Stage Two for 1st-2nd Year Physiotherapy Graduates

In my book "The Health Practitioner's Journey," I outline four stages in a health professional's career. The second stage is Commercial Success. This entails maintaining a patient list consistently over 80% full, with referrals coming from various sources, including word of mouth. Through diligent efforts in achieving clinical excellence, this stage yields commercial success as patient lists and referrers grow.

Owning your patient list

Stage two is an ongoing process that can set the groundwork for starting your own business. At this point, I discuss a practitioner "owning" their patient list, a figurative term signifying patient loyalty, where they would follow you if you moved from your current practice. This loyalty is established through advocacy, as patients recommend you to others, as detailed in the ladder of loyalty in my book. 

During this stage, you become more aware of the conditions and patients you wish to treat, possibly developing a unique selling proposition. For example, targeting specific referrers, like a sports club, can help you focus on treating athletes.

The journey to commercial success

Working towards commercial success is a rewarding part of a practitioner’s  journey. Treating more patients, enhancing clinical skills through courses and mentorship, and staying informed through reading all contribute to your success. You may find yourself sought after for specific niches or invited to speak at events, reflecting your professional development. It's crucial not to become complacent; hence, developing strategic plans to nurture existing referrers and attract new ones becomes vital in this stage. While seeking new referrers is important, understanding the associated risks and benefits for the referrer is equally crucial, this allows you to establish trust and  a strong relationship. I dedicate a portion of my book to discussing managing the benefits and risks associated with gaining referrers. These are integral aspects of becoming a commercially successful healthcare practitioner.

Methods for improvement

I have mentored numerous practitioners on achieving commercial success. After collaborating with my colleague Jon Ford to implement a clinical mentoring program during our tenure at LifeCare, we shifted our focus to enhancing practitioners' commercial awareness. The process primarily involved gaining buy-in and understanding meaningful key performance indicators (KPIs).

Jon and I developed what we believed would be useful measures, including:

• The average revenue generated per practitioner hour.

• The average number of patients seen per hour.

• The average revenue per consultation or the average fee charged.

The introduction of these KPIs provided practitioners with a baseline from which to work. A managing director of the listed company network at that time advised me that creating meaningful KPIs and actively monitoring them would lead to improvement. This is precisely what we observed. We ensured that the KPIs were easily accessible for practitioners to review monthly, leading to increased engagement. We witnessed their commercial improvement, and the enhanced KPIs became a proxy for growth.

We combined the KPI approach with a planning document titled "Achieving Your Career Objectives," which I have included in the appendix of my book 'The Health Practitioner's Journey'. This document helped practitioners plan their quarterly objectives for improvement. Goal-setting and planning encompassed not only clinical aspects but also their referrer base and targets for increasing referrers. Teaching them to utilise their time more productively in both clinical and non-clinical aspects further boosted their productivity.

To illustrate the impact of these activities, we devised a league table for the network, highlighting those who generated the highest dollars per hour KPI. We realised that those with the highest numbers were also among the acknowledged best clinically. While not entirely surprising, this revelation served as motivation for all and confirmed that clinical excellence leads to commercial success.

I trust this glimpse provides a taste of the comprehensive details in my book about this stage of your journey. 

My book is available on my website, www.michaelkenihan.com.au or from Amazon.

M.A.Kenihan

Stage One for new Physiotherapy Graduates

When I was at Lifecare we established three levels of education for our practitioners. The initial stage was for graduates, 1 to 3 years into their careers. They were in the first stage of education which I call Clinical Excellence. 

It was important to have mentors who would teach these practitioners. I had guided Ross L through commencement of practice at Lifecare Prahran Sports Medicine Clinic and was fortunate to mentor him through stage one (with assistance from exceptional clinical mentors) and into Stage two commercial success. Just six years after graduation Ross was ready to fly!

I asked Ross if was interested in taking a new step, involving becoming a mentor and teacher of others. Despite his initial reluctance, Ross eventually agreed, thanks in part to some persuasive encouragement from me.

We were eager to commence level one mentoring with formal group sessions with the group of graduates from years 1 to 3 that were working at the Lifecare practices in Melbourne. In all we commenced with some eight graduates from six different practices. We named the sessions ‘manual handling and clinical reasoning’. 

I cover those aspects of learning in detail in my book 'The Health Practitioner's journey'. We identified that upon graduation these two aspects of practice need further teaching and by building up the skills in a group environment we believed we could facilitate greater clinical excellence in the graduate’s practices.

Learning in a supportive group of peers where you share what you know and learn together is a wonderful way to enhance your skills. Encouragement from both Ross and peers created an environment where the graduates rarely missed a session. 

The sessions also developed into an opportunity where participants could bring case studies to the session and collaboratively problem solve to find how to best treat or progress these patients in their recovery. A majority of those who participated found that their patient list grew quickly as they had acquired new skills that they applied to their practice. This also prepared them to enter Stage two, of Commercial success and they were well prepared with a solid base of clinical excellence.

Ross took to the challenge like a duck to water and contributed significantly to the development of these practitioners’ skill base. Equally importantly, Ross learnt valuable skills that he was able to apply to his own practice. Stephen Covery calls this approach three person teaching as I had assisted and trained Ross, he had trained his new grads and then encouraged them to share what they had leant to others at the businesses they were working in.

Structured learning needs to be interesting, relevant, and fit for purpose. By combining Ross’s acquired skills and engaging with a thoughtful, enthusiastic group of individuals who understood their position in their journey and the skills they needed to progress we created a very successful learning environment. We had cultivated a generation of new leaders in the Lifecare practices.

The Health Practitioners Journey Model

When I was planning  the structure for my book, “The Health Practitioners Journey” I thought about how a career in health practice usually unfolds. I thought it would be easier to explain by breaking it down into four stages.

Stage 1

The foundation of a successful career needs to be one of becoming as clinically excellent as possible.

Whomever I worked with, I reinforced that initial credibility as a practitioner comes from having a degree of mastery of the technical/clinical aspect of the craft. I also advise that years 1 and 2 from graduation are not about focussing on what you earn as the primary goal, but on building your clinical ability.

Stage two

Focus on commercial success where you start earning more and become busy.

The focus for stage two becomes more about developing referral relationships and gaining return patients. There needs to be some training from mentors and others for this stage. Maybe even some short courses that relate to commercial matters of customer service, finance and business development.

Stage three

Direct your career towards starting your own business to maximise equity.

This stage may not be for everyone. If you are comfortable with stage two and earning a satisfactory salary then you may choose to continue practicing where you are but if drawn to start something for yourself, commence a new challenge and apply the new knowledge then stage three maybe a natural progression for you.

Stage four

Leverage your asset by selling the business.

At some point you may want to realise the value of your asset by selling the business. You may continue working but with the business you started in the hands of someone with new energy. Stage four may mean retirement but may also be about new opportunities too.

If you have worked hard in the stages outlined above along the journey you will have harvested knowledge. Such knowledge will be invaluable as you move on to new challenges or want to grow the assets you have created

I use the metaphor of the “list “ as practice clinicians have a “list of patients/clients” that they see, particularly in private practice. In stage one you build the list, then in stage two you own your list, in stage three you lead your list, and finally in stage four you sell your list.

The notation at the base of the model indicates a timeline but this was never meant to be interpreted as tightly linear, many practitioners dip in and out of the stages or stop at a point in the journey where they find their satisfaction.

As I mused about the stages of the journey, I thought that perhaps the best way to convey the stages was by developing a model for the journey. That model is the essence of this book.