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.

Bec Clare: I call this time of year onboarding season. I mean, we should always be onboarding new team members and growing our team.

Ben Lynch: We collectively could be much clearer on the expectations of new graduates.

Bec Clare: We know that there's a lot of talk around burnout. We also know the statistics around how long typically allied health professionals now stay in the profession.

Ben Lynch: Now some might go, a new grad doing 80% of their clinical time in eight weeks?

Bec Clare: Sometimes it's like, I don't want to hire a new grad because I just don't feel like I can be there for them. You can, but two sessions in their first week for the first four weeks.

Ben Lynch: How good does it feel to impact someone in early career with this level of training and support? This episode will be right up your Allie if you're looking to onboard a new graduate therapist. We're diving into decreasing the time it takes to get them settled, profitable and competent. And trust me, you want to hear Beck's take on how to get them to take ownership of their own growth. Plus stick around for when we discuss some of the structures that help rapid clinical competence to develop. Before we dive in, today's episode is brought to you by AllieClinics.com. If you're the kind of clinic owner who loves to feel organized and stay ahead of the chaos, you'll love Allie. Think of it as your digital clone. It's the single source of truth for all your clinic's policies, systems, and training. Test it for free at AllieClinics.com. And in other news, applications are now open to work with us one-on-one at Clinic Mastery. If you want support to grow your clinic and bring your vision to life, just email helloatclinicmastery.com with the subject line podcast, and we'll line up a time to chat. All right, let's get into the episode. My name is Ben Lynch. I'm again joined by Beck Clare, owner of Physio West here in Adelaide, two amazing sites located in shopping centres, which we've recently discussed. Beck, today we're going to be talking more about new graduates and onboarding them. I think one of the fears a lot of clinic owners have is, firstly, should I hire new grads if you've never done it? Or if they have done it before, maybe they had a bad experience and they're wondering, do I go back to that? Well, and so I'd love to explore why that is the case, but I actually thought we should just jump straight into it because yesterday we had our internal training with all the consultants. We've spoken about that before. We're incredibly privileged to work with hundreds of clinics at different sizes and stages. And all of our consultants come together every single week to trade notes and insights, like, what are you hearing? What are you seeing? And we work together on our skill sets to better support clinic owners. The topic of conversation yesterday was around onboarding new graduates. At this time of the year, a lot of clinics are doing it. Maybe you're not onboarding new graduates, but just new therapists. And there are still principles and practices that I think we'll end up covering in today's conversation that are applicable no matter the career stage, but we want to emphasize the new graduate in particular. Here's what I took away from the session yesterday. we collectively could be much clearer on the expectations of new graduates and we could actually perhaps raise the standard of those expectations, essentially ask more of them. sooner rather than later and have better accountability mechanisms in place to ensure we give them the best chance of getting there. I want to speak to some specifics here because I'm interested in how you define quote-unquote success. in a new graduate context for their onboarding, like tangibly, objectively, measurably, however you like to define it. When you look back after several months of this new team member being onboard, what are some of the signs, some of the outcomes that you're looking for to know that we did a good job, they did a good job, collectively it was a great start for their career with us. So maybe we'll start there, we'll kind of use that principle at the very beginning of clearer expectations, perhaps higher expectations, and sooner. We want to have them meet them sooner. So how do you define, how do you think about success for new graduates in their onboarding?

Bec Clare: That's such a great question and I feel like this is so topical. I call this time of year onboarding season because we should always be onboarding new team members and growing our team where we've got the capacity to do so. But this time particularly is where if you've got therapists who are more experienced, they're tending to move about. They've had their end of year reset or it's when all of our new grads are coming out, they're desperately waiting on their ARPA registration and then their provider numbers and then we're ready to go. So Science for Success, what I'm looking for is their ability to communicate with their leaders. So to be able to have an honest communication channel, be able to sit down and tell us how they're feeling and how they're able to assess their clinical judgment and their level of experience that they're providing clients. Why this is important is so often we hear, particularly from new grads, we call them early career therapists because we basically consider anyone under sort of three years to still be quite early and fresh in their career. And depending on their experience at another clinic, you could be needing to do a bit of a redo. It's important that we understand the landscape. They often will start talking about burnout really early. It's often because the universities are talking to them about that. What does burnout look like? Be careful of this, be careful of that. And so we want to have really good open lines of communication with our early career therapists that they feel safe to be able to flag that and then we can adapt workflow or be able to have conversations about the reality of private practice life means that you might well be back-to-back with clients. And we've talked about that on a previous episode. How do we get you to be in flow? Therefore, it doesn't feel like you're burning out. So that, for me, that's a key measure of success is can our new team members have that honest conversation with us early before they're then tapping into things like sick leave and all of the other things that come with the signs of burnout.

Ben Lynch: How else do you address burnout proactively with them? Whether you frame the conversation in certain ways, you share different resources with them. We've spoken before about different clinics using employee assistance programs with psychologists as part of one of the perks of being at the clinic. There's a bunch of different resources. We've used the Resilience Project. Previously, the journal, the book, there's a wonderful array of things. We did a previous episode with clinical psychologist Sean Goldberg on burnout, which gave a really great lens for you to look at it. Go check out that episode. But how do you do it at PhysioWest and by extension, the clinics that you see and work with, what are they implementing to address this in a more proactive sense?

Bec Clare: calling it out early, actually having a conversation about it. We have a conversation about it in induction. We go, look, we know that there's a lot of talk around about burnout. We also know the statistics around how long typically allied health professionals now stay in the profession, which is not long. It's somewhere around three to five years, which is really sad for the profession. You've done all this study. You're here to help people. And then something has happened or a series of things have happened that mean that you can no longer do that and you're looking elsewhere. And I think it's in part our responsibility as business owners to start having those conversations and start resetting and shifting the paradigm. So we talk about it in induction. We partner with Sean Goldberg, so MindUp, our EAP provider for us. They're absolutely wonderful at what they do. So we ensure that that's somewhere where our team feels safe that they can reach out to and specifically looking to… Can you just talk us through that a little bit more?

Ben Lynch: It's not familiar to a lot of people. What is it? Why did you choose to do it? How does it work?

Bec Clare: Yeah. We offer our employee assistance program. It's three sessions per employee per year. They can reach out to MindUp, so Sean's team, and book in confidentially. We then just receive a bill. So we don't find out who has accessed the program, but typically you actually get a little bit of a sense of who might be accessing the program. You've probably, in fact, encouraged them to do so based on a conversation. So what we wanted was for our team to feel safe and secure that they could reach out for mental health support without feeling judgment or that it would go on their record or that they would then necessarily be wrapped in cotton wool and it made obvious to the rest of the team, right? So we wanted to ensure that privacy and Sean seemed particularly good at that. We also chose MindUp because they specialize in stuff like burnout for healthcare professionals. And so we really wanted someone aligned with that who could help team members not just listen but put in place strategies to help them continue in private practice.

Ben Lynch: I can imagine as well as a leader, whether you're the owner or a clinic leader, senior therapist is responsible for those one-to-ones, that relationship mentoring, supervision. It also acts as a really great compliment or buffer for them because often they'll tell us, I feel out of my depth having some of these conversations. especially when there is burnout or there's some mental health challenges that the team member's going through, to really be able to lean on the support there of an EAP program. Okay, so that's really good. So you've got, you're addressing the burnout conversation proactively, helping them understand that that can be normal. Here are some of the things to do if you're starting to feel it and experience it. we've got an employee assistance program, and you're really emphasizing the communication with them and the leader. You also mentioned the assess their clinical judgment. This was something that Andrew brought up yesterday in his own reflection and learning. It's like, I really have pared back a lot of the complimentary stuff that goes in and onboarding and just really focused on running a great consult. The new client assessment, the subsequent consult, the management plans, like nail that side of being a healthcare professional, because that causes perhaps the most anxiety and stress for a new graduate you go from. I remember when I went for 90 minute consultations at the uni that no one paid for to a 30-minute consult that's $150 in private practice in four weeks' time. And there's all those doubts that you have like, well, have I done enough? This went really quick. Is it worth $150? Should I get them to come back? And so, I can really see how the emphasis on the clinical care, especially early, is super important. One of the reflections that I've had in seeing so many onboarding systems through the course of Allie and through our consulting role is there's a real lack of repetition. And I put that out because we created this thing called 0 to 100. It's essentially the first 100 days of a new team member's journey. The idea it was spaced out like that is, one, it typically aligns with a probationary period. Two, it gives you enough time to install things and see how they go with it. But perhaps one of the key points that people miss, they often come back to me and say, Ben, you know, a hundred days, it was too big. I scaled it back to 30. You know, there just wasn't that much content or I was stuffing it. And I think I've missed sharing the point and they've misunderstood the point that there needs to be repetition. And that's what I see time and time again. It becomes a checklist. So I've done it once, tick. I'm done, move on. Rather than this repetition like perhaps and hopefully you're used to in the university context of like, we're going to spend a whole term just focusing on this skill set or this pathology or this assessment or these techniques and really master them. So I'd really encourage, especially for new grads, the repetition is the key to that competence that breeds the confidence. So that's something that I see. I'm really interested. success measures in an objective sense, and I want to pose one to you. I don't think we've talked about this, but then I want to hear if you've got something similar. Everyone kept talking about utilization, and I hear this a lot in consulting clinics. And I think people have this idea of where they want a team member to get to, and maybe it's cleared by this percentage by this date, but it might be too far in the distance and we try and really support them. We don't want to put too much pressure on them. So I've got this mental model that might be something people could consider or find their version of, which is eight by eight. Just sort of make it simple to remember, which is really using the number eight throughout the whole sort of objective context of success. So if you imagine you've got a full-time employee practitioner, we don't expect them to be fully utilized in those hours work. There's always hours that they're offline. So if we said of their available clinical time, let's say they're only available for 30 of those 38, that 80% of their time was utilized for billable services by week eight. Now some might go, a new grad doing 80% of their clinical time in eight weeks? You can temper this with your profession and your training structure. But so many of the clinics we see set this expectation too far in the distance. And then they're having to fix these problems where they're not used to doing the repetitions and work. And then the question is, what would need to be true in order for the new graduate to be able to hit those benchmarks by that date? And it really forces you to improve your support and training. So if that were true, 30 hours, you're looking at around 24 billable service hours per week. In an MSK context, maybe that's around 35 appointments a week. OT speech, psych, four and a half, five billable hours a day. So I want to pose that as a clinical outcome for a new grad in eight weeks. And rather than say there's no way we could do it, what would need to be true in order for a new grad to make that possible? Do you have similar types of outcomes that you could work towards that you frame up with new grads?

Bec Clare: I think this taps really nicely into what we've actually just spoken about because the temptation is to start slowly with our new grads and to go, okay, 80% by six months or 12 months. And then we do run into the cadence and burnout conversation because they're just not used to running at that. They've been almost quite protected over here with those 90 minute longer consults like they have done at uni. And then they also start to have that question around, I'm meant to be a professional but I don't yet feel like one, therefore overloading consults. And we'll perhaps come back to that in terms of value and how we assess their clinical competence, right? I absolutely think 80% by eight weeks is doable with the right support. And what does the right support look like? It's being available to our new grads and having structured time in the diary. The way that we use a success measure is that we want to have put the groundwork into our early career therapists before they actually start consulting. So they've come along to some CPD, they've got all their systems ready to go because in part some of the hesitation about giving our clients is not just clinical and experience. It's about, do they know how to navigate the room? Do they know how to use the practice management software, the exercise software, the VOLT tech? You've got to layer all that in and that comes with some practice and as you say, repetition. Our benchmark is that we know their break-even number. And so they should start week one, they should at least have enough clients in their diary to be breaking even. So as a business, we know that it's only growth from there.

Ben Lynch: Yes. And to give a bit of an approximate number, we would typically see this, depending on the profession, is going to be somewhere around 15 appointments a week, approximate in an MSK context. You know, that's probably around seven to 10 billable hours in another context. Okay. For their first week, that is.

Bec Clare: Their first week, as a minimum, that's what they're seeing. And then we can build from there. And that ties nicely into the eight by eight, Ben, because if they're doing 15 and we want them to sort of get to 24, they've already got a groundswell of clients that if they are then treatment mapping and rebooking and doing everything they need to from a clinical perspective and an experience perspective, those clients should remain and we can continue to build with new ones after that.

Ben Lynch: It's a really great point. There's a lot of variables here, as you're saying. Are we doing all the right things to get the new client flow in, or are we triaging people off the wait list into this new team member's diary? They need to have, obviously, the folks to be able to see. I probably wouldn't expect them to do too much. on a marketing or client acquisition front in their first 90 days, maybe even first six months. But that could also be an expectation that's at least spoken to, but maybe not acted on straight away. I think you just want to be competent seeing the next client and running on time and being able to do that back to back for a full day. But I think that's where we all got to, wasn't it? That we've all made mistakes of trying to be super supportive at the start, but perhaps taking the wrong approach, which was don't give them lots of clients. That's all relative, lots. But, you know, ease them into it and then we find, oh, we just kicked the can down the road and now it's a problem that's six months or nine months. So we're better off perhaps getting the reps in earlier.

Bec Clare: And Ben, we talked to what is normal. you know, what does a successful high performing practitioner look like and at what stage? So at six months, what would we be expecting from, what does your day look like and how would you be then value adding to the client and to the clinic as well? So we're really starting to frame up, okay, you've got your first eight weeks, your first 12 weeks, your first six months. And then sort of at that six-month marker, that's when we'd love to see you engaging, if not earlier, with some referrer partners, offering some internal CPD to the team. Like you've now found your feet and you've found your groove. Let's get that contribution now flowing. Most will do that much earlier than the six-month marker, but we sort of go, let's put the fence post in at six months and let's celebrate when that happens. earlier than that and they feel really good and that sort of buoys their confidence. We see a lot around, well, I'm meant to be this professional and I don't yet feel like it. How can we help build that confidence without sort of, I guess, pumping up their tires where it's not necessarily there? Like we want to celebrate the milestones and we want to make them meaningful as well.

Ben Lynch: That's a really good point. The distinction that I'd have as well just on the 80% is of available clinical time is quite discretionary. You can really massage it. So you might say, we're going to allocate three hours worth of training. And then there's two hours worth of mentoring sessions one-on-one. And you can make the mix. So I wanted to say for folks, if that does feel high, it also depends on how much you're actually counting as available clinical time. There's a framework that I learned through Sarah from the people plugin, which is Uber. We've spoken about it before. It's O-O-B-A, and it's been a really practical framework for me thinking about culture, performance, standards, and that is the O stands for outputs and outcomes. B is for behaviours and A is for attitude. And so you can almost segment a bunch of these things that we're talking about into those buckets. For instance, the outcomes is 80% utilization after eight weeks. Some of the behaviours that you're talking about include those communication frequency, the calibre, whether it's filling in the focus sheet or their reviews, however that structure is, maybe it's completion of those things. early preparation of sessions. And then we're seeing some of the attitudes side of things, which is largely living out your values, if you've defined them clearly, the reflection piece. And then the output or outputs include things like being able to follow up the referrers of the clients, being able to deliver the sessions. being able to contribute to the CPD and the preparation of that. So being able to put them in these little buckets here, I found really useful to look at how we make this, I'll say, quote, well-rounded. Maybe some folks are thinking, well, this is very business and commercial structured if we're just focusing on utilization. And that's the fast track to burnout is to say, we need to get you to this high level of utilization without considering some of the other things. And then we could also look at, well, what are we doing in each of those areas to build competency and capacity in behaviours, attitudes, outputs, et cetera. So I think that that's a really useful framework. The other thing, just to connect the eight by eight. is that they would be getting a score of eight out of 10 in their net promoter score from clients, or an 80%, that they'd be getting 80% rebooking by that eight weeks. Hopefully sooner, but I'm just saying by the eighth week. and that they'd be 80% utilized. You might even look at that by eight weeks, they've made 80% progress through their onboarding checklist. So just as a bit of a mental model for progress at a point in time and you nuance it to the individual and how they're doing, it could form the basis of how you then structure some of that early training to maybe remove some of the clutter and just focus on the core thing. I'm interested in the frequency, the style, the format of the mentoring conversations that you have. I'll share what I think is, again, another point of reference for folks that came out of yesterday's meeting, which was a version of the first four weeks, twice a week connection with that team member one-on-one. somewhere between 30 minutes and 60 minutes. There's a lot of independent things that they can be doing, especially if you've structured up some of your onboarding through Allie. And then somewhere for the next eight weeks, it goes to weekly. And from there, you could go to fortnightly. So we're sort of looking beyond 90 days going out to fortnightly or monthly, whatever makes the most amount of sense. Again, I don't think you want to spend too much time doing a lot of talking and mentoring. You need to strike that balance of they're going to learn a lot by doing and reflecting themselves. How do you think about and what's your approach to the mentoring rhythms early on for new grads?

Bec Clare: I think definitely being there as having purposeful time in the diary so that they know when they can come to you. Particularly, say, if you're on the tools, still consulting yourself, it can be a challenge. And sometimes it's like, I don't want to hire a new grad because I just don't feel like I can be there for them. You can by two sessions in their first week for the first four weeks. You can't have those purposefully blocked off in the diary. They don't need you there all the time. And in fact, that goes to that how can we help them become professionals? They have to go and do. They have to get the reps in, they have to practice with real patients. And so ensuring that you've got those booked in the diary, that they know when they can come to you and talk to you about whether it be clinical things or that consult just didn't feel right or I don't know how to use this system, it's in the diary. That way you're getting less of those ad hoc sort of check-ins or have you got a minute, I'm not sure about this. And setting that up for success means that those sessions are also really full and purposeful, and you're not talking as much. They're coming to you with their challenges, what have they tried, and how was their problem solved. That's starting to train an independent thinker.

Ben Lynch: We've spoken about the 1-3-1 model before, which is, what is the one problem? They need to articulate it well. There's that great saying that a problem well articulated is half solved or something like that. And then for them to present, here's my three possible solutions or the three things that I have tried. And then it's typically, what are my three possible solutions? And then what is the one recommended one? What's the one that I think is best of those three? So that they become a problem solver. Now, you might offer them an alternative solution that they can adopt, but they're coming to you with that. I just thought as you were talking there, perhaps this is something that you've done as well. If you're using a chat platform like Google Chat or Slack, you can have a specific channel, mentoring channel, for that team member that's private, it's only got the mentor, supervisor, or you the owner in it, and it's a place where they can put a number of these questions or challenges that they've got for them to be solved async or just keep you up to date with how they're going. I think with that, self-reflection was one of the key things that was mentioned through the course of yesterday's training and just ongoing. We've talked about using like a focus sheet, which is Google Form or a Survey Monkey, that gets completed prior to a mentoring session that makes the team member feel think about and reflect on the previous one week or one month or anywhere in between on a set structure of questions so that they're coming prepared or they've just done the thoughtful reflection. Perhaps early on in a new grad's journey, an end of day reflection for them doesn't have to be super long. Five minutes, here's what worked, here's where I got stuck, Here's what I'm going to focus on tomorrow. You know, I'm going to be more prepared for session one or when the client cancels, I'm not going to use it to do this activity. I'm going to choose the other activity. So just doing those reflections, I think speeds up the learning process for them. That's what I'd be looking to do with a lot of team members. And perhaps the frequency of the mentoring sessions is really just to speed up the learning process and consolidate those experiences. When you get the team members, the practitioners to review their caseload or how they're going with it, are there certain questions, structures, reflections that you use to help them learn quickly? How do you make sure that that actually crystallizes into a changed approach?

Bec Clare: This year we've actually implemented something that's been really insightful both as leaders but for our early career therapists. So we'll have a mentoring session and they perhaps go through a presentation. We've really wanted to crystallize the communication piece for the client. Practitioners are really good. They've got so much knowledge in here. They've been taught loads at university, except their ability, what we find from early career therapists is their ability to communicate that in a way that makes sense to a client is the challenging bit. And conveying that treatment plan. So what we've implemented off the back of this year is off the back of every mentoring session, the team member goes away and they video themselves summarizing the last five minutes of a consult. So, leaning also into Vin Zhang's Sync Sound. Have I got that right, Vin? Yes. So, they're looking at their body language, they're looking at their tone, they're looking at how they're mirroring, but they're also looking at how they're actually communicating the message. So, they post that video into their support channel, so their mentoring channel, as you mentioned. We have that in Slack for every team member, even our client care team. Um, and that's got their mentor in there and Grant and I as the business owners, um, and their accountability buddy, which is a support person in the team. They post that in there and then their first comment in the thread has to be their own learnings and their reflection on the video. Then their mentor jumps in and says, well, this is what I noticed. Here are the things you did really, really well. I love how you spoke to this and here are some of the things that we can practice together in our next session. We've been running that for the last six weeks with our early career therapists and if we roll back to their first video versus the one that they've just recently posted, the change and the progress that they've made is visible to all. And we've loved that reflection piece now as well. Often, early career therapists will get to three months, six months and go, I still don't know anything or I feel like this is really, really hard. This has been our ability to go, let's go back and look at your first video, as cringeworthy as it is to listen to your own voice, and now let's look at your most recent one. Look at how much progress you've made. Imagine where we're going to be in another six months or in six years from now. Let's keep doing this. It's just been an absolute game changer.

Ben Lynch: It's such a good point because that came up yesterday as well, not in that specific example, but really that principle of review and the accountability. We're so focused on what's next on the checklist, working our way through it, that we don't do review or repeat very well. And so I love your review piece there and having that evidence of like, here's where you were, here's where you are, it becomes very obvious very quickly as to their progress.

Bec Clare: for early career therapists, the way that they, in our experience, the way that they perceive value is that they've given lots in a consult. They've either assessed lots or they've given lots of exercise or lots of advice or they've spoken just a lot. And in part what that does is the patient leaves overwhelmed, they can't remember and they just don't feel like they've been heard or any rapport has been built. So what we're looking for in that snapshot is them adjusting their cadence over time. The first videos, they go for six or seven minutes and there's so much in them. And then the more recent ones, they're taking a bit more pace with it. They've got some more tonality. The value and the explanations that they're providing are so much clearer. So we're also creating clearer communicators, which I think is really the key to a really good practitioner is that you're a clear communicator.

Ben Lynch: Yeah, absolutely. I think a younger career therapist can get the same sort of outcomes and can be as utilized as a really senior therapist just by difference in their communication quality. I've seen that time and time again. And I think that is experience really crystallized is your ability to pattern recognize and communicate what only needs to be communicated. Obviously, then you need to be able to prescribe the relevant treatment. But I agree with you. I love that emphasis on communication. The other written side of that that we spoke to yesterday was around case notes. There's obviously some wonderful tools now that allow some AI recording. And we'll talk about those in upcoming episodes. But if you're still writing notes or whether you are using AI to help transcribe notes, the ability to bring those notes up in your mentoring session and talk through, okay, Beck, talk me through, you know, Sally Jennings here and the consult. What do you feel went well? What do you feel you got a little bit stuck on? What are some things that you would look to improve for this consult? And what are you going to do next session? I think finding your structure to review case notes with a team member in 5 to 10 minutes means that over an hour, you're going to cover a number of sessions that they did today or this week. And I think that accelerates the learning without just talking about it. When we actually get to see, like, show me your work. What did you discuss? What was your treatment recommendation? And then we get some of that clinical judgment piece that you were talking to. I can actually assess, well, how did you think about this diagnosis, differential diagnosis? What was the plan that you prescribed? What are you going to do at the next session? And we can get some sense very clearly. as to the calibre of their clinical expertise or judgment. Because at the end of the day, no therapist knows exactly how a client's going to respond in a day or a week to the treatment that they've provided or the recommendations they've given. So it's about just talking through that reasoning, which I think new graduates should be the best in their career when they come out of university at giving the reasoning. I mean, most universities harp on this to get through your exams. You have to explain a lot about the clinical reasoning as to how you got to that diagnosis. So they should be well-equipped to be able to do this. And I think it's something that maybe in private practice we get into our habits and that comes with experience. Maybe you just, you see patterns and so you sort of jump to it. But I think that's a great one to labour on with new graduates is the clinical reasoning. How did you arrive at this? And can we do a couple of these every single session that we get together?

Bec Clare: Just on that, I think the very best set this particular bit up for success. Because it can feel like, as a business owner, you can feel like, well, am I micromanaging this team member? Am I looking at all of their treatment notes? How are they going to feel about that? For an early career therapist, they've come in and they're like, my boss is checking every note. Oh, I might feel a little bit anxious. Set it up for success right at induction. My role here with you is to help you be the very best practitioner, the very best clinician, and provide the very best experiences. I'm here as your coach and what do coaches do? They want the very best out of you. So I'm going to provide you feedback. Is that okay? The way that I'm going to do that is I'm going to just have a look over your notes because I'm going to be able to see your pattern recognition and see your clinical reasoning play out in your notes. You will have the opportunity to talk them through because there's going to be stuff that I don't get from the notes but that I do. And so it's a conversation versus a critique. So I think setting that up for success means that you're going to have really great conversations and collaboration with an early career therapist versus them feeling like they're being They'll say that, micro-management, you're checking on me. I think the very best set that up early. That's the expectation piece that we spoke to, Ben, whether it's 80% utilization or impact hours, you might want to call them, but set up the framework by which you're going to give feedback and advice as part of your expectations.

Ben Lynch: It's a really, really important point is the pre-framing. I mean, we all spoke to that as well as a lot of the tough conversations that perhaps you have to have down the track can be avoided or the severity minimized by pre-framing things a lot earlier. And perhaps the ultimate version of this is through the screening process in the hiring interviews that you have. that makes the onboarding a lot easier. And if you've pre-framed some of the things you'll be covering in the onboarding, it makes it a lot easier. So there's a number of different variables here for folks to be considering. We're jumping, of course, straight into the onboarding side of things. You've done a lot, your clinic's invested a lot in the clinical excellence side of things. I know what you do with Spence, with James, and with Grant as well. Just unpack for us a couple of things that you feel have been essential, you see as high-value investments in creating a culture of clinical excellence.

Bec Clare: It comes back to that, the culture of it. So our team wanting and thriving on learning, but also contributing to one another. In terms of clinical excellence, the team also going away and doing a bit of their own work. So whether it's, we share an article and everyone then comes along to a session, having reflected on that, how do we currently do that? Where do we stand on that? Whether it be treatment protocol or rehab. We also, do a fair bit in person where we can. Just being MSK, hands are pretty important as physios. Ensuring that we actually are using our bodies well. It comes down to positioning as well. Ben, as a pod, you would have done this. Certain techniques, you can do them in one position or another. what is the toll on your body personally and how does that feel for the client? How secure do they feel? We actually put a lot of emphasis on that early on. What we found, particularly for our early career therapists and It's no one's fault. The universities just can't provide them with the types of placements where they can get their hands on in a way that means that they're ready to go in private practice. It's just the reality of the landscape at the moment. Some of our early career therapists that are coming through now have done one MSK placement of five weeks. and that's all they've done in terms of hands-on treatment. And yet we're then expecting them to carry a full caseload where they are putting their hands on people and prescribing exercise. So we go heavy on that early. So this year it's looked like a six-week program where they come in one day a week and they just practice their manual skills and exercise prescription. So it's partly in the gym, partly in the rooms, and we just check how close are they to the bed? Are they using enough pressure? They just haven't had that experience. Yeah, it's a great point.

Ben Lynch: I often found myself supporting younger therapists as my career evolved and you sort of realize the inefficiency of even just navigating the room and the consoles that they used to call like the appointment dance. Like you want to move gracefully through the room, you know. through the table using the equipment in the most efficient manner possible, even from how the patient would come in, in my context, in a pod setting and sit down and take off their shoes and then go to the table. And it's like, are there ways for that to be more efficient or is it clunky? They sit down, take off their shoes, they start a conversation about the weekend, which is lovely, but we're now six minutes into the consult, they're not even on the table. I think with experience you learn these things that can allow you to run back-to-back appointments and it feels super easy because actually you were just inefficient before. So I think that's where we've spoken about shadowing, co-consulting, and getting the reps in. One of the great things, especially if you're short on clients, is and where appropriate. I know this is different for psych and OT and speech and GPs and dentists and physios, etc. But just run with me here. Can they treat other people in the clinic? Reception team members are often a great one, even if it's just going through and doing an initial assessment. or talking through what the therapy involves so that they could understand it. Because often the receptionist is the one answering the phone, triaging the waitlist that needs to have confidence in booking that client into their diary. And if they've experienced it, it gives them that sense, all right, I know what they're capable of, and ideally they're good enough, and so they feel confident to book the client in. The other thing is if there's just blank time in their diary, it's a good way to get the reps in without twiddling their thumbs. Or can they bring family and friends, so often clinics will have a family and friend policy in terms of like a discount and certain amount of visits, whereby, again, you just get those reps in. So I'd look at those things as well.

Bec Clare: Co-consulting benefits in this last period has just been so helpful, not just for our early career therapists but across the board for all of our team. You talk about the appointment dance and it's so genuine. There was one that Grant had this week and this team member might be talking about this because it's actually led us to look at how we do things in the clinic more broadly. It's the notion of assessment. You're here assessing the client, the computer's over there. Assess, type, type, type, type, type. Assess over here, run back to the computer, type, type, type, type, type. We're like, oh gosh, we need AI. We need Heidi in the clinic stat. Because apart from the number of steps that that clinician was getting up in a day, the disjointed nature of that consult was really apparent. And you want to take really great notes. You want to record that range or whatever you were assessing there and have that accurately recorded. But the experience for the client was pretty disjointed. So whether it be your early career therapist, absolutely see how they're progressing with their clinical reasoning and also their ability to communicate. and their treatment mapping, but also any of your therapists as part of your mentoring, the co-consulting, just seeing how your clinic operates. You might be really good at it. You've got your door closed. How well are they doing? And what can you improve broadly for your whole clinic?

Ben Lynch: In assessing the effectiveness of your onboarding, are there certain conversations, surveys, reviews that you have with the team member themselves? This was a topic we previously had around onboarding, specifically around the personal side, because we tend to look at onboarding the person, onboarding them in their professional role, and then onboarding them as a practice member. And there's different things on those checklists in each of those streams. And it's always an interesting question to ask a clinic owner, after doing all of this, how will you know that, quote unquote, it's been successful? It's not going to go perfectly, but how will you assess that it's been effective? slash where the opportunities are to refine it for next time. We've spoken to a number of those before, but do you do like a retrospective with the team member and say, all right, let's just review your onboarding. What would you change? What was good? Do you do that? Yeah. Just talk us through how you get an assessment of the overall onboarding if it's a hundred days at the completion of it.

Bec Clare: We have done this each year and it's why we've iterated the induction and onboarding process each year based on the feedback from our team and always running that feedback through the filter. Most team members will always say, I'd love a little bit more support or I'd love loads more support. Okay, what is viable and what's most impactful? So we ask questions, what's been most impactful? And we actually ask this frequently during the onboarding program because if we just ask it at the end, they're only probably remembering maybe the last month. our memories tend not to stretch back too far. So we probably do it at a three-weekly cadence to ask them what's been most impactful, what have you implemented and has been successful, and rate your confidence. So we're wanting to see their confidence and competence rise, but also them actually implementing their learning. That's been the key. That's really great.

Ben Lynch: Yeah. I love seeing that progress and that tracker, however you choose to do it. The checklist is a great one to be able to show the progress as well. I was doing a session the other day with a team member as we continue through their onboarding here at CM, and the whole session was just spent purely on the personal side. There were a number of goals that they had. Personally, we use that wheel of life as really a spine for looking at them holistically. And the specific area that they chose to focus on, we typically say a rising tide lifts all boats. So if there were one of these areas, I think there's about eight in total, that if we were to focus on improving it, making it better, you feeling like you've got more progress, that it would sort of have this spill over effect into the other areas. In that saying, the rising tide will lift all boats and you get an improvement in that very subjective but self-score of how you're doing in those areas. Others are finance, career, relationships, etc. So they chose health. And we said, okay, what are some of the things that you would love to be doing in this area of health? So they went through a list of different things. And then rather than it become a checklist, we started to talk through when it comes to this side of life, what are some of the preferences that you have, some of the things that have worked in the past to really unpack it. And we found, okay, they're super analytical. So they love data. They love that feedback loop. They really love outdoors. They really love doing it in a social environment. We started to unpack these principles because they were getting a little bit stuck on what to do, what specifically, what activities am I going to do? And once we got clear on things that had worked before, their preferences, it became super clear then, okay, we're going to embark on this activity, this tracking device, these habits. I come back a week later and they've made progress on all of those things and it's like, hooray, we can celebrate. We're starting to raise the tide there. But being able to have that sort of checklist from those notes in the mentoring session and just anchor back to them, hey, last time we spoke about this, Fill me in. How did you go? What worked? What didn't work? And then we're able to get into some other things on the docket for that session. But I just wanted to share that because for folks that are listening in, it can feel like there's a lot to work on and to manage, and at times there is. But being able to give it time and space to focus on some of these non-clinical things, I think perhaps contribute to lowering the likelihood of burnout or people not being able to have the tough conversation or bring something up they feel sensitive because they haven't quite got the trust or connection with you just yet. And nothing is fool proof. But I think it's something that we're always trying to refine. As you go through your onboarding right now, Bec, is there a certain key change or key lens that you're using right now that's different from what you've done before as kind of the anchor point that you're using as in this onboarding we're really focusing on X or Y?

Bec Clare: There's two things. Firstly, we're talking about expectations much sooner. And that'd be around expectations, whether you talk about KPIs, CEIs, clinical excellence indicators or impact hours, whatever that might be. We're talking about those early so they become normal. And we're talking about them using the story that they tell us versus it just being a number.

Ben Lynch: As in the numbers tell us a story about how you're taking it.

Bec Clare: Yeah, the numbers tell us a story about, you know, a high cancellation rate tells us that clients are not particularly bought into that treatment plan. Or a high rebook percentage means that you're doing a really great job in the consult. And then if you've got a high cancellation rate, there's something happening in between. Are you spacing appointments out too far? It can allow us to unpack that a little bit. We're not just going, you need to hit X number by X timeframe. We're looking at the story in behind it to allow us to dig a bit deeper. So talking about expectations really early on. And the other has been our absolute emphasis this year on communication. We've gone really heavy in previous years with clients and team members' ability to communicate their treatment plans. That's where we've seen, and it's come out of our co-consulting, at the end of last year, where are our team currently at? And we've gone, okay, this is an opportunity for us. We're good. How can we be 1% better every day? And we've gone communication piece is our theme for this year. We know that our onboarding and an induction program already covers really well the client experience part and the culture part. We've gone, okay, what's the biggest opportunity now? is communication. And what I'd say is that it's, gosh, if I look at our onboarding and induction before we started Clinic Mastery, which was what, six or seven years ago, I'd be like, oh, it was pretty well non-existent. But it's evolved over time. And that's the key message for anyone who's either starting out or is going, oh my gosh, I've got to review this. Ours has been different every year because we've got different humans in the room. that need different things from us. The landscape is different and we are different as a business. We've grown and evolved, therefore so should our induction, our onboarding. The point is start somewhere. If you've got nothing right now, do something and then continue to iterate it. Ours is still not perfect. We had a conversation yesterday about how we're going to measure its success. right at the end commercially and from a viability perspective, what numbers are we going to run? And so we're still workshopping what that looks like other than gaining the feedback over time. We want to go, yeah, what's been the financial outcome of this investment? Have we got, I'll say, our return on investment?

Ben Lynch: I really believe this is a competitive advantage for clinic owners into the future because if you can dial in your onboarding of any therapist, especially a new graduate, You can use a lot of that in your hiring efforts and recruitment efforts to attract more of the right people. We often say, and it comes from Steve McKnight, one of Dan's good mentors, he said, really, we're in the business of recruitment and training. I often see a lot of people will put out a job ad and talk to their training and mentoring and how good it is. And we often get to see behind the curtain of what is good and what is not so good, or at least relative. And there's so many ways to improve it, but it is such a competitive advantage and it is worth investing in, in terms of your own time to develop these things. Not only to attract people, but how good can it be to say, yeah, we know with a high degree of confidence that we can get a new graduate to 80% utilized in eight weeks without them feeling overwhelmed. Wow, you can really go hard at hiring new grads, right, and have great confidence in any of your expansion. And even if you don't want to take over the world, it's like, how good does it feel to impact someone in early career with this level of training and support? It feels fantastic. Perhaps they stay in the profession longer or they just feel like they've had an incredible experience. One of the questions that I love asking anyone. but a new graduate, let's say, is tell me about some of the aspirations you have in your career. Describe to me what an amazing career would look like if we sort of look out three to five to ten years from now. And they'll describe things like, I've got respect amongst my peers. Clients are satisfied, get a great experience and great outcomes. And it's some version of that. I do a good job and I'm known for doing a good job. And so I find that that's a really useful anchor point for them starting to be clear and primed about, well, What standards would you need to have in order for that to be true? Because rather than the expectations coming from me down to you, as you addressed earlier, Bec, obviously there are expectations and standards of the role and of the culture. But if I can tap into some of the desires that they have for their own career reputation, that I have a reputation of doing a good job, being a good teammate, being a good therapist, And we explore that in a bit more detail. What might we observe? A high net promoter score, you know, low cancellation, a high rebooking rate, you know, great client outcomes, dah, dah, dah, dah, dah, the ability to do it back to back and feel like it's relatively easy to be stimulated and curious about, you know, different areas within my profession, different specialties. to be learning and developing and growing. If they can start to articulate those to me, it becomes a brilliant anchor point whenever things start to stray a little bit, because they will. So, hey, this is still true. This is what you want for your career. My job is to support you in making that come to life. And hopefully, you've got an open-minded person that you've recruited that they're on board with that. And I realize some people won't be turned off by it. As we look to wrap here, I think we could keep going on onboarding for new graduates. Is there a key point that you want to get across to folks listening in or a key action that they ought to take away from this episode?

Bec Clare: Induction is something that you'll continue to iterate. And you should continue to iterate it every year. And just look at how well you've done it before. That notion of, I might be good at this, but how good am I? Oh, sorry. I might already know this, but how good am I at this? Josh Norbedo. So we're really wanting to continue to improve the system time and time again and be 1% better.

Ben Lynch: Wise words, Beck. I love it. One percent better every day. That is mastery. That is why the name is what it is for us. Mastery is about the continual pursuit of being better every day. It doesn't need to be bigger, but it certainly needs to be brighter and you enjoy the process along the way with those marginal gains. Well, that's all folks for this episode. Head along to clinicmastery.com forward slash podcast for all the show notes and head over to the free resources section. There's an abundance of really cool tools that you can plug and play or guides as to how you can grow your clinic sustainably. Bec, I'll see you on another episode very soon.

Bec Clare: Pleasure. We'll see you soon.

Ben Lynch: Bye-bye.