April 23, 2019

Aligning The Mindsets Of Owners And Their PT Teams Equals Retention And Growth with Kim Rondina, DPT

PTO 47 | PT And Owner Relationship


Kim Rondina, DPT of Wisdom PT Coach, knows what it's like to develop leadership teams and build a thriving practice as she's done both successfully. However, as she coaches and trains PTs and their bosses, she is noticing that there can frequently be a gap between what the PT and owner are wanting from each other. What she notices is that if the owner, the leader, will take the time to really listen to their therapy team and tap into their strengths, dreams, creativity, and desire to succeed, they will get more out of their teams, work together to attain clinical and individual PT’s goals, and develop a team that is dedicated to the vision and mission of the owner. Creating that kind of environment can become a powerful purpose that drives growth, retention, and recruiting.


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Aligning The Mindsets Of Owners And Their PT Teams Equals Retention And Growth with Kim Rondina, DPT

On this episode, I have Kim Rondina of Scottsdale, Arizona, who I've known for many years since working together at a similar facility back in Arizona prior to owning our physical therapy clinics. One thing I know about Kim is she's truly a dedicated physical therapy professional. She’s an endless student and she’s continually seeking knowledge. She has an immense passion for physical therapy especially guiding therapists and accelerating their development and providing the coaching and guidance needed to do that. She is actively involved in teaching throughout numerous professional organizations now and has trained with as well as led study groups to enhance the skills of her local professional physical therapists.

She previously held positions of Director of Clinical Development and Director of Practice Performance for a fifteen-clinic outpatient private practice in Arizona and thus led their growth and development of hundreds of licensed physical therapy professionals and directors. She's engaged in such diverse coaching environments as one-on-one trainings with directors, roundtables, hands-on treat tanks and code treatments. She's also an owner of Transform Manual Physical Therapy which is a thriving cash-based practice without any marketing efforts. Her environment is very unique in that she treats clients on a monthly basis and has a three-month waiting list at any given time representing the raving fans that she's developed through her expert care. The cool thing about her is she provides not only expert care. She's an excellent private practice owner obviously and successful at doing that, but also has transformed herself into an excellent coach for not only the leadership teams but also the staff physical therapist to improve their manual skills.

I'm excited to bring Kim on. We cover stuff that really focuses on connecting the mindsets of PT owners and their therapy teams so that they can get on the same page. When you do that it can be powerful and beneficial for your company in terms of the environment you create, your retention of PT members, your recruitment of PT members and ultimately the growth, stability, freedom and profitability of your PT practice. Although it's something that has to do with culture in a sense, she shies away from that word, but I think it's all about creating an environment and a shared purpose. I'm talking too much. Let's get into the interview here and take a listen to what Kim has to say.


I've got Kim Rondina out of Scottsdale, Arizona. She has been a long-time peer of mine and is the Owner of Wisdom PT Coach. She's also a physical therapy clinic owner named Transform Manual Physical Therapy. Kim, thanks for coming on. We've known each other for a long time and we've had a hard time getting together on this interview. I'm just excited to put you on.

Thanks, Nathan. I'm grateful to be finally joining you and your readers. I wanted to thank you also for providing such a valuable resource for owners in various stages of their discovery and aspiration across being practice owners. It's definitely an appreciation in your direction as well.

Thank you. That's very nice of you. You know how all my podcast start. I want to know your story. In fact, I know a lot of your story because we've been around the same block down in Arizona but you've transformed since then and that's what really gets me excited about bringing you on, is to share with the community where you're at, at this point. Bring it back a little bit and share with us your story.

I had a similar beginning to most. It’s been a little bit of an interesting journey since then. I was exposed to PT as a high school in the intercollegiate athlete. It took me down the path of graduate school at USC where I got my DPT in 2001. Over the years, I worked in a variety of outpatient environments and grew into a role in which a great deal of my work was with leadership development, organizational culture, performance analytics and clinical excellence. I have a curious, analytical personality and over the course of my career, that's provided for some amazing learning experiences and opportunities both as a leader and a mentor. I definitely have a tendency to see things as many little labels outside the box but more importantly, my role is assimilating information to help people make better decisions and choices throughout their careers. A big part of that for me too is developing an appreciation for connecting with people where they're at in their journey. I appreciate this opportunity that you're providing to your readers and creating mindset shifts in how we can transform as therapy professionals doing so.

PTO 47 | PT And Owner Relationship
PT And Owner Relationship: Have the confidence to value yourselves and the services, and patients will respect that, but you do have to differentiate your service.


Just as you're going through what you're talking about, you've seen a ton of growth, and I've seen a lot of professional growth in you as we've come across each other over the years. You went from a traditional staff physical therapist to Clinic Director to being a big part or playing a large role in a large physical therapy group down in Arizona over many different departments. You were there for a number of years.

I was a therapist. When I first came out of school, I had a lot of ambition and ideas of what employment opportunities were going to provide me and I failed along the way because I had three jobs in four years. I never felt like I found a place that really connected with what was important to me, which was patient care, quality experience and outcomes for patients. I settled into a larger organization, a private practice down in the Scottsdale, Arizona area and was with that organization for ten years. I went from being a staff therapist to actually creating two jobs. The first of which was professional development, meaning there was an absence of mentorship within our four walls in our clinics.

Our directors had a lot of responsibility. At the time that I was with this organization, we had fifteen clinics and over 70 therapists. You can see the scale of operation wasn't a simple one but the absence of having time to commit to the growth of our therapists and our professional staff was definitely a need. We created some opportunities for that. That evolved into a little bit involving outcomes and performance analytics and looking at how our industry was changing and how to help our therapists be successful within those changes. It was a big part and that was an absolutely amazing learning experience and one which has shaped where I am now.

You were with that group for ten years but you all of a sudden decided to quit. Give us a snapshot of what that was like and what you've done since then.

It was definitely an unexpected moment in my life. I'm not much of a risk taker when it comes to traditional ways of doing things but on a Saturday, I decided that I needed to change my path and my course. I really didn't know what I was going to do but I just basically started to be curious and have an open mindset about what opportunities might lie in front of me. Eventually, not sooner after, I started to take on it a little bit of risk, and I opened a cash-based private practice in Scottsdale. I started that practice about three years ago. There were a lot of unknowns with that, a lot of scrambling to figure out what met the needs of me as an owner, my emphasis on clinical expertise and excellence and then obviously thriving as a financial entity as well. It took me about six months to have a full schedule. At this point, I'm proud to say I don't spend a penny on marketing. I bucked the trend. I don't spend a penny on marketing other than my initial website, and then I have about a two-month wait list. I'm focusing on my passion and my love for the highest level of care for the communities that we serve.

What gave you the confidence to not only break from this company that you've been with for many years but then also decided to go cash-based?

I think the confidence came from knowing that I did have some strong referral basis at the time that with my eighteen years of practice. I get my name on a script and I had worked with physicians over a period of time and I was able to provide a different level of care, service and outcome to our patients. I trusted that and went with it. On the cash-based side of things, I had some peers and I had started to do some training in a group that majority of the patients that had trained for this group were cashed-based. I built a network of individuals that could help steer me and give me guidance and direction and worked through those moments that you have and the things that you put up as walls or barriers. They helped me see through them and see the opportunity. I flipped the switch on the mindset and be curious about what could this look like.

The #1 Factor of Job Satisfaction: Good human relationships between boss and employee. Thus, aligning the mindsets of owners and their therapy teams will lead to growth as well as improved environments, retention, and recruiting efforts. Click To Tweet

You had some kind of coaching/consulting at about that time when you got started.

Informally, the more peer aspect of things. I have a few mentors that are more on the clinical side of things. One mentor is a little bit on the coaching side and probably less so on the formal side. My mentorship and consulting came from the growth and development within that organization that I was with for many years. It’s definitely a wide spectrum of exposure and understanding the variables that influenced my ability to be successful.

Kudos to you. That takes a tremendous amount of courage to not only step out on your own but also go against the grant and go cash-based. I know it's trending that direction in a lot of our clinics or companies but to do that right out the gate, it’s really impressive. That’s great.

It’s definitely an exciting opportunity. I worked with a lot of individuals now that goes through the same thing. “What gives you confidence? Why me? Is the patient going to be willing?” and all those questions. Unfortunately, it's prevalent in our industry, and I'm glad to see that it’s trending in the opposite direction and people have the confidence to value ourselves and value the services. Patients will respect that but you do have to differentiate your service. It's not just the status quo because our patients are discerning consumers and respecting that in what we offer for sure.

Imagine the audience was a bunch of guys who are considering going cash-based or are thinking about starting a clinic that is strictly cash-based. What kind of encouragement would you give them? What kind of feedback would you give them or things to consider?

Most importantly, be adaptable. You have to meet the needs of your consumer. When we come out of PT school, there's a paradigm in which we think that the application of our services in the scope of our work is what our patients seek, or referral sources were sent to us. In truth, I worked with a variety of practitioners that I never thought I would have relationships with, from people who work in the world of Reiki to Feldenkrais to acupuncture. These guys all create an opportunity to make a difference for a patient and it does differentiate. In the more traditional medical model, it is somewhat self-limiting based off of what directionality and who goes to what doctor, and are they seeing a primary or a specialist? Being adaptable means looking for potential opportunities for a patient's health and well-being regardless of the source. That's the adaptability there and having the confidence to do that and take on any patient that comes to you.

What other advice would you give somebody?

Secondly, you spoke to the confidence element of things. You've endured a lot to graduate with a doctorate level degree and your skill set is more valuable than you believe. We lack confidence when we're early graduates, but you'll find a way to be successful if it's important enough to you. That means you'll probably become more resourceful than you ever thought possible. That means you'll network in ways when you talk to people and think outside the box, having all the mindset and be curious. You start to take on a different role and identity when you're seeking to be able to have that autonomous and autonomous practice and freedom that we all seek in our profession.

Now that you are where you're at, looking back, maybe you’ve established this early on in your clinic ownership or even before you got there. There had to be an inner purpose that made you decide to quit on that Saturday. You eventually decided to open up your own place and go cash-based and work with these other types of medical health care practitioners. What was your purpose? What is your purpose now?

In that moment, it literally was a belief that our therapists deserve better and second and foremost, belief that our patients deserve better. I think we all can attest to some external forces that are influencing our industry between reimbursement issues with referrals, growing issue with retention and recruiting. It truly came down to providing interaction and an opportunity for a patient, for the first physical therapy business I have. It’s to make a difference in clinical excellence and demonstrate the level of which PT can make a difference in a patient's life. On the second side of things, our therapists deserved better and many times someone influenced us to be brave enough to take the leap into becoming an owner. Exploring our relationship with our decisions of becoming either an owner or a therapist with our expectations as either a leader or an employee really dictates our ability to have sustainable success across our careers. That to me is where we start to take control of our future and redefine and evolve where our practices and/or industry are going.

A lot of what you're working on now is either in your own clinic but also with the people that you're coaching. It’s helping them take control of their future and really define what they want to get out of life.

I mentioned that one coach/mentor of mine. She once told me that the best way to get the attention of physical therapists and especially owners is to appeal to pain. There's a little irony in being a physical therapist and saying that but definitely my experience has proven her recommendation accurate many times over. Some of our pain points as owners both internal and external, within our four walls as organizations or businesses, I call them the four Rs. The top challenges for practice owners we're all dealing with, I briefly mentioned that reimbursement. We also have issues with referrals, our retention of employees especially our A players and then recruiting, being able to bring those A players into our organization. I was flipping through some stuff. We transitioned to an entry-level doctorate in the early 2000s. I saw an article published in PT in Motion in April 2018 that was surprising.

For an eleven-year period of time, primary care physician referrals to PT dropped by 50%. Is our dependence or reliance on a referral basis really creating a thriving culture for therapists with that expectation of building a relationship with physician groups, the primary care or specialist space? The reimbursement goes without saying as far as the cost containment emphasis and the impact it's having on our relationship with payers and thus the cash-based environment that I choose to be a part of. Retention is a topic of conversation. I'm hoping it switches more to solutions. The student debt to salary ratio is exploding. There are lots of job hopping for financial gain, high turnover and burnout.

There was also a study demonstrating that from 2016 to 2017, PT saw the highest increase in turnover rate amongst all allied healthcare professions. We feel it, but when you start to see it in objective ways, it starts to magnify and create a focus on our need to maybe bring greater attention to our people, our therapist and our experience as professionals and employees. That's a little bit of a lot of the conversation that I have with aspiring young therapists as well as practice owners. Anybody who knows me knows that I like numbers. Another crazy statistic is the recruiting side, trying to find that player that fits our culture, fits our dynamic and fits our vision as a company.

What drives employee satisfaction is understanding their intentions and their purpose. Click To Tweet

First and foremost, PT is considered the third most difficult job to fill by a very well-respected human resource organization. The APTA also likes to always keep an eye on us and that our workforce and this one is going to blow you away. There's an expected shortage of over 26,000 therapists in the next couple of years. What's our role in that as business owners? Are we pushing people away? Are we eating our young in the sense of burning them out and having that high turnover and not getting them a quality experience as an employee? We're emphasizing it with our clients and with our referrals, but are we doing it with our own therapists that we're bringing in our organizations?

In your experience in the positions that you have with that large organization, this speaks back to your story in that one of your first roles then was the maturation and development of the professional skills of the PTs in your company. You also said on that one of your jobs was with leadership development. If you're really going to retain and keep people from burning out, I think it's a lot of those two things. Am I wrong? What do you think?

At a basic level of leadership development and definitely growing people, clinical expertise is there. The missing link that I hear commonly with the groups that I work within the practice owners that I touch base with is really connecting and relating to one another. The mindset of an owner, we all can respect the demands and what that looks like. The mindset of an owner has somewhat taken a step away from the mindset of a young therapist. This has very little to do about the generational dialogue that's out there.

The Millennial group has some attributes that create some demand for us to be nimble as employers, but they also create a really great opportunity for us to redefine our experience as an owner. Many times, they want and expect exactly the same thing we do. That comes down to purpose and environment. Many of us started a practice basically saying, “I want to be able to treat patients in this certain fashion or I want to be able to provide an environment that allows me to do X.” That's no different than the employees that we're hiring. Here's a little bit of a hard truth. The number one reason employees quit, what's your experience, Nathan?

When they quit, it's usually a better-paying job or malalignment. It just isn't fitting.

It definitely impacts their decisions but here's the truth. The number one reasons employees quit is their boss. People will leave a job not because they don't like their work or because they found a better position but because they don't like their boss.

When you say boss, that doesn't necessarily have to be the owner. It could be just their superior or who they refer to.

PTO 47 | PT And Owner Relationship
PT And Owner Relationship: People will leave a job not because they don't like their work or because they found a better position but because they don't like their boss.


Absolutely but in essence, the owner is still responsible for creating the culture and the expectation of whoever that supervisor relationship is with. The main issue and this alludes to what you were speaking to about why people leave is they don't have a sense of belonging. They can't really relate to what they're being asked to do on a daily basis. A study by Kota in 2018, they looked at job satisfaction in PTs and the number one influence of job satisfaction is better human relations. This gets back to, are we connecting with other people and are we creating a culture that enhances their experience as a therapist? Are we creating a culture of business? If you want to make a difference in recruiting, retention and our ability to thrive as practice owners, we have to ask some hard questions about what we're creating. Those drivers of satisfaction are purpose and environment.

That purpose is what motivates and drives us. We want to connect and relate and as business owners, we can say that's why we started what we're doing. The other element is the environment and this is the experience they have as your employee. The caveat there I'm going to say is there are a lot of times that people go through a checklist of everything they need to do in an organization from a mission to a vision statement to core values, review the checklist of onboarding. That's all great, but it has to be a non-arbitrary engagement. It needs to be genuine. Do you help your employee fulfill their aspirations as a therapist or are they simply a widget within your system that you've built? For me, that's the second aspect of my growth and maturation as a contributor to the therapy profession is to help bridge the gap between the mindset of an owner and the mindset of a therapist. We can stop dealing with some of the things that are potentially internally mediated and driven into some challenges that we have as practice owners.

Pulling back the curtain a little bit. What would you recommend owners do to step back and see if they are connecting with the therapist that they have on staff? What could they do to connect better with the therapist that they work with?

First and foremost, we have to focus inward. I mentioned some of the external things that influence our industry but lots of times as an owner, the first thing we need to do is focusing on ourselves. We need to get clear with our motivations and our intentions. We have to live them, and we have to grow our perspective as far as what our role and our responsibility is. We can't keep getting distracted by the parts of doing our business because we're always chasing. There's always not enough. There's not enough time. There are not enough therapists. There are not enough clinics. There are not enough referrals. There's not enough in the budget. That scarcity mindset really has to be washed out of our mindset as an owner.

Would you recommend they get clear on the company's purpose and then just try to start discussions either in staff meetings or one-on-ones with them and really communicating?

Yes, but no. I'm going to take a step back to that inward on ourselves side of things. Many times, owners will put language to their motivations in objective terms or in material things that they want to accomplish. They really have to get a sense of what they want to feel in their experience as an owner because that will dictate the what of how they approach their employee base and their therapist. If you make it about numbers, many times therapist resist that. If your meaning is, “I want to hit a certain profit margin,” or “I want to grow or create this goal and I want to have this many more new patients in the next six months,” or “I want to add to clinics,” the truth of the matter is it all comes down to what someone hears as more and the never enough and that mindset of scarcity. It’s switching the gears and getting a sense of what you want to feel.

If that profit margin or those goals give you stability and a sense that you're on the right path, those are the type of language skills and the direction of how you engage with your employee. One of the things that I commonly have practice owners, younger therapists go through is I’d have them spend three minutes and I basically say, “Write out your 25 most important wants in life and it's just free for all.” Majority of the time when you get to the end and you ask them, 90% of the things they write out are all material things or data-based like, “Here's a goal,” but it doesn't connect and relate to your experience and experience is a feeling.

The number one reasons employees quit is their boss. Click To Tweet

That relationship that we have with why each of the things that we have a conversation with our employee is important. Let it be a meeting or a performance review or simply having a connection with them. How's your day going? What's making a difference for you and that 360 feedback? There are endless possibilities but it literally comes back to, what is the feeling that you want to have and the experience that you want to have as an owner? How do you bring that into the relationship that you have with your employees?

When you're talking about these things, you haven't used the word culture, but that's what's talking to me.

Buzz words happen. That was part of my responsibility in my prior position. I think culture becomes a concept and it doesn't become the context in which we relate to people. Our therapists, they hear that word and they think it's important to someone else. If you ask them what's important in their culture, they might not be able to answer it. If you ask them what's meaningful to them or what's important in their environment, that's a language that they can relate to and share an experience. For example, environmental aspects. We mentioned a younger generation of workforce, they challenge hierarchy and they don't like the status quo. At the same time, they're absolutely open to change.

The opportunity there is finding the mindset that's open and curious and trying to find and create opportunities to build your dreams together. It’s because you both have the expectation of having a fulfilled career, let it be as an owner or as an employee in coming to work every day, having that job satisfaction and excitement coming to work every day as much as you do driving home. There's always that re-grounding of a question. The how is left up to the creativity of each individual organization. For some people, that's a non-answer but for other people, it gives freedom. That freedom and that autonomy is what allows us to evolve away from the status quo of what hasn't worked over the generations of therapists and so forth. I'm a little bit of an older therapist, but we've got therapists that have been around a little longer than us and they talk about the good old days in the ‘80s. We know we're not going back there.

We've seen a transformation of what influences what physical therapy practice and what physical therapy ownership looks like. Take responsibility for starting with ourselves. Create that intention of what that experience is when we walk in our four walls. How do you want to relate and encourage the people that have basically said, “Yes, you're the person I want to grow my profession with?” Meet their needs. In truth, when you find a willing partner, it's amazing the dynamic nature and the opportunities that will come of simply meeting them where they're at versus trying to get them to see things your way. Our human nature is people should see things our way.

Especially as the owner, you want to say, “These are the stresses that I'm dealing with. I don't know if I really care about your stresses all that much because if I don't make a profit, then both of us have a lot of stress on our head.”

In truth, the most genuine stakeholder we have in our practices are our therapists. It's not our payer sources. It's not a referral basis and it's not our community. Unfortunately, our community is still struggling to figure out who we are, what we do and finding us regardless of direct access and the work we've done in that arena. Our biggest stakeholder is our therapist. Don't look at your budget. Pull that guy out. Ask yourself, “Out of your budget, how much do you spend on marketing versus developing your greatest asset being your therapist?” More times than not people's marketing budget is greater because they're trying to deal with competition. They're trying to differentiate themselves. Now with social media and the ways that we have to get in front of people, it’s more of a financial commitment than ever on the budgeting side.

We also know that therapists on the average generate about three to four times their salary as revenue for your business. Doesn’t it make sense to basically create the investment in our therapists and their ability to maximize that top line revenue that they're generating year over year and create retention and satisfaction? Rather than some of the marketing money that we spend to the people that the entities have shown that they don't value our profession as much as we do. I know it's a scary proposition because we've spent decades focusing externally and giving external people power to define our success. That's not really how we're going to be fulfilled.

I'm just envisioning what it would take for an individual owner to really connect with the PTs that are on your staff and what that would mean. For me, you can correct me if you have a different opinion or idea, but it takes some one-on-one conversations where there is a truly vested interest in what that physical therapist wants and needs in the future. What you can provide them to help them meet their wants and needs as long as it doesn't sacrifice my wants and needs, then we'd come to an understanding. If I can provide you some of the wants and needs and even some of those dreams that you talked about on the top 25 dreams they have for life. If I could buy them experience, if they want to go to Italy for a week, what can it do as an owner to get you to Italy for a week? Is that the kind of stuff you're talking about and at least opening the dialogue between the owner and staff therapist?

I'm definitely coming to work for you if you're going to get me to Italy. That's one of my dreams, but yes.

If you kill it and you've got a two-month waiting list, I’ll send you anywhere you want.

To your point, absolutely. As practice owners, we have to be adaptable in understanding what our role and responsibility is. We can spend time doing, chasing, committing and going through the cycle of business of our professions. We all have those sour points of the things that frustrate us, and we feel like we're in an uphill battle against in the things that we feel like recycling old habits and old conversation points with our peers and so forth. You can get ingrained in that. I understand that, but that's usually the things that don't bring us joy and satisfaction. The aspect of our therapist team is they can relate to us as a therapist. When we sit down and say, “What is it that I can help you attain?”

Stepping back, someone committed to each one of us. We've had people that have influenced us. It might be in an informal way or a formal way where they sat down in front of us or dropped a little message that basically changed the way we saw our profession and how we can be successful and thrive. It's absolutely sitting down. I’ve built performance reviews. I've seen tons of different performance reviews over the years and they can be fantastic tools, but you have to ask yourself, “What is the therapist experience?” We've all had gone to reviews when we were therapists and for the most part, you feel like it's a process because it's a checklist. You have to go through it at the end.

It's basically usually connected as, “Am I getting a raise or not?” The intention there is I have to do this process as a leader or a supervisor. You're going to have the expectation but it doesn't mean that I get greater financial stability in the future. That's not long-term loyalty. As a business owner, you're not going to build loyalty off of that, and that's what we strive for because we want that stability. We want that ability to brand ourselves and have a familiar face for a doctor to refer to. Even if you have to go through an entire performance from you, you have to have an endpoint where it really comes down to the individual therapist.

It's okay to try something and get surprised when it actually exceeds your expectation Click To Tweet

This is where the caveat is. Your leadership team has to have the time and the expectation of creating that level of engagement. It’s knowing their staff and truly committing to their future and not being fearful of them leaving, not being fearful of them becoming a competition. In truth, if we elevate each other and one another, the entire profession succeeds. Keeping people down is not working and trying to make sure that we keep our share of the areas in which we have our clinics and so forth. The truth is PT needs a lift up, not just a business or a region of the country. That comes from helping every new graduate and every employee that we have to really elevate the level of impact and growth that they seek to have.

The elevation, it seems like the trajectory of physical therapy in general because back in the day, a lot of it was about numbers, seeing your patients, being the better technician and improving your skill. I don't know if it's just a progression or if it's come with the generation of physical therapists and workers that are coming into the industry nowadays, but it's more than that. It's more of like, “I want to be in a place where I'm in alignment with their purpose,” or “I want to be a part of a group that's got a greater charity that they're involved with,” or “I align with these people because they've niched out into this specialty that I align with,” or “They've allowed me to create a niche within their practice that I really believe in and develop and hone my craft.” There seems to be more of that going on and less of the strict numbers because the numbers then take care of themselves as we invest in purpose and invest in the individuals, the therapy team.

Imagine if you’re changing how you approach your therapist and you start to discover what really motivates them and the gifts that they have to share and how they see themselves making an impact. All those things will start to open up the possibility of how your business grows, how it has different arms of the business, let it be we're going to reach out and do UroGyn or we're going to do CrossFit work or we're going to work with high schools. That comes organically within the people that you're having, but it only happens because they're driven by that meeting and that impact rather than a business owner saying, “Here, this is our next phase.” It's hard to pull people uphill.

The sense of belonging and going back to what drives satisfaction as an employee is the whole essence of everything is. It’s understanding their intentions and their purpose. Maybe this is my bias and my passion but hearing people's excitement about what they can do and what they can offer, my role at that moment is to be curious. It's to be open-minded. It's not to put my foot down and say, “Nope, that won't work. We've tried it before.” What future are we going to have or what type of employee relationship or employee culture are you going to have if they run into walls and you're that wall? Don't be the boss that creates the employee to quit.

Creating an environment like that just lends directly into two of the four hours that you're talking about, retention and recruiting. Your ability to retain at that point goes through the roof because these people have something that they're passionate about and recruiting means, they're not only doing what they love but they're spreading the word, “I work in a place that I really love to work at. You ought to join me.” You can show that to other therapists that you're recruiting. “This is what we're able to provide you. If you have a real passion for something, we can set you up for that.”

It is truly about nurturing and providing their ability to influence their future and your business. I'm sure you've interviewed dozens of people with a variety of different work environments. If we are paying attention around us not just necessarily our local communities but nationally, we see who's making a difference. We see who has raving fans of employees. You get a sense that there's freedom of exploration and there are a true curiosity and interest in how our business can be different, and that doesn't mean that everything has to look dynamically different than where you are now.

It just me not all clinics are going to look alike but it still comes down to your people and how you relate to them and giving them an opportunity rather than saying, “Here's the hierarchy. I've been here, I've done that. I built this. I'm the one with the risk and I know the numbers.” It’s giving an opportunity for someone to open your mind and shift your mindset and make a difference in your business because of retention. We get those A players, but we also squeeze hard to hold on but when we squeeze, we’re really not open. That's when we close off, get guarded and feel a threat and that's usually not when we're most dynamic, creative and adaptable.

PTO 47 | PT And Owner Relationship
PT And Owner Relationship: PT needs to be lifted up, and that comes from helping every new graduate and every employee to elevate the level of impact and growth that they seek to have.


When you say open, you have to really be open to the possibilities that you might not be able to be the best fit for that person. You want to try to create an environment where there's the ability to create and explore and do more but sometimes it’s just not a fit, and that's okay. I understand. How can I get you to the next place?

I have a peer that I worked with at my prior position, and she publicly admits that the best thing that ever happened to her was getting fired because she definitely wasn't a fit. There were a structure and an organization that focused on her weaknesses and dampened her creativity and the uniqueness. She was someone that is an amazing clinician, but it didn't fit into what the culture of the organization was ready for at that moment. She publicly admits, “I wasn't a right fit. I'm glad I got fired. It opened up this whole element.” That's just an example of sometimes the greatest gift that we can offer an employee is to admit we're not the right fit and there are all the sayings about the speed in which we hire and fire. We don't have to go into that. It's never easy to fire someone but in essence, you can do it with the right intention, and you can send the right message. You can still remain a resource for that individual across their career.

The benefit of that is it really speaks to you caring about that person enough to say, “This doesn't work for either of us.” When you're that vulnerable or that open and honest with each other or at least you come to that conclusion together, they’ll bend over backward to help you out. We had a guy that it just didn't fit. We were talking about the programs that we were doing, and we implement this, that and the other and he would improve for a while and then backslide and improve for a while and backslide. Finally, it got to a point where I was like, “Maybe this doesn't work for us,” and my business partner had an open and frank dialogue with him. We came to understand that it's time for us to part ways. I think he gave us two months’ notice and said, “Even if you bring them on, I'll stay around a couple more weeks to train them on what I'm doing.” It was great. It was wonderful and I know he's gone onto another group in town and they absolutely love him, and he's a great fit there. It just didn't work for us and so there's a benefit. I didn't want to go down to this is how to get rid of somebody. It goes to show that when you truly are open and honest with your team and looking out for what's best for them, that things can turn out the right way.

When I have a new graduate or a younger therapist coming and you're asking for career advice, the first thing I ask them is, “What are the top three things you look for in a career opportunity?” It's amazing to me that they can't answer it. When I say, “What are the top three things that you won't tolerate in a professional opportunity?” they know those things right there. They see the bad, and they avoid the bad but don't necessarily look for the right fit. As owners during our interview process or even with our team development side of things is identifying, “What are those three things that are important to you and are the things that we can honestly offer?”

We know the generation coming out right now, they all want mentorship and more learning. Do our business environments, our culture, our workflow and the demand of our day allow for true mentorship in the capacity that they're expecting? As owners, we all think that we're growing our people but what does that look like? Really working through what that expectation is because the last thing you want them to do is to feel that you're not committed to them as a professional because they've just spent over a hundred thousand dollars getting educated. They want you to help further that growth aspect. On the owner side of things, where does that get in our day?

Look for those opportunities, really finding and discovering through conversations, through networking, through seeking people within your own organization that are willing, able and interested to do something that you haven't done before. Allow for it to happen. Sometimes it's okay to try something and get surprised when it actually exceeds your expectation. Sometimes as owners, we always have that cautious tendency where we crawl into things and hope it works out right or we've put up a barrier before because we just don't think it's going to work. Allow yourself to try things and be amazingly surprised at how they thrive and grow organically within your organization.

Is there anything more you want to add? How can people get in touch with you? What speaks to you?

If we elevate each other and one another, the entire profession succeeds. Click To Tweet

As a message of the day, focus inward. As hard as it is not to allow all those external influences on us, encouraging in a culture and society that we have where there's so much business and chaos. Focus inward, ground yourself, get clear on your intentions, live them every day and grow through a perspective. That inward reflection also speaks to who you are as a therapist. Bring that focus on your clinical team, nurture them, influence their professional future and that is going to be vital to your fulfillment as an owner. In doing this, we're going to have an amazing ability to evolve the industry by committing to the people that are true stakeholders and that's our therapists. If there's only one thing that you learn is really differentiating who makes a difference in our profession and in your practice success. Let it be understood that it does come from within those that have dedicated the time, the energy and the passion for serving others.

When you really commit to your therapy team, if you're able to help them achieve some of their visions, goals and aspirations, even the dreams and experiences that they have in life, they'll do whatever they can to make sure that company that they work for succeeds or that you're also achieving your goals at the same time. They take a vested interest in the company that provides them with such wonderful opportunities to thrive, succeed and achieve their dreams. They’ll do whatever it takes.

I'm excited to see it playing out, for sure. As far as getting in contact with me, I am on LinkedIn both under Kim Rondina and Wisdom PT Coach. I do a Monday morning reflection in there just to re-ground us into some amazing thoughts in life in general. Also, through my website, you can contact me through Kim@WisdomPTCoach.com.

Thanks for being with me, Kim. This is awesome. I really appreciate it.

Thanks, Nathan.

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About Kim Rondina

PTO 47 | PT And Owner RelationshipKim is a dedicated professional, seeker of knowledge, and endless student. She earned a Doctorate of Physical Therapy from the University of Southern California. Her interests are wide-reaching from discovering skills that will further enhance the lives of her clients, to self-awareness and all things 'why we do what we do'.

She combines an immense passion for guiding therapists and accelerating the development of the highest quality skills in real-world clinical environments, with a style that encourages appreciation of the journey.

Kim is actively involved in teaching throughout numerous professional organizations that she has trained with as well as leading study groups to enhance the skills of local professionals.

Kim previously held the positions of Director of Clinical Development and Director of Practice Performance for a 15 clinic outpatient private practice and has lead the growth and development of hundreds of licensed physical therapist professionals and directors. Kim engaged in diverse coaching environments including a one-on-one with directors, round tables, hands-on 'treat tanks', and co-treatments.

Kim is also currently the Owner of Transform Manual Physical Therapy, PLLC, a thriving cash-based practice WITHOUT any marketing efforts. It offers a unique environment of treating clients on a monthly basis, yet having a 3-month wait list representing the RAVING FANS she has developed through the expert care that she provides and personal mastery skills she embodies.


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