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Blog #40 - How are you paying your young physios?

This is a topic that has risen recently in our own clinic with an exceptional 2nd year physio wanting to move onto a commission model.

Our graduates get rewarded above the award wage and we offer a very attractive package to entice them to our rural clinic.

Recently, I was talking with a friend that is about to graduate from vet science and his first job is in private practice with a $44 000 package. I thought WOW, our physio grads have nothing to complain about, as most graduates on a salary make no less than $60 000 in private practice.

After 12 months of mentorship and development to transition into a private practitioner, we now have a young 2nd year physio on our hands that wants to move to a commission model. That is great, because it shows that we have instilled the skills to be able to build a caseload and retain a caseload and that is one of the hardest things graduates struggle to do in their first year in private practice. So, we have done our job.

But in discussions with this young therapist we touched on some barriers that may be faced when shifting onto a commission model at this stage of their career.

What happens when we need you to complete non- billable work? e.g. reports, social media, follow up phone calls.

Now that we have a staff member that only get’s a % of billings, does that mean that they will not want to complete the non- billable work that is so vital to private practice?

My argument is that without the non- billable work going on in the background then the billable work will diminish. Reports back to GP’s encourage ongoing referrals, follow up phone calls with clients encourage word of mouth advertising to other family and friends, social media posts create exposure to the clinic and your reputation to a broader audience. Therefore, I would hope that nothing changes in this department of non- billable ongoing care for our clients and the business. Do you get to pick and choose your clients based on $ value? E.g. Workcover, NDIS, DVA, Private

My young therapist had the exact response I was looking for. If I can pick and choose who I want to see, then clearly, I have patients lining up out the door. Since that is not the case, then I would be crazy to say no to any client for fear I may have an empty appointment slot and no pay. I would rather see someone then no one at all.

What happens on days where I complete outreach or sports coverage and I am limited to the number of patients I see, but it is a valuable service for the business?

This is a tough one and a decision that needs to be made prior to commission model confirmation. If the role involves certain activities that require the therapist to participate in for the business to provide a service to the community, then perhaps a day rate needs to be agreed upon for these activities. This then becomes tricky with payroll to keep track of if each week is different. Otherwise, it may be the decision of the therapist not to take on these roles any more and remain in the clinic seeing clients. This is fine if you have other staff that are willing to continue to provide this service.

You will not be able to sway reception staff to book more patients in with you because you are now on a commission model.

This was a concern from an administration perspective that this young physio may discuss their pay model with the reception team and ask them to book clients in with them first so that they have a pay packet to take home each week. You must have a process that admin staff will follow to combat this problem. Obviously, these decisions will be made on a few factors:

- Patient request of therapist

- Time availability to suit

- Best suited practitioner for the injury

- Book client based on numbered therapist system.

- Last booking with therapist 1, next booking therapist 2 etc. then start back at the beginning.

Most commission models sit somewhere around 40% of billings for a young physio. You can have a combination of a base salary and bonus commission billings once you reach your salary return.

It is very hard for a business to offer more than 40% commission if you are not charging more for consultations with a specialty. The business carries all the risk of overheads e.g. rent, electricity, phone etc., you just have to turn up and do your job. If you don’t think this is fair, then perhaps you should consider going into business for yourself.

As business owners, we want to remunerate you well for your good work in the practice, but it must be at a sustainable level for the business, otherwise you will have no job to come to. Consider other remuneration in your package that may not be financial. This could be PD payments, retention bonuses, relocation allowance, rental assistance. Think outside the box, not all rewards need to be financial.

If you would like to see a Salary Model for a Graduate Physiotherapist in our own private practice, please email me at the link here

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