Understanding FTEs and How They Help Us Know How To Recruit

The abbreviation is fte Full Time equivalent. And this is the metric we use.

To measure what one employee exchanges in the company. And so remember, one other confusing part we have as leaders is that we oftentimes look at people as one person, but when we're talking about recruiting needs, we break down their representation in the company into being an fte.

So for example, we don't have, not everyone who works for us is full time. And one person works 20 hours, another person works 40 hours. So one person does not fully represent a full time equivalent just because they're one human being. So when we start, this is the only time actually in business when I look at the leading of people as more of a numbers game than a human game. Because what Laurie asked is very mathematical in her question. So remember, we're not ignoring the humanity in the hiring that comes next, but there is this first step that comes into breaking down the mathematical opening of another hire. And the other thing we get stuck on too, by the way, is oftentimes we get really stuck that like one person, I don't hire until I need one full time equivalent.

There's so many different. There's endless people and endless needs out there. And the more specific we can get with what we actually need in real time, the more success we have in recruiting. Because when everyone's looking, and that's what most people's people are doing in their ads. I need a full time PT, the one ad that's like, hey, I'm looking for someone who's 20 hours a week, who only works Saturday, Mondays and Thursdays from.

From like 9am to like 7pm like we in our own filter, we're like, I would never want to do that. Why would I ever put an ad out for that? Because you're right, there are very few people that speaks to. But for the people that speaks to, that's how it just stands. They're like, whoa, this is exactly what I need. Quick story on that. My wife and I were, we came back from Europe, we were homeschooling our kids and we realized that we needed some professional help. So what my wife and I did was we leveraged the techniques that I've learned over the years from other professionals on how to attract talent to hiring an in house teacher. So we went through and we did this activity where we're like, all right, so what would be our ideal situation? Well, we can't afford a full time talented teacher for our two kids. Monday through Friday. My wife likes to homeschool a little. So she Was like, I would love to take on two days. We got really specific, not just with our needs, but our wants. Like, so we wanted a brilliant teacher who only needed to work three mornings a week. My wife was going to fill in the rest, but she had to be amazing because she was going to do this advanced curriculum for one of my sons who's exceptionally smart, Which I'm not bragging. When you have four kids, those things are more of a burden. Like, crap, what am I gonna do with this stuff? So we went through and we wrote up the ideal hire before we created the ad. And it was so funny because my wife turns to me after we're done. She's like, you know, I can almost imagine like Mary Poppins showing up and teaching our kids and like that same balance of like spoonful of sugar, but like firmness and all these things. And I'm like, okay, sure. You know, she's the principal. I'm just her assistant in that situation. So we created this job ad and we put it out there. And it was the most specifically odd combination of things. And we had four applicants. One of them is Ms. Laura, who's been teaching my kids for two years now. Ms. Laura is from England and she even has the accent. She's highly specialized. She's highly specialized and gifted and talented. Training for the exact ages of my two younger sons. And she travels. She doesn't have to work. She just loves teaching. And guys, we have a room in our. In my house that's turned into a classroom. You go into it. It's inspiring. And it was like, wow. By just being really clear, if I had all those limiting mindsets, if I need a full time person and you know, we were able to afford her because she's only so many days a week. I mean, it's crazy how it ended up working out. It feels almost miraculous when it does. When we're that clear. But we have to get whether it's God or the universe, the more clear we are in terms of what we actually need and want, the better success. We gener, we manifest people. I know that sounds a little bit kooky, but it's how I operate. It's like we almost manifest them objectively. Probably what happens is that we're inspired to come up with language in our advertisements and in our interviews that is perfect for that avatar, that ideal candidate.

So the first thing we do is we look at the objective need and that's the full time equivalent. Going back to that. So when it comes to the full time equivalent need.

One physical therapy. Let's look at a full time employee. Let's go with PTS. For now, one PT of FTE is equal to 40 hours, even though a non exempt employee doesn't need to. Like they're not set for 40 hours. Like technically they can go above and beyond that and they're going to get paid the same. For the point of measuring what our need is, we look at one PT FTE as 40 hours. Right. So that being the case, what would, what would a part time PT that works 20 hours, a 0.5 FTE, how many hours is that? Did I give you the answer already? Did I say, did I say the answer, Michelle?

No, you didn't.

But 20 hours.

Okay, thank you. I know that's crazy obvious but like this was a concept that took me a while to put my brain around, to be honest with you guys.

Oh, it's, it's, it's one that we are tackling in the rockstar directors masterminds quite frequently. So this is great.

Yes. And so there's different formulas that help you derive how many equivalents your clinic needs. And what's cool about this is that there's a formula for front desk, there's a formula for technicians, if you work with technicians, there's a formula for pts, a formula for administrators. The, the formulas are all different. But let's start with the PT1 just for ease. So the next thing you need to know would be how many patients seen per week.

Is a full time equivalent as a minimum. This is actually where a lot of us get in trouble. We don't have a minimum expectation of production for our providers. And just saying that for some of you probably makes the hairs on your neck go up. Cause like, could you imagine going to your PT and saying, look, our minimum production level is this many visits per week, they'd be like, oh, you're in it for the money, I'm outta here. Every industry in the world speaks like this and people don't take offense to it. But in healthcare, especially in pt, we have to word things in a way that really helps them understand it's for everyone's benefit. But the first thing we need to understand is how many visits per week corporates on a minimum basis, a full time equivalent. So that's different by state. Alaska it might be 40 or 38. In New York State the average is closer to 90 visits a week.

It varies by reimbursement by region. So you need to know what those are if you're a leader, if you're an owner in this room and you don't know what those minimum standards are. That's where you have to start before you recruit. All of your other problems are tied to that. Not knowing that and your culture potentially. But we'll talk about that next. If you're a leader in your company and you don't know what that is, find out what that is immediately. Can someone give me what they're. If you do know what your minimum expectation is per for a full time pt. What can someone who knows that share with me what that is in their company?

60 patient visits. So it's 1.5.

Yes. Per hour.

Per hour, yeah.

Visits per hour, yeah.

So one NT.

Yeah, check that out. 60 patient visits equals one FTE. That's how we did things in Arizona. And our states are kind of similar in proximity, so that makes sense that we have a similar reimbursement and therefore the similar minimum expectation. So when we're looking to hire people and Michelle, in a minute I'm going to pass it over to you to explain like the weekly trending thing that we used to do.

But right now, and right now the thing I want you guys to focus on is that just knowing this right here is the key of understanding what you need in terms of objective objectivity to make sure you have enough volume of income coming in to pay for the PT that you're hiring. So you need to know your visit minimal and you need to know your max. If your employer doesn't have a max, you should probably encourage them to create one for us. It was. Our minimum was 60. Our maximum was 80. With our Medicare load and federal payer mode, it was like no way you could be ethical in billing our minimum standard billing per visit without that. Without that. But with that, with that knowledge of 60 patient visits per week, now we can do something really fun we can look at. Let's use this as an example and take one of your clinics. So clinic A.

Clinic A is seeing currently 240 visits a week on average.

So what is the full time equivalent? Need of that clinic to stay? Yes, Ramsey, very good. So that'd be four full time equivalents.

And so rarely does the math ever work out that beautifully. Okay, so let's just do. Let's just do something kind of fun. Let's go.

What is 270? Let's say it starts growing. So we hire our 4pts and it's crushing it, right? But guess what? Because you have great pts and great marketing, now that average is inching up to 270 patient visits per week.

Per week.

What's our FTE need now?

We're going to have 4.5.

Bingo. 4.5 ftes. Crap. I need a part time employee. Maybe. Maybe I can see Michelle just like brimming with things to share. I'm going to pass it over in just a second. So this is where. And nothing's ever stagnant either, right? Like we ebb and we flow. We ebb and we flow and, and, but, but I want to highlight this point first and foremost because we have to start with the, the math of the equation before we can create everything else around it on its own. It won't help us grow because we need to have the culture and all those human elements to it. But I will tell you the reason margins are so pathetic in physical therapy is because we don't know how or don't measure the production of each hire relative to the money they bring in. It's that simple. Though, if you think about it, if it's a, if it really is going to be a business to turn a profit, we have to know for every hire I make, what kind of income I can anticipate. But that means me being able to know those numbers and teach my employees what those are. So developing the culture of like metrics and accountability is first and foremost when it comes to growing a company at all. We have to know what those are.

Sam.