In Part I of #physicaltherapy Musings, I recounted my observations of 2024 CSM and how the state-of-the art in physical therapy is best represented by the exhibit hall. After all, these folks pay big bucks directly and indirectly to be present and they do so with an expected return. For those selling wares it is gaining a customer database in terms of scanning in contacts for follow up. For those trying to lure #physicaltherapy students, it is scanning contacts for follow up to hire. The only thing that has changed in this regard is the name saving technology. At my first CSM (1987), they wrote down your name, now they scan the QRC code from your name tag as though you were a grocery item.
By reminder, the exhibit hall is now dominated by employers of all size and types-from hospital systems to private practices, public company, private equity backed companies to temporary placement or travel services. The booths ranged from all sizes and types in attempt to woo students to come by and get scanned. If you had an SPT (student PT) next to your name, you got to be Taylor Swift or Travis Kelce inside the hall-they couldn’t keep your hands or eyes off of you!
Our booth at Confluent was very inviting and creative-set up to chat with students as they came by, some book signings which created additional opportunities, and a special “bubble” set up to sit down and chat directly with some privacy. A constant theme amongst the many trying to recruit the over 3,600 student attendees was to find the magic bullet that attracts prospective candidates. There is an underlying belief that this generation of student is looking for something very different in their first PT employer and everybody is trying to find it. The reality is that not much has changed.
I try to be a bit different in my meetings with students, not only in terms of the year they are in (1st, 2nd, 3rd) but whether or not they are a student that went directly to graduate PT school (most of them) or if they are second career. For example, I never ask them what they are looking at in an employer or what specialty are they considering. After some general introductions, I did ask many of them what has been the most common question that you have been asked by potential employers. This led to a resounding-“what are you looking for in your first employer and what specialty are you considering?”. So much for trying to be original.
By way of context, according to survey data, the average first year PT on their first job has changed mildly over the years-has gone from about 6 months to currently 8 months! Whatever employers are looking for in a match to align mutual interests it simply is not working. 30 years ago students wanted an environment where they could learn, grow and develop, and be mentored into a master clinician. Student’s want a fun environment, they want all the key security benefits, and they want to make a difference. Today, their wants are the same. They might not be as aggressive in the development side (e.g. delaying residency) and they might need a bit of coddling (clinical readiness issues which will be subject of its own post) but their desires and needs are exactly the same.
Two environmental things that are notably different today-vast amount of student debt (150-200k is typical) and tremendous shortages occurring at a time just after major labor and general inflation-the malaise of 2022. While salaries have gotten much higher they are still out of step with tuition creep and the vast amount of student debt-that’s simply a fact but how this flies in the face of an over regulated and poorly reimbursed field is the greater viability challenge. The unintended effect of all of this is that both students and employers are very focused on the primary attractor of compensation via sign on bonuses and other techniques (e.g. productivity or other bonuses). What hasn’t changed is mobility and optionality: a new PT can work in any environment in almost every state and obtain about any specialty they want. It does appear that compensation has moved up the ladder and is at least tied as a primary attractor for students because of combo of inflation and student debt. So, why is first year length at their employer so short?
Based again on survey and anecdotal data, “mentoring” programs have disappointed many. Instead of a collaborative, structured relationship, mentoring has become “this is the way we treat patients around here” and “this is the way we use the EMR”. Many mentors are just mildly more experienced than the mentee and the mentor is also been pressured by numbers as employers have doubled down on the way to keep them accountable for productivity, visit intensity, and new patients. It is kind of hard to mentor when you are worried about your own productivity bonus or required patient quota. All of this creates a downward spiral resulting in disengagement. This creates the 8 month tenure and reflects what Gallup reported many years ago, people don’t leave their job, people leave managers, not companies. Gallup’s own sobering poll results from last year: 62% are indifferent to their work lives. 18% are downright miserable.
So what is the antidote? First, it is critical that what employees want hasn’t fundamentally changed in years but more importantly, new employees or the students we are trying to recruit work in the team, work with a mentor or supervisor, not for the company. Second, train employees in engagement (5 Cs —Care, Connect, Coach, Contribute, and Congratulate), setting expectations, the difference between “mentoring” and a structure mentorship, and how to measure how well they are doing (pay particular attention to numbers 1,2,4,5, 11). An employer can get a PT student in the clinic, but it is the clinic (team) that keeps them.
And don’t look for that to change anytime soon.
Thoughts?
Future posts will focus on interviewing and what the research tells us that additionally, Employees Really Want!
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Thoughts and opinions expressed are my own and do not reflect any organization I am affiliated.
Long Time Coming 