8. Conclusion to HR Module

Human resource excellence is paramount for the growth and success of private healthcare practices, as it directly impacts every aspect of workforce management, culture, clinical performance, and practitioner retention. By optimizing practitioner scorecards and workforce strategy, practices can ensure that client care is delivered in a timely, efficient, and cost-effective manner, which enhances client engagement and loyalty. Additionally, upskilling an owner’s capacity to coach, provide feedback, and offer training and development opportunities, enables practices to win on team member retention.  Which ultimately, is a win on client experience and in turn, on the financial viability of your practice.

Understanding your best people are your greatest asset is crucial for a practice owner as it shapes the foundation of their practice’s success. Exceptional team members not only contribute to day-to-day operations but also play a significant role in shaping the practice’s culture, reputation, and long-term growth trajectory. Recognizing and valuing the talent within the practice fosters a sense of loyalty, motivation, and commitment, leading to higher levels of engagement and productivity.

Attracting and retaining top talent is more critical than ever. Exceptional team members not only contribute to the practice’s bottom line but also serve as ambassadors for the brand, attracting other high-caliber professionals and enhancing the practice’s reputation in the community. By nurturing a culture that values and rewards excellence, practice owners can differentiate themselves as employers of choice, positioning their practice for long-term success.

Practice owners-always more skilled at their professional craft v. human resource acumen.

Practice owners often excel in their craft or field of expertise, possessing a unique passion, creativity, and dedication that drives their clinical success. However, when it comes to managing the people or human aspects of their practice, many owners struggle due to several factors inherent in the healthcare industry. 

Many practice owners are highly skilled healthcare professionals who may lack formal training or experience in HR management. While they excel in providing clinical care, they may find it challenging to navigate the complexities of HR functions such as recruitment, performance management, and compliance with employment laws and regulations. Also, private healthcare practices operate in a highly regulated environment, with stringent requirements for team member qualifications, certifications, and licensure. This adds an additional layer of complexity to HR management, as practice owners must ensure that their workforce meets all regulatory standards while also managing the day-to-day operations of the practice.

Practice owners often face unique challenges related to staffing shortages, high turnover rates, and the need to balance client care with administrative responsibilities. These factors can strain resources and make it difficult for practice owners to devote sufficient time and attention to HR-related tasks. As a result, they may struggle to effectively recruit, retain, and develop talent, leading to issues such as low employee morale, productivity, and client satisfaction.

At ELEVATE, we understand the best way to compete and grow your practice is for the owner to be a great leader, coach, and storyteller.  I remain steadfast in my belief that the greatest advantage any practice can have is world-class leadership.  A close second, an owner must understand that ‘your best people are your greatest assets.’ Your star performers create a brand agency with your clients because they know you are in the people business delivering healthcare.  At the end of each day, if you strip away your technical skills and business acumen, you are left with relationships.  Said another way; in the end, we are people, people caring for people in communities where we have a privilege to serve.

At ELEVATE, we spend an inordinate amount of time with practice owners upskilling them to become great People leaders. 

ELEVATE-At the Nexus of Practice Purpose and People, is a great HR Plan

The symbiotic relationship between your practice purpose and people is a cornerstone of successful practice operations. Purpose provides the guiding vision, values, and impact that informs every aspect of a company’s activities, from strategic planning to day-to-day operations. Purpose, paired with the client experience, also known as your culture, serves as the practice’s North Star. This star aligns the efforts of team members, funders, and partners toward a common goal and instills their work with meaning and significance. Purpose and impact inspire passion, commitment, and resilience, driving individuals and teams to overcome challenges, pursue innovation, and strive for excellence in pursuit of a shared vision.

Consulting with a 3rd party HR professional is essential for private healthcare practice owners to navigate the complex landscape of workforce management effectively. HR professionals bring specialized knowledge and expertise in areas such as recruitment, employee relations, compliance, and performance management, allowing them to address critical HR-related challenges and ensure legal and regulatory compliance. By having dedicated HR support, practice owners can streamline their HR processes, minimize risks, and focus on delivering quality client care and growing their practice.

Your HR professionals should play a vital role in talent acquisition and retention, helping practice owners attract, hire, and retain top talent in a competitive healthcare market. From crafting job descriptions and sourcing candidates to conducting interviews and negotiating employment offers, HR professionals can guide practice owners through the recruitment process, ensuring that they find the right fit for their practice culture and clinical needs. Additionally, HR professionals can implement strategies to enhance employee engagement, satisfaction, and retention, such as performance management programs, career development initiatives, and recognition programs, fostering a positive workplace culture that encourages loyalty and long-term commitment.

Together, purpose and people form a symbiotic relationship that drives practice success. Purpose provides the overarching direction and motivation that inspires action and guides decision-making, while people translate purpose into measurable outcomes and tangible achievements. Without purpose, people often lack direction and meaning, leading to aimless activity and wasted effort. Conversely, without people, the owner’s purpose remains an abstract ideal, disconnected from reality and unattainable in practice. When purpose and people are aligned and integrated seamlessly, practices can achieve their full potential, realize their aspirations, and create enduring value for all.

At ELEVATE, we will always be generous with our knowledge.

The development of this HR learning module for healthcare practice owners represents a significant milestone in ELEVATE’s journey to empower practices to achieve their full potential. Through comprehensive research, strategic planning, and collaboration with HR industry experts, we have crafted a resource that addresses the unique challenges and opportunities facing healthcare practice owners today. By equipping practice owners with the knowledge, skills, and tools they need to succeed in business, we are not only driving individual practice growth but also contributing to the overall advancement of the allied private healthcare industry in Canada. As ELEVATE moves forward, we remain committed to supporting practice owners on their path to success by fostering a culture of continuous learning and improvement within the healthcare community. Together, we can ELEVATE the brand agency of owners in the conversion from practice valuation to personal wealth.

Best,

Gary

6. Case Studies: Real World Examples (effective leadership and building high performance of a clinician – scorecard KPIs)

Introduction
In the increasingly complex landscape of healthcare practice management, the optimization of People, Financial, and Operational performance is paramount to the growth and sustainability of healthcare practices. This case study explores common challenges faced by practice owners specific to talent retention and practitioner performance and the downstream impact they have on the financial health of the clinic. 

In today’s allied healthcare environment, the market conditions for talent recruitment have undergone significant transformation. Practice owners are facing unprecedented challenges in attracting and retaining top talent due to factors such as changing demographics, shifting employee expectations, and rising costs of living. This has forced many practice owners to play on compensation to retain their talent, resulting in driving up the market compensation rates for allied healthcare professionals across the country. Retention is crucially important, especially in times when recruiting top talent is challenging.

This case study will examine the situation of a practitioner (employee), approaching the practice owner, to seek an increase in their compensation. We will apply many aspects of the HR module, including strong leadership skills and communication, performance management, contracts, and compliance with policy and employment standards. This case study will also reference both Launch Operations and Launch Finance components.

Problem Statement
In the competitive landscape of private healthcare, practice owners face numerous challenges in recruiting and retaining top talent, which can have significant impacts on maintaining financial viability while delivering quality care and access to clients. In our experience at ELEVATE, we have seen many practice owners attempting to hold employees and Independent Contractors through increased compensation. Owners have no other currency when it comes to the retention of their team. Practitioners will jump from practice to practice for an increase in fee split, without considering all the intricate factors that impact earnings and total compensation. This case study highlights a challenge that ELEVATE’s team has been presented with several times and has successfully managed with practice owners giving owners more currency to leverage when it comes to team member retention and loyalty.

The practice owner was approached by one of their practitioners (employee) who had been offered an alternate employment offer with another practice at a higher percentage fee split. To stay at the current practice, which was preferred by the practitioner, they expressed the need for the external offer to be met. This practitioner is currently at a 48% fee split and the external offer is an Independent Contractor offer at 55%.

A healthcare practice owner may find themselves in a dilemma when a valued employee is offered a lucrative compensation package elsewhere, leaving them feeling stuck and uncertain about how to retain the employee. They may also feel overwhelmed by this scenario having played out numerous times over the course of the last few years causing challenges in building a cohesive high-performing team that produces an exceptional client experience. The financial and cultural costs of turnover are often underestimated. In these situations, the owner often lacks awareness of alternative strategies to enhance the employee’s earnings and engagement beyond a direct change in their fee-split leading to retention, loyalty, and high performance. 

In addition to the challenges above, ELEVATE and the owner note that there is a noticeable gap in this practitioner’s ability to consistently meet key performance indicators essential for justifying such an increase. Despite the practitioner’s expectations, their track record does not align with the level of performance required to warrant a raise. This discrepancy raises concerns about the practitioner’s understanding of the value they bring to the practice and their commitment to delivering results that merit higher compensation. The practitioner must reassess their performance goals, demonstrate measurable achievements, and align their expectations with their actual contributions to the organization to make a compelling case for a fee split increase.

Objectives

  1. The owner facilitates a 1:1 with the practitioner to information gather with respect to the external offer presented to the team member. What is the total compensation package of the offer? What is the value of the existing contract to the practitioner?
    • Is the external offer a growth position or taking over an existing caseload?
    • Is the external offer an employee or independent contractor relationship?
    • Review your existing contract with this employee with respect to total compensation and year-on-year earnings. Understand the monetary value of the following,
      • Employer-paid benefits
      • Vacation pay
      • Statutory holiday pay
      • Sick leave pay
      • Employer paid taxes
      • Fee-split earnings
  2. Owner development of practitioner KPIs and assessment of trends for the next 6 months of the following metrics
    • Schedule Occupancy
    • % of clients discharged with 3 or less visits
    • Average number of visits or revenue per file (EHB, Auto, WCB)
    • Cancellation and No-Show rate
    • Client outcomes (RTW/RTADL)
    • Direct referrals (F&F, GP)
    • Is the clinician treating 30/60 or 20/40
  3. The owner creates opportunities to upskill the practitioner on effective care planning to positively impact KPIs. 
  4. Owner reviews the current monthly revenue targets and actuals vs. targets with the practitioner.
  5. Owner works with HR to create a practitioner development and retention strategy. This involves creating a robust plan for performance management, performance evaluation, and merit/compensation. This plan should include
    • Establishing clear performance objectives and expectations
    • Implementing regular performance reviews and feedback sessions
    • Identifying opportunities for skill development through training and coaching opportunities.
    • Compensation structure that aligns with individual and practice goals.

    By integrating these elements cohesively, the practice can effectively engage, motivate, and retain top talent while driving overall performance and success.

  6. Owner in collaboration with HR assesses the following scenarios with respect to improved KPIs and business impact (GM),
    • Practitioners remain at the same fee split in their current employee contract. Here the owner and practitioner have agreed to work together on upskilling to get to or exceed KPI benchmarks
      • with an increase in schedule occupancy to 85%.
      • In addition to 85% occupancy, assess with change in scheduling practices moving the practitioner from 30/60’s to 20/40’s.
    • Increased fee-split in 6-9 months once the practitioner is exceeding benchmarks
      • with an increase in schedule occupancy to 85%.
      • In addition to 85% occupancy, assess with change in scheduling practices moving the practitioner from 30/60’s to 20/40’s.
    • Alternative at 6-9 months is to assess impact of moving to an Independent Contractor contract and fee-split rate (removing all employer costs) if of value to the practitioner and owner
      • with an increase in schedule occupancy to 85%.
      • In addition to 85% occupancy, assess with change in scheduling practices moving the practitioner from 30/60’s to 20/40’s.
    • Consider employment standards and human rights laws when considering changing the working relationship from Employee to Independent Contractor to mitigate risks of constructive dismissal.
    • Consider the CRA guidelines of what is required in a working relationship with an Independent Contractor and within this context will requirements be met?
  7. Move forward with action plans and support to realized improved performance of the practitioner and business outcomes to support any changes in compensation.
  8. Monitor progress, track key performance indicators, and provide ongoing support and guidance to the practitioner to ensure the successful implementation of initiatives and achievement of objectives.

Methodology
Improving the overall retention, revenue, gross margin, culture, and client experience of the practice. Here are the methodologies used by ELEVATE’s Human Resources Consultant to drive performance and retention:

  1. Contract Review: Review of the current employee contract. Looking at the total compensation package and other value provided to the employee. 
  2. External Contract/Offer Review: Analysis of the external contract offers total compensation and value in comparison to the existing contract. 
  3. Compensation Benchmarking: Analysis of the market for comparison in compensation and benefits for similar roles within the industry and specific market geographies. 
  4. Coaching on Measuring Performance: Coaching the practice owner on the significance of a compelling scorecard allowed the owner to move beyond using compensation as the sole retention strategy. The shift towards a scorecard-based approach not only promoted a culture of transparency and goal alignment but also empowered practitioners to take ownership of their performance and development, fostering a culture of accountability within the practice. 
  5. Scorecard Development: Collaborative development of both the Clinic and Practitioner Scorecard. HR guides the practice owner in establishing clear performance metrics and expectations that drive accountability. Collaboration among the owner, HR consultant, and other key stakeholders is essential when determining important and meaningful metrics for a scorecard. This ensures alignment with the overall practice goals, promises, and values. Established performance metrics were agreed upon that drive high performance, meet industry best practice benchmarks, and foster continuous improvement across the board. 
  6. Implementation of Performance Management Process: HR provides coaching on leadership skills the complexities of performance management, and how to tailor the approach to suit each unique situation. By understanding the intricacies of performance management and adopting a flexible and personalized approach, the HR Consultant effectively supports both the owner and team members in reaching their full potential and driving overall success. 
  7. Coaching Conversation for Performance Improvement: The HR Consultant supports the owner in developing a performance improvement plan and coaches the owner in the communication of the plan to the Team Members. This requires strong communication skills, transparency, and coaching skills from the owner to drive personal accountability on behalf of the employee. The HR consultant also reduces any risks by ensuring compliance with policy, laws, and regulations.
  8. Scaling Performance Management to Win on Retention: The HR Consultant partners with the owner to build a strategy for measuring performance, providing frequent feedback and recognition, coaching, and professionally developing the team. This involves building and delivering communication, to the collective team, around the importance of the scorecard. The HR consultant also supports the owner with 1:1 sessions, communicating the scorecard alignment to the practice’s values, driving accountability, clinical excellence, client experience, practitioner growth, and continuous development.
  9. Clinic and Practitioner Performance Monitoring: Full implementation of clinic and practitioner scorecards with consistency in reviewing the data and trends with each individual and collectively as a team.  HR Consultant coaches the owner on driving meaningful conversations around best practices and performance to develop a culture of accountability and continuous growth. The owner must become a strong people leader who influences and fosters an accountable team driven by performance and growth. This is the pathway to building a strong team culture where the owner wins on retention. 

By implementing these methodologies and working collaboratively with the healthcare practice, the HR Consultant helped retain the practitioner, improve the performance of the practitioner, and scale a strong performance management strategy across the practice driving team engagement, individual growth, and increased clinic revenue positioning the practice for long-term success and sustainability.

Implementation
The Human Resources Consultant partnered with the practice owner to support the development of a strong people strategy with the end goal of increased team member engagement, performance, and retention. This comprehensive strategy involved evaluating the existing workforce and contracts within the practice, conducting compensation benchmarking, and fostering personal accountability for growth and development through performance assessment and feedback. The HR consultant and practice owner placed a strong emphasis on team members’ values and intrinsic motivation, aligning the strategy with the practice’s purpose, values, and strategic plan set forth by the practice owner.

To begin, information was gathered to compare the total compensation and value of the current and external offers as well as market compensation and benefits information. With this completed they were able to show the employee the external offer of an IC at 55% was less with respect to total compensation and value of the current agreement. They were also able to seek to understand where the employee placed value on compensation, benefits, and other areas that create value for practitioners. From this conversation, it was determined that compensation, growth in clinical skills and human skills, along with the practice culture were all significantly important to this employee’s engagement and retention. 

The HR consultant shifted the conversation with the practice owner to focus on a performance management strategy. Performance management is a comprehensive process that involves setting clear performance expectations, regularly monitoring and assessing employee performance, providing feedback and coaching to improve performance and rewarding or addressing performance outcomes. It aims to align individual goals with practice objectives, enhance employee development and engagement, and drive overall productivity and success within the practice. This also required the HR consultant to work with the practice owner on developing a company policy for performance management to ensure transparency for team members, compliance with laws and regulations, and mitigate any future risk when actively managing sub-optimal performance. 

This required collaboration between the HR consultant and the practice owner to create meaningful key performance indicators (KPIs).  The KPIs were accessible and easy to pull through the EMR to build a clinic and practitioner monthly scorecard.  All KPIs were aligned with industry benchmarks for client experience, operational excellence, and clinical excellence. The scorecard would provide a consistent and regular review of data and trends to effectively support performance feedback and coaching conversations with each team member. These metrics support and guide the action plans required to improve client care and outcomes. The practitioners are required to develop the action plans with guidance and coaching from the practice owner on how to impact the KPIs positively. For example, effective and consistent care planning with all clients to improve client practitioner rapport and caseload retention or managing client drop-off lists re-scheduling clients who have no upcoming appointments. These activities take hard work and a consistent approach with weekly touchpoints between the owner and the practitioner. 

The HR consultant spent time coaching the practice owner on communication to support the successful implementation of the performance management strategy. This involved communicating the broader purpose and values of the practice, finding shared values with the team members, and aligning the performance objectives and goals accordingly. The HR consultant dedicated time to coaching the practice owner on adopting a coaching mindset and improving accountability among team members. The outcome of this would foster a growth mindset in the team which would increase engagement and team culture.

Having scorecards in place and reviewing the performance trends of the practitioners, the HR consultant was able to highlight with the owner the opportunity for improvement in several KPIs for the practitioners. This would elevate client experience and outcomes, as well as the financial performance of the practice. The HR consultant supported the communication plan for delivering feedback and the plan for coaching performance improvement. Through conversation with the employee who was seeking a compensation increase, they were able to establish a 6-month performance improvement plan (team member accountability, owner supported) to improve client experience, clinical care, and as an output increased revenue for the practice and personal earnings for the practitioner. Furthermore, this met the employee’s expectations and desires regarding the value they placed on growth and development. The employee made the decision to stay at the current practice after seeing a clear pathway for their development.

Independent Contractor External OfferCurrent Employee Agreement
Total Revenue billed annually$300,000$300,000
Fee split55%48%
Annual Gross Earnings$165,000$144,000
Employer-paid benefits (average cost)$0$4,000
Vacation Pay (6%)$0$8,640
Sick Leave$0$3,323
Statutory Holiday Pay$0$5,538
Employer-paid taxes (EI, CPP)$0$5,160
Admin fee-4% of billables0%
Total Compensation (before taxes)$153,000 (51%)$170,661 (56.9%)

Results: 6-Month Progress Update
The HR consultant continued to provide consultation services to the practice for 2 hours per month for 6 months. Provided below is a progress update on quantitative and qualitative improvements, as well as opportunities to go forward. 

Quantitative Results:

  • The team member is still with the practice and continuing to participate in the ongoing development of clinical and human skills.
    • Through consistent and effective care planning with clients the practitioner has been able to achieve the following improvements.
      • Average number of client visits has increased from 3 to 6
      • No show and cancelation rate went from 20% to 12%
      • % of clients leaving care within the first 3 visits went from 56% to 25%
      • Family and Friends referrals have steadily increased month on month and now represent 35% of new referrals improving the caseload mix and positively impacting revenue and earnings.
      • Schedule efficiency has improved from 50% to 74% 
      • Earnings have increased by 10% 
  • Attrition of 1 IC practitioner occurred, misaligned to practice values and purpose and unable to develop accountability to performance on KPIs.
  • All practitioners utilizing KPIs to guide clinical improvement and development.
  • Overall revenue of the practice has increased with the same manpower ratio, thus increasing profit

Qualitative Results:

  • The practice owner and team have reported a significant improvement in accountability to performance. There is positive uptake of the weekly and monthly 1:1 meetings with the practice owner to review the caseload and the practitioner scorecard to set action plans for the week and month. 
  • Practitioners reported higher engagement with the practice with respect to the professional development opportunities through coaching and experiential learning. 
  • Measurement of engagement was completed at the start of the 6 months (Best of Me, Best of We survey) team engagement improved from 64% to 81%. 
  • The practice owner has reported an increase in suggestions provided by the team members for improvement in services and ways to be more present within the community.
  • Increased frequency of team participating in social gatherings outside of work hours. A team that plays together stays together.

Opportunities:

  • Develop scorecard for the administrative team and align all scorecards to the annual functional strategic plan.
  • Continued development of the practice owner’s leadership capacity 
  • New practitioner starting in 3 weeks. HR will consult with the practice owner to support the practitioner’s onboarding including the alignment to KPIs and graded KPIs as the practitioner builds caseload and competency. 
  • Through the recruitment process, the practice owner has 3 additional practitioners wanting to join the team, creating bench strength for future practice growth. 
  • Further development of the practitioner’s human skills (communication, empathy, emotional intelligence)
  • Continue to increase family and friend referrals to grow the EHB caseload changing the caseload mix to yield a higher revenue and earnings for the practice and practitioner. 

Conclusion
The partnership between this Human Resources consultant and the health care practice owner has yielded remarkable results in practitioner retention, accountability to high performance and self-improvement, and a strong cohesive team culture. 

It is essential to recognize the intricate dynamics of recruitment and retention in healthcare practice, going beyond mere compensation to attract and retain top talent. By maintaining a balance that allows team members to feel valued and invested without giving away the practice on compensation, one can significantly impact both the client experience and the financial health of the practice. Striking this balance is key to ensuring long-term success and sustainability in today’s competitive healthcare landscape.

Closing Leadership Nugget

I continue to believe the greatest leadership character is that of COURAGE.  My favorite Courage passage comes from a BMW excerpt:

Courage and why we need it more than ever.

Courage is independent and disruptive.

It questions, shatters, and awakens.

We need bold creative voices, all of us.

We need fresh thinkers with optimism.

We believe in the front runners, the avant-garde,

Those who fight stagnation and backwardness.

Courage knows only moving forward,

Driving the pioneers of our culture to inspire tomorrow,

To create a sublime kind of now

And reach a superior level of excellence.

This is where a new kind of value is born.

Citations & Acknowledgments:

  1. Healthcare Human Resource Management by Walter J. Flynn
  2. Strategic Human Resource Management in Health Care by Myron D. Fottler
  3. Human Resources in Healthcare: Managing for Success by Bruce J. Fried
  4. Healthcare Human Resource Management” by Bruce J. Fried 
  5. Effective Human Resources Management in Healthcare by American College of Healthcare Executives.
  6. Heffernan, M. “Beyond Measure” TED Books 2025
  7. Ron Price, The Complete Leader 2014 Aloha Publishing.
  8.  Excerpt from The Art of Owning the Moment, BMW
  9. Mainardi, C “The Essential Advantage”2011 Booz and Company Inc.

I would like to express my sincere gratitude to my colleagues and mentors at CBI Health who have provided invaluable guidance and support throughout my development as a Healthcare executive, especially in the areas of Operational Excellence, People, and Leadership. Special thanks to the late Christopher Szybbo (CEO), David Maxwell (COO), and Avi Barkin (CFO) for their expertise, beliefs, and insights that spanned the best 15 years of my career.

Additionally, I extend my appreciation to all the healthcare practice owners who have trusted ELEVATE’s insights and expertise to achieve shared goals. 

Lastly, to the healthcare practice owners that ELEVATE will engage with in the future…I am excited to share what gets me up every morning.  I continue to be amazed at ELEVATE’s ongoing impact to eradicate entrepreneurial healthcare poverty across Canada.  Our competitive advantage of being able to 2x the profit of healthcare practices is a powerful statement. Empowering practice owners to win on Brand Agency is an impactful ‘why’.  We collaboratively achieve this by converting practice valuation into greater personal wealth. 

Best,

Gary

5. Fusion of Right-Brain and Left-Brain Themes

Fusing right-brain strengths with left-brain strengths is essential for healthcare practice owners to excel in today’s dynamic human resources landscape. Here are five examples of how they can achieve this synergy:

  1. Competitive Advantage: Investing in coaching and performance measurement sets the practice apart as a leader in its field. By demonstrating a commitment to excellence in practitioner development and performance management, the owner enhances the practice’s reputation as a great practice to work. This strategic innovation can ultimately serve as a key differentiator in a competitive healthcare market, driving client and team member loyalty and practice success.
  2. Client-Centred Design: Leaders can leverage their right-brain creativity to create a high-performance culture that exceeds clients’ needs, preferences, and experiences. They can then utilize their left-brain analytical skills to assess the practicality and effectiveness of their team’s design, ensuring that they align with clinical best practices and regulatory requirements.
  3. Leadership Development: Effective leadership requires owners to be great coaches and logical tacticians. Owners can use the right brain growth to become amazing coaches and providers of timely and concise feedback to connect with team members on a personal level, understanding their motivations, strengths, and challenges. Owners can then apply their left-brain logic to structure teams, delegate tasks, and set clear KPIs, fostering a collaborative and high-performing work environment.
  4. Data-Driven Decision Making: Healthcare practice leaders can blend their right-brain intuition with left-brain data analysis to make cost-of-labor decisions relative to hiring team members as employees or ICs. They can trust their instincts and gut feelings (right brain) while also relying on evidence-based data and metrics (left brain) to validate compensation increases for high-performance practitioners. This balanced approach enables leaders to make tactical decisions that drive positive outcomes for the practice and the clients they have the privilege to serve.
  5. Purpose and Timely Communication: Purpose, impact, and values-led communication is key in healthcare leadership. Leaders can use their right-brain creativity to craft compelling narratives and messages that resonate with team members, inspiring trust and engagement. Simultaneously, they can leverage their left-brain clarity and precision to ensure that communication is accurate, consistent, and aligned with the value of performance management and compelling scorecards.  

By integrating right-brain strengths such as creativity, intuition, and empathy with left-brain strengths such as logic, analysis, and organization, healthcare practice leaders can enhance their leadership effectiveness, drive innovation, and navigate complex challenges with confidence and agility.

 

ELEVATE YOUR PRACTICE WITH GARY THORNE

Book A FREE CONSULTATION Today!

Tailored solutions to address your unique challenges & ELEVATE your Practice.

4. Left Brain Themes: Precision Planning

Your People Strategy is your Practice Strategy

Building Strong Performance through Consistent and Meaningful Measurement

Effective performance management is a cornerstone of success in the healthcare industry, where the quality of care directly impacts client outcomes and practice performance. By implementing solid and consistent performance management strategies, healthcare providers can optimize the delivery of services, enhance client satisfaction, and drive continuous improvement across all levels of the practice. In this module, we will delve into the intricacies of performance management in healthcare, exploring best practices, tools, and techniques to monitor, evaluate, and enhance the performance of healthcare professionals and teams. Join us on this journey to unlock the potential of performance management in healthcare and elevate the standards of care delivery.

Performance management is the ongoing process of communication and feedback between a team member and their leader towards the achievement of individual and collective practice goals. Having a clear and transparent process in place for performance management is essential as a foundation for having healthy and meaningful conversations that result in positive business impact. 

Performance management is critical for your practice’s success. Your team of practitioners and administrators should be clear on what the overall strategic priorities of the practice are prior to setting their own practice and administrative goals. It is important for your performance management process and the set goals to be in alignment with your practice values and purpose. Alignment of how we do our work with our why will foster a culture of teamwork, collaboration, trust, and high performance and productivity. The objectives must be meaningful to the team members and aligned with best practices.

A Performance management program typically has an annual cycle. Here are the 5 steps that direct the cycle.

1. Planning
Planning includes providing clear communication to the larger team of the strategic priorities of the practice. One area of focus may be to increase intakes by 15% through marketing strategies focused on community and physician engagement along with driving family and friends’ referrals. A Practitioner then may also set an objective of increasing direct referrals by 15% in the current year, achieved through action planning 100% completion of physician communication and directly soliciting family and friends’ referrals from their active caseload. Goals are required to be SMART – specific, measurable, attainable, relevant, and time-oriented. In this phase, both the leader and practitioner need to identify the resources required to be successful. 

2. Feedback
Feedback is an essential element in this cycle. This means two-way feedback. Both you as the owner and your team members should feel comfortable giving and receiving feedback. Providing constructive feedback is an ongoing part of the performance management process. This feedback should be specific, actionable, and timely to help understand how continuous improvement can be achieved. 

3. Review & Revision
Owners must understand it may be necessary to revise objectives and focus based on the review and the changing needs of the practice. This may involve starting at step one again with new targets or adjusted strategies.

4. Scorecard & Continuous Improvement
Using data and having tools to objectively evaluate performance, respective to role accountabilities, is essential to understanding where to align resources to achieve success in driving high performance and winning on your strategic plan. Having a compelling scorecard for both your practice and each team member (practitioner and administrator) in your healthcare practice offers several benefits that can contribute to overall practice success and performance improvement. 

A scorecard provides clarity and transparency regarding performance expectations and goals. By clearly outlining key metrics with benchmarking against industry standards and best practices, you establish a framework for achieving desired outcomes. This creates a level of transparency and clarity for team members, so they understand what is expected of them and align efforts with your business objectives. Scorecards, when implemented correctly, should foster a culture of continuous improvement and accountability within your practice. When practitioners and administrators have visibility of their performance metrics and see progress toward their goals, they are motivated to strive for excellence and take ownership of their performance and development. 

It is important for practice owners to understand that a scorecard is a tool that accompanies a meaningful conversation around performance trends, strengths, and areas of opportunity. It should be comprised of a mix of key practice performance indicators which are lead measures or lag measures. The key performance indicators should be metrics that can be easily tracked and pulled by your EMR. This will reduce the amount of manual tracking, which can lead to human error and inefficient processes. 

5.Regular Meetings
Maintaining a schedule of regular meetings is essential for you and your team members to discuss the metrics and trends. Weekly meetings create an opportunity to provide feedback (positive and constructive), use coaching skills to develop autonomy in problem-solving and recognize the strengths and achievements of the individual. The meetings should not need to be more than 15 minutes per week and should have specific areas of focus. Items for discussion should include client drop-off lists, care planning actions, a review of the client’s discharge the previous week and outcomes, and the current week’s capacity in the schedule for access and waitlist management. After the meeting, established action plans must be set for the week ahead, specifying accountable parties for each task to support and drive continuous improvement and maintenance. 

A scheduled monthly meeting with each team member should also be in place to review the practitioner and administrator scorecard and reflect on monthly trends. Review of your lag measures are typical discussion points at your monthly meeting (% of clients with < 3 visits, number of direct referrals, client experience scoring). Action planning should occur collaboratively, and ideally driven by your practitioners, to establish what needs to be adjusted or continued for the next month. 

Overall, maintaining a performance management process with a tool, such as a scorecard, for each team member empowers individuals to take ownership of their performance, fosters a culture of accountability and continuous improvement, and provides valuable insights for practice management and decision-making. By leveraging scorecard data effectively, you can optimize practitioner and operations performance, enhance client experience, and achieve excellent outcomes for your healthcare practice. This allows practice owners to identify key areas of strength and areas needing improvement to address promptly with targeted support and coaching. It also provides the necessary means to formally performance manage a practitioner with continued sub-optimal performance. 

It is not uncommon for individuals to voice concern and dislike of being “measured”, particularly in healthcare. In our experience we have encountered practitioners who use the scorecard information to reflect on their practice, inform their practice decisions, and use it to help direct self-improvement in areas identified. Others have felt a scorecard is not a reflection of the care they provide. They perceive there to be too many complex factors in healthcare and influences outside their control. Some practitioners perceive the measurement of performance against benchmarks to be unethical as they believe it influences clinical decisions in a negative way. 

It is imperative, when introducing a performance management process and a tool like a performance scorecard, that you communicate the value of the tool to identify trends and see areas of opportunity or reward. Scorecards provide valuable data for improving healthcare quality and client experience when industry standards are used as benchmarks. It is a tool that supports a meaningful conversation and is not a punitive measure, but a constructive platform for growth and development. The ongoing dialogue encourages individuals to hone their skills and build competency. It is your job as their leader to support them in this process. 

Below ELEVATE has provided an example of a Practitioner and Administrator scorecard.

Practitioner Scorecard:

Lead IndicatorTargetAction Plan
Access to Care/Productivity
Schedule Efficiency>85%
Cancellation/NS rate< 12%
Revenue per monthDependent on pricing (22,000-28,000)
Clinical Excellence
<20% cases have < 4 visits< 20%
Revenue per caseDependent on pricing/contract vs EHB
Client outcomesCan assess RTW/RTADLs
Client Experience and Brand
Google Reviews> 4.8
Direct Referrals (F&F/GP)50-70% of intakes
Client Experience Q90% score 9 or 10
% clients with No next visit< 10%

ELEVATE Blog: Grow My Practice – 4 Tactics to Improve Clinician Productivity

Administrator Scorecard:

Lead IndicatorTargetAction Plan
Access to Care/Productivity
Schedule Efficiency>85%
Cancellation/NS rate< 12%
Clinical Excellence
Bad Debt< 1% of Sales
AR<1% of Sales
Client Experience and Brand
Google Reviews> 4.8
Direct Referrals (F&F/GP)50-70% of intakes
Client Experience Q90% score 9 or 10
% clients with No next visit< 10%

ELEVATE Blog: Grow My Practice – Why Your Healthcare Practice Should Use a Business Scorecard

Your People Strategy is your Practice Strategy

Choosing the Right Fit: Independent Contractors Vs. Employees in Hiring Practices
When building a workforce, practices often face the crucial decision of whether to hire independent contractors or employees. Each type of worker offers distinct advantages and considerations that can significantly impact the structure and dynamics of your practice. Understanding the differences between independent contractors and employees is essential for making informed hiring decisions that align with the organization’s goals, budget, and long-term strategy. In this module, we will explore the key factors to consider when determining whether to hire independent contractors or employees, helping you navigate the complexities of workforce management effectively.

Cultivating a strong team culture: The Influence of different contract relationships
We have spoken frequently of building a strong team culture within your practice. Teams that work together towards the same purpose and show up each day invested and demonstrated similar values in the work they do. 

The distinction between independent contractors and employees can have a significant impact on team culture and operations within a practice. Independent contractors often bring diverse experience brining different perspectives, specialized skills, and a sense of autonomy to the team. Their flexibility and independence can foster innovation and creativity, adding new dimensions to the team dynamic. At times, independent contractor set ups can pose challenges integrating with the team due to their unique working arrangement. Often, they work with multiple practices resulting in limited and infrequent hours delivering services at your practice. This can create challenges when team member schedules do not overlap allowing collaboration, knowledge sharing, and the ability to build strong relationships.

On the other hand, employees typically have a deeper sense of loyalty, commitment, and alignment with the organization’s values and goals. They may contribute to a more cohesive team culture through long-term relationships, shared experiences, and a common sense of purpose. Balancing the strengths of independent contractors and employees can enrich team culture, promoting collaboration, learning, and adaptability within the team. 

Exploring Performance Management and Growth and Development: Comparing Pros and Cons for Independent Contractors and Employees

Performance management is a critical aspect of maximizing productivity and ensuring alignment with your practice’s goals, whether working with independent contractors or employees. 

For independent contractors, performance management is less robust and more transactional. Managing the performance of independent contractors may be more complex due to their external status and varying levels of commitment to your practice. As a practice owner who hires independent contractors, performance management will involve setting clear expectations, establishing key performance indicators (KPIs), and providing regular feedback on performance. Since independent contractors work outside the traditional employee structure, effective performance management is crucial for ensuring that the independent contractor delivers high-quality work in alignment with your practice’s goals and standards. Challenges may arise when there is a lack of alignment in expectations and standards. It is important to note that in a true IC relationship, they have autonomy and control over how they achieve their objectives. The independent contractor has ability to schedule on their own terms, choose the work they perform, and how they complete their work. It is also the responsibility of the independent contractor to identify and invest in their own self and professional development. This is important to think about when considering new graduates. As an owner, the capability to guide, mentor, coach, and develop the team members is limited in an independent contractor working relationship. These benefits are often highly valued by new graduates, and they should understand the limitations of being an IC when looking for work. As an owner, be cautious about hiring new graduates as ICs, retention may be challenging. 

Performance management for employees involves setting clear expectations, providing regular feedback, and offering opportunities for growth and development within their practice. Employees benefit from long-term career progression and a sense of belonging that can enhance their commitment and engagement with the team and practice goals. As a practice owner, you set your employee’s schedule and they are responsible for completing any work in which your practice provides services. Offering a comprehensive training, growth, and development program requires time and resources, and may result in significant benefit of team member retention. 

Both approaches come with their own set of challenges and benefits. Striking a balance between the unique needs of independent contractors and employees in performance management, growth, and development is essential for fostering a productive and harmonious work environment.

Comparing the Costs: Independent Contractors vs. Employees

Practice owners can derive cost and operational benefits from hiring independent contractors. When determining the advantages and disadvantages of both, it is important to keep culture fit, stability for your clients and practice, and long-term success in the forefront of your mind. 

As previously mentioned, independent contractors typically will come with clinical experience and skills that employees may not always have. As a practice owner, you can often, but not always, rely on the IC having strong practice management capability and great revenue output. Your time and investment of resources should be less than what is required for a newer practitioner hired as an employee. 

Independent Contractors also will provide a level of flexibility to scale your access to care up or down as needed, without the long-term commitment of full-time employees. This flexibility is particularly advantageous during seasonal or unpredicted fluctuations in demand. There are no costs of terminating an IC, although contractually a notice period is often required. ICs should come with the expectation that work may vary. Legislation and law protect employees from swings in scheduling, such as hours and days worked, which may cause financial hardship. There is also a cost to terminating employees which is outlined in provincial legislation. Termination may be required due to fluctuations in demand but also may be due to individual performance or fit. 

Considering the costs associated with employees is also imperative to review and understand as a practice owner. Legislation requires that employees be paid for statutory holidays, vacation pay, and, in some provinces, paid sick leave. Additionally, the CRA holds employers responsible for paying taxes such as Employment Insurance, and into the Canadian Pension Plan. In some provinces, such as BC, there is an additional Health tax that employers pay and WCB premiums. Furthermore, to stay competitive in the market when hiring employees, it is important to consider employer-paid benefits or shared cost benefits. Health benefits can be a differentiator for some team members. These benefits and taxes add approximately 14-18% to the employee’s base pay. With all of this in consideration, hiring ICs can be more cost-effective. Independent contractors are responsible for paying their own taxes, benefits, and overhead expenses and reducing the administrative costs for your practice. Below is a link to the CRA website, to understand the differences between an employee and an independent contractor.

CRA – Employee or Independent Contractor

Below we have provided you with an example: As a practice owner, it is important to realize that an employee on a 50% fee split may be a manpower cost of 59%. It is a CRA guideline to charge an administrative fee or rent fee to an independent contractor. The cost-benefit of having practitioners who are employees Vs. Independent contractors. 

Independent ContractorEmployee
Total Revenue billed annually$300,000$300,000
Fee split55%50%
Annual Gross Earnings$165,000$150,000
Employer-paid benefits (average cost)$0$4,500
Vacation Pay (6%)$0$9,000
Sick Leave$0$3,460
Statutory Holiday Pay$0$5,770
Employer-paid taxes (EI, CPP)$0$5,160
Admin fee-4% of billables0%
Total Compensation (before taxes)$153,000 (51%)$177,890 (59%)

Overall, the costs of employees represent a significant investment for practice owners, coming with both advantages and disadvantages. While hiring and retaining talented team members can drive your practice’s success, it is essential for owners to carefully consider the financial costs and benefits to ensure sustainability and growth.

Policy Adherence + Compliance in Allied Healthcare Practices

Policy Power Play: Safeguarding Your Success Through Strategic Risk Mitigation
In the fast-paced and highly regulated field of allied healthcare, ensuring policy adherence and compliance is paramount to providing quality care, maintaining client and team member safety, and upholding ethical standards. Through this module focused on policy and compliance, you will gain a comprehensive understanding of how policies serve as part of your foundation for your day-to-day operations. By establishing robust policies, procedures, and compliance measures, as a practice owner, you can navigate complex regulatory frameworks, mitigate risks, and shape and promote a culture of accountability and transparency. In this context, a proactive approach to policy development and compliance management is essential for safeguarding both the integrity of your services and the well-being of your clients and team members.

Policies provide structure and guidance for both employees and independent contractors, outlining expectations and standards of conduct within your practice. By establishing policies on key areas such as employee behavior, workplace safety, discrimination and harassment, and the use of company resources, you can ensure consistency and fairness in how issues are addressed and resolved. This clarity helps create a positive work environment where everyone understands the rules and knows what is expected of them. Your practice’s policies should assist in upholding your purpose and values. The policies help guide your actions and how team members show up and work together.

Having a policy framework helps to mitigate legal and compliance risks for healthcare practices. By having policies in place that adhere to relevant provincial and federal laws and regulations, practices can minimize the likelihood of disputes, lawsuits, or fines resulting from non-compliance. For example, policies related to data privacy, security, and confidentiality can help safeguard client’s personal health information and ensure compliance with applicable privacy laws.

Moreover, policies play a vital role in shaping the culture and values of a small business. They reflect the organization’s commitment to certain principles and beliefs, such as integrity, respect, and professionalism. By articulating these values through policies and consistently enforcing them, businesses can cultivate a culture of trust, accountability, and mutual respect among employees. This, in turn, fosters a positive reputation both internally and externally, attracting top talent, enhancing employee morale and retention, and building stronger relationships with customers, suppliers, and other stakeholders.

When policies are in place to govern, it simplifies the performance management process in the event a team member has demonstrated misconduct or not followed specific processes and expectations. It is important to have policies which are up to date (laws and legislation) and published to your team members. Demonstrating that you follow your policies and procedures can reduce your risk should you be challenged legally by a current or past team member.

Policies should have four main components:

  1. The policy itself needs to be defined.
  2.  It should outline the purpose of the policy, and then provide the process so the team member has clarity in how to follow the policy.
  3.  It should outline what the consequences are if the policy is not followed. For example, a leave of absence policy will outline the rights and associated obligations under circumstances that may require a team member to take a leave of absence. The policy should outline the process for requesting and seeking approval and reflect the provincial legislation. It should define the types of leave of absence and associated expectations and processes for each. 
  4. It should provide team members with outcomes and potential consequences should the process not be followed. An example of an employee not following a leave of absence policy is an employee who takes an unplanned extended vacation without notifying you as the practice owner. This employee is absent for several weeks without approval, leaving the rest of the team scrambling to cover their caseload and causing an impact on client care. As a result of the employee’s failure to follow the leave of absence policy, they could be formally disciplined or deemed to have resigned from their position with proper processes followed. 

To summarize, having well-designed policies is essential for small businesses to maintain order, mitigate risks, and nurture a positive and compliant work environment conducive to growth and success.

Reflective Questions

These questions are designed to encourage learners to think critically about how practice owners and clinicians can apply the concepts learned from the Left-Brain Theme module of ELEVATE’s Launch HR course to drive positive changes in their healthcare practices.

  1. How will you ensure that the performance management process in your practice directly contributes to achieving your strategic priorities, such as enhancing client satisfaction or improving service quality?
  2. What specific steps will you take to establish a culture of regular feedback exchange in your practice, ensuring that it leads to actionable improvements in performance and client care?
  3. How do you plan to effectively utilize performance scorecards and data analysis to identify areas for improvement and drive continuous enhancement in practitioner and operations performance?
  4. Considering the importance of regular meetings in performance management, how will you structure and facilitate meetings to maximize their effectiveness and drive tangible outcomes for your practice?
  5. Based on the discussion of independent contractors and employees, how will you strategically balance your workforce mix to leverage the strengths of each type while maintaining a cohesive team culture in your practice?
  6. Reflecting on the differences in performance management for different workforce types, how will you adapt your performance management strategies to effectively motivate and develop both independent contractors and employees in your practice?
  7. What factors will you consider when conducting a cost-benefit analysis between hiring independent contractors and employees for specific roles in your practice, ensuring that your decisions align with your financial goals and practice sustainability?
  8. How will you translate the insights on policy development and compliance into actionable steps to establish and enforce policies effectively in your practice, promoting a culture of accountability and mitigating legal and compliance risks?

 

Need Further Help?

Book A FREE CONSULTATION with Gary Thorne, ELEVATE’s Founder!

Tailored solutions to address your unique challenges & ELEVATE your Practice.

3. Right Brain Themes: Igniting Purpose

People don’t leave practices; they leave owners

Nationally, the voluntary resignation rate has increased by 25% compared to pre-pandemic levels, with factors such as professional development opportunities, meaningful work, and workplace flexibility emerging as key drivers for employee retention. While compensation remains a significant factor influencing attrition, other factors often contribute to disengagement among team members before the issue of compensation arises. You must invest in your team, purpose, and values. Help your team members become masters of their craft.

Building Your Superpower as a Coach
Being a great coach/owner of a healthcare practice holds immense importance in fostering a thriving and high-performing team of practitioners. Effective coaching helps practitioners develop their skills and knowledge continuously, ensuring they stay updated with the latest advancements and best practices in healthcare. By providing regular feedback, guidance, and support, practice owners can empower their practitioners to enhance their clinical and human expertise to deliver best-in-class outcomes for clients.

Great coaching fosters a culture of continuous learning and improvement within the practice. When practitioners feel supported and encouraged to grow professionally, they are more motivated to invest in their development and strive for excellence in their work. This not only benefits individual practitioners but also contributes to the overall success and reputation of your healthcare practice. A culture of learning and improvement attracts top talent, boosts employee morale, and ultimately leads to better client care and engagement.

Coaching also plays a crucial role in aligning the goals and values of the practitioners with those of the practice. By understanding each practitioner’s aspirations, strengths, and areas for development, practice owners can tailor their coaching approach to meet individual needs and help practitioners reach their full potential while also meeting the goals of the practice. This alignment creates a sense of purpose and engagement among practitioners, fostering a collaborative environment where everyone is committed to achieving common objectives and delivering high-quality care to clients.

Being a great coach enables practice owners to build strong relationships with their practitioners based on trust, empathy, transparency, and open communication. When practitioners feel valued and supported by their leaders, they are more likely to be engaged, loyal, and dedicated to the success of the practice. This positive relationship dynamic fosters teamwork, creativity, and innovation, driving continuous improvement and growth within the healthcare practice. Investing in coaching and how to deliver feedback, not only benefits individual practitioners but also strengthens the overall performance and success of your practice. 

The GROW Coaching Model:
The GROW coaching model is a widely used framework for structuring coaching sessions and facilitating meaningful communication aimed at achieving the personal or professional goals of your practitioners. GROW stands for Goal, Reality, Options, and Will. Here’s a brief explanation of each component:

  1. Goal: The first step in the GROW model involves establishing clear and specific goals. As a coach, the healthcare practice owner works with their practitioner to define what they want to achieve, ensuring that the goals are realistic, measurable, and aligned with shared values and priorities (Practice and Self). By clearly articulating the desired outcomes, the practitioner gains clarity and focus, which sets the direction for the coaching session.
  2. Reality: In this stage, the focus shifts to exploring the current reality or situation. The coach/owner helps the practitioner assess where they are in relation to their goals, encouraging them to reflect on their strengths, challenges, and resources. Through open and honest dialogue, the practitioner gains a deeper understanding of their current circumstances, identifying any barriers or obstacles that may be hindering progress toward their goals.
  3. Options: With a clear understanding of both the goal and the current reality, the next step is to brainstorm and explore potential options or strategies for moving forward. The coach/owner encourages the practitioner to generate creative ideas and consider alternative approaches to overcoming obstacles and achieving their objectives. By exploring a range of possibilities, the practitioner can identify actionable steps and develop a plan of action that aligns with their goals and preferences.
  4. Will: The final stage of the GROW model focuses on commitment and accountability. The coach/owner helps the practitioner solidify their commitment to taking action by clarifying their willingness and readiness to implement their chosen strategies. Together, they establish specific milestones, deadlines, and accountability measures to track progress and ensure accountability. By fostering a sense of ownership and responsibility, the practitioner is empowered to take proactive steps toward achieving their goals.

The GROW coaching model provides a structured framework for guiding practitioners through a process of self-discovery, goal setting, action planning, and accountability. By following the GROW framework, the coach/owner can help practitioners unlock their full potential, overcome challenges, and achieve meaningful and sustainable results in both their personal and professional lives.

Here are two great Ted Talks to build your knowledge and competency for coaching

Video: Stop Complaining, Start Coaching – Millennial Leadership

The Difference Between Coaching and Feedback
Coaching and feedback are both essential components of effective communication and development within private healthcare practice, yet they serve distinct purposes and involve different approaches.

As outlined above, coaching is a collaborative process focused on facilitating professional and personal growth and development over time. It involves guiding practitioners to discover their solutions, develop their skills, and achieve their goals. The coach/owner acts as a facilitator, helping practitioners explore their strengths, weaknesses, and opportunities for improvement. Coaching typically takes place through ongoing conversations and interactions aimed at building self-awareness, fostering learning, and promoting long-term behavioral change.

Feedback is more immediate and specific, providing information about a particular behavior, performance, or outcome. It is typically given in response to a specific event or situation and is aimed at reinforcing positive behavior, correcting mistakes, or guiding future actions. Unlike coaching, which focuses on broader development, feedback is often more transactional and goal-oriented, with the aim of improving performance in the short term. Feedback can be both positive, highlighting strengths and successes, and constructive, addressing areas for improvement and growth.

Coaching and feedback serve different purposes, yet they are complementary approaches that can enhance the effectiveness of the practitioner and practice when used together. Coaching provides the opportunity for deeper reflection, exploration, and skill-building, while feedback offers timely guidance, reinforcement, and correction. By integrating coaching and feedback into your leadership style, owners can create a supportive and growth-oriented environment that empowers individuals to reach their full potential.

Building Your Superpower–Delivering Feedback

Before we explore the EEIC feedback model, it is important to understand two key feedback points. As an owner/coach, always ask your practitioner for permission to provide them with feedback. In addition, the coach/owner must be aware that there will always be two ‘masters’ in every conversation.

  • As the coach/owner-you are the master of intent
  • As the practitioner-they are the master of impact

The EEIC feedback model is a structured approach used to deliver constructive feedback effectively. EEIC stands for Explain, Example, Impact, and Change. Here’s a breakdown of each component:

  1. Explain: The first step in the EEIC feedback model involves clearly explaining the specific behavior or performance that you want to address. Start by providing context and framing the feedback in a non-judgmental manner. Clearly articulate what the practitioner did or said that prompted the feedback, ensuring that your explanation is specific, objective, and focused on observable actions or outcomes.
  2. Example: After explaining the behavior or performance, provide concrete examples or instances to illustrate your feedback. Offer specific examples of when the behavior occurred, providing details and context to help the practitioner understand the situation better. By providing real-life examples, you make the feedback more tangible and relatable, allowing the practitioner to see the impact of their actions more clearly.
  3. Impact: Next, discuss the impact of the behavior or performance on others or the organization. Explain how the behavior affected you, the team, or the broader goals and objectives of the practice. Be honest and transparent about the consequences of the behavior, highlighting both the positive and negative implications. By emphasizing the impact, you help the individual understand the significance of their actions and why it’s important to address them.
  4. Change: Finally, discuss the desired change or improvement that you would like to see moving forward. Offer specific suggestions or recommendations for how the practitioner can modify their behavior or performance to achieve better outcomes for both clients and the practice. Focus on actionable steps that the practitioner can take to address the feedback and make positive changes. Encourage open dialogue and collaboration, allowing the practitioner to share their perspective and participate in problem-solving.

The EEIC feedback model provides a structured framework for delivering feedback in a constructive and supportive manner. By following the EEIC approach, the coach/owner can ensure that your feedback is clear, specific, and impactful, fostering growth and development in practitioners and your team.

Creating a High-Performance Team/Culture

Creating a high-performance team/culture is essential in a private healthcare practice that has adopted both a growth and performance mindset. The quality of client care experience directly correlates with the effectiveness, collaboration, and accountability of the healthcare team and the shared love a team has for the brand it represents.

A high-performance team comprised of skilled practitioners and efficient administrative staff ensures that clients receive timely, accurate, and compassionate care. From diagnosis to treatment and follow-up, every interaction with the healthcare team influences the client’s experience and outcomes. A high-performance team contributes to improved operational efficiency and productivity. In turn, this translates into better financial performance, as the practice can optimize resources, minimize costs, and maximize revenue generation. Moreover, a high-performance team fosters a positive workplace culture characterized by trust, engagement, and job satisfaction. Team members are more likely to be motivated, committed, and loyal when they feel valued, supported, and empowered in their roles. 

Creating a high-performing team within a private healthcare practice involves a tactical approach that addresses the clinical, financial, operational, and people aspects of the practice.  Here are six key tactics for practice owners:

  1. Align team member performance and measurement with the purpose, impact, and values of your practice.  Aligning business productivity and performance with the values and impact of the practice reinforces the practice’s identity and reputation within the healthcare community and among clients. When the practice consistently delivers high-quality care and services that are in line with its stated values and purpose, it enhances its credibility and trustworthiness among clients, referral sources, and other stakeholders. Clients are more likely to choose a practice that not only meets their healthcare needs but also resonates with their own values and beliefs. Similarly, referring providers and partners are more inclined to collaborate with a practice that demonstrates a commitment to excellence and a shared vision for positive impact in the community.
  2. Establish a Clear and Concise Clinical Scorecard:  Begin by defining clear expectations and goals for both clinical practitioners and administrative staff. Communicate these expectations effectively and ensure that everyone understands their role in achieving the practice’s objectives. By aligning practitioner responsibilities to creating a world class client experience and greater access to care, you create a sense of purpose and direction within the team. 
  3. Invest in Training and Development: Provide ongoing training and professional development opportunities for all team members. This includes clinical training for practitioners to enhance their skills as well as training in customer service, communication, and administrative processes for administrative staff.  This training and professional development will positively impact client experience, outcomes, and operational efficiencies. It is important to be able to measure impact and trends. Typical KPIs found on a practitioner scorecard include Google review scores >4.8, full cycle care plans on 100% of client files, <15% of EHB files with <3 visits, no-show/cancelation rates <12%.  For the administrative team members, KPIs could look like >85% daily schedule efficiency and bad debt, as a ratio to revenue of 0.05%.  Investing in the continuous growth and development of your team fosters a culture of learning and improvement.
  4. Promote Collaboration and Communication: Encourage open communication and collaboration among front-end team members (Admin) and back-end team members (practitioners).  The owner must ensure the administrative team controls the schedule and that all ‘white noise’ is taken out.  White noise is a catch-all term for ‘prep time’, ‘charting time’, ‘external calls to referral sources’, etc. These are often items which lower the engagement of clinical practitioners and can be completed or supported by administrative team members.  Create channels for feedback and encourage constructive dialogue to address any issues or concerns that may arise with optimizing efficiencies.
  5. Foster a Positive Work Environment: Cultivate a positive and supportive work environment where team members feel valued, respected, and motivated to perform their best. Recognize and celebrate individual and team achievements and provide opportunities for social interaction and team-building activities. A positive workplace culture promotes morale, engagement, and overall satisfaction among team members.
  6. Empower and Delegate Responsibility: Empower your team members by delegating authority and responsibility appropriately. Encourage autonomy and decision-making at the level of creating a world-class client experience and greater access to care. Trust your team to take ownership of their work. By empowering team members to make decisions and take initiative, you promote accountability and foster a sense of ownership over outcomes.
  7. Lead By Example: As the practice owner, lead by example and embody the values, impact, and purpose of your practice you wish to see in your team. Demonstrate integrity, professionalism, and a commitment to excellence in all aspects of your work. Be approachable, supportive, and receptive to feedback, and strive to create a culture of continuous improvement and excellence.

By implementing these strategies, private healthcare practice owners can create a high-performing team that is aligned with the practice’s goals, values, and vision. A collaborative and empowered team not only delivers superior client care but also contributes to the overall success and growth of the practice.

Your BEST People Are Your Greatest Asset.
As a private healthcare practice owner, the adage “your best people are your greatest asset” underscores the pivotal role that talented and dedicated team members play in the success and growth of your practice. Your best people are those individuals who consistently demonstrate exceptional skills, dedication, and alignment with the values and mission of the practice. They are the clinicians, administrative staff, and other team members who go above and beyond to deliver outstanding client care, foster positive relationships with clients and colleagues, and contribute to the overall success of the practice.

Recognizing that your best people are your greatest asset entails acknowledging their invaluable contributions and prioritizing their well-being, growth, and development within the practice. It is often said that 20% of your team members contribute to 80% of your practice value. An ongoing personal and professional development (PPD) plan is essential for your top performers.  Investing in ongoing training, professional development opportunities, and career advancement pathways can help nurture the talents and potential of your best people, enabling them to thrive and contribute even more effectively to the practice’s success.

Moreover, as a practice owner, it is essential to cultivate a culture of recognition, appreciation, and open communication to ensure that your best people feel engaged, fulfilled, and committed to the practice’s mission and goals. Regularly acknowledging and celebrating their achievements, providing constructive feedback and mentorship, and involving them in decision-making processes can foster a sense of ownership and empowerment among your top performers. By prioritizing the well-being and development of your best people, you not only strengthen the practice’s internal culture and performance but also enhance its reputation and competitive edge in the healthcare market.

Reflective Questions

These questions cover key aspects of coaching, feedback, team culture, and leadership, encouraging healthcare practice owners and clinicians to apply the concepts learned from the Right Brain theme module of ELEVATE’s Launch HR online course to their current or future practices.

  1. Consider each of your team members. How will your coaching style adjust to address the unique needs and career aspirations of each team member?
  2. Reflect on a specific strategy from the GROW coaching model that you can implement immediately to enhance performance and goal achievement within your team.
  3. Consider a team member who currently requires feedback (positive or constructive) How will you integrate the EEIC feedback model to deliver the feedback effectively and promote professional growth among that team member?
  4. Document a concrete example of how you can align team member performance metrics with the values and objectives of your practice to drive excellence in client care and service delivery.
  5. Document the practical steps you will take to foster open communication and collaboration among different roles within your healthcare team to improve workflow and client experience.
  6. What are three things you can adjust to create a positive work environment that prioritizes team well-being and engagement?
  7. Reflect on specific actions you can take as a practice owner or clinician to lead by example and instill a culture of continuous learning, improvement, and excellence within your practice.
  8. Considering the importance of recognizing and investing in top performers, outline a plan to nurture the talents and potential of your best team members to maximize practice value and success.

 

Have Questions?

Book A FREE CONSULTATION with Gary Thorne, ELEVATE’s Founder!

Tailored solutions to address your unique challenges & ELEVATE your Practice.

2. Navigating Success

The Ongoing Battle for Top Tier Talent?

The pandemic has exacerbated an already existing shortage of qualified healthcare practitioners, presenting significant challenges for healthcare practices across Canada. As the demand for allied healthcare services continues to surge, healthcare practices are faced with unprecedented pressure to meet client needs, leading to a heightened awareness of the scarcity of skilled practitioners. 

Furthermore, the pandemic disrupted traditional pipelines for recruiting and training new healthcare practitioners. Universities faced challenges in transitioning to remote learning environments and limited hands-on training opportunities for students. Clinical rotations and preceptorships were also impacted, reducing exposure to real-world healthcare settings essential for skill development. In addition to these challenges, there has been and continues to be disruption in the examination and credentialing process for some healthcare practitioners. Consequently, fewer graduates entered the workforce during the pandemic, exacerbating the existing shortage of qualified practitioners.

The chronic shortage of healthcare talent across Canada has put practice owners in a difficult position, often leading them to overpay to attract and retain talent within their doors. Practice owners find themselves competing in a fiercely competitive market where offering higher compensation and benefits becomes a necessary tactic to secure talent. While this may temporarily alleviate staffing shortages and fill critical positions, overpaying for talent can have lasting implications on the financial viability of the practice.

Overpaying for talent will strain the financial resources of private practices, especially smaller and independent practices that have lower working capital levels. Low working capital is usually a direct result of the owner treating their practice like a hobby. The owner runs personal expenses through the practice to minimize end-of-year tax implications. A practice’s working capital ratio should be in the range of 1.4-1.8. This means current assets are 1.4-1.8x that of current debts. How much cash (assets) does your practice have on hand to pay labor, rent, and other expenses (debt) in any given month? Overpaying for labor has flipped the working capital ratio to 0.8-1.0x current assets to current debt. A significant warning sign for owners that they might not be able to cover next month’s payroll. 

ELEVATE Blog – Do You Have Enough Cash in Your Healthcare Practice to Grow? 

The tactic of overpaying for talent continues to create unrealistic expectations among existing team members. Team members who witness their peers receiving inflated wages and benefits may become dissatisfied with their own compensation packages, leading to morale issues and potential retention challenges. Additionally, overpaying for talent may set a precedent within the industry, perpetuating a cycle of escalating wages and exacerbating the problem of healthcare labor shortages in the long run.

Practice owners may find themselves in a constant battle to outbid competitors, neglecting crucial factors that contribute to employee engagement, loyalty, and job satisfaction. This can result in a transient workforce, with team members jumping ship for 1-2% higher fee split opportunity without establishing meaningful long-term relationships with the practice owner.

Overpaying for talent may provide short-term relief for practice owners grappling with team member vacancies, it is not a sustainable solution in the face of chronic healthcare talent shortages. Practice owners must adopt a more holistic approach to talent management, focusing on creating attractive workplace environments, fostering a positive organizational culture, and investing in strategies to develop and retain talent for the long term.

Value of Launch HR to Practice Owners/Clinicians

As a module, Launch Human Resources will bring immense value to practice owners grappling with ongoing retention, culture, and operational challenges. ELEVATE’s HR module is rooted in industry knowledge and expertise related to retention strategies tailored specifically to the unique needs and dynamics of private healthcare practices in Canada. Launch HR will not delve into recruitment strategies.

Launch HR provides valuable insights and best practices for optimizing your practice’s retention efforts, from crafting compelling team member scorecards to upskilling yourself as a coach and provider of great feedback. This module will help practice owners retain talent who are the right fit for the practice’s culture, values, and long-term goals.

Launch HR will offer pros and cons of hiring a practitioner as an employee or independent contractor.  As well as insight into your practice’s policies and compliance with provincial labor laws and College regulations.  

Additionally, ELEVATE’s Launch HR will provide practice owners tactical insights into implementing proactive retention strategies aimed at reducing turnover rates and improving team member engagement. This may include implementing a performance management program and professional development and career advancement programs while fostering a supportive and inclusive work environment.

As a general HR comment, practice owners, don’t know what they don’t know when it comes to labor laws, regulations, and regulatory compliance. Launch HR is a great starting point for practice owners searching for insights into retention strategies and performance management. This module can assist practice owners with building high-performing teams, enhance team member engagement and retention, and ultimately drive sustainable growth and success for their practices.

1. Introduction to HR Module

Introduction:

Welcome to ELEVATE’s Launch HR Module, where we unlock the secrets to HR excellence and empower you to navigate the dynamic landscape of healthcare practice management with confidence. 

HR excellence is not just a buzzword — Your practice ethos should center around ‘train your people well enough so they can leave. Treat them well enough so they do not want to.” HR is more than just retaining your people, it is about mastering the art of coaching, providing feedback, communication, culture, legal compliance, and career pathing.

HR excellence thrives when practice owners prioritize their BEST people as their most valuable asset. It begins with fostering a culture of trust, transparency, and continuous learning, where Team Members feel empowered to contribute their best and are supported in their professional growth. By investing in comprehensive talent management strategies, including training, performance management, and skill development, practices can retain and grow top talent. HR excellence is marked by effective communication channels, fair and consistent policies, and proactive efforts to address team member concerns and promote a positive and safe work environment. Practices that prioritize HR excellence also drive sustainable business growth. All that to say, what a crazy last 4 years it has been for practice owners, and we continue to battle the lingering effects of the pandemic in top-tier talent shortages.

As all practice owners can attest, the last 4 years have challenged our ability to practice growth in ways we never thought possible.

The convergence of a range of factors, including team member burnout, the transition to hybrid work models, workforce exit, the rise of virtual care, displaced teams, low practice culture, and the emergence of gig work, has significantly impacted practice owners. Team member burnout, exacerbated by the relentless demands of the pandemic and heightened stress levels, has taken a toll on the overall well-being and productivity of healthcare practitioners. Burnout not only affects individual team members but also impacts team dynamics, client care quality, and overall practice performance.

The transition to hybrid work models, necessitated by the pandemic, has introduced new challenges for private practice healthcare owners. While offering flexibility to team members, hybrid work arrangements have disrupted traditional workflows, communication channels, and collaboration efforts within the four walls of the practice, lowering team engagement. Moreover, managing a dispersed workforce, divided between in-person and work-from-home settings, requires talented leadership, clear communication strategies, and robust technology infrastructure to ensure seamless practice operations and maintain a cohesive team environment.

Workforce exit, driven by factors such as retirement, career changes, or dissatisfaction with working conditions, continue to pose significant challenges for practice owners. The loss of experienced practitioners not only impacts the continuity of client care but also creates recruitment and retention challenges for the practice. 

The rise of virtual care and gig work has further reshaped the healthcare landscape, offering new opportunities and competition for traditional practices. Private practice healthcare owners must adapt to these changes by embracing technology, fostering a supportive organizational culture, and implementing strategies to attract and retain top talent in an evolving healthcare marketplace.