Percentage of Arrival

So the important thing to recognize here is that percentage of arrival is owned by the front desk and everyone on the team is responsible to get it done. This has to go with the difference between being accountable to something and responsible. So the difference is this. For example, a physical therapist is accountable to patient visits per week and the amount of money that they bill per visit. And they're responsible for new patients. Accountable means that's their primary job. Responsible is about helping everything go right. So as CEO of my company, I'm not accountable to taking the trash out, but at the end of the day, if that trash isn't taken out, I take it out because I'm still responsible. The difference is that a true leader, after they help in that case would hold the person who is accountable accountable to make sure it gets done. So percentage of arrival is the primary statistic of the front desk. Helping them understand that is absolutely vital because they are going to need to be held accountable to that and bonused when they get into certain ranges. So in the field of physical therapy, the percentage of arrival rate on a minimum standard, this isn't the goal. A minimum standard is 85%. What should the goal be? Well, I will tell you, it's always between 95 and 100%. And if you don't think that's possible, I'm right there with you. I had a practice in Coolidge, Arizona where 50% of my population was Medicaid. It was a very low income and all those things that we give excuses to as to why people don't come. And one of my favorite coaches told me, he goes, wow, you sure are making excuses to believe that, that it's just harder for your people to show up for their appointments again at a 50% percentage of arrival. And I thought that was expected with Medicaid. And so because of this coach, I changed my mindset and then I spent hours and time and money investing in what is the ultimate solution in helping get your patients show up to their appointments. So I'm going to go right into my iPad again. The first thing to remember is that it is a all team effort. And the first person, the very first person who makes an impact on that percentage of arrival is the pt.

Now you could argue, yes, the way that the new patient gets scheduled by the front desk has an influence on it. But hear me out. The conversion of a patient to their percentage of arrival happens on day one. And the first relationship that has the most impact is the physical therapist. So the physical therapists, when I have a low percentage of Arrival. I will always go to my front desk and my physical therapist at the same time. Right. They have to work together as a team. So the physical therapist does a number of things. They get an agreement.

And if you would like more information on that, we did a training in one of our weekly training videos that is uploaded. It's in the second week in September. You can look it up and have your whole team watch that video. And I go into all of these steps in great depth. But right now I just want to give you the overview. So the physical therapist doesn't say, yeah, I'd like for you to come to therapy two to three times a week for three to four weeks. And then we're going to see how you're doing in four weeks and decide if we're going to continue. That's where we lose our patients right there. This is how we, we train our teams by watching those videos on how to get the agreement. Mrs. Smith, I can tell with your lower back pain, it's caused problems for you and that you want to hold your grandkids again. I can get it better. And in order for that to happen, I need two things. Number one, that you come to your visits. I want you coming three times a week for four weeks, and I want you to to do your home exercise program. Would you be willing to do those two things in order to get your pain under control, in order to live the life you want? Yes. Great. So that is step one is that the physical therapist gets agreement, and the agreement is achieved by understanding the pain and potential success.

Of what that patient needs. Again, there's a lot more to this, but we're just hitting this on a very high level. So once the physical therapist makes that connection. The second piece is social conversion.

Whenever we are converting someone to be a client of ours in our physical therapy practice, they have to buy into the plan of care and then they have to feel seen and heard. So this is where when a new patient comes back, it should be our company's policy that we bring them back and we announce them to the team and the other patients again, we don't want to embarrass the person, so you don't have to make it like a big grand thing. I'll tell you, though, that's what I used to do. I'd be like, hey, Everybody, this is Mrs. Smith. It's her first day for physical therapy today. And all of my team were trained to go, oh, hey, Mrs. Smith, nice to meet you. Welcome. Immediately, they feel like they're joining A club, right? Like that's a part of the program. And the whole time we're talking to this person and integrating them on their first visit in particular, because once they're bought in, they will keep coming. Number three.

The team serves as the reminder.

What that means is at the end of the visit, we train every one of our people. We don't have to do it to the point where we're irritating the person, but we want to say, hey, Mrs. Smith, when do we see you again? You know, did you schedule for your next appointment? Can't wait to see you then.

And then the fourth piece is the handoff.

When the first visit is done, whenever possible, which should be every. Almost every time the physical therapist who did the evaluation walks that person to the front desk, goes to the front desk and says, hey, Susan, this is Mrs. Smith. We're going to get her back better. So this is what I need from you, Mrs. Smith. I want her coming three times a week for four weeks. She's agreed that she's going to do that. So I want you to schedule all of those visits right now. Now, Mrs. Smith, I understand that things are going to happen. You might need to make reschedules, but I really need to emphasize that the only way to get there is if you reschedule and not cancel unless you're really sick. Right? Because if you cancel, it's going to delay the results and I can get you better. Right. So, Mrs. Smith, I want you to book all of those up. And so listen, Susan, it's your job to make sure she comes in. It's really high toned. Susan, I really want to make sure you get that she needs to come in, right? Yeah. Okay, that sounds great. Such a pleasure to meet you. Now, towards the end of my time, the last two years, we would actually have a little piece of paper that, that our physical therapist would bring, like a prescription pad to the front desk. And it had the frequency and duration of their plan of care. And.

The patient and the therapist would sign it with the desired outcome. We are making an agreement as a team to help this person achieve their goals. And then when they hit that goal, by the way, we celebrate the daylights out of it. The fifth and final component here is reinforcement. So what that means is that's when. That's when we train our front desks on how to handle a disagreement. And we did that in one of our weekly videos of last month. I think it was late September, where Michelle went through and trained the front desks on how to handle a phone Call cancellation. So, in short, this is where we do in fact, implementation cancellation policy. But remember, the cancellation policy and the fee is always to reinforce the agreement. And where we get confused as owners is that where we are going wrong with percentage of arrival is that we're not making the agreements clear. The reinforcement is just to serve to back up the agreement. So if the agreement's not in place, adding a cancellation policy thing isn't going to change things. You're just going to constantly beat your head against the wall. But when we get clear as to what the agreement is and there's a clear handoff, like one of my coaches said, the drop almost always occurs at the handoff between divisions of a company. In this case, the back office to the front office. When that front desk is empowered, a couple things happen. Number one, they can reinforce it with cancellation policies. And there's a whole training on that, like, hey, Mrs. Smith, you canceled in less than 24 hours. Listen, I can only let this happen once. Next time we have to have that happen. But more importantly, we want to make sure you can play with your grandkids again. Let's get you in this week, right? And then we are empowering our therapists to hold the front desk accountable. That's the reason you can't do it very well is because it's not yours to do. The physical therapist has to understand that the results are contingent upon the patient coming to the therapy. Like, why don't we see that more clear? The stats in the research on this is crystal clear. When people come to their physical therapy appointments, they get better and save the industry of health care, not to mention the patients, billions of dollars a year if that happens. So that physical therapist needs to go to the front desk and even take phone calls from the patients when they cancel if that patient is starting to show a problem. Because sometimes people cancel because they got hurt. Sometimes people cancel because there's something they don't know and they're scared to confront the therapist. So they call that front desk, knowing that they're just trying to get through their day. But if that front desk knows that cancels are unacceptable at our practice and it's their job to be the reinforcer of the powerful exchange of agreement that comes their way. That's when they can feel comfortable saying, hey, John, Mrs. Smith is on the phone. She's trying to cancel. I told her she needs to talk to you because this is the second time she's tried to do this. And then me, the therapist walk up and I take the phone call what's really going on here? Do you really want to do this? Is everything okay? Like, what's going on? And that is how we get to percentage of arrival rates above 95%. I was shocked because, going back to my story in Coolidge, we had a situation towards the end there where we were hitting 95, 97, 98, 99. Percentage of arrival. It's very possible when you understand the concepts we just talked about, about creating an agreement and reinforcing it with the right team. And I promise you, most of you, if not all of you, you have team members who would love to do this if they just kn.