August 4, 2020

Creating Rock Star Teams By Improving Your Recruiting, Hiring, And On-Boarding Processes With James Savas

PTO 110 | Creating Rock Star Teams


James Savas is a Senior HR Professional who has worked in the healthcare (and PT-specific) industries for decades, and there is one common issue that he sees PT owners make. It usually looks something like this: the owner hires someone to fill a position, turns around to work on patients and put out other fires, cross their fingers hoping they've made the right hire, leave the new hire to their own devices, and expect them to come up to speed in a week or two. Most of the time, this process doesn't work well for either party, and frustration mounts to the point where the owner throws their arms up in the air and laments, "if only I could find good people." What most owners don't recognize - or take the time to detail - is that there are a number of steps they've missed between recruiting and getting an employee up to full speed. If they take the time to organize the process, the whole system can be a powerful foundation for establishing a rock-star team. In today's episode, James joins Nathan Shields to list a number of simple things that owners can do to create the team of their dreams.


Listen to the podcast here:

Creating Rock Star Teams By Improving Your Recruiting, Hiring, And On-Boarding Processes With James Savas

I've got James Savas. He is the Deputy CEO at Hands-On Diagnostics, and that's how I got to know him. James is an expert in many things related to HR, but specifically, he's a senior HR professional with a specialty in Business Development. He's also a certified educator and executive coach. He brings a lot to the table from past experience and PT specific experience. Not just PTs, he worked in other healthcare settings as well. I'm excited to bring him on so we can talk about HR-related issues and depending on our discussion, how these things go, we're looking at making this a two-part episode where we talk about a lot of things related to HR. I want to do that because James has a ton of experience. James, thanks for coming on. 

It's good to be here. Thanks for your time.

Share with everybody a little bit. You’ve got a ton of letters behind your name. You've got a ton of good experience. Give us the breakdown. What are some of the professional experience that you have in regards to PT in the healthcare settings and what you've done and brought to the table for PT owners in the past?

I’ve been in the game for many years on some smaller projects. I worked for dentists and chiros a little bit, but mainly the PT sector. Most of my time happens to be with private practice owners and orthopedic clinics generally. What I'll do is depends on what discussion I have. I have to work with an individual that has a good intention to do something with their game that they want to expand either they're too much in the game to expand. They don't have time to think about the administrative side or that HR side or whatever you want to call it. They want to get out of the game and own and let that machine roll.

I am dealing with guys on my track here on those two different sides. I've worked with guys up and down the Rockies, New York, Southern Florida, Central Florida, a little bit in Texas. Mainly the PT side. I'll go in as an HR professional, as a recruiter, depending on the gig. Business development is a big part of what I do because a lot of the owners out there help that can be of service to you guys. They don't have that guy, that ear or that outlet for, “Can I put something on your shoulders? It's all on my shoulders. Can someone else share the burden?”

I generally had been that guy. I'll be the figure out, organize brain, they know that they can do it but they don't have time for it or they don't want to do it. That's a nutshell, but I've seen the chiro practice game overseas in Ireland and all over the parts of the US. I'm dealing with a national company that has a whole bunch of owners all over, I think 26, 27 states. I like what I've done. I worked in Rural Montana and I've worked in the Story of Queens. I've seen both sides of the game pretty much. I can talk to an Alaskan up there if you might have some troubles and the guy in Miami who’s working.

That's good because a lot of owners that I'm supposing are reading, they're like, “I wish I could afford a guy like you to come in.” I know in my situation, people would ask me all the time, “How's the business going? How are things coming along?” Almost to a tee for about ten years, I was like, “I love treating the patients and I enjoy that, but I can't stand the HR stuff.” Having to deal with the employees, the person who gives me no notice and says, “I'm out of here.” Maybe doesn't show up or someone who does give me notice, but they happened to be a PT. I know it's going to be 2 or 3 months before I find another PT even though this PT only gives me two-week notice.

It's like, “Stabbed me in the heart.” Those things kill me and holding people accountable, all those things were hard. Hopefully, we can get into some of that to give some owners some ideas on what they can do to improve that HR side by spending a little bit of time in there. As you worked across the country, we want to talk a little bit about recruiting, hiring, and onboarding. Before we hit those three things, what are some things that you came across in your experiences with PT clinics, in particular, that seems to be an ongoing trend? It’s like you'd come across and say, “This is how you guys think,” or “This is how you guys work.” There's some kind of trend going on here that you need to correct typically when you walk into a PT practice. Anything like that?

I lean into it a little bit before, but what I'll see is that normally the owner has a bunch of ideas for expansion, things he’d like to do, what people he likes to fire, people he or she like to bring on, and he or she got time for not as much evaluation of that data. They have ideas statements all locked in this idea stage. Some of the fixed ideas that they can't afford an employee to do that. Often a debate I get for them is they need to hire, they can’t afford to hire they bring the guy or girl on, they are no good. They have to let them go. They wasted all this time training them.

It is that the attention on those things is not there and their ideas of when they should build up their staffing, how often they should then let go of the dead weight. You have both sides, you have that spot. It's a manager's function that they don't always do that they're busy in treatment or they're busy in other things. That executive manager role where they should be observing the employee going, “That's no good. Why is she still here? Why is he still here?” It's both sides. It's keeping staff that should be there and dumping the dead weight and no time to evaluate that. On the front end, “When do I need staff? Can I afford the staff? How do we get them productive?” Because I'll bring them in and I'll let them go and then I'm busy when they get it done.

I think I know exactly what you're talking about. You've got an idea and you say the solution is to hire blank. Maybe it's to get rid of blank, but you haven't taken the time to work through the process of how to bring that person on and onboard them successfully. I think that's what you're talking about. You were missing steps in between. We've got this idea. We think we see the solution, but there are a lot of steps in between that make that solution successful. We jumped from idea to solution and then go and work on our patients 40 hours a week without lifting our head up to observe, “How are they doing? Did they get any training whatsoever?” I remember many times sitting in interviews saying, “You have this title, but your job is to do whatever needs to get taken care of.”

Creating Rock Star Teams: It’s a manager’s function to keep the staff that should be there and dump the dead weight.


It was much less delegation and much more of abdication of any responsibility not knowing that the ultimate responsibility always fell on me if they didn't do their job. Poor job at training, onboarding someone, and having some processes in place. It sounds like then as PTs, maybe healthcare practitioners in general that are independent owners failed to take the time to lay out those steps and bring someone on successfully and train them up.

The other side of that went, “They're not doing good. See you later.”

The idea is this person's bad. The solution is to let them go. There might be more steps in between that make that successful that could help us along the way if we do it right. You've been across the country with PT clinics. I'm assuming your role as an HR professional was to do some recruiting. We can never talk enough about how to recruit PTs and get them on board. What were some of your successful actions to recruit PTs and bring them to even some of the rural settings?

The first thing I do when I got to the recruitment part of the HR cycle is to get communication at schools in my zone. In parts of Alaska, there's no PT school maybe around up there. I would get communication with the PTs in the area and what schools are in the area.

Even if there aren’t any local schools, those PTs can reach out to their alumni or their alma maters.

Getting that line is the first thing I'll do because I want to be well thought of by those schools. I want them to see my name, PT, and go, “We had an intern over there.” “I've heard that.” “He graduated from this school.” I want that PR is done well. As a comment, there's this element of the recruitment side. It is a marketing PR action in bulk, especially the recruitment side of it. The PR value of letting the schools know who you are is one of the first things.

Looking at the current good staff you have, who's been there 5, 10 years, or 2, 3 years, the owner's included. Even the front desk girl, the marketing individual or whatever it is. “Who do you know?” One of the biggest successes I've had in recruitment. I ran it as a pilot for myself to see to test myself years ago when I said, “I'm going to put no recruitment ads out.” I'm not recommending this. We had about a hundred staff, some satellite clinics. It was a big company. I said, “I'm going to only promote to my staff. I'm going to send out a weekly email to my staff, a few bucks ahead for a referral bonus internally for other staff. I'm going to bang it out and I'm going to run it like a campaign.”

Every week, there was a newsletter or a promotion from recruitment HR guy going, “Who do you know?” I get at least a name a week, if not 5 or 10. At one point, I had an 87% retention rate, only dealing with strictly my staff's referrals. That's how I got a guy from the UPS man. His daughter, his friend was in school for PT and we got her. The value of those lines and people never think of those things. They don't think of their staff, the mailman, or even the schools, but those two routes, they keep the new students come in and beat you on this side and they keep your current active good people that you’ve got in your business thinking. Those are two of them.

I love what you said about recruiting through your current team. If they're A-players, they're more than likely going to hang out with other A-players and bring you on. It’s the same thing with the students. If you can get a few of those students from certain classes who are in alignment with your company, and they toot your horn, then they're going to bring on their other awesome PT friends. They're not going to bring on a friend who's no good and more than likely they're not hanging out with those types of people. They're going to recruit for you and tout the benefits of working at your company and bring you on. I know that those are huge successful actions. I know, especially in rural communities.

I've had Dr. Sabrina Starling. She lived in Rural Wyoming and would help people recruit simply by using your network. Go to Christmas parties, “How's the business going?” “The business is going great.” During the course of conversation with anybody, maximize your network and say, “We're looking for someone like you. You're an awesome person. You're productive. You're a rock star. You've achieved many goals. Is there anybody like you that would want to work for me?” Take advantage of your network and leverage it.

To add to what you're saying is generally, they’ll refer people like themselves to some degree. They roll with that crowd, but also, they're not going to refer other people because they don't want to be felt bad of themselves.

It's great to leverage your local schools and alma mater. I know my business partner leveraged local PT schools down in Phoenix. To the point where we had PTs who said, “At any given time, if you have an opening in your clinics, let us know.” We had people “on the bench” and that was our goal. It took about 2 to 3 years to get to that point. He did an amazing job recruiting to the local schools, such that if any PT were to leave at any time, no fears, we would call up people and say, “Put in your four weeks’ notice, we're ready to go whenever you are.” We had 2 or 3 people that we could call at any given time to come on. It puts you in a different position altogether, minimizes the fear and puts you in a power position for sure.

Most small PT practice owners hire to fill a position without taking the time to considering what a new hire needs to be successful. Taking a little time on that process would save both parties many headaches. Click To Tweet

The big thing is constantly promoting. Most owners I've seen goes, “The law's leaving. We're expanding. We need only one PT.” They’ll recruit for one PT or they'll lose one and get one back. They'll sit on their laurels and go, “We're good because I have the number of equivalents working for me now.” It's got to be constant action. Owners that are single-handing the business are not going to spend 5, 8, 10 hours a day recruiting. Any constant flowing and constant thought about it. Maybe an Ad, an email to your staff, that takes minutes and email to the school, “How is it going director?” It’s been a while. It's little effort, but it keeps that PR communications live. It's in there. It’s got to be constant. If you guys built it up where you had a waiting list, that's what you’ve got to do. We used to interview for the heck of it when we didn't need an interview 1 or 2 a day. “We don't need anybody yet, but we're here. They can shake, hug, love what you got here. I'll be back.” If they don't come back, I gave them a call and said, “Who do you know?” “You're not looking.”

I tell my coaching clients because we got to a point where we always have the ad out whether we were hiring or not for any position on our team. We were doing interviews for the tech positions, the front desk positions that were a little higher turnover. We were doing monthly group interviews for that and sometimes we were able to pull some gems out of that. Sometimes we didn't. We always had a PT ad out. Never let that strap off. We always had it going, always collecting resumes because you never know, especially where we were in Arizona. It's notoriously hard to recruit, but you were in a similar situation in Rural Montana. Just a little bit of time each week, it shouldn't take too much. If you can set aside 30 minutes to an hour, send out some emails, send out a text, promote, make a phone call. That's all you need to do. We get to that point where then as we are hiring, what are some of the things you recommend that owners establish as a “hiring process?” We had certain phases that we would take potential candidates through or potential employees through, but what do you recommend? 

What’s completely underplayed by most is what’s next? We can talk about Rural Montana when I was up working for a client, a handshake, look them in the eyes, and maybe a pump on the back. That was your application. “I like you. You're a stand-up guy or girl, let's do this together.” There's something to that. That should happen appropriately every time again. I look at the recruitment onboarding that part is a bit off, where it stops and starts its own thing. It can be a technical subject because evaluating an employee both current inside but also coming in. I find that tantamount to you seeing a patient and seeing what's wrong with them.

You're going to evaluate them all over the place every which way you can to get to the bottom of what the problem is. I evaluate the heck out of these people coming in. There is the interview process. I have a testing regimen. We always would do. There’s a resume review, application review, a testing regimen. I have a couple that I've used a lot and then interview questions and then reference calls too. After all, that, when they're coming in, if that's what you're talking about, what does day one look like? Employee manual review policy, but let me know what piece we're talking about.

Let's talk initially about the hiring phase prior to offering the job or the day one of being on the team. Our steps taken were, collect the resumes. We do a phone call, but that wasn't much of an interview we wanted to screen for. What was their phone voice like? What was their tone level? Were they an excited person or they sound down? If they could simply pass a couple of those things and as I said, we also did some group interviews, but if we could get to a one-on-one interview, then we were doing some intelligence test. We would focus heavily on values. Make sure we were talking about our values and what those mean to people.

Making sure people were attentive when we talked about values and not swung back in their chairs and not caring any body language, assessing that stuff. There’s time to also talk about the job description and what your productivity expectations would be and what you're required to do. After the one-on-one was then a job shadow, preferably not with the interviewer, but with somebody else. After everyone agreed and they'd gone through all the processes, then we offer them the job. That was ours. What do you recommend on top of some of those things or different from some of those things? 

Creating Rock Star Teams: Evaluating an employee is tantamount to seeing a patient and seeing what's wrong with them.


A phone screening and a reference check. There’s like the normal systematic things you do. You do reference checks. If I got only one of the three, I got at least one, but try to get at least two.

Something successful for us in regards to the reference checks in which email was always the easiest. I don't know what it was. If I tried to get them on the phone, inevitably, they didn't have “time” to call me back. If I could say, “I'm interviewing this person. They put you down as a reference. Could you either give me a call or email me back your thoughts about them?” That made my reference checks much more successful and timelier. 

For time, that’s a great idea. I liked the opposite of myself. I had time to do this. I had to speak to the person on the phone because I wanted to ask some questions. I wanted to hear what they said. I wanted to hear them go, “Lag, do you have an answer?” I did do that because if I'm doing a reference check, then the applicant knows there are some interests. I'm even going to that point. After the phone call with the candidate and I liked them, I'm probably going to have you come in. What I'm going to do is I schedule them to come in and before they would come in, I do the reference check. If I liked them enough after the testing, “I'll see you tomorrow at 2:00,” but I didn’t hire them yet. When I could do that, I could leverage the applicant. I could say, “I called three people. I couldn't get through to Cindy, Joanne, or Mark because they're hot.”

That's been successful. After the initial little phone thing and then the reference checks and now they're coming in for the interview, what you asked them to interview? You could strip that thing out 50 pages. I think the role and the expectations, the bonus structure, what all of that needs to go. I generally do that at the end. I like to start it off personal, “Tell me about yourself. What do you do?” I love the question along the lines of, “What do you do on your time off?” I don't want someone who’s good at watching television.

They have a whole lot of favorites, no offense, a bunch of favorite podcasts, TV, and that's all they know, all they do or that's a lot of what they do. I'm out there, I'm hiking, especially for the rural parts. I want to be out there. I want someone who skis in the winter and likes the summer. That's a big part of it. Once you get to know them and it's a fluid or it's garbage because you'll know that quick. I want someone to interview me in the interview. I want someone to go, “Let me ask you.” They either go, “I have questions for you.” They have a pen and that’s fine. It’s formal. They’re going to be organized. They interview me, “Why are you here? How long have you been here? Why did the owner do this?” I love those questions.

I look for a great personal character and they're involved in life outside of my business. We looked at PTs in one of my practices, I worked for who wanted to own. It might be off-putting to an undergoing. I don't want someone that wants to take over, kick me out, or open next door. At the same time, I don't fully agree with that because as long as they were qualified, good applicants and everything that you do qualify them under. Once you get them in, if their purpose is like, “Down the road, 5, 10 years, I want to have my place, move back to where I come from.” Why not facilitate that? I think that's a misstep too sometimes. I don’t want someone that's, “I’m just going to live here in two years, at least so I can pay for it.” Think bigger.

There were some things over time that I got used to asking. I started steering away from, “What are some of your strengths? What are some of your weaknesses?” It was surprisingly common. I'd ask them what their weaknesses are and they'd say, “I care too much.” I steered away from that and started asking more like, “What books have you read recently?” I want these people who are intrigued. If they're honest, they're like, “I don't read books.” “What do you do? How are you growing?” Maybe they could be listening to a self-improvement podcast instead of an entertaining one.

Secondly, “What is your five-year plan?” Even with texts, with the front desk and older people who I would interview for positions, I want to know that they've got some goals in place. “I'm not sure.” I enjoyed asking some of those more specific, deeper questions. I enjoy talking about values. A friend of mine who I interviewed a couple of times, Sturdy McKee out of San Francisco, wouldn't hire anybody that hadn't played a team sport in the past. You can understand why, because you are working much like a team in a PT clinic that people maybe they're doing individual sports might not be used to the team concept much. That was one of their filters. I love those kinds of things that filter people out and you find a certain candidate when you start narrowing things down.

I love that idea and you reminded me that we used them at one point. You can be the passive indeed goer where you put an ad and that's all you do, or you can pay a month, which was reasonable at the time and see resumes. What was nice about that is you can search for keywords like NCAA or soccer, football. There’s a word bully in searching a certain criteria. I worked for an agency for a while too. I have a recruitment agency side. I've seen both universities. They're different universities. To be able to search, you're talking about a tool. I can search for football, Montana, and hiking.

What was your experience in the past? We've had some good experiences with on the job interviews. We'd tell them, “We expect you to come in for two hours.” Sometimes we'd pay, sometimes we didn't. I don't remember if we had a policy in regards to it, but either way, there was an expectation that they would come for two hours and sit with the person in that position. Even maybe come in and do some of the work but there was a definite expectation that they would be engaged. You want to see how they interact with patients, how they interact with other employees. Even though they're new to space. If it was a front desk or a tech person, two gold stars if they brought a notebook and took notes. What are your thoughts on the job shadow?

I love that. That's what we call it, a job shadow or a working interview. We didn't use them frequently. I would say it wasn't for every employee equal working interview, but there were somewhere I was especially questioning the fit or their background. What do they know? If I had a billing person come in, I'm going to want to a little bit more, “Sit next to Joanne. Let's see you talk to Joanne about your job. I want to see you at the desk with her. Look at some claims, tell me what these fixes mean.” I want a little more live stuff. For certain technical positions, I loved it. Certain receptionists, what we wanted to see, like we had a girl who was in there for years. She was the boss, a reception manager. We stick girls next to her and let her feel them out for half a day, 4 or 5 hours.

On the PT side too, I had one of my first employee way back was a chiro. She had PTs and she'd hire a massage therapist. She asked him to treat her in the interview. “Can you go back here?” “I'm not a clinician.” “X, Y and Z aren't feeling too good. Can you get back there?” She judged them on their ability to do it and understand your language and stuff. I love the hands-on idea. Every PT we hired, we would have them shadow our clinical director or our lead PT. Any technical clinical position, I'd have her do a little walk around. I do a little intro to the space but then I go, “This is what we do.” She looked for indicators like eye contact stuff. Are they involved? Are they asking questions? I would tell her what I wanted her to do and she does it. That was invaluable. I can work half day or something.

A lot of these people, for 30 minutes to 60 minutes, they can snow you over. They can talk a good game, they can show some personality, but when you get them with peers and not with the “boss” or the head guy, and maybe they'll let their guard down a little bit more. For two hours, they start showing their true colors. How often are they bringing up their phones and checking their text messages? How often are they off to the side? I had a coaching client who was interviewing a PT and she had been working in the home health setting for some time and she said, “You've been working in the home health setting for long, how would you help somebody? How would you screen if they came in for low back pain?” She says, “I would do this and that.” “Why don't you show me?” She's like, “I would do this, that and the other.” “No. Imagine I'm the patient and tell me what you want me to do.” She couldn't do it.

Most good applicants that wind up being hires want to know that someone's going to be watching out for them. Click To Tweet

Imagine if she had gone off of the interview, the face-to-face talking portion, and not asked her for some specifics and hired her on. Those kinds of screens are important. They were talking game talk. Maybe they were able to go through that portion, but then they would do a job shadow with a PT in the clinic and you wouldn't see any engagement between the candidate, the PT and the patient. They weren't asking questions. They were simply standing there against the wall, watching what they were doing and I'm like, “You don't have any soft skills. I understand you can technically do what you need to do, but you don't know how to talk to people.” That would simply write them off. Otherwise, we were ready to bring that person on that desperate, but I'm thankful we didn't.

One of the clinics they worked for not too long ago, they had a home health piece and then the clinic and brick and mortar in-clinic services. What was nice is even to some PTs and you didn't want them in the clinic. You want a clinic PT to be a certain individual. You want high communication. You want the comradery there and you want the ability to handle a bit busy-ness. You're wasting 18, 20 plus a day to be productive. In the home, they're saying 2, 4, 6, 8 hours a day, maybe different games. They were even different hires there. I liked them, but he's not a go-getter. Stick him in the home.

That made sense for that guy, because maybe he can on his own terms. Let him take his time with six patients to enjoy, but he's not going to work in my clinic and mess me up in there. One thing to add to what you said too. I wasn't sure about the person's honesty level and I wasn't sure about their real intentions. I would give my clinical director or the other manager questions. I would give them things to say in front of us. It’s almost like a private investigator. Have them talk about their last job or the last employer. The face I get in 60 minutes is handshakes, big smiles, hugs. When they're in front of this peer, not their boss, they could have a different conversation. I'll say it's their scenario, but I definitely will use that too. Even once or twice a patient who I knew was in the clinic, “I'm getting the new PT coming in for their shadow. With legal restraints, give them a hard time.” They roll with it or not. I'll play that side too.

I can't overstate the importance of those job shadows, because like I said, there were plenty of times where people pass through the interview phases with flying colors. They got to the job shadow and we're like, “Red flags done.” It's important to have those. The next step is important because we don't know how to onboard people. I wonder if business schools teach that at all. How do you onboard somebody day one? You would think that it takes much hand-holding and much time and effort. I know that there's a difference between the PTs and PTA and the rest of the team. What are your recommendations to establish an onboarding process for those two different groups? 

Behind that, you need general policy stuff. State by state if you have to legally have a handbook or not. I know that depends, but you need to have something to provide. I think most good applicants that wind up being hires want a regimen of some kind. They want to know that someone's going to be on them, not micromanaging. All the people I've hired over the years, they want someone that's going to be watching out for them. They want to be disciplined when they need to be. These are the good people that you hire. I think if you have a regimen of, “Here's the checklist we're going to do here. I’m open with my communication and direct. We're going to do this checklist of steps here.” I always included in my onboarding day one is some kind of orientation. You can look at that from the viewpoint of, “This is where the front desk is and go meet your boss.” That's what a lot of people will do. Shake your hand, “I’m your boss, come to me with problems, I’ll see you later.”

Having the formality there, the regimen, I like to have almost like a scavenger hunt. That’s what I create because I want them to come in for any position. It’s a PT, a trained professional, a little more sideways by that or an administrative person. I literally will have them find out where you're going to work. “Go and see what your cubicle is. Go meet your boss. Go shake the owner's hand. Count the number of chairs at the lunch table. Find out if we have a microwave.” It sounds completely goofy maybe what that does is it orients the person in the environment. I'll have to go out the front door and come back. “Do we have a signup?” “You don't have.” “What does it say?” “It's an old business.” It works as an investigation for me because then, “We have no computers. I forgot that.”

It gets them out of their comfort zone. It throws them a little bit off, gets them comfortable. I have to meet five people at least that first day. “I'm doing this weird checklist thing that HR guy said. Let me shake your hands.” That's a big part of it because it gets them a little comfier. People know who the heck they are to some degree and then I'll give them a buddy. I’ll say, “This receptionist is your buddy. Questions about where the lunchroom is, ask her.” “Betty, here’s your buddy,” shake hands and I'll leave him alone.

They're all for about 30 minutes-plus digging around the office. People are seeing them interact and they're doing whatever and I'm getting the packet ready. I'm getting the onboarding process. There's your checklist. You have to review the purpose of the company. The owner wants everyone to know this, because like you said before, even going through the interview stage. If your purpose and theirs don't align, they should not be there. I had noticed this part, I had an owner that would meet with every PT two weeks every month and go over, “How's it going in life?” The owner would meet directly, 30 minutes to an hour, and go over there like, “What do you want to achieve with 5, 10-year plan? How does it align with us and does it align with us?” I think the formality of a checklist, I like that orientation thing.

Creating Rock Star Teams: Always include an orientation on your first day of onboarding.


An employee handbook, review, simple policies, the dress code, the piercings and tattoo code, and voting policy. If you want to take days off, this is the form that you use. We use an HR professional, it was a onetime shot to develop that employee handbook for us and they are out there. I don't know how I found her, but she sat down with me 2 or 3 times and we'd go back and forth on email. She'd give me the standardized stuff that was required by our state. The policies that we had to provide and federally had to provide. She said, “What is your time off policy? Let's put that in there and what do you want?” She would guide me through the creation of that employee handbook and there are independent people out there that can do that for you.

I think even companies like Paychex also have an element that they can do that too. I fully agree that that needs to be there, whether your state legally needed to have it there or not because you don't know how many times an employee who leaves under unfortunately bad circumstances. “I want my last paycheck. I want my bonuses. I want my unused paid time off.” “You signed this. It said we don't do that.” How many times does it save your butt? Fifteen to thirty policies about functionality in the clinic written down. One thing I would say is that the owner needs to spend the time to know them, that's the thing too. Having an HR company do it. It can't just be in your email and you went, “Did I?” Many times not for bad reasons, but you have to know them because if you don't know those and you're going to be the effect of what you don't know.

I know the APTA can help. I think Rick Gawenda was promoting some policy and procedure manuals that can help you with compliance. That's a different thing, separate from the employee handbook, but you’ve got to make sure that's on your checklist. What's your HIPAA policy? Are they going to do some video training? There's a lot of video training on HIPAA that qualify. Maybe your state requires some OSHA training and Medicare Fraud & Abuse. Making sure you check these boxes, not waiting for the next team meeting, that's maybe scheduled in the next eight months to do those compliance things, doing them at the front end. That's why I like some YouTube videos that can support you in that regard. MedBridge has some of those compliance videos. Sit them down here, “Watch this for the next 30 minutes. If you have any questions or concerns, let me know. Scan over our written policy so we can sign you off on the compliance portion of that onboarding.” I think a lot of people miss that, especially as small clinicians, we don't even think about it. 

I think you hit something too. When we have a robust onboarding, I’ll put that in an ad. I'll tell you the truth because we've talked much about the recruitment, the ad side of things, which we can do separately or whatever. When you're advertising for a PT and all that stuff, when I put a robust onboarding process or rigorous, they get the idea that, “They don't mess around.” You're this much more apt to get an employee that, “They have a robust whatever.”

Someone professional or looking for an organized structure. That makes the difference between a mom-and-pop shop and an enterprise. I think that's where a lot of PT owners want to get to. A mom-and-pop shop are at the front of the store. They're greeting every customer. They're taking a reorder and that's what a lot of individual clinic owners are when it's them and maybe one other PT. If they want to truly get some freedom, they want to move over to an enterprise. An enterprise has the structure of a hiring process and an onboarding process to ensure the success of those people that come on board and that they're fully “trained.” I know you can take that to many levels. Our onboarding process was towards the end, there was offsite.

They would have almost likely a full day of onboarding training at a different place. I know even in Blaine Stimac’s case in Montana, I interviewed him. I think his onboarding process was spread out over the course of six months or even a year. They'd have a few days and then they meet up again 30 days later and again, 60 days later, 90 days later. Meet up again at the six-month mark and review some of those principles as they needed to and hold them accountable. You can go crazy with it, but at least having some structure for that onboarding can establish a foundation for the team.

I know Blaine is a basic structure. That is a lot to be said about. You can call it ongoing training. You can call whatever you want to call it. There’s this onboarding element where week one is a whole different game plan than month six, I think you should. There needs to be a 60, 90-day, whatever your terms on your employee manual. Review how they're doing in 3 months, 6 months. It has to be there for sure. That's part of that thing at the beginning, I mentioned where you need to know what this person is doing in your clinic. How has it been going? Spend the time to build out the policies, the regimen, and build out the basics. Spend time now so it’s done. Because once it's done, it's done. Once you have the manuals, it’s done.

Once you get that signature, if they have a question regarding the paid time off policy, go check the handbook, “You don't have to ask me anymore, you know where the handbook is. Go look for it.” That helps the trainer. Initially, it's probably the owner but in the future, hopefully it's not, but if you have an organized checklist, that's something that you can hand over to someone else. That's where you start gaining some freedom is when someone else, not the boss starts espousing the purpose and the values. “This is what we do.” When that goes peer-to-peer, that means a lot more than from the boss talking down. It helps out a lot and it also ingrains in the trainer, those same values and expectations, and helps them along the course of it. If something is written out if there's a “curriculum” to it.

If your purpose and your prospective hire’s purpose don't align, they should not be there. Click To Tweet

Even in a small clinic, where you have an owner and a couple of staff, letting a peer having one person. I had a receptionist do it. I've had the lead PT do it but having somebody else responsible for that basic administration. Make sure that this new employee does this and this and report back to me that they've done this. It's off your plate as an owner a little bit. Maybe you give them a little money on the side appropriately for doing that. Maybe they have a little bonus, but you have to give up some of those hats.

I'm going to cut off our discussion here because I want to transition into how to get people out the other end of the business. That is getting rid of dead weight, disciplinary procedures, developing that HR. Not just from the beginning like we talked about, but through the course of the life cycle of an employee. It might be going out the door in good or bad circumstances. Before we move on to that, if people wanted to get in touch with you, James, how would they do that? Are you willing to share?

(917) 312-4294 is my phone number. I love helping people. I worked for the company because I'm helping multiple owners in multiple states at the same time. I couldn't do that years ago. My email is

If people have some questions, they can reach out to you at, that makes it easy. Readers, watch out for the second part of our conversation. If you won’t, just move on to the next part and we'll start talking more about the life cycle of an employee.


Important Links:

About James Savas

PTO 110 | Creating Rock Star TeamsI love working with ambitious, driven individuals who have dreams of going big(ger) and just need the right support, backup and capacity to see it accomplished. I help them get that done.

The majority of my professional career has been in the Medical sector with the majority of that time in the Human Capital Management/Recruiting and Business Coaching/Development spaces.

Over 20 years I've strategically planned and executed programs and projects for my partner-businesses' expansion from as few as 4 offices to up to 16 office across 3 states. In my time working directly with various Owners and their staff throughout the boroughs of NYC and down the Rocky Mountains, I've hired well over 500 effective and productive Owners, Executives, Managers and Professionals, as well as created the training regimens for those people and their staff.

In addition to my savviness and acumen as a business expansion professional, I'm a successful soccer director and coach and a very very proud father of 3 amazing beings.

My Mantra is - Keep the create in life and be surprised by nothing!

Additional Points of Interest (some outside PT and some for fun):

* Published article in Impact PPSAPTA magazine (2008) "Hiring & Retention"

* Nationally Licensed Soccer Coach

* Director of Development of several Soccer clubs/groups

* Certified Assistant Teacher

* Co-owner (former) of a small family-owned retail dessert business

* International traveller (school in Italy & worked short-term in Ireland)

* Avid survivalist/camper/outdoorsman

* Humanitarian (as I'm able), directly assisted during 9-11 @ ground zero NYC

* Interned w/ MSNBC out of college (Broadcasting Major)

* Was a celeb-host at the 1996 Grammy's and 1997 ESPN Awards (some good stories not for air)

* Was on HGTV (with my family) in episode of a Montana HouseHunters

* Music composer/Short Story writer (Sci-Fi)

* Best hat I wear - DAD; pays shitty but great rewards!

Love the show? Subscribe, rate, review, and share!

Join the Physical Therapy Owners Club today:
Increase your revenue in the next 30 days using this one simple metric...
This one stat, if measured and addressed with your provider team, will increase your revenues within 30 days. Just leave your name and email below.
© PTO Club 2018 - 2019
linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram