Episode 36: Trials and Tribulations of a New Clinic Director

[00:02] AD: Alliance Physical Therapy Partners in Agile Virtual Physical Therapy proudly present Agile and Me, a Physical Therapy Leadership podcast devised to help emerging and experienced therapy leaders learn more about various topics relevant to outpatient therapy services.

[00:20] Richard: Well, welcome back to Agile and Me, a Physical Therapy Leadership Podcast series. Today I'm excited just to welcome megan phillip, CD of advent rockford in grant, just outside grand rapids. Yes. So welcome, Megan.

[00:34] Megan: Thank you. I'm excited to be here.

[00:36] Richard: Good. Would you be so kind as just to give an introduction of yourself to the listeners? So a little bit of background, perhaps?

[00:44] Megan: Yeah. So I am Megan, as we've said, and I've been with alliance, the whole alliance family, for about five years. Actually, a little bit over five years now. I've started my career as a new grad in our partner down in this south part of Michigan called Armor. And then recently I've transferred up to the Advent. I went to school in Nashville, Tennessee, for PT school, so I had to go to Belmont University. And probably my favorite thing about PT is that I get to work with so many different patient populations.

[01:14] Richard: And I know I've said this to you, Megan, before, but my stepdaughter was at Belmont as well, so there's a connection there.

[01:21] Megan: Yes, Belmont is a great school.

[01:22] Richard: It is absolutely a lot warmer down there than up here at the moment as well.

[01:26] Megan: Oh, yeah, for sure.

[01:28] Richard: So, anyway, Megan has done a remarkable job since starting with the alliance partners and was recently transitioned to a clinic director, Rock, and today really wants to talk to Megan about that transition as an emerging leader. How that? Has happened and how she has done that and perhaps also how alliance has supported and perhaps could have better supported her as an emerging leader. So thank you for sharing your insight today.

[02:06] Megan: Yes, you're welcome.

[02:08] Richard: So what I found when I transitioned from a staff therapist, a treating clinician, to a leader of a clinic was there was a lot of things that surprised me. I suppose ignorance is bliss sometimes. If I knew what to expect, perhaps I wouldn't have been so keen to actually jump into the role. It's certainly in the beginning, anyway. But what surprised you most about taking on your first, I say managerial role as a client director, particularly the fact that you've only been out of school for a reasonably short period of time.

[02:46] Megan: Yeah, I'll say I got to kind of experience a different kind of lead into being a clinic director. My time back in Armor, I got to kind of learn and be guided along the way a little bit. So I got the good pieces of being a clinic director to start with, so it made me really interested in actually having the opportunity to lead a full clinic. So same thing. Ignorance is bliss. So when I actually started to kind of be on my own and have my own title owned clinic. I think the biggest thing that I noticed was surprising to me was how much I had to change my customer service. It wasn't just about the patient anymore, but it was about my employees as well. There's a whole different aspect to each employee. Everyone has their likes, dislikes, their ways of learning, their ways of going about their patients, their ways of taking feedback and those things. And it's adapting to those situations I think were the most surprising. I had to do one therapist to have a sit down every week and go over stuff for 30 minutes. Another therapist only wanted to know what they didn't do something or that something that was coming up. Like a patient had made a score about some comment about something they did or something like that. And then there's other staff members that really want me to be by them and be like, what do you think about this? What do you think about that? And that kind of thing. So I think the whole customer service thing expanded from patient care, which at that point, patient care was like, oh, I got this down. And then customer service with my employees and how I manage them and talk to them kind of had to be molded and shaped individually to each of them.

[04:30] Richard: I think you're very brave going into clinic leadership after a few years of care, because I remember as a new graduate, I didn't feel comfortable even as a clinician for quite a period of time, and it took me quite a while to get that down, as you say, and to start to lead other people. I think I would have I couldn't even look after myself until I probably reached into my 30s, let alone look after employees as well. So, Kudos, in that respect, I also believe that the fact that you had a great mentor or were started in what I would say is a high functioning clinic or environment is really critical, isn't it? Because you develop good habits and you know what works, and you know what works well early on. And I think you can then take that relatively easily and then apply it as you develop as a leader. Unfortunately, when I started out as a clinic director, the clinic that I inherited was actually a turnaround. So I never had that experience with a leader that could help me grow and point me in that at least get me start in the right direction. So I'm sure that was very helpful, wasn't it?

[05:51] Megan: Yeah, I say I got to kind of see the good first. And weirdly enough, I feel like that was the most helpful, because I got to see how everyone worked together as a team, how we could manage different aspects of a clinic, whether it was like one person was sick. And we had to all come together and take those patients. Or if we had time, where our cancel rate was high or numbers like that, or even just how do we work better together to treat our patients? It was helpful to see the good so you knew kind of where the top was. And then when you got to the bottom a little bit, because we all get to the bottom at some point, I could think back on those experiences and figure out how to kind of take some of them and mold them to the clinic that was either struggling or that had some things that need to be taken care of.

[06:38] Richard: And I always say managing patients whilst there are challenges with patients. Absolutely. That's the easy bit in a way, isn't it? When you're trying to lead, manage, coach, grow clinicians, then certainly it's a very different dimension and certainly a very different job, isn't it?

[07:03] Megan: Yeah.

[07:04] Richard: Any other surprises perhaps that you want to share?

[07:09] Megan: I would say I think it has to go back to me as well. I definitely have to be on more percent of the time. I have to stay positive when things get rough. We had this experience the other day, actually, yesterday we had a clinician that was sick, people get sick, but then it turned into everyone had a lot more patients than they were expecting. So staying positive and being like, we'll get through this, we'll work together, it's going to be all fine at the end of the day. So really paying attention to how I responded to situations, whether good or bad, and how I presented myself within the clinic to try to help when bad things happen, when good things happen, but also just present kind of like the culture and the atmosphere of the clinic and hoping that the rest of my employees would kind of follow with that. So, like myself, one of my mentor actually said, you always have to pay attention to what you're doing first. Whether it's how humble you are, how positive you are when things get tough, how you deal with diversity and things like those.

[08:09] Richard: That's really impressive, to be honest. Because emotional intelligence is just really what we're talking about is critical to success as being a manager and leader. And the fact that you've picked up on that so quickly and understand that is a great testament to you as a young leader. So that's fantastic. The other thing is, I completely agree. As a leader or manager, I say you have to be on your game. That's not to say you can't empathize when things are tough, but certainly that positivity is so critical because people depend on you. They look to you, they feed off you. And what's always amazed me as a leader is the fact that whatever tone I set so quickly, others will match that tone, be it positive or negative. And it's really quite profound, isn't it?

[09:04] Megan: Yeah. It's impressive how fast something can turn around just based off a leader. Right. Like yesterday, I could have chosen to be like, oh, we're going to have to move all these patients. This is going to take forever, this is going to be really challenging. And said I was like, here, this is what we're going to do. And then we started with 1 hour at a time and then we just kind of went from there. So in a matter of 1 minute, because my front office kind of walked in and was like, oh, this is going to be fun. I was like, It'll be fine. We'll figure it out. From that minute on, the rest of the day was good and we took it as we took it. Right. Even if things like one person canceled Sweet, we moved them, we'll put this other person here. So just like even taking it one step at a time and pulling people back on that is, I think, a big part of setting the culture and the atmospheres. Because if you go too far down the road, especially in physical therapy, and you're like, oh, 07:00 P.m. Later tonight when it's like 07:00 A.m., things can change in such a quick time. So really just kind of setting how those things are going to go.

[10:05] Richard: Absolutely. I always say on a rough day, nobody dies, but hopefully I'm right with that. I don't think anyone ever has, but certainly I know some days can be easier than others. Can't they?

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[10:45] Richard: I don't think you can ever be too prepared as going into the role of Clear director. And I firmly believe the role of Clear director is probably one of the hardest in the organization because you do have to balance multiple demands. In my role as a leader, I don't have to worry about patient care directly, so I can focus on what I would say is really one thing. Whereas a client director is one of those few roles within the business where you've got to focus on multiple things which really presents its own challenges. But what things perhaps could have been done to help you be better prepared when changing roles from a staff therapist to a clinic director?

[11:31] Megan: I think for me the biggest part is not one single PT usually goes to school to be part of the business side of a clinic. So I got a good taste of that as I went through my first few years in alliance and Armor. But I think that the hardest part for me was relating all of the numbers together and trying to balance that patient care with we still need to have the business side to stay open and do what we want to do and grow and be what we can be and be the best clinicians we can. So that whole numbers, this is how many skilled units per visit you're doing. This is your retention rate, this is your alteration rate, this is your drops. All of those things were kind of the most challenging and trying to work on them and then picking the one, because if there's a couple that need to be improved upon, picking which one's.

[12:25] Richard: The most important certainly can be overwhelming, can't it? When you look at metrics numbers and you're not used to it because there are a lot of metrics that one can use and look at, and then there's a number of key performance indicators. And looking back, I didn't necessarily have the coaching to tell me or guide me with regards to what's truly important. What should you work on first? Otherwise, I'm sure I played a lot of Whack A Mole with regards, well, okay, this week I'll look at this metric, and next week I'll look at that, and the week after I'll address that. And I never really, for the first few years since I was a leader, really had that focus, which would have been very valuable. And the other thing I would say is PT schools just really don't prepare you at all with regards to anything outside of being a treating clinician. Yes, there might be a class on business, but that usually involves how to open your own private practice, which is completely different information and knowledge than managing a clinic within a larger entity. Is that fair to say?

[13:46] Megan: Yeah, I think too, adding on to that, I think even when you do business class in PT school, it's kind of like guided in fantasy, right? So it's like, oh, I think this would work. But no one's actually going to tell you if that business that you've learned and that we made a business model for a clinic is going to work, right? It's like, oh, here's your square footage and here's all these things, but it's not going to go into practice. How do you learn how to put it together? But it's kind of the same thing with this. You might kind of know what skilled units are, and you might know what your FTEs are and all of that, but until you start seeing them live in practice and things like that, I think it's good to know. But it's hard to kind of learn and know what to do until you get to that point. Yes.

[14:32] Richard: When the rubber hits the road, it's pretty different, isn't it? Yes. I went to business school and did kind of a game, a virtual game of running your own business. But that's Monopoly money, when you're actually dealing with reality and true dollars and how that impacts the team and their employment and your bonus, it's a very different type of game then, isn't it?

[14:57] Megan: Yes, it is. It is a whole different world.

[15:00] Richard: Anything else perhaps we could have done as an employer or schools could have done, but probably more from an employer perspective. What could the employer have done to perhaps better prepare you be that information training, resource, mentorship? Is there anything else that perhaps could have been better?

[15:27] Megan: I don't know if there's anything better, but I know that one thing that helped me that I was able to have is that when bad like, let's say a bad NPS score came and we had a chat with a patient or there was some confrontational situation with a patient about a bill, something like that. It was very helpful for me to be pulled in with my mentor. And so I would not really communicate and say anything, but I would sit in and listen to how some of those conversations went. Because if I didn't do that, I have not always been the greatest person. With that kind of confrontation, I don't know that I would have started off as decently well as I have with addressing patient concerns and having a friendly voice to something that's not always friendly.

[16:10] Richard: Yeah, crucial conversations are tough, and it's hard enough to communicate effectively in normal day to day environment, I believe. But when you add in some anxiety and an issue that's upsetting an individual, be that another employee will be that a patient, certainly that's a skill set that needs to be learned, and you need experience of that. So yeah, that's pretty anxiety provoking, isn't it, for a new leader?

[16:41] Megan: Yeah, I think the whole, like, putting people into situations, even if they're not quite a clinic director or some type of leadership, letting them have kind of some exposure to those real time situations is super helpful. In a mentorship or just in a general clinic, if, you know someone is interested in becoming a clinic director or a leader, pulling them in on certain things like that to kind of experience and see how they kind of work themselves out is probably invaluable to me now.

[17:12] Richard: What I've always been interested in is why people would probably become a clinic director in the first place. So in outpatient physical therapy, there's such pay compression now that new graduates are coming in a reasonably high base, and therapists that have been around for 20 plus years are probably only in some places, say, $15,000 difference between a new graduate and somebody with multiple years experience. I think there is perhaps a perception that clinic directors earn a lot more, but that's not the reality. So there must be other intrinsic factors that motivate somebody to become a clinic director, because it's certainly not for money. Let's be brutally honest. That's a therapy. Nobody's attracted by the money anyway. So what appealed to you? What do you enjoy most about being a clear director?

[18:08] Megan: I mean, most people would probably call me a little crazy, right, for wanting to be a clinic director? It's not a job that really ever stops, and it's a job that's multitasking. I think that's one of the things that pulled me into it. I like to have multifacets to a job, so I like the treating side of things, but I also like having to build a team and get a team to work together and present an opportunity for the clinic to do well together versus a single person at a time. In addition to that, I do like the business side of things. I like to learn new things and how the numbers also work together. And honestly, with being in a clinic director role, since starting this, my new favorite thing is actually marketing, which also is a lot of Pts run away from, right? Because it's hard to go out and be like, hey, my name is Megan. I'm a physical therapist. I work for Advent. I just want to come talk to you about the services that we offer. And it's hard to do that in a personal way without feeling that I'm a salesperson. I'm just here to try to sell you my services. So marketing has become probably my favorite for me, it's a big challenge, and it's almost kind of like a game in a way. Like, how can I be personal and really capture these people so that not only can I get patients, because obviously that's part of it, but how can I help them be better, how can I help their athletes better? How can I be more helpful in a way that benefits our community as well?

[19:38] Richard: That's great that your perception of want to better turn marketing or referral relationship is a positive one. And I think that's in part, probably, I would imagine by the support you had as well to help you learn the skills to be successful at that, to do it on your own, I think is even more intimidating. But you're right, I believe with regards to physician relations or referral relations, it's really trying to understand how you can better serve the referring physician, how you can better serve their patients in the community. And I think once you understand that that's really the objective, I think it takes away some of that anxiety or the perception that, well, I'm just asking for a patient. That's not really how it is, is it?

[20:36] Megan: No, it's not. It's interesting how marketing ends up working. It's never usually that place that you just randomly stop by and try to talk to someone and give your business cards. So when I first started an Advent up here, I didn't really know the area. I didn't really know anyone. So that's kind of how I started, just and familiarize myself with places where I could potentially have opportunities. And I did do a little bit of that just to see, because I've never done just like a cold caller. I show up and try to hand a marketing or a card out. But to be honest, most of my marketing things that have become successful are more through patients. Like, I have a patient that was in Kalmazoo but works up here now and at a studio for dancing. She put my cards out and now I have contact with the owner of this dance studio. I have a patient that works for a company that has big amount of employees, that they are mechanics and auto body shops and all of that and he gave my card to their owner. Things like that I think are more of the way that marketing really, truly happens versus just going out and being like, here's my card. Yes, there's some of that. You'll have to go out and talk to a physician and show up at their office and just say, hey, I'm Megan, I'm here to say hello, is there anything I can do to help you? But definitely like, the true marketing things where we have really gained patience in the last couple of months in my clinic are from patients who know people and making connections that way.

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[22:47] Richard: Other point you make about is building teams and there's something I can definitely relate to early on my career when I was managing the first couple of clinics that I had and I really loved the opportunity to direct build a team and then direct it and also to facilitate everybody's growth and development within that team. So, for instance, I have one clinician that was part of my team that now is a Premiership soccer PT within the UK and I have multiple others that have been extremely successful from a clinical perspective and career perspective. Whilst they were very motivated, I do like to think that perhaps I'm a little bit responsible for their growth and development. And as a professional, that kind of warms me a little bit with regards to knowing that I've not only helped patients but helped other clinicians in their career.

[23:54] Megan: Yeah, I think I am the same way. I want a team that wants to be a team and that wants to better each other and not just themselves and help each other. I mean, we hired a new grad to join our team, so we've already had the chat at our meeting this past week, not just make her welcome, but how can we help her to easily transition into being in a clinic, first off by herself, with her own patients. And how can we provide an environment that is welcoming for learning and mistakes? Because we all make mistakes. I still make mistakes. I don't know everything. At least once a week at a patient, I'm like, I don't know what to do with you, but we'll figure it out. So teamwork is probably my biggest goal for whenever I have a clinic that I lead. Because if you have teamwork, everything else falls into place. The numbers will fall into place, the referrals will fall into place, anything, just if you work as a team and you show that you're here to help those patients together, nothing else really is that hard.

[25:05] Richard: Yeah. Talking about mistakes. I think it's really important to provide plenty of opportunities to leaders and that's really leaders of any level of the organization. Opportunities to experience many different aspects of the business or to see lots of different things and be exposed to different facets, to round you out as a leader, be those other business components of the business or be those experiences to help you develop soft skills. But I think it's also important of an entity to allow you to fail. I talk about tripping over, and it's okay to trip over. It's okay to fail. In fact, those are the times you tend to learn the most. And then it's having the team to pick you back up and say, that's fine, we expected it. If you didn't trip over, you weren't running fast enough anyway. But learn from it, let me help you get over it and then move on. And I would hope that that has been the case for you since you started as a client director. And if it has perhaps do you have an example?

[26:30] Megan: Let's see. When I was in Armor, we had an interesting situation where we had a patient who was she was non compliant. She would call and cancel their appointments and then expect to have other appointments and things like that and just didn't understand or respect the rules. And she called one day because she was an insurance that required authorization. And she had been told time and time again because she had been a recurrent patient, like, you need authorization through your doctor from your insurance. And for whatever reason it might just because she was hurting. She was a patient that had multiple things. She was in the military for a long time, so she had things from that. But she called and was literally yelling at our front office coordinator on the phone. And eventually I just walked into this situation and she was front office corner, sitting there like just phone out here way past outside her ear, like just crying because she was being yelled at for the past 10 minutes. And so she asked me if I could talk to her and for the first 5 minutes kept my cool was trying to be understanding. And it just got to a point where she wasn't going to change her mind, she wasn't going to calm down and listen. And so I raised my voice a little bit. I won't say I yelled, but I basically told her, if you can't calm down, then this is not your place. If you can calm down, you can call me back. And I actually hung up on her, which might have been maybe a little bit appropriate, but maybe not a little appropriate. So learning how to deal with things like that, because that's in a moment, right? You're not going to have time to write down your answers to all of that. It happens in real time. So there's been a lot of instances where I've had nothing, like, major mistakes, but mistakes where I'm like, oh, I could have maybe handled that a little bit with maybe a little more grace, sometimes a little bit less frustration. But mistakes are always welcome and questions are always welcomed, right? So same thing with the team. I try to tell everyone in mind, if you make a mistake, I hope that they're small and easy, like, quickly to pass. Right. They're not big and they take a while to resolve and then that you learn something from that.

[29:06] Richard: Now, we talked about ways perhaps you could have been better prepared, but were there things that were done for you that looking back after being a Clint director for a year or two now, are there things that were done that really helped you prepare and what were they?

[29:23] Megan: Yeah, I think just speaking for me, I spoke up that I was interested in at some point being a clinic director, being in a leadership role. And so that was very early on. And I think one of the biggest things that helped me is that I got to learn alongside the mentor. But also my mentor wouldn't give me anything unless he thought I was ready, right? So he had a very specific kind of plan, in a way, in his head. And even when I was like, yeah, I'm ready, let me go, he was like, no, you're not ready. Here's a couple of things you need to still work on. And I think the Cold program that we've developed at alliance has been super helpful as well. The ability not only to learn for those couple of days, but also to be around other people that are interested in leadership or in leadership at any level has been really helpful to me within the alliance group.

[30:20] Richard: You raise a very good point that you need to speak up and tell your leaders, your manager, if you want something, because I think I've certainly experienced it personally in the past when I was developing as a professional. I just assumed that my leader, my manager, would know what I wanted, which is so far from the truth. And I wasn't necessarily. Asked, but I didn't verbalize it either. And I think shame on me in a way. And I think it's really important that everyone within their career very clearly articulates what they want. It's not to say you're always going to get it, but at least you have a plan. And if you can't get it in the position one is in, then it's having an honest, open conversation with regards to, okay, let's move you where you can, or we don't have the opportunity, and perhaps you got to find it somewhere else. But I believe that oftentimes people will get frustrated because they're not getting what they want, but they've never actually verbalized it in the first place.

[31:36] Megan: Yeah, that's very true. I mean, I can say to that I was not good or great at verbalizing what I wanted or my goals were until probably two and a half, three years out of school. I mean, I was just trying to keep alive and see my patients and get them better to a decent extent in that sense. So I also could have done better in the beginning with that. But it's definitely again, it's something to learn from. If you want something, no one's going to read your lens.

[32:03] Richard: The other thing I think is you have to be an environment which promotes and supports people expressing opinions, thoughts, ideas, because there's definitely cultures that can be not beat you into submission, but certainly don't encourage that people employees being vocal. And certainly what I try and do as a leader is listen to everybody as best as I can and allow them to express thoughts, opinions. Now that's not to say that their answers will always mirror what they say, but certainly it's important to at least listen and try to understand that hopefully that's been your experience as an emerging leader, that you have been listened to and that's been positive experience. And they did take into account your thoughts and wishes.

[33:03] Megan: Yes, oh yeah, they definitely did. I think too, I learned from that because whenever I end an email with my staff or I end a conversation with one of my staff members, I always ask them, do you have any comments, questions or concerns? And then you always know I'm here. If you have questions, I may not be able to answer them right away because I'm busy, but I will always answer them when I get the time. So I even explained that to my new hires when we were interviewing for a new PT. I said I have a lot of things going on, like I'm treating, directing, I have other things, emails, things like that. But if you always have a question, I'm never going to tell you no. It might say give come back in 5 minutes. But I will always make sure that I answer your questions and be open to be there for that. And I think sometimes that's hard because we do have so many things going on but I really try to push for the fact that nothing is out of the box and there's no crazy questions.

[33:57] Richard: Now, we've covered perhaps this in a little bit already but what things do you feel you need from an employer to help you be successful as an emerging leader? So what kind of factors and practical things or it might be approaches or culture. It could be any number of things. But what types of things do you need to be successful?

[34:20] Megan: Yeah, I definitely think that we have touched on a little bit. But culture is a big thing, especially in the newer gods that's kind of the world that they lived in. Their culture is social media and things like that. So they understand culture very well because they live it 24/7. So I think the culture of being open to questions and the idea that there is no bad dumb questions and then being open to looking at things from different viewpoints, right. We all have our ways of thinking but sometimes we need to be open and listen to even if they're not leaders, they're just staff members or whatever they might be on how we could maybe do something differently to make it more efficient, a better process or even push us into being a better clinic as a team. In addition to that, I think just opportunities. I've been with alliance long enough for it to grow and change a lot in five years and I think that we get more and more opportunities every year on how we can participate in leadership things or participate in other learning experiences that help us kind of meet those goals that we have of either leadership or just becoming a better therapist.

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[36:15] Richard: Yes, those definitely the opportunities for growth and development are imperative, aren't they? And I think you can everyone's meaning of growth and development is different. I think it's important as an emerging leader, as a clinic director and also as you develop as a leader further that you understand clearly what each individual's meaning and perception of growth and development is. Because some people want to grow as a clinician, some people want to grow as a leader, some people want to grow to something outside of what would be kind of the normal skill set. And I think it's understanding as a clinic director and as an organization that everyone wants something slightly different and it's trying to work towards that and hopefully that's within the organization sometimes it isn't, but it's certainly within the organization. And by doing that, you motivate people, you encourage them, you keep them engaged, and it promotes what I believe is a very positive environment. Yes.

[37:34] Megan: Yeah. I think with the growth and development, you have to understand where each employee is at. Right. So sometimes employees have what they already want to do. Some players are still developing that, and that's all. Okay. You don't have to have a plan at every stage of your career. Right. You can have a plan and then finish that plan or that goal and meet it, and then kind of start to develop another one and kind of take however much time you want on that. But definitely understanding where each individual is in that whole process is helpful in how I try to engage them in different aspects. So I have one clinician that really wants to do something with golf, and he has his certification already. And so we've started the process of marketing and doing things for that. I have another clinician that is kind of formulating exactly what they want to do. Is it more Parkinson's? Is it more dry needling? Is it this? So trying to help aid them in that, I think, is a very important part of my job as a clinic director without pushing them one way or the other. Right. So I know little about golf, but I have people that know more about golf than me. So hooking that one individual up with those people and letting them roll is kind of my job, whereas the other one might be a little more involved. Maybe I need to bring in some other mentors or something like that to kind of get taste of what all those different things are and maybe even throughout from that. What specific thing you want to focus on next?

[39:02] Richard: Yeah. When we talk about growth and development as well, I think it's really important to include life outside of work as well. So what I believe is important as to the best of my abilities, again, is to help employees be successful, is supporting them in their overall growth and development as a human, as a husband, as a wife, as a partner, as a mother, father, whatever it is. Because by supporting that growth and development, I'm still supporting the business and supporting the patients and the communities I serve. And as a clinic director, to be truly successful, I think you have to understand where everyone is at in life as well as within their professional career growth. Yes.

[39:56] Megan: We have had one clinician who just had a baby, and so we have been working. There was a time where it was a bad day at home, and so I was like, Well, I don't have a patient right after lunch. We have the same lunch hours. I'll take your patient after lunch, so you have an extra 30 minutes, and you can run home and go deal and help out with however way you need to help out at home with babies. So knowing that those things are going to come along and trying to accommodate them as we can, I think makes it even more of a team, right? Because then we know that those other employees know that we're there for them. And it's not just in the clinic, but it's like you said, in life outside of careers.

[40:41] Richard: One thing where companies can always do better is communication. And I'm constantly amazed at how much I communicate. It never seems to be enough. But I think as an organization we do a reasonable job, certainly can improve. But what's your thoughts on communication as it pertains to helping you be successful? How have you been communicated to the amount of communication, the types of communication? So I'm not sure if you got anything to kind of add with regards to communication.

[41:24] Megan: Like I said, I've been around here long enough that I've had kind of where there was very little communication in the early beginnings to now where we have a consistent system of this is your report to this is who you're going to hear from. That's always changing, right? Because things grow, we have to kind of change roles and things like that. But I think the same thing with communication is that how you communicate might change depending on who it is, right? So one person might do well with directness and one person might have to be a little bit less direct with but I think communication is something that we always are working on because we can always, like you said, always do better. Sometimes I say one thing and then I find out that that's not how I got taken. And I was like, okay, well, we got to kind of come back, group back together and let's try this again. And sometimes that's like one person, sometimes that's the whole group. But just really trying to focus in on what can I do better and how can I do that better with either individuals, like I said, or just as a group, I find that certain things, the more specific and this is how it is not like room for interpretation does better in certain respects like kind of systems and processes. Right. Like if your patient doesn't show up, your front office is not here, give them a call so that they have at least we've reached out to them or fill this out every week so that we know what the plan is for your patients. Otherwise otherwise it just kind of gets lost in the shuffle. But again, communication is a hard thing because you have to dance a little bit in how you communicate at different levels with different people, in different situations.

[43:11] Richard: The concept of systems and processes. And I would probably add in the idea of standardization. I certainly noticed that it seems to be somewhat generational, my generation was perhaps valued a little bit more flexibility and weren't necessarily the best at taking direction. Certainly clear guidance, whereas what I think I found, and again, I'd love your perception of this, is certainly younger generations are entering the workforce. I think crave, or not necessarily crave, but appreciate clear parameters, boundaries, standardization, they don't see it as unhelpful. I think they see it as very helpful in allowing them to see exactly where they need to be successful. And I think that's really important for helping to train emerging leaders and not saying being 100% prescriptive, but certainly provide much clearer direction than perhaps older generations thought was necessary.

[44:33] Megan: Yeah, I think that having a clear direction, a clear plan with some room to be creative or outside the box a little bit is what generally I see in even I mean, I'm not that old, but younger clinicians even younger than me. I am kind of like you. I sometimes am not great at following directions, nor do I really always want to be told what to do. But I definitely have seen the clear direction plan work better in the last almost years since I've been clinic directing and only had younger clinicians. And then I've seen the other side of things that you talk about. When I helped in another clinic where everyone was pretty much older than me, telling one specific clinician what to do never went well. You had to kind of almost twist it into the fact that it became his idea and he was comfortable with it for it to kind of happen. So there's a whole nother entity to that because you're not just going to work with new people, you're not just going to work with the people that have been practicing for 2030, 40 years. So adapting to that is definitely a challenge at times.

[45:50] Richard: Now, as we said, as physical therapy school does a great job with providing, I think, the basic education to be set you in good position as a treating clinician. But there are definitely other facets of the business world or as a professional, it doesn't necessarily set you up so well. What areas of the business do you feel additional training would be helpful for you as an emerging leader?

[46:23] Megan: I think really sitting down and having a Business 101 time like here are the aspects of business, whether it's financials, marketing and things like that, and being like, here's kind of the umbrella, this is what it includes. And then this is kind of how they all work together, because I didn't realize until I started doing more of the business side that financials have a direct relationship to how well the clinic does. If the clinic stays open, if your employees are happy because they can get a raise or they can get a bonus, or just want new fancy shiny things, things like that. So just kind of being more particular in how that umbrella fits within physical therapy because obviously it's a business, but healthcare is a different business than any other business out there, right? So it's different than if you're selling carpet or if you're working on cars or whatever it might be. It's kind of its own challenging, weird, always changing situation. So I wish I would have been able to come up with an actual marketing plan before I actually did any marketing, because I'd never done that before. What are you going to focus on? You can't focus on everything. So what are your first one or two things that you really want to focus on, and then after those start to come into play, like, how are you going to take those with you and make them more of a long term marketing plan and those kind of things?

[48:00] Richard: Time is against us, I'm afraid. It's flown, actually, before we finish. Any final thoughts or words or wisdom for anyone that is thinking of becoming a clinic director or has become one recently? And as an emerging leader, anything that you've learned that you want to share, perhaps?

[48:24] Megan: I think that knowing that it's not an easy job. It's something that you have to be able to multitask at, right? And it's something that you might have to in the night, 08:00 at night, send a quick text, hey, can you come help me tomorrow? Because my clinician can't come in or hey, this happened with a patient. I'm going to stay after work and reach out to them and try to resolve this. And that's not a bad thing, right? That means that we're really trying to emphasize the fact that we're treating our employees the way that we should with respect and trying to accommodate them and make them part of the team, but it's also helping us as a group treat those patients with the best care that we can have. The other thing is, if you're really interested, try it. Ask for an opportunity to try it. It might be a little scary, might be a little nerve wracking, but if you don't try something small in a leadership role, you're never going to know, right? You might end up hating it. And that's probably better to not like something small than to get into a bigger leadership role and then not like it, right? Because that trickles into life. You're a leader at work, but that leadership also goes other places.

[49:35] Richard: Wise words. Thank you, Megan. I love talking to you and some great insights, so I appreciate it.

[49:42] Megan: Thank you so much.

[49:43] AD: This podcast was brought to you by Alliance Physical Therapy partners. Want more expertise and information? Visit our website@allianceptp.com and follow us on social media. You can find links below in the description. As always, thank you for listening. You.