly conversations about where, where do you want to go and where. Where do you see yourself three years or five years or ten years from now?

I love that because what's the number one job of a leader, but to make more leaders. So if someone coming out of school like an Aaron, is looking to find a way to navigate financially and to avoid the burnout, it requires a mentor. That's what I got. I was so in my journey. Blaine, you reminded me of when I almost walked away from my practice in 2007. I started my business in 2003. By 2007, I was done. I was treating a crazy amount of patients and making no money. Money and hiring people was a nightmare because I didn't know how to manage or lead them. And so I told my wife I was going to walk away. And she was on board. She was completely on board. She saw this hell that I put myself through. But then I met this then. But she said, before you quit, why don't you join a network and hire a business coach? And I did. In that business, coach totally showed me what I didn't know about leadership and that his mentoring totally changed my. My worldview to the point where, like when we were busy, when we had our. At one point, we had five locations, none of my team was burning out because they were being. They were exchanging well, like, they. They had a pretty typical base salary, but we bonus them based on productivity and taught them basically how to become entrepreneurs. They didn't own the business, but they were leaders in the business. And the biggest thing that worked for us was this leadership program that I learned from other mentors. So, Blaine, what you said, I think is. Is gold having an owner who's going to serve as a. Or maybe not the owner directly, but someone in the company that you work for.

Serving that role as a mentor to help you achieve your dreams. And so that way people don't have to have it all figured out, but they just, they have the right who and teach them the how as they figure it out in real time. Because you could do what other people do, which is throw them to the wolves and have them see a bunch of patients and just get super burned out that way. But you mentor them with their, like, PT skills, but also on their leadership side of things.

You're. You know your previous business partner, Nathan Shields, he has a really cool podcast, the PT Owners Club. And he often says, I love that podcast. But he often talks about how he says you're. Your net worth is equal to your network. Am I saying that correctly?

Network is your net worth.

Yeah, your network is your net worth. And I wish I had understood that when I was a younger pt. Sometimes I look back and little lessons like that. But if I had understood that when I was graduating then I would, I would be so much further ahead now. But, you know, just developing those, those relationships with people are golden. Those are the things that are going to advance you in your career and help you have opportunities in the future.

I love that. Aaron, what do you think? How does that land? Is that something you've heard before? Is that new to you? I'm just curious, as someone who's coming out of school, what you think when you hear that?

I haven't heard that before. It makes a lot of sense to me.

And I mean, the network is your net worth. Like, that's great. I'm trying to, like, put that in my brain and remember it for always because.

I really like that. And I think the whole, like, the leadership, like being a leader in whichever arena is best fitting for you and is your interests, I. That definitely resonates with me.

So yeah. And I think that's so cool that you have an unlimited continuing education fund. Like, that's super rad. I like one of the things from, like some of my classmates and I, we've been approached by different clinics and clinics have said like, oh yeah, we're looking for new directors. Like in the next year or two, you could be a director and like the leadership as a director. Sounds interesting. It's also sounding nerve wracking though, because how do you. Do you have experience doing that? Sounds like you were working for a few years and then you had your own clinic. So do you feel like if you were like stepping into that kind of leadership role that you then, you know, you have to give up some of the time you'd spend developing your PT skills.

A great question. I'm going to ask Chris to answer that. Chris, what do you think?

Well, I. I mean, we have a. In our clinic, we have a similar pathway to that. You can either go, we want you to be an experienced therapist first. And it usually takes. Although you're well prepared at a doctoral level, you do need a fair number of reps until you've seen more than you've had the opportunity to see so far.

So I would suggest it probably takes at least two years of experience. And I'm not sure what a clinic director means to those clinics that you interviewed at. It can mean different things in different places, but it might make sense to become an experienced therapist, not necessarily somebody that's OCS or SCS or hand therapy, just to get experience, to be able to handle what walks through the door in that particular setting. And then maybe a clinic manager supported by a director before you move into a clinic director role, because that generally has expanded.

Responsibilities like extended hours and those types of things that perhaps they didn't mention to you, did they, Erin, tell you what it meant to be a clinic director or were they just laying out the pathway?

Some have been more general and some have been somewhat more specific, but not in terms of like the hours.

So.

A lot of times a clinic director has extended hours. And if it's a one or two therapists.

Clinic, it's just inviting you to, you know, do the work of one and a half therapists for.

Not a commensurate change in pay, I guess would be a good way of saying it.

You know, I think it's important when you're evaluating those types of places to look at what burns therapists out is a. Not getting enough money. So it does sound like 70,000 is not a reasonable salary for a new grad. Although orit is that what the salaries start at in the Pacific Northwest?

I think it depends on the. I've just listened to my team on these things. I think it really depends on what environment we're looking at. I believe that my clinicians start at. I have to do the math. I think it's just under that. But they also have a, I've been told a really ridiculous benefits package that I give my team members just because of the space that we work in, because we're in persistent pain. And so like Blaine, right? There's the unlimited con Ed, there's a lot of pto, there's all those things. So. But it sounds, it sounds right for outpatient orthopedics in this region to be around that. I've been told that my salary is a little bit, it's on par or a little bit higher compared to other small clinics.

Well, I mean, in Connecticut.

A lot of places offer salaries that low.

We tend to reduce the stress on new grads, start them higher, build in a guaranteed bonus the first year to kind of provide some financial security.

Provide the mentoring and kind of a low volume schedule until you're up and running. And I think that, Aaron, that's what, when you're interviewing with places, if they're not gonna, if the salary's low, I would find out what the.

What the productivity expectations are. And productivity is really not a bad word. It's really just what the math behind everything looks like. How many patients do you have to see? What's the general average reimbursement? I don't want to get too far down in the weeds.

So that you can really evaluate if it's a fair offer or not. I mean, again, without getting too far down in the weeds, you really can't consume your total package. Can't consume more than 50% of what you're generating in order for a business to remain solvent is really what the issue is. And I don't know if Will wants to talk a bit more to that, but that's kind of just a fact of life.

Love that. Chris, I love how you were spelling this out. And talk about experience. Aaron, I'm so hoping that you walk away with just so much. Like instead of having to go through these painful lessons by spending some time with us tonight, you're in a position where you're absorbing decades of collective experience around owning. Because we were all students too. We all went through the directorship route. Chris hit it on the head beautifully when he said directorship can mean so many different things. Like Aaron, in your case, some of these people talking to you right out of school about directorship, it probably is because they see a great leader in front of them and they're smart. They know the number one reason why people leave a company is because they don't see a future in it. So they're painting the end in mind. And that's what I would have done too. Like maybe we can talk about directorship. Other companies are trying to justify giving you a higher salary and the only way they can think about doing that is by filling a need in a leadership role that's maybe desperately being, needing to be filled. I have experience like these guys have.

Directorship positions can either be the beginning of entrepreneurship, or it can be the dump position that everything comes down to and that person is the most stressed out in the business. So the question, Aaron, is how do you distinguish between the two when you're interviewing? I'm going to ask you, Aaron, what do you think? Like, how can you tell when someone's offering you a director, like a new grad positioned with, you know, some soon promotion to director? How can you tell when it's like a great opportunity to learn how to grow versus a position to fill a need and one that you might regret and burn out in?

Well, I mean, as far as I can gather, I would assume it's partially like you could get a sense based on the other clinics and the other directors and the culture that's already existing with the other leadership, looks like.

But I don't know if there's like, just like to be a business owner, you, you, you have an incentive to, like, look out for your employees and your leaders, but you also have an incentive to make money. So it's just hard to know, like, is it. Is this, Is this worth the. Yeah. Is it worth it to me to potentially set myself up for this? But I don't know, do you have any other ideas for what to look out for?

Most definitely. But you definitely, like, I threw that to you to get you in that. That, like, we're coaching right now. And it's your. Your response shows you have a good head on your shoulders, Aaron, because that response was so. Yeah, let's look around and see the other. The other people there. Let's take a look to see how they're doing modeling that behavior. Chris typed in the message. He said culture. Chris, how can Aaron identify the culture of a practice that she's interviewing at?

Well, I mean, there's always kind of the basis of the whole thing is to find out if they have the statements like their purpose, vision, values, and find out what those, in fact mean versus something that's just kind of written down and never visited.

Is really what it all boils down to. And you can do that.

It's nice to have to see it and read it and have it explained to you. But it's also important to go and kind of observe the clinic for four hours or a day to actually really see what happens.

You know, people burn out because they're under stress. And if the clinic is set up so that the physical therapist can do physical therapy and not have to do any of the other stuff like schedule patients or collect copays or make appointments or log on to an insurance company's website if you have the person, the support personnel to do that. And the place is organized and you can see that on their schedule that they're not double booked and that the Director isn't working 12 hours a day, five days a week. I mean that's all the type of.

Information that you need when you're evaluating a place.

Yeah, the culture is, culture is always the thing. And so what Chris said, Aaron, just to highlight is you want to ask about first go to their website and go okay, let's see if we can find their purpose, vision, values. And you know again, this is the training that you don't get in school that I want you to hear really clearly that small practices that are run really well with people who aren't burned out. Everyone in that company usually knows how to verbatim the company purpose. Because when that company can identify why they exist, that means that they're really focused on creating an environment where people feel comfortable, safe, productive and happy. And so they tell you this is what we stand for in our values and here's our vision. When people say oh, our purpose, I don't know, I wrote that down somewhere. I don't know what that is. Or if they like, yeah, our vision is just to be the best we can be instead of being really articulate and something that, that gives you an indication of how much they focus on culture and then or retyped in the chat, how long have their people stayed? So you're talking longevity, Right. Aaron can determine burnout by simply measuring this litmus test of, of long of pers people who've stayed on the team. Right.

So that's huge. The other thing I would throw in there Aaron is to ask them specifically about their leadership development program. Here's how you can tell another way. And it's a key way to tell if a company that's talking to you about director is going to use that as a position that's kind of a catch all versus a real gift. Because I'll tell you man, the right director development program, they'll teach you how to be the entrepreneur and maybe the entrepreneur that you never even knew that you were work if it's done right. So you just ask, so what is your leadership? If you, if you want me to be a director, what does your leadership development program look like? Aaron, in two seconds you will know if someone's going to be in a catch all position when they say oh well, you know, we're going to support you in that role. We'll put you in that piece and we'll just. You'll have someone that, who's working with you, who's going to help you be successful. You can tell that they're just kind of figuring it out over time versus what Chris said. Aaron, do you remember that? He's like, well, our leadership development program begins with you mastering your skill set. So we need you to have X number of hours only focused on that until we can assess what that. Until you feel comfortable and you've mastered your skill set. And then like in my case, when I had my practice, I couldn't wait to tell people about my leadership development program. I would show them. Here's, here's the packet. Here are the books we want you to read. Here's the mentorship that occurs. Here's our targets for progression. I could paint the path very objectively, very clearly and quickly to someone who was. I was hiring as a new grad and I used to, by the way, Aaron, I never had a hard time hiring rock stars because I specifically looked for people who knew that they wanted to open their own practice one day. I would seriously. Not everyone, but most of the people I hired were future entrepreneurs. And my promise to them was, I will teach you how to open a practice in a way that prevents you from jumping off of a bridge. I'll teach you how to do that with me for two to three years. All that I ask is that you don't surprise me and that you let me help you do it and that you don't compete directly against me. That's all I ask, you know, let me help you find a new area. And most of my people would stay on board because they learn they could benefit from all the benefits of owning a practice without having to open a practice. And the ones who did open a practice, one of my old employees has now 10 locations and, and he doesn't. And he's, he's not stressed out. And neither the big look, if an employer has a stressed out team, I guarantee he or she is stressed out. Yeah, like, I think in school, especially coming out, it might look like there's a dichotomy of like, we have to make money or we have to keep our therapists happy. It only works one way. We all are happy and we are all making a lot of money. And a lot is a relative term in physical therapy clinics because even a highly successful clinic isn't making a ton of money. It's just making enough to where the owner goes home feeling like they are Getting exchanged. Well, with there are like, there's a spattering of PT owners across the country that are truly taking advantage and they're over billing and they're taking advantage of people. But I will tell you, they don't last long because they can't hire people to do that and then eventually they get caught up with the government. When I was in PT school, I thought that like, every third owner was out there to take advantage of the system. And what I've come to realize is the owners, 99.9% of the owners I work with are just the most passionate PTs who thought, how can I increase my impact and my income? That's it. And they're more on impact than income. So I hope that helps. Aaron, was that useful to kind of talk through how to identify the difference between a good leadership development program versus one that's just going to, you know, stress you out?

Yeah, absolutely. Yeah. Thank you all for your insights on that and writing this down.

See, I love it. Aaron, you're so grateful for you. Thank you. We appreciate your input because you're serving us as well. You know, we are getting close to the end of time and I feel like we just had a great, like, you know, point where we can hit, hit like a, a continuation point. So, Aaron, I'm going to ask you.

A question that might carry us on for a little bit longer. Is there anything that you have questions on that we can help you with? You've got, you've got an entire, like, council of experienced leaders and PTs who have done the business thing for decades. Like, do you have any questions on, like, how to negotiate a salary or how to find the job of your dreams? Or like, I don't know, like, is there anything that you have questions on, on any level?

Oh.

Well, I'm actually going to be reaching out to clinics in the next, like, week or so to set up, hopefully, informational interviews. And I also think that getting some time in the clinic is probably beneficial too. So how would you recommend going about that? Like, do I email one of the directors and ask for some time? Like, how much time would you want to spend with them? Like, I don't want to be like, you know, I don't want to over, like, expect them to take a whole day to show me around.

Yeah, I love that. You. So I mean, sure, I understand what you're asking. Are you asking, hey, how do I interview multiple potential employers in a way like Chris suggested, where I'm going to go shadow their clinics? Is that right?

Yeah, yeah, I Love it.

Well, the good news is Orit is here. So Ori actually lives in the Pacific Northwest, so I know Orit would be very happy to meet with you and do a, A mock or even real interview just so you can, like, get some practice in, even if she lives in an area that you have no interest in moving to and I don't know where. I don't know where you live.

Literally. Just sending a direct message to Aaron on that.

Yeah, great.

I'm happy to. So the, you, you know, the, the thing that I've always said is, and I love, I love talking to these guys because, you know, like, we're all so different, but we're all the same as business owners because what Will said was absolutely true, that we all, We. We really, all of us have come. We want to do things better. We want to be like. We want to be like. We feel like whatever we were doing beforehand wasn't as good as what we can be doing running at our own clinic. But the, The. The piece and my brain, just like, I lost my brain.

Yeah, yeah, I. Here's, here's where you were going. You want to support Aaron in doing those, and I think that would be great because again, it's not about whether or not there's even a fit here between you two. Ori is all about serving people and she has a team just like Blaine and Chris, that are not burned out. I only work Aaron, so I sold my practice in 2018. All I do now is I work with business owners and students. The student piece is the charitable arm of what I do. It's called the Next gen. So I combine the best owners and leaders with the next generation to help them overcome the challenges of our industry to be successful and by so doing, promote pt. So, like, I can promise you personal, personal that, like, I would. First of all, I, I'd want you to interview with or. Because she will give you objective feedback on, like, hey, you could do this better. This is what you need to look at. This is what you do really well. And then you could observe her clinic to get a good, like, example of a rockstar clinic to observe. And then when it comes to setting up interviews with other people, Aaron, you really do hold the cards. I want you to, I want you to think about that from a kind way. I met students back in the day that knew they held the cards in the relationship, and it was really frustrating because they're like, well, I don't know if that's good enough. And I'm like, well, you don't get to work here.

But.

But you can, you can be really kind and be like, hey, I really, you know, do some research online and before you go, talk to anyone would be my first bit of advice. Target clinics. Look for purpose, vision, values. Look for team, culture. Look for, you know, honestly, size for me isn't always an indicator of better, but usually two or three locations sometimes means they're doing something right. Even though I know lots, some of the best people I know just have their. Their single location. They keep it small. So for you, just look online to see what calls to you in that regard and then apply online and see how it goes in terms of just how. Let them lead out, Aaron. Let them lead out. If they don't even offer for you to do some shadowing there, you can always ask to do it, and there's nothing weird about that whatsoever.

Okay.

And if they don't offer it, maybe take it like a little bit of a red flag too, honestly. Like, I don't, you know, I don't know any experience. My buddies, the men and women I know who, Who've been doing this for decades, who have multiple locations, like, it's just common knowledge that you want this, the potential higher to shadow because it goes both ways.

Right? Like, you get to see the PT in the environment. You get to see how they interact with patients. And then I. I used to tell my interviewees, I used to say, hey, ask anyone anything. I want you to ask people, what's the best thing about working here? And I used to tell them, ask what then what the worst thing is.

And the reason being was because if I hired someone and the worst thing about working at my practice was something that they couldn't tolerate, they would quit.

Yeah.

So I used to tell them in my interview, here's what I. Here's what most people think is the worst part about being here. At one point, it was difficulty getting time off. At one point, it was poor communication because we had expanded multiple locations. If I told them that in advance, some people you could see wince. I'm like, oh, that this may not be for them right now, but, you know, if you can get. Take their pulse in the. In that group environment, you know, kind of ask them, just go, yeah, so what? You say it like this, Aaron, you go, what are the challenges? What. What challenges do you guys face here as a team? Is how you ask, what's the sucky part about working here?

What challenges do you guys face here as a team? You just ask them that. Yeah, great. And then like, you can tell how authentic they are in the response because they should be like, oh, you know, it's been really hard because of this. You'll go, okay, is that something I can handle or not? And then you ask, like, what are. What are the best things? What do you love about working here? And if people don't like, oh, man, let me tell you why I love it here. If they can't. If they're like, oh, it's. I think they take pretty good care of us, you know, what do I love about it? You know, the hours are flexible. It's like.

You want to feel the passion behind those questions and, you know, ask more than one person because I'll tell you, I never had a team where everyone was 100% passionate. I always had a couple people who were up and down a little, but, you know, you get a sense of what's going on.

Yeah. Okay. Thank you.

Yeah. Well, closing thoughts. I'm going to turn it over to Blaine and then Chris. Closing thoughts. Moving forward, based on this discussion, what parting advice would you leave for Aaron Blaine?

Where I was mentioned before about finding people whose values align with yours, so in company should be very clear on what their values are and their purpose. Our values here in my clinic are teamwork, integrity, transparency, and gratitude. And our team members that align with us on that, they do great. And our team members that don't align with that, they don't last here. And. And so just find people that you. That you align with and just remember to, you know, don't be afraid to be creative either. There's. There's traditional ways to earn a living as a pt and there's a lot of, like, creative ways that they don't tell you about in PT school. So keep an open mind. And there's tons of opportunities out there.

Man, you guys are on point. All the. All the company owners are just on point with their. Their language today. That is beautiful. I. I love your idea of Hope, Blaine, of, like, just get in, find people you love. You can figure it out later. Your network is your net worth. Like, get with people you love and, and get passionate in trading with. And then this whole thing called student debt is a different problem. Chris, what's your parting words of advice?

I. I would. Would really suggest that you take the time to get into the clinics that you really are interested in based on your research. I would suggest that you do try to.

Avoid sending out what looks to the clinics like somebody just fishing for a comparison of offers off the bat when you first Started talking. I just wanted to caution you about that. I really think it's imperative to get into the environment, see the environment working.

I often give people the opportunity to meet independently with as many of the staff as possible in a room so that they can ask the staff what.

It'S like to work here.

Just to echo what Will said. That really, to me, is the key. So you do your research up front and then you go in and you confirm it. And if there's a red flag, you really need to do a gut check and make sure that your gut is telling you that what I'm seeing here is not what I want to see, it's what's really in front of me.

Love it. Okay, well, this has been fantastic. Aaron, I'm so grateful that you're here. I have a small ask of you before we close.

Yeah, what's that?

So we just started these master classes. This is the second one we've done. And so most of our view, most of our attendance is. Is like the recording on the back end. We would love to have more participants in the call. We're going to constantly provide an array of different owners to ask any question, but we're going to focus on this thing called overcoming burnout. I would greatly appreciate next time I send out emails if you wouldn't encourage people that you know to attend, because when we have more people attending, we can really have discussions that matter. And I am confident between what you guys are doing on your end and what these guys are doing on their end is that we can bridge all these problems and just save everyone a lot of time and money, you know? Yeah, that's something you'd be willing to do for us.

Yeah, absolutely. I would be happy to.

Thank you. That means a lot. And I sure appreciate you being here as, as our. Our focal point. And, man, you were just the right person to be here. You just. Your questions, your insight, your leadership. We have no doubt that you're going to be successful. And I don't. I'm not just saying that. I've literally interviewed thousands of PTs over the years. I can tell pretty quick on the ones who I think are going to do incredibly right. And I. I'm not wrong.

So thanks. I really appreciate all of your insights, all of everyone who chimed in, gave me such thoughtful ideas and Ori, I'll be reaching out to you.

All right, well, guys, that's it for this. This month's our next training is always going to be the second Wednesday of the month. We might change the time, actually Aaron, do you have a recommendation on that? Is this a good time for this, this event, or should it be a little bit later, or does it not matter from your perspective?

It.

I think if it was a little bit later, it might work for more of my classmates. But I, you know, I'm. I'm sure people are also happy to listen to recordings, and that.

Yeah, that's where most of our attendance is on the recording.

I think next.

I think next year or next month, we might push this starting an hour later just to see what that looks like. But thank you for the feedback.

Yeah.

All right, guys. Have a great evening. Thanks for being here. Go, fight, win. We'll see you.

Thank you.