Ben Lynch: G'day, good people. Welcome to the Grow Your Clinic podcast by Clinic Mastery. Here's what's coming up inside of this episode. There was a video that circulated on the IG.

@thecuriousphysioproject: Is there anyone else out there who aggressively disagrees with commission-based systems in healthcare and rebooking rates being a KPI? It gives me the ethical ick.

Ben Lynch: This is a young physio who cares about the profession. You have to acknowledge that there needs to be financial upside to more productive therapists.

Jack O'Brien: We all agree that 5% rebooking is not good and 100% rebooking is not good.

Ben Lynch: Hey, everyone. Welcome back to the episode. My name is Ben Lynch. I'm joined by Jack O'Brien and Bec Clare, J.O.B Bec, good to see you both. J.O.B, before we dive into what has become quite a hot topic on the socials about practitioner pay and performance, let's get into a few things that are on your desk. Key notifications for folks tuning in.

Jack O'Brien: Yeah, really just want to say hi and welcome to a bunch of new members, new clinic owners that have joined us. What do we got here? We got Tashari has joined us in the Business Academy. Kaitlyn has graduated from Elevate to the Business Academy, so super kudos on that front. We have had Damian and Jody join us in Allie. They've signed up for their trial with Allie. So, mention for you listeners, if you want to explore what poaching looks like, see if you're a good fit for our programs, Send me an email, jack@clinicmastery.com. And if you want a trial, Allie, 30 days, no credit card required. It's easy. You might as well sign up. You can head to a11yclinics.com. That's a11yclinics.com and get your free trial started. I think that's the key notifications today, Benny.

Ben Lynch: Fantastic. Well, we've been talking a lot about clinic owners asking this question more regularly and perhaps with some deeper thought attached to it. Is it still worth it? Is it still worth owning and running a clinic with third-party payers changing or freezing rates? basically limiting your ability to earn income and with the award changes increasing the expenses, clinic owners are getting the financial squeeze and wondering, is it worth it or how do I make it worth it? And we've got an online summit coming up for members very shortly about practitioner pay and performance may have already happened at the release of this episode. But clinic owners are saying to us, I don't have a clear enough framework for navigating the pay conversation with team members. I'm so often put on the back foot with, you know, can we chat message or, you know, how can I earn more? And they're all of a sudden scrambling. Specifically, a clinic owner said, you know, I understand people want to clearly know how and when their pay will increase, but my challenge is deciding what to pay. Do I pay the award? Do I pay above? If it's above, how much? I need clear guidelines on the KPIs also to match the key performance indicators. Like what are the expectations of their performance? I said, if I don't have this clear, the conversation has always been hard, and I find myself stumbling around the conversation if it's not 100% clear in my mind, and it can appear to the practitioner that I'm trying to pull the wool over their eyes. Perhaps even worse, there was a video that circulated on the IG, Instagram, that caught our attention. In fact, it caught a lot of people's attention with over a hundred comments, a lot of shares. And it comes from a early career physiotherapist called Ariel. who shared her thoughts on commission structures and KPIs in healthcare. We're going to go to that now and I want to get your reaction to it, Jack and Bec.

@thecuriousphysioproject: Is there anyone else out there who aggressively disagrees with commission-based systems in healthcare and like rebooking rates being a KPI? It gives me the ethical ick. Now, I can only speak as a physio working in South Australia, but it infuriates me. and I just don't understand it. There should not be any ulterior motive to why we would want to rebook a patient or recommend a certain thing to them. Whether that is conscious or even subconscious, like if there is a chance that booking this person in again is going to help you get more money, how can we be sure that our motives are pure? And high rebooking rates? I don't understand that because isn't the goal of literally any healthcare field discharge you're trying to push the person towards self-management. I understand that physio is a really hard job and so being rewarded for that hard work is really nice. I really do. So it's tricky because I don't know how to fix this. I don't know if we need to increase base salaries but then I don't want to increase the price of physio and decrease like access for people. All I know is it frustrates me and I disagree with it and I'm wondering if anyone else shares these thoughts.

Ben Lynch: Well, that was quite an interesting take about KPIs in healthcare. J.O.B, you got in the comments. A lot of our friends got in the comments.

Jack O'Brien: Well, first of all, I want to acknowledge Ariel, the Curious Physio Project. So kudos for having a say. It takes a lot of guts to get in front of the camera. And it really sparked a lot of conversation, mostly healthy conversation, if not healthy, revealing conversation. But specifically, I want to shout out a few of our friends in the comments. Jeff Ford, B Strong Physio, absolute legend, had some really measured commentary. Lou Bibby, who is a long-time member of Clinic Mastery, a wizard in the osteo space, she piped up. Mic Rizk of course, always one with an opinion, and I had some really measured, considerate thoughts. Even Brad Beer, the great BB up on the Gold Coast, has strong opinions and well-formed, thoroughly thought through. overwhelmingly love a conversation because there's many ways to see things and we all get better the more we talk. We must be able to talk without fear of character assassination, the ability to have challenging conversations in public. So more of that, please. Let's have more conversations. I could zero in on a few of the things that Ariel said and maybe we can do that now, but I've got plenty of commentary.

Ben Lynch: It's a really great point. I would echo that too. Well done. She's documenting her journey fantastically, sharing some really great thoughts and it's provoked conversation. And I thought she balanced what she put out there with, you know, I don't really have a solution, but I think it needs to be talked about and addressed. And so here we are, Bec, when you first saw this come through, what was your immediate take? And I do want to unpack it in more detail because not only for the younger therapists out there, but for the clinic owners who are having a hard time communicating some of these frameworks, we want to provide a perspective on how you might be able to do it. But Bec, when you first saw this come through, how'd you respond?

Bec Clare: I agree. I want to shout out to Ariel about the courage that it takes to put that on social media. And I think it's, it's around actually us having a conversation about this. There are many ways to be right. And the fact that we can be vulnerable and share, you know, the ick that we feel means that we can actually unpack it and get to a constructive point. that can balance a number of different competing demands, if you like. This is a young physio who cares about the profession, who cares about her patients, and if nothing else, having those core values at the heart of what she's trying to do allows us to have a fruitful conversation.

Ben Lynch: Agreed. Bec and I checked out a bunch of her content on her page, and I agree with you. She seems super passionate about helping patients good on you, and it's great to be putting that content out, promoting the profession as well. J.I.B., there's a number of elements here that we can unpack. Perhaps we'll Unpack it a little bit more. I'm not sure how much preparation Ariel put into what she eventually shared on that, so I want to give some grace there in terms of each one of the sentences, but we've got a few parts here to unpack. The first part is around, you know, is there anyone out there who aggressively disagrees with commission-based systems in healthcare and having things like rebooking rates as key performance indicators, sort of as part of being paid more.

Jack O'Brien: As we do this, I'm going to take a very charitable position towards Ariel. She calls herself the Curious Physio Project and so I really respect the curiosity that she comes with this and to your point, Benny, maybe there was some thought, maybe there wasn't, maybe it's just thinking off the cuff. To the pay point of view, I think an interesting perspective to consider is that there is a commercial reality to what we do. Ultimately, Money doesn't grow on trees, it comes from somewhere and then there are costs that go along with providing said service and employing people, keeping a business legal and meeting all of our financial obligations. It was mentioned in the reel a little bit that we We'd love to see salaries increase, but also don't want fees to increase because that limits, potentially limits access to services. So, there is a commercial reality to healthcare that must be considered. But beyond that commercial reality, it's a value exchange. And this is really what I come down to. When patients choose to come to healthcare, because no one's coerced into coming to healthcare, you have to physically, of your own volition, get in the car, press the button to turn it on these days, not turn the key and drive and get out of your car and go to a clinic. No one's coercing you to do that. And so people do it because they see that it's valuable and people perceive value very differently. And if you as a clinician are providing a valuable service in the eyes and minds of your clients, then that's a good thing. And that's how we figure out how remuneration and covering bills and profitability.

Ben Lynch: People have to be paid back. And so how do you frame up that conversation with your practitioners? They, they need to earn a living. How do you frame up to them, especially early on in their career journey about that exchange of value that patients come along to get healthcare and they pay for that. And then we're able to pay you and give you some pathways or progressions. How do you start to talk about that in a way that they understand that their pay and healthcare are tied together?

Bec Clare: We start from a point of understanding a new team member's relationship with money. So, like, what's their background? How have they interacted with money before? What's been maybe their parental circumstances? Because that often frames up how it is that we want to engage what belief systems or perceptions we impose on our clients versus allowing the clients to make those choices. And I think that that's really a nice framework to start because I could run everyone through the $1 coin exercise all I like, but if I don't understand what it is for them, whether they've had surplus money, Whether they've had quite a comfortable life or whether they've come from a background where money was really hard to come by, that's going to frame up how it is that they view their wage, how they view a commission structure, how they interact with clients around the value proposition and how many appointments they should have. So I'm really wanting to start at a level of understanding first before we start, I guess, sharing our knowledge of the space.

Ben Lynch: Sounds like you like to address it head on and actually call out, let's talk about money. Let's not have it as a taboo subject that goes under the rug here. We actually want to address money. What is it? Why do we have it? Why are people paying for these services? Why aren't they free? You know, Brad Beer's comment in the thread was, you know, go work in public health if it's not about that. That was an interesting sort of probably knee-jerk response. And perhaps that's part of the reality is that, hey, we are in private practice. We have the ability to set fees, you know, depending on the services that you work with, the clientele that you work with. And it allows us to invest in tools and tech and CBD and facilities, expansion, marketing, all these other things. So there needs to be a margin, there needs to be some profitability in order for us to do it sustainably. Otherwise, at the extreme end, we're not able to help anyone because we're going to go out of business. And so it's quite interesting that connection of pay and performance in a way. People are going to get paid a certain amount and there's a minimum level of performance required for that to be a sustainable trade. To take the extreme version, I can't pay you 80 grand a year and have you see one client a week. That's just not going to work. So there needs to be an expectation of how many clients we're able to help. And of course, we want to help them get their outcomes. Who was it someone, Jack, I don't have the thread in front of me, but said, the goal is the client's goal. I thought that was quite an apt sort of like summary of ultimately what we're trying to do. Brad Beer spoke of his POGO finish line, physio finish line that they have. Patients achieving their meaningful goals when they come along. But I think it's important that you're going to have a minimum expectation.

Jack O'Brien: Let's double click on that. This is a hill I'm willing to die on. The goal of healthcare is not discharge. It's often said that our goal as clinicians should be to discharge a patient as soon as possible. I don't buy it because if that was the case, you'd have someone walk through the doors for an assessment and you would discharge and then you would never see them again. Now, would they achieve their outcome, their goals? Almost never. Completely unlike, they're coming to see you because they've got a goal they can't achieve. And so that, discharge as soon as possible is antithetical to patient-centered care. Patient-centered care means, to your point, their goal must become our goal. So what is the goal of healthcare? The goal of healthcare is not discharge ASAP. The goal of healthcare is effective and efficient outcomes. Get to the outcome in an effective and efficient way. But that does not necessitate a quick discharge. We know that tissue times take at minimum six weeks for tissue turnover. Chronic conditions or long-lasting conditions can take longer. Sometimes we're dealing with lifetime disabilities or functional impairments. These things take time. We all go to university for years and we spend tens of thousands of dollars and we expect that behavior change and knowledge transfer to our clients can happen in a 30 to 60-minute window? Please, give me a spell. These things take hours, even weeks, to affect change over time sustainably and in an outcome-driven manner. So, you know, effective healthcare isn't discharge quick. Effective healthcare is outcome-driven and patient outcome-driven.

Bec Clare: I also think the superpower of, say, modalities like physio or EP is that you're not just helping someone with their maybe acute injury and to get out of pain. They often come with other goals to move better, to have the joy of movement back in their life. And the superpower is that we can actually help guide them to achieve those outcomes and to create meaningful habits that change a life. I'm not a clinician. Um, but if I was to go to a therapist and I have a set of goals, I'm the type of client who actually needs a bit of handholding, who needs accountability. If I saw a therapist who had discharge as soon as possible, well, I'm going to be back on the table, back in the room in no time because I wouldn't have done the things, right? I know I'm a business owner who needs to build the habits, but I don't do the things.

Jack O'Brien: We're dealing with complex humans. We all know that healthcare and recovery or progress and functional improvement is non-linear. It's incredibly, it's not just complicated, it's complex, even wicked to use a technical term. That is a technical term. And so, the point is that you can't just see someone prescribe a therapy or an exercise and expect that it will work because there's a myriad of other factors that are way outside your control. Stress, and sleep, and nutrition, and emotions, and ability to remember, or time capacities. Humans are very complex beings, and what people invest in is not the clock and the time on the wall behind you. They invest in your expertise, and your problem solving, and your accountability. It's the outcome that people are investing in. They're not buying your time. they're buying the outcome.

Ben Lynch: What's an interesting distinction on this as well is literally the word care in healthcare is like, am I caring enough about the goal now and any future goals? Often once they get through perhaps any acute transformation or evolution, they now can do things maybe they couldn't do before or they're back to where they were or some version of. And new things become possible or desired, or literally time has elapsed. And I go, Oh, you know, I'd like to try this. And I think if I care enough about you, I'm actually asking what's the next meaningful goal in your life so that I could support you, guide you, educate you, nurture you, whatever that may look like. And so, Oh, what's interesting. I literally think here of the GPS coordinates. Where are we today? Where are we going? And that sort of destination, it sounds like almost that end point. that Ariel has spoken to is, well, the end point is discharge and people not to rely on me or to have self-reliance. It's interesting if that sort of end point in the GPS was pivoted or if we explored different endpoints as to how you might then navigate that road towards the outcome. It's quite interesting, yes, the push towards self-management. We know how much gets lost, misheard, misinterpreted, forgotten in consultations.

Jack O'Brien: I think actually, sorry, we don't know how much gets lost and that's the point.

Ben Lynch: That's a very good point, actually, yes. The assumption is plenty gets lost, misinterpreted, forgotten. And a lot of people, to your point, Bec, aren't particularly accountable to themselves. They don't typically follow through on the things you tell them to do. And part of that follow-up and nurturing, seeing them again, is actually to help find better ways, easier ways, perhaps some interventions that you're able to provide to get them to that outcome quicker or sooner or more sustainably. Because people nod their head and say yes, and then they forget about it or don't do it. Uh, I think part of the distinction of rebooking is accountability to care that the things we prescribed have been done, been done properly, or that we're iterating on that for a better outcome rather than say, come back if you need or see how you go.

Jack O'Brien: That's patient-centered care, right? To quote a philosopher from the early first century, a bonus points if anyone knows where this is from. It's like we as humans are very complex. We do what we don't want to do and we don't do what we know we should do. And so, if we are truly patient-centered, and this is really the psychosocial element of bio, psychosocial care, it's to consider human behavior, that we don't do what we're supposed to and we do do what we're not supposed to. And our job as trusted experts alongside our clients is to guide them towards their desired outcome when they need us.

Bec Clare: role as well in healthcare is that it's, and we touched on it a moment ago, is that while a client might come with a desired outcome, our role as healthcare clinicians is also to help inspire what could be next. Someone doesn't know what they don't know. So it may be, you know, if you help them move more freely and they're finally able to do the 5K run, what stops them from now doing a half marathon or a marathon in the future. And that inspiration piece that then allows you to help them on that journey, I think is really, that's maybe sometimes what clinicians also don't necessarily have front of mind is that we can inspire something better for that patient and help them to reach that. What also comes to mind is that there's also a viral reel going around of physios who are going about their day-to-day life and then they're thinking about, oh, I wonder how Emily's marathon went. I wonder how this person went walking their dog. I wonder how this… And it goes through the fact that physios and healthcare clinicians, they don't switch off. They genuinely care about the people they're looking after. And I think if you're asking those questions about, I wonder how this patient went, and they're also on your discharge list, There's something not quite connecting in the fibers there.

Jack O'Brien: Yes. Spot on. Spot on. I'm just looking back through the comments and I do want to make sure it's publicly noted. Ariel did stand corrected on the goal is always discharge. She did state that, you know, the goal, uh, it should, the patient's goal is our goal, uh, was, was a correction that she, she accepted. So again, massive kudos. I love the open-mindedness and the curiosity because it's in the name.

Ben Lynch: Well done, Ariel, that's really good and documenting the journey is just a fantastic way to do it. So part of the emphasis here again to be charitable was around kind of the ick that she spoke to of focusing on rebooking rates as one example of a key performance indicator and how that might be emphasized You know, for various reasons, one notably because it attaches to pay or commission for the practitioner that, hey, perhaps you're rebooking this person because it benefits you financially as a practitioner. Now, if that was literally what was happening, then that is a really bad clinician. I think we could all agree that. Now, maybe she says, well, subconsciously, you rebook them in and, okay, you know that that's also going to help you hit some numbers. But let's just talk a little bit about some of the expectations that we do have to have in place, especially in private practice, so that this is sustainable. because it's very unreasonable to say, yeah, just show up and however busy you are, well, as a clinic owner, we're going to just continue to fund that even if it's at a massive loss. Some of these measures here are proxies for us to know that this is sustainable. I can't continuously spend on new clients and fill you up only for you to see them once. I'm going to go broke pretty quick. So I need to have some expectations that there's nurturing, that you're actually going to see a client through their care plan to their goal. And rebooking is just one of a suite of stats that you can use as a guide, as a proxy. It's not the thing. But as a guide to know, yes, you are nurturing people beyond, say, that first session. As an example, J.O.B., you are the numbers guy. So just talk a little bit more about how you pair numbers with practitioners understanding the importance and relevance to health care and the journey for patients.

Jack O'Brien: First, on the ick. Remember, an ick is a signal for anyone unsure, maybe you're 35 years or older. Ick is a phrase that people refer to this like icky feeling. It's maybe a Gen Z slang and I say that in good faith. Ick is a signal, it's not the truth. It may be the truth, but it's a signal to explore. We don't have to define our ideas by just our initial gut feel responses. We want to explore them and perhaps debunk them. And so when it comes to KPIs and numbers, you're right, it is a proxy. It's in the name, right? When we talk about key performance indicators, an indicator is a proxy. It's not the truth. We at Clinic Mastery often refer to them as clinical excellence indicators. They are proxies for how clinically excellent you are. And so I reckon most of the audience listening along would agree with us that a rebooking rate of 5% is not good. That's not good performance. That is not helping people. That's literally people walk through your doors and walk back out and never come back again. That is not good.

Ben Lynch: Here's why. Let's double click. I'm interested in your take. Because, and part of our assumption when we talk about it here at CM, is that through your care, through your assessment, through your clinical judgment, there is always some future plan Ariel spoke to it, self-management, well, surely you're prescribing some version of a plan, a self-management plan, some set of steps or interventions or things to do towards an outcome that's meaningful for the client. And rebooking says, well, did they commit to that plan? Can I see that they rebooked according to that plan? Now, it may be contested, well, they don't need to come back in in order to action that plan, but just to connect the D.O.T.S that that's ultimately what we're trying to do, right, is assess of the plans we've delivered. Well, that would be the first one, our plans being delivered, a management plan towards a meaningful outcome for the client. And did they commit to that through rebooking the next appointment? So J.O.B. keep going, I broke your flow there, but just to connect the D.O.T.S, because you touched on it beautifully before, of why rebooking matters.

Jack O'Brien: We all agree that, you know, 5% rebooking is not good. And probably 100% rebooking is not good. You know, if you never discharge a patient, that's probably there's something awry that's worth exploring. So there's a number somewhere in there. that indicates performance, it indicates great client care, it indicates great clinical outcomes, it indicates, you know, patient rapport, all of these things. And we can see, again, we get visibility across thousands of clinics now for the decades that we've been working with clinics. And inside Allie, we see what high performers do, what those who have incredible clinical skills, those who have been in the game for years, And we know classically that those who get great outcomes and experiences for their clients have a sustainable rebooking rate. And it varies across professions and styles of clinic. But there is a number that indicates setting the pace and really performing at a high level. And there is a number that indicates room for improvement. That will differ from clinic to clinic, but it absolutely matters. And ultimately, it's It's a reflection of, here's what it is, your rebooking rate is a reflection of you having a plan and a vision for your client to progress towards their goal. Because if I'm treating you, Ben, and if I'm a physio and I'm helping you become, not just recovering from injury, but getting stronger and robust and more resilient and protecting against injury and improving your quality of life, I must have a vision for where you are today and where I can get you between now and next session. And so a rebooking rate is an indicator of clinicians having confidence in their ability to prescribe a plan. Rebooking rate, I'll say that again, rebooking rate is evidence of a clinician that is able to progress and plan a client towards their desired outcome. And so, what we do see is like, I'm going to be a bit stereotypical here and say new grads who maybe can handle the acute phase really well but maybe struggle with third phase, fourth phase, you know, planning and vision. their rebooking rate starts to drop off after a couple of consults because they just don't know what to do. They don't know how to progress, how to take things to the next step. So, rebooking rate is a reflection of us having a vision, a collaborative vision with a client to be able to progress them. It's ultimately a reflection of your clinical excellence.

Bec Clare: The thing to rebooking rate, the rebooking rate doesn't stipulate the frequency of the appointments that you need to have with the client. it's a percentage. So you can still have a client who's been prescribed a self-managed program that you're checking in with over an extended period of time. So the rebooked percentage doesn't mean that you need to be seeing them every day or every second day, albeit you might in an acute phase, I don't know. But you can still have a self-managed client who is rebooked. They're not too parallel.

Jack O'Brien: Yeah, two things can be true at once. In fact, there was something else that came up in the reel where two things can be true at the same time. I think in the reel it was said that there's a bias. Yeah, we have this bias. If our commission or our reward structure is tied to a KPI, we have bias.

Ben Lynch: Yes.

Jack O'Brien: Yes. And bias can be accounted for, and when accounted for, it's not always bad. Now, unaccounted bias that really does skew things is something to be cautious of, but we see in, you know, we would expect in peer-reviewed journal articles for a bias to be called out and accounted for, in which case, it adds strength and robustness to the quality of evidence. And so, the same is true in clinical practice. We all have our biases. In fact, I would suggest most early career professionals have a bias towards a poverty mindset or at least they have a bias towards making prescription based on the hip pocket of a patient rather than their hip, as the cliche goes. So, we all have bias. The point is, do we account for our bias? Do we manage our bias and can two things be true at once? Yes, there is remuneration probably tied to good clinical performance and we can still make the best clinical judgments for our patients despite any financial incentives. We are highly educated, informed, clever people. We can do this. We can handle bias and still have our client's best interest as first amongst competing priorities.

Bec Clare: Ariel referred to it as motives being pure. And I think you can still have pure motives and be a healthcare professional and still have an incentive and rewards-based program in place. I think if you are a clinician who is rebooking only because you get a reward based on that, well, you do have an unhealthy relationship with whatever that incentive is that's in place. But you can still absolutely care for your clients and still be pure in your mindset and still take home a really good pay that is incentivized.

Ben Lynch: There's some reality to this, you know, small business that is, you know, even if you're a quote, great clinician and you get great outcomes with your clients and they love you and you love what you're doing, but you're seeing two or three people a day in a physio context and you're working full time. There's only so much we can pay you because you're not bringing in enough money. And so if I sort of straddle this with extremes that should we just pay everyone the same irrespective of years experience, irrespective of their quality, irrespective of how many people they help, I think if you ask any health professional, Why do you do what you do? The answer is some version of, I love helping people. I love helping people, you know, get back to normal or integrate better in life and work, whatever that might be. But it's like, I love helping people and I want to make a big impact. Well, you know, staying within the bounds of reality here, ideally then you would want to help as many people as you possibly could while you're allocated to do that job. So let's say you're nine to five, Monday to Friday. Ideally, you're helping as many people as you possibly can. That would be the truest and greatest expression of your passion and your skill set. It wouldn't be to help two or three people a day. It'd be to help 14, 15, 16, whatever's reasonable so you do it in a good time, right? And so then the question is, well, what if I've got a teammate that is seeing 50 clients a week? and doing a great job, staying on time, doing their notes, quality care, et cetera, getting the clinical outcomes. And I've got someone that's doing 15 in a week. Well, do you think the person doing 50 should have some greater financial upside because they're adding tremendous value to more people in the community than the person doing 15? If the answer is yes, then you have to acknowledge that there needs to be some financial upside to more productive therapists. So, you could see it as, oh, some biased incentive to try and earn a whole lot more. What if we sort of flipped that subtly and just said, what if we were rewarding people that were highly productive and effective in their role? Because we could look at it from two different perspectives. So, I think that's worth noting as well. Okay, sure, there might be literally some commission-based systems. I think this is worth noting, whether you paid literally a percentage of billings, whether you paid a base plus some reward structure on top or just a straight base and maybe there's some versions in between on those things. Ultimately, as a clinic owner, you're trying to say, I'm taking a risk. Literally, I am risking losing money on you because I'm going to front up, let's say in this case, a base salary of 80 grand, and I'm going to do what I can to help fill your books. And then once you hit a certain number where you're paying for yourself and some of the other overheads, I want to give you the opportunity to earn more if you're doing a really great job in helping more people. Of course, the subtext there is not only helping more people, but helping more of those people achieve their meaningful outcomes. Of course, that's always at the center of what we do. And some of those measures are proxies, indicators beautifully stated, Joby, for me to know how well you're doing in different areas. And, you know, do I need to, or can I allocate more new clients to you? Or are you not rebooking them particularly well and so we need to work through some of the training there about treatment plans and management plans and that would tell me whether those things are happening to some degree. It's not the full picture. Yeah.

Jack O'Brien: Well, there's two things on that. You get out what you put in, right? You work hard and you do a good job, not just work hard and do a poor job, but you work hard and provide value and you get out what you put in. The second piece is, here's what we see the best clinics do. The best clinics look at KPIs in context. You look at your CIs in context because here's what we sometimes see, a rebooking rate of say 85% looks like it's in the healthy band but if you also have a cancellation rate that's like 25%, well, what that tells me in context is maybe you are compelling in the consult and we just get people in the diary but our patients don't trust you or they don't believe you or they don't prioritize their care and as quickly as they got in the diary, they drop back out again. And so it's all things in context. This is the nuance and the sophistication that, again, I totally respect and appreciate. Curious Physio Project here was a real on Instagram. So it's not an exhaustive PhD thesis. But the nuance is lost when we take all of these things out of context. We must look at it in context with your NPS and your patient satisfaction and word of mouth referrals and your relationships with other healthcare providers. How is your cancellation rate versus your DNA rate versus your PVA and your average dollars per console? All of this, that ideally you have it in one view so we can view it in context, AllieClinics.com if you're looking for that link, but it's everything in context.

Bec Clare: The CEIs, I call them CEIs, I can't even say the word, the acronym KPIs, it's about the context and the story. It allows us to then go I'll say digging, but it allows us to sort of fossick for what is the story that is in behind these numbers. I also think other things in terms of context are important. If I look at my team, our two separate clinics, they have a separate sort of different clientele base. One clinic, we do quite a lot of pre-employment assessments as an example. Now, if I was to look at the clinicians at rebook rate, and said, our benchmark as a clinic is X and that is it, well, they wouldn't be part of our high-performing group because, of course, you're not going to rebook a pre-employment assessment. So, you've got to look at each of those numbers and understand the story in behind them and how they're being recorded and achieved. And I think it's just the conversation versus saying, here are the numbers, here is what you need to meet. And I think that's where perhaps the conversation gets or sparks that ick reaction, right, is where the conversation is one that is either given or is interpreted that these are the numbers and here is what you need to meet versus here are the numbers and this is how it tells a story for how you're caring for clients. And I think that that's the true piece behind being a clinic owner is how you can help your team understand what those numbers represent in terms of care versus them being numbers on a page that they are required to meet.

Jack O'Brien: I love that Bec. And you know, when, when we as clinic owners approach these things to explain the nuance, so here's what I would say, clinic owners need to be very well versed in how to navigate these leadership conversations. These are difficult, complex topics that require a skill that you practice. And ideally you learn from a mentor. These things aren't taught at university, how to navigate subtle nuanced conversation. So, so leaders invest in your communication skills. And on the flip side, if you're a healthcare professional here, maybe you're not a business owner, you need to also learn how to have these conversations. There was two things that this reel said, and again, super charitable towards Ariel. We'd love to have more of these conversations with other folks in the healthcare community. We all get better when we have conversations. But the curiosity I love, come to a conversation seeking to understand. We want to be open-minded and, again, aware of our own biases and aware of our own beliefs that are maybe not limiting beliefs, but just inherited beliefs that aren't fully formed or fully explored. So if you're on the receiving end, seek to understand because, and I'll quote Ariel here, but again, in context, it may have just been an off the cuff thing. She said this, she said, it infuriates me, referring to payments for KPIs. It infuriates me, but I don't understand it, end quote. And it's like, I just don't understand how you can be infuriated by something you don't understand.

Bec Clare: Perhaps there's infuriation in the fact that there's missing information that she doesn't understand. Maybe that's the infuriating part.

Jack O'Brien: Right. Totally, totally. So, you know, I think let's not, so what I'm trying to get at here is let's not be infuriated by things that we don't understand. Let's seek to be curious about things that we don't understand. And perhaps there's something we're missing.

Ben Lynch: On that note, let's close this chapter of the podcast. We're going to talk more and more about this because it is increasingly becoming the most important thing clinic owners need to navigate amongst changes in third party payers, award changes, cost of living conversations. It is so important to running a sustainable clinic. Bec, Jack, thank you so much for your contributions, folks listening along. You can head to clinicmastery.com/podcast for the show notes, all the references we talk about and our recent partner page. J.O.B, you've been working very hard on curating the best partners.

Jack O'Brien: So, stand by folks, there's gonna be a number of announcements of trusted partners in this space. Some will be guests on the pod. We have a bunch of opportunities, deals, offers, discounts for you, our podcast community. So, stand by over the coming weeks. You are going to be suitably impressed by these partners that we have curated for you.

Ben Lynch: Well, hats off to you. Wrap the episode. Thanks, Bec. Thanks, Jack. Bye-bye. Bye.