Transcript
Marla: All right, we are just about to get started, wanna welcome everyone and thank you so much for taking the time today to come here. I know everyone is extremely busy and there's a lot of competing priorities, so it means a ton that you're taking this next hour to be with us. My name is Marla Ranieri and I am the head of Clinical Innovation and Clinical Strategy at Prompt.
Pedro: Hi everybody. Pedro Teixeira, co-founder and CEO of PredictonHealthh. And we're excited to be here today. I think it's gonna be a fun session.
Marla: Yes, we're gonna be your co-host for the day. We're talking about a really great topic in the industry, which is preventing burnout of rehab clinicians. so just a few housekeeping before we start. We really want this to be informal. We want it to be conversational and absolutely encourage you to ask questions. Please do that in the q and a. On the bottom, there is a nice little q and an icon, so if you ask them through that, we will make sure to answer your questions as best as we can.
And if for some reason we can't, we'll follow up and answer them later. We put together a phenomenal panel today about great leaders. You're gonna hear from them, so absolutely Pedro's gonna introduce them in just a few minutes. But we're really excited to pick their brains discussing prevention, burnout, and what strategies we can do to combat that.
And hopefully all of you guys are feeling the same about this topic. It's a really hot topic, we're seeing it in ourselves, in our clinicians, absolutely feeling how hard it is to retain therapists, but the data also shows how important this topic is. Recently, A-P-T-Q-I reported that one in five healthcare workers have quit their jobs since 2020.
And continued research suggests that up to 47% of healthcare workers plan to leave their positions by 2025. I know that we don't have enough therapists coming out of school and into the field to combat the demand that we have right now for patients. Losing 47% of therapists is pretty alarming. and I think it's really important that we're focusing on how do we foster that passion that they went into the field for and make sure that they're not getting burnt out or they're not. Finding some things that's making them leave the field completely. and that's what we wanna identify today and figure out what strategies we can all do to prevent that and foster that. Recently Prompt did a survey and hopefully, if you guys haven't seen it, would love for you guys to take a look where they asked rehab providers who left the field either for nonclinical or just completely to a different industry in total. And 68% of those outpatient providers said they left the field because of the demands and burnout and just the overall mental capacity of burnout.
So that's one of the top reasons and that's why we're talking about it today. And I'm gonna pass it along to Pedro to introduce our panelists and we'll get the questions started. Really excited to hear from all of you.
Pedro: All right. I am honored to get to introduce our wonderful panelists today.
I was especially excited about the fact that you're gonna have to hear from folks on the front lines who have experienced seeing patients, and of course also running organizations right through this very difficult time. 'cause burnout impacts a lot of things. so we have the wonderful Ben Carlson, CEO of Carlson ProCare. Ben is the CEO, and, of a 15 provider practice with five locations based in Connecticut. I've known Ben for a while. Dr. Nick Nordtvedt, all VP of clinical development at Dynamics physical therapy. There, the group is over in West Tennessee based with 18 locations. Dr. Kallie Slette is the Director of Clinical Operations at Movement for Life, an employee-owned physical therapy practice with 27 locations across Arizona, California, North Carolina, and Virginia.
Thank you so much for being with us here today to share what you've been learning and dealing with in the space. And I'll pass it back to Marla for our first one up here.
Marla: Great. Thank you so much. And, so let's start with a question that it's pretty obvious, but it's good for context setting. and I would love to know how you define burnout and if you've experienced it or witnessed burnout in your career. And Kelly, I'm gonna pass it along to you to answer that question for us.
Kallie: Sure. Thanks Marla. And thank you guys for just bringing us all to the table to have this conversation. So first of all, when I thought about burnout, if I am super candid and off the cuff. The first thing I thought of is I was like, oh, it's when the suck outweighs the good. And then I dove into that a little bit more and was like, what it really is it's when that, I think people think about the word stress is like a dirty word, but when I thought about it deeper, it was really when the bad stress or the distress chronically outweighs the eustress or the good stress.
And so that made me think a little bit deeper. And one of the things that I made the connection about when I was preparing for this was thinking about burnout really reminds me of what we think about in the clinic when we think about like central sensitization in the pain science realm where burnout is really this concept of we have all of these external factors at play in our lives, from our own experiences, from what we're, what's happening at home, what's happening in the workplace, what's happening outside of us in the larger, profession, world, et cetera.
All of that input has an effect on what our output is, right? And so burnout, I think one of the things that I've come to realize is that it's a really individualized experience too, and that the same input for two different people can have a very different output or set of symptoms related to that. And so that's really helped me shape what my understanding is of burnout or how I've been looking at burnout differently than maybe, back in the day where I assumed, every provider that has these three things that are contributing to their day are going to experience burnout.
And that just doesn't seem like it's the case. and as far as my experience with burnout in my role, I get the privilege of being able to spend time with both our clinic directors on a regular basis, as well as our new hire, physical therapist during their first year of their kind of new hire onboarding, and.
It's through these experiences where when I'm working with them and I see on paper two individuals going through very similar experiences, whether good times, bad times, somewhere in the middle, and having very different outputs, if you will, of their experience, of what they're going through, what their struggles are.
And so that's really helped me focus on what are those individualized attacks that we need to make to prevent this in our team.
Marla: That's awesome. That's absolutely, I think you, you hit the nail on the head and I like the way you said it in the beginning. The suck out way is the good. and would love to pass it along to Nick. Have you experienced burnout personally or, just again, what you feel like burnout is in, in your group and in your team.
Nick: Yeah, for sure. And I think that was an amazing analogy, comparing it to central sensitization. So I think that's a really good way to look at it and contextualize it in our industry that I think should appeal to a lot of therapists that will understand exactly what you mean by that. so burnout for me is what I, yes, I have gone through burnout. I would be surprised if there's a clinician that if they weren't burned out by the time they started out of PT school, like day one in the, in, in their first clinic, throughout, their entire career, it's rare that you're gonna find probably doesn't happen, that you're gonna find anybody who hasn't gone to some degree of burnout. and I think it is individualized. So one thing that I think of when I think of burnout, not only is it individualized, like Callie said, but you're also gonna have people think that there's too much. A lot of times they think, oh, I've got too much, I've got too much paperwork. I don't have enough time.
I don't have this, that, or the other. If I could just have something. And I think that something that a lot of people miss is mission, vision, a goal other than 10 patients a day, 12 patients a day, 25 patients a day. However many units a day, whatever your cancel no-show rate is.
I think that a lot of times those are the goals that we give to people and they're important. Don't get me wrong. We certainly follow those goals, at Dynamics, but I think that what they're missing is like the true vision of what they're trying to accomplish and what the company or clinic that they work at is trying to accomplish.
Whether it's community change, community involvement, trying to make sure that we have healthier communities that can participate in sports, in industrial work or whatever, whatever your niche may be in the clinic that you serve. our communities are all rural for the most part. So we see everything that walks in the door from a six month old with torticollis to an injured worker, to an injured athlete, to an elderly person who just doesn't want to fall.
So trying to train our people in understanding this is what we're working towards. This is the person you serve, and this is how we serve those communities to make them healthier. And then the other thing I want to point out is, I don't think that this is necessarily an industry specific thing.
I think that it happens in all industries. Pedro comes from a medical, an MD background, and I'm sure that there's plenty of MDs that are burned out. I know of several in my area that I've come across that go through periods of burnout and talking to our people and understanding what their individual needs and requirements are is definitely important too. but yeah, I don't think that it's just the PT industry that goes through these sorts of things.
Marla: Yeah. And absolutely. And think that you absolutely hit with the culture and with what means the best to them and what are they resonating with, and not just those goals of that, how many patients you've seen. and Ben, I know that you've been in the industry a long time as well. Do you find people are getting more burned out now than previously? and is it more new grads? Is it experienced grads? But what are you seeing?
Ben: Yeah, thanks, I think there's some great answers across the board so far to set it up.
And I'm seeing. And as execution goes to Nick's point, actually, I think recently, culturally on our end, we've seen a little bit more burnout actually on the front desk side than we have on the clinical side. And I think that is because we have been doing a lot of work on culture and, looking at refreshing clinics and technology for the therapist. and we've seen a little bit more on that side. So again, I think it is, to Nick's point, it's a thing that's not just clinical and it is something that you're seeing across different industries. so I think another piece to it too is a, an indicator is when people stop. Innovating or wanting to innovate when change is presented, I always see that as a really good indicator of when somebody's getting burnt out.
If you start getting the answer and be like, we're changing again, or I have to change the routine again. people get into that cycle and that hamster wheel and that comfort zone. And if they're not willing to, are not excited about changes. 'cause as leaders, we're obviously always bringing a lot of changes and some good, some bad, some work, some don't.
But, if they're not connecting with the mission that we're trying to improve the experience for our staff and for our patients, then I think that's an, that's a quick, easy route to, to burn out. As far as where else I'm seeing it, I. We are doing a lot of interviews. We've got a lot of, as everybody, we're interviewing regularly, looking to bring people on. I would say we're seeing it in the interviews much more in the people that are, five plus years out. That's, I've had, we've had some really great new hires recently, all of which have been new grads or, in that first two years. And a lot of them are still in a place where they're excited about what they're doing. They're just maybe looking for something new, looking to still raise the ceiling, in their own development and see that there's still room for them to grow. And as we all know in our field that. Area of one to five years, that is where there's the most room most in most places for a clinical person to grow.
So we're not seeing it so much there, but I'm certainly seeing in interviews, the five plus years particularly it seems to be people that are in hospital based and networks, and they're coming on and I'll, we'll get, I always do video for my first call and give me an idea of where people are.
And some interviews I've had recently of people just looking completely disheveled and beat down. and It's hard 'cause that's also where we're starting from and we're like, there are other options for you. don't give up. but that's definitely where I've been seeing it in the last, certainly like the last six months or so, is in more in the interview process and seeing that burnout there.
Marla: Perfect, I think that, thank you so much. I absolutely think you're right with that. We're seeing it all around in that five to seven years where they're just not wanting to change, they're not wanting to do anything new and grow. Then, they're burnt out. and Pedro, pass it along to you to ask the next question.
Pedro: Yeah. So I think you've all clearly pointed out that this isn't just like you're working too hard, right? That a lot of folks in rehab therapy are working really hard and there's lots of settings where people work super hard and that doesn't necessarily burn them out, right?
There's more nuance to it, and it reminds me of the, I'm a bit of a nerd, so I'm gonna reference Einstein, sorry. But there's that quote that he says, if I had an hour to solve a problem, I'd spend 55 minutes of those hours understanding it first and the last five minutes solving. And my question is, for all these things that you're seeing, what are those factors that are going in right beyond, of course, like working hard, That are really triggering things and whether it be in their day to day and certain burdens or frictions that they're having to experience or other things, that are really contributing to it. I would love to hear what folks are seeing as these factors that are driving all these wonderful clinicians into a state where they are burnt out.
Kallie: Nick, you wanna go ahead first?
Nick: And I'm looking in the Q&A, we've got some of that, coming from Lindsay, it looks like, what, how would you guide a clinician through some of this stuff? if I've got a clinician that I consider, or that I think is going through burnout, or they express to me that they're going through some degree of, and they'd always call it burnout. They might call it, I'm just, I'm disengaged, or, whatever, however they want, call it, there's something they're going through. I want to know if I see this person, or if this person spends 8, 9, 10 hours a day in the clinic, at least 14 hours a day or more, but they're not in the clinic.
So I wanna make sure and I, I'm not gonna get into their marriage relationship and that, all that kind of stuff. But I do want to know, is there something going on at home? Are you having trouble with a spouse or with a child or something like that? Because that's definitely gonna play into.
Your work life, if you're going through issues at home. How are things at home? I want to know, what kinds of stressors do they have at work? What do they see? Is their, biggest stressor at work? Is it not enough time to document? Is it too much documentation? Is it not enough time with patients?
And honestly, a lot of times it comes down to the time with patients, which takes away from documentation time. So if we can cut down on that documentation time, a lot of times I feel like that increases their emotional bandwidth that they can spend with patients. Because that's what we're good at.
We're good at patient relationships, we're good at gaining buy-in, that we can help you with your problem, whatever that problem, you can't reach up into the cabinet. You can't pick up a grandchild. You can't walk across the room to go to the kitchen to fix a meal. We're good at helping them with these functional tasks. That's where our people are also good and where we want to spend the most time with our patients, where they can make the most difference in their lives. And that's the value that our patients perceive, not in the time spent. Document typing on the computer.
Kallie: Yeah, I'd definitely, I'd echo what Nick has to say. I think we can all agree from the administrative burden side of things, there's some very obvious callouts that have only continued to increase in our profession as opposed to going away. I actually landed on more of a, this bigger picture around, I don't feel like our providers feel like they have a lot of control.
And humans as a. Being, we like to have a sense of control and that fell into kind of three additional subcategories for me around this control idea was like, we tell them, what hours they're gonna be in the clinic, how often they're scheduled, who have taken a lot of the ownership, if you will, off of how their day goes.
And so there's a little bit, there's a lack of flexibility or a lack of variability in their day potentially outside of just the different PA patient types they may be seeing. But also there's, because we are unfortunately as a profession right now, we've watched, I'm telling the tale, everybody knows we've watched reimbursement go down, we've watched productivity expectations go up.
And because of that we've also seen, it's a time is money thing for our leaders as well, So our leaders are having less time. Potentially less of a focus in their culture around that employee engagement. What is, we talk about the mission of our organization, but what's the mission of that human in front of us and how do they connect to our mission?
And are we, are we setting up success pathways, if you will, to connect that human to the mission that we have? And are we finding those people and spending the time to engage those people in that timeline? Are we spending enough time? Is there a culture of feedback in our organization where we're not only giving feedback to our employees, but we're seeking it out regularly and being really transparent around the action that we're taking on the feedback that we are seeking.
Pedro: I really love that and it reminds me, 'cause I've seen in a lot of clinical settings you can have really tough times, like really hard work. But if you feel like you have a degree of autonomy in pursuing it and you're getting to solve problems and you're getting to have the ideas that can help a lot to really balance out the difficulty of the hard work that you all do.
And also if you feel like there's a reward and that you are making a change and an impact, that's really meaningful, right? The improvement that you see in your patients right day to day and week to week can really help, give that positive stuff to balance out the suck as you said earlier. Then to that point, we look at a lot of data, our team and we see these late night 2:00 AM 3:00 AM sign-offs. We see weekend sign-offs. We know that financial pressures are also an issue. I wonder if any of you have noticed, are there warning signs on sort of those things that you're seeing?
Again, financial pressures or these other things, timing of when things are being done that are like signs, that you've anecdotally seen yield, tell you this person needs help.
Ben: Yeah, I can jump in. Yeah, I think, normally pretty clear. I think any of us have that conversation with our spouse or our business partners. You have the people that are the dinner table, conversation, right? That you always talk about at the dinner table. That's always, maybe you haven't identified that it is a burnout, but if somebody is regularly coming up in conversations with leadership for whatever reason of saying, oh, that was odd.
Like they're, came in late a few times, or, they haven't done that for two years, or, their way that they're dealing with patients isn't quite the way that it was. A lot of times you have those people that you already are having some type of conversation about, for whatever reason.
And it's a pretty good indicator if you're talking about 'em. They also are feeling something's going on. I would say too, I think that the financial burden, I think is a big, financial strain. I think it is a really big important thing that we really have hamstrung ourselves as a field with development and growth opportunities for people.
So you do have a lot of excitement from people in those first few years because they can see there's those additional changes, those additional growth. But a lot of people got into healthcare because they want to. Work with people, they want to treat patients. And once you, in that five year, you maybe even get to be a clinical director, not having opportunities for people to grow and develop that they don't want to be, they're ready to grow and develop with where they are naturally in their career, but they don't want to be a clinical director.
They don't want to spend less time with patients. They wanna spend more time with patients. But our only options for them financially to advance or, and to, as a career advancement is normally going into a leadership role that then takes 'em away from treatment. So trying to find new avenues and new paths for ways of helping people continue to develop their skillsets and growth that maybe is a little untraditional, I think is important.
Pedro: It's funny to me too, that. You end up when you're burnt out. I think you just have like less of a reserve, for the human challenges for and for displaying right? To have that empathy and to deal with some of these emotional challenges that you have with patients.
But it's also that human aspect of patient care where you're really spending time and you invest upfront, but then you get that connection, and that connection's part of that therapeutic alliance that you form. And it's also part of getting the buy-in and then also then getting the reward on the other side.
So like you're simultaneously losing your amount of reserve. You have to do that hard emotional work, with another person, with your patient, which is also the thing that would help you get that sort of rewarding thing on the other side. Again, I don't see many patients these days, but I don't know if anyone had, if that like vibes or if you have any sort of refinements that you all would say about that aspect of this, bandwidth for patients, in a situation where you're starting to get really burned out.
Nick: Yeah, I can see that for sure. and patients can sense that too. Like they can sense like a therapist that's burnt out that they're working with. So when I was at, I'm not a clinic director anymore, but when I was a clinic director, if I had a clinician that was in, in my clinic and, you could feel it.
The vibe changes, the patients can feel it, the coworkers can feel it. The front desk feels that the other clinicians feel like what's going on with And so at some point, as a leader, you need to address that and go talk to that person. Hey, do you just need to, what's going on? Do you just need to go home for the day?
Do you, what do we, what can we do to help you here? Do you need to take an extra hour of lunch to things either in your head or do you need to make a phone call? 'cause them being like that in the clinic's not serving you and it's not serving their patients either. Which is only going to, it's a, I think what you're trying to talk about there, Pedro, is it's gonna It's gonna have the opposite effect on improving the patient's overall outcome for that day anyways. And who knows what the downstream effect is. That of that is, how much of that buy-in you lose from that patient just from that one day that had a difficult PT treatment,
Pedro: Total opportunity for spiraling and not a good way of spiraling attitude. Absolutely. For sure. I really appreciate folks sharing that. I know, Marla, you've got some great questions now for us to learn a little bit more from each other on things to do. So I'll hand it back over.
Marla: Yes, absolutely. And I hear a lot of you saying documentation time, admin time, and we've got some great questions from the audience just saying, what are you recommending that you do to fix some of these issues? we've got a question saying what EMR or mitigating documentation time? What do you guys recommend? and we've got a couple more I'll ask as well, but let's start with that. Just what are the changes you're recommending to mitigate that documentation or the admin time that's happening?
Kallie: I can start. So we focus really intentionally as we, as we moved to Prompt with new features in the EMR as well as with prediction health. We spend a lot of time around our, we call 'em our efficiency tools because we believe our providers are best served when they're face to face with their clients and not spending the time taking extra thought or thinking about.
I love what Christie put in the chat, figuring out billing units to meet Max possible reimbursement. Like I'd love to meet the physical therapist. That was really good in math and that's why we went into the field because most of us, that's not our strongest suit, or at least it was not my strongest suit. and so anything that we could do from a templating perspective, an efficiency perspective around default settings for. interventions, anything that we could do and lean into those efficiencies, templates and build those out from the very beginning with our providers, it allowed us to do two things, right?
It not only allowed us to focus on efficiency, but it also allowed us to look at our clinical quality and go, how can we use our clinical quality and work backwards to create those templates, to create those efficiencies, if you will, to push the best patient care or encourage the best patient care forward as well.
Yeah, I'll jump in, and I may answer Chrissy's point directly. I say one, one thing that we, we also, I think everybody on this panel is both prediction, health and prompt. And there's lots of features to talk about that help the team, both clinical and non-clinical, but also just from a psychological standpoint.
One of the things that we found, and this was once we really got into the weeds with prediction health and the data, and understanding, what our team was doing and what was working, what was not working is, I've found that therapists do not respond well to money conversations, which is exactly what your point is, Chrissy, which is, what's the maximum reimbursement and focusing on that being the way that you're having that conversation.
The therapists understand the right way of coding and how the codes are supposed to be utilized, that also follows the best reimbursement. And so that's a different conversation to have with a therapist is having a conversation with them, understanding why the code should be used and why this is the right code for what they are doing.
And if that's what you're leading with, therapists normally respond a lot better to that because it's about compliance and it's about quality of care and it's about them as a professional understanding their craft versus this is the most reimbursement, this is the best way to do, the reimbursement model.
And normally what we've found is if you follow that track and really get into it and see where the therapists that maybe are inherently falling off by overbilling, one of the CPT codes, it's normally just 'cause they actually just have a poor understanding of. The right utilization, and if they have that corrected from a compliance standpoint, the reimbursements normally will follow.
At least that's what has been, what we've seen on our end. So just, just encourage you to try and take, it's the same outcome, but, it's a, it seems to be a better approach and something that's more receptive to a therapist. And again, that's one of the big reasons why we've been a big fan of Prediction Health is because it gives us that data that allows us to have that conversation with very objective numbers, metrics, and, showing what that therapist is doing unique to them.
Marla: Ben, I'd love to follow that up with, after you did start using PredictionHealth, did you find that your clinicians were understanding it better, improving better, and learning from the way that you've implemented that technology?
Ben: Oh yeah. Oh yeah. Absolutely. Absolutely. Yeah. And that, that was why I was making the point is, and I can, I have a bit of a unique stance in this, because you guys can all imagine anyone who's on this call, and I am a second generation, my father started the business, I have no PT background. So you can imagine me coming into a business and seeing this from a data point and trying to talk to therapists about CPT codes and what they're doing right and what they're not doing right. Did not go over well for a period of time, because that's what I was focusing on, is that conversation. And it's not a therapist. You don't understand, which is true to a certain point. But when we were able to shift, and for me as an administrator to have that data to also help me understand better, but then to show them from a compliance standpoint why this is the right path, why this is the right combination, why we want them to be focusing this way.
It's a very different conversation. And it also gets out of the subjective side of things, which is that, That's like a, death wish if you're trying to have this conversation from a subjective point of view versus having the data points to say, Hey, let's look at this, and then let's also look at how that stacks up to the rest of the team and we can see these are the metrics, these are the numbers we want to get out, and this is where we're trying to go to.
Kallie: Great. Yeah, that's, I was gonna say, Ben, is that being able to compare to the rest of the team was probably the most powerful thing that we've seen from the data, is just being able to look at the outliers, but also look at our bell curve and learn where are our key points of that we do need to address.
And then being able to show, if you will, and be super transparent with the human that we are coaching, and be like, we're coaching because this is, this is an outlier and This is what we're, attempting to move towards. And so I think you hit the money right on the head and thanks for being vulnerable about not being a provider point.
'cause I think it's a super important point to make that a lot of leaders do struggle when they're having that coding conversation.
Ben: And you'll find, I don't know how everybody else on this call, but I find that PTs also are inherently very competitive individuals. So to that point, I've had one therapist in particular who said she's gonna retire for the last five years.
She continues to every year say she doesn't wanna retire, but then gonna retire. And so she's at the end of the career. These conversations were stuff that she had no interest in until we showed that she was lower than one of the new grads that we just hired. Now every month she wants to know what her stats are. She wants to know what that number is because she's, she, is no, there's no way I'm gonna be bottom of the barrel. And again, it wasn't terrible. She was only five points below the new grad. But that sparked a more fun conversation around it and allowed us to have that conversation with some more light than, this is just about us getting the most reimbursement for the visit.
Nick: I wanna jump in on the coding. So ever since we've been with PredictionHealth, we've also really looked at those core four and that core four diversity that you see on your PredictionHealth dashboard. And certainly prompt is very helpful on our treat and flow with how we can keep up with the minutes on each code that you're billing.
But we also direct our clinicians like, Hey, there's gotta be a continuity to your treatment session and to your entire plan of care. And we've simplified those codes, those codes down to we want to correct manual therapy, we wanna retrain neuro ed, we want to give people stronger therapeutic exercise, and then we wanna make 'em functional therapeutic activity.
And it just so happens that therapeutic activity is a function, which is where, what we want our people to do. And it's not. It's not by accident, that's also one of the better reimbursed codes. That's where we want people to get at the end of the treatment. We want to have them doing something functional so they can go home and continue doing that functional activity.
And then when they're done with their plan of care, they want to be functional, they're not coming to you to not be functional again, they're coming to be able to walk, reach, lift, carry, all those kind of things. Which, when you explain it to clinicians like that, they understand, oh, the, that's the code I should be billing for half the stuff I'm billing for therapeutic exercise anyways.
And a lot of times once you explain it to 'em that way, you can, that increases the in addition to showing them the bell curve, on their PredictionHealth dashboard. And, I think that's one way that we found that we can continue that, show that continuity of care where this ends to get them to bill and code more appropriately.
Marla: Yeah, and I've noticed that, we just did a new integration with PredictionHealth Prompt and PredictionHealth with Sidekick, where they're actually recommending the new codes or the recommended codes as you're doing it. Utilizing ai, and that's a great question that we have in the chat.
It says from Jeff, has anyone used the AI integrations for documentation at this point? And would love to hear your guys' perspective on that. If anyone's currently using it.
Nick: Sidekick. It reduces your documentation time. All right. Significantly, it improves your audit score and PredictionHealth.
It can give you ideas of, so if you're having someone you're really trying to hit function with a patient and they're having trouble figuring it out, I've got a patient with this diagnosis that has these limitations. What can I do functionally for them? You can ask Sidekick and it'll give you 10 different things that you can do for function for someone that's.
12 weeks post-op rotator cuff that has difficulty still doing these things. What are some ideas? If you're really having difficulty, if you're going through a string of burnout as we're talking about here, and you can't concentrate, can't figure out what I'm gonna do with this patient, it gives you some great ideas.
And I think that kind of change or that, that new kind of idea can a lot of times put some people out of burnout. Hey, I'm gonna switch gears and I'm gonna use, implement some new exercises. I'm tired of the same old thing that every patient is doing. I need to get rid of these and try something new.
I think that can help drive some people out of burnout as well. But yes the AI tool Sidekick from PredictionHealth has been, certainly from a note generation standpoint and from a compliance and audit score standpoint, has been a great win, great tool for, I haven't, every clinician we have with Dynamics is using it at this point, and it's not, it's been an excellent change in implementation for us.
Marla: Can you guys quantify documentation time about maybe how much it's decreased the therapist, or how much less they're doing after hour documentation? That's for anyone.
Nick: I don't have an exact number of how much less. It's significantly less. We're going from 10 to 15 minutes to complete the paperwork on an eval to less than five minutes.
I can quantify it that way in most cases. just from it, listening to you and capturing all that subjective information and taking away the time to type, from a, time to sign off doc, time to sign off has gone down significantly. We were probably in that two to two and a half day range. We're consistently less than two days and a lot of therapists are 24 hours or less. much less time documenting, weekends and after hours. So all of those have improved significantly, which all that information lives in PredictionHealth on your, in your PredictionHealth dashboard. So we're able to see that and go through that. So that's another opportunity to address burnout. Hey, you're burned out, but you're up till midnight doing your notes, and we've given you tools like Sidekick and that should help make it easier to where you don't have to spend hours and hours documenting after your kids go to bed at night just to keep up.
Marla: Yeah, absolutely. And I feel like you probably are using this as a recruiting tool as well, Cali, Ben, any of you, would you give an example of how that's helping with not only retaining therapists, but potentially recruiting new ones?
Ben: Yeah, sure. I was just curious 'cause I pulled up on my other screen here to see when we did the scribe rollout and the change. So I could just speak to that a little bit more as well. And I'd say the same thing with Nick and I told the panel before we jumped on the call, some notes. As far as any type of rollout, any new change, any new tech is always challenging, right?
It's always a hurdle to get over. We figure out how to position it and talk with the staff and, how, where things are gonna go wrong, where the headaches are gonna be, who's gonna, who's gonna adopt, who's gonna not gonna adopt. And I would say that of all the things that in my six years of being in this field, the scribe tool for PredictionHealth was the, it was just a home run from day one.
We did a soft rollout with clinical directors for literally, I think two or three days. And after those three days, they're like, this is a no brainer. Let's roll it out. Normally we'll pilot something for two weeks to a month before rolling it out. And then we didn't even make it past day three where they're like, let's roll this out. We had one of our clinical directors after two weeks of using it, he's been with us for 20 years. We were on a call at the end of the week, leadership call, and he pulled this aside at the end and said, I gotta tell you, this is the first time in my 20 years experience that I'm not taking notes home. That's a huge statement as far as retention. It's also a really interesting conversation with particularly new grads. but I think also helping with therapists when you're recruiting, on the later end when they are getting burnt out, showing that there are investments being made to try and cut down on the administration side of things. new grads love it. It's sexy, it's cool, it's AI and all those things. It's interesting. I always like to ask people when I'm interviewing 'em, what technologies you have your eyes on that you think are gonna impact the, field in the next five years. And then they're like, AI obviously. And I'm like, great, let's talk about AI and how it's implementing.
And some of the stuff that we talk about that PredictionHealth and Prompt are doing, a lot of them are like, oh, wow, I didn't realize we're already there. I'm like, yeah, we are. That's the tech investment that we make as a company and other people make as a company and that's why we make it.
But just looking at some stats here, we had. From the month that we rolled it out, or let's say 90 days after rolling it out, we had seven providers of our 15 that had significant decrease in notes, signed off on the weekend from the before rolling it out, some of which are, I have three providers on here that are 25% decrease as far as notes being done on the weekend.
So that's a pretty substantial, statistic
Marla: That's amazing. That's awesome. And I know we wanna keep getting that down because people bringing work home after hours is not what they wanna do and they also really wanna focus on the patient. So if they can get their notes done a lot quicker, then that's a win all around.
So appreciate that. Kallie would love to hear from you as well. Any other, it could be with documentation or it could be administratively, because I know we talked about it. Administratively, there's a lot of burnout from the front desk. I would love to know what technology changes you guys are making to combat that.
Kallie: Yeah, for sure. I was just going, I was gonna echo what was said around just that time in the clinic and the ability for any time. I think one of the things that Prompt and PredictionHealth have focused on right out of the gate, and it's been a really powerful thing, is making sure that they do have that kind of tight integration and they've continually gone back to the table and found additional ways to make that work even more seamlessly. I think what I hear consistently from our providers is we can't log into one more thing. And so how do we figure out a way that while we're introducing technology into the clinics, that we're also not adding into that bucket, if you will, or even though if it's a time saver and it's a great feature, if it's a divergence in their workflow, that takes another login or that takes additional change in their process. Some of that is just seeing the forest through the trees and knowing that we're, we're working towards a solution to get people maybe out of a burnt out state, but anytime we can meet them with a solution that's more ready made right when they, right when they jump into it, I think is just something we as leaders need to make sure we're thinking about. Even if the tech looks really exciting.
Marla: Yes. The seamless integration that makes it one and not multiple platforms is huge. 'cause that's what we're trying to achieve for sure. Yeah, so we would love, again, throw it out there to anybody else about more of that front desk burnout as well and what you're doing on that.
Nick: So for us on the front desk, we've seen a lot of, so they're obviously gonna work on Prompt more than prediction Health at the front desk, but, Plan of care compliance through prompt.
A lot of the features that prompt has, like plan of care compliance, whitespace filler, online scheduling, we've implemented the prompt kiosk here lately that's been helpful for patient payments and that sort of thing. If they have a card on file, they can take care of all that without, that having to go through the front desk.
And one of our, and I've heard this from other companies, one of our, initial, fears with implementing kiosk is that it's gonna take away from the patient touch that the front desk has. And we've actually seen the opposite. I think that has actually enhanced our patient experience at the front desk because the patient experience at the front desk is now more about how are you, how are things going?
Is there anything else we can do for you today? That sort of thing. Can I get you a bottle of water? Can I get you a cup of coffee? So we're taking on more of that, we're not having to ask for money. We're not having to ask for a copay. It's all taken care of at the kiosk.
And so we're able to provide a different sort of value to the customer experience by not having to deal with scheduling and that sort of thing. We can really talk to the person as opposed to the, the technical kind of things that are usually difficult to talk about. Hey, I need you to schedule more.
I need you to pay the copay. We're able to have a more conversational sort of interaction with our patient when they come in as opposed to a transactional interaction with that patient.
Marla: Yeah, and you're not getting rid of the front desk person. You're actually using them to do their job better, connect with the patient to be able to have that therapeutic alliance.
Nick: Absolutely. Absolutely. It's definitely been a benefit as opposed to a detractor for us.
Kallie: I think the other thing that Prompt has done well in their dashboard settings is many times a lot of those features that you just talked about, Nick, they're only visible to a front, someone in a front office or an administrative type role, And Prompt has really brought that back to a provider and they can really own their caseload, right? There's a lot of finger, there's a lot of features right at their fingertips where they can be the one to send the wait list invitation to the patient very easily at the click of the button.
They're very aware of any patients that have fallen in from, into a lost status. And so that ability where, it's easy for the provider to also have that information top of mind so they can be more of a truly more of that team member or that colleague with that front office as opposed to.
They do the administrative work, I do the patient care. I'm the hero. They're the bad guy at the front that tells 'em they can't schedule 'cause they don't have authorization. And I think we forget, like you, I thought it was great Ben, that you or Ben or Nick that brought up the front office burnout in the first place.
Because I think we forget that as providers, they treat our front office, our patients often treat our front office very differently than they treat their providers when they walk past that front desk and come back to us. And remembering that they don't get the daily wins that we get on the floor with the patients.
And how do we find ways to connect them to the Y. even silly features like the ability and how easy it is to see the patient satisfaction score and those, those feedback come into the platform for our front office to be able to see those things and see the difference that they're making in these patients' lives as being a part of their care team, I think is really powerful and beneficial.
And we need to talk about those things as an organization or find ways that we share those things as an organization, across roles. And so platforms that make it easy to do it is a big deal.
Ben: Yeah, so I can jump in and double off of that.
As far as the front desk and some things we're working on, I just wanted to share a quote that I heard recently that I love that is really relevant to this, which is, invest in technology as a company to be high. You be high tech so that your team can be high touch. And that's something that I think is a really important piece to what we're talking about here, is a lot of people get scared.
They're saying, oh, you're gonna roll this out. What's it gonna do for my job? And saying, no, a lot. You're more valuable to us as a company to be able to have that extra minute to help somebody out to their car than to have to do this. insert. Bad process that is not, that can be solved by tech that we currently are doing.
And there's plenty of them we can put into that bucket. but I think it's a really important thing to be doing. And we just had a conversation actually today with my front desk leadership team on how we're not utilizing the refill feature in prompt, effectively, we're using it, but we are, right now, we're over-prescribed in all of our facilities.
So it's easy for some of these things to fall off and fall by the wayside. because we don't need patients. We don't have that many spots to be filled. And you say, that doesn't. Take away from the fact that we still have opportunities to improve in what we are doing and having that ability and just literally, like I said, just had this conversation with the team an hour ago of being able to go in on Monday morning if you're using the tool properly, and send out text messages to all the different people saying, Hey, here are all the availabilities that we have that could fit the schedule versus what we all historically are doing.
And I had one of my teammates that was still doing this, say, oh, I didn't realize that I've been, every morning I've been calling every single person on this list. And you're like, again, how many times do we get that, that it goes to voicemail or we don't get them? Then we play phone tag, all these back and forths.
So it eliminates a ton of extra work. And then sometimes it also engages in a conversation. That person will call us afterwards and say, I can't do that, do you have anything else? Or, this is going out with my case. It also creates that engagement without us having to spend all that time on the phone.
And one of the things we've been talking about with the team is all the tech things that we're rolling out is so that people can be more present in the moment with the patients in the facility. And if they're being pulled in 15 different directions all the time, it's very hard, particularly for the front desk to do that.
So that's where a lot of these techno tech advancements are really helping the patient experience overall. And then I think it is gonna also help with the burnout of the front desk team.
Marla: And when you said earlier, like Kallie said earlier, does a suck out way the good calling and doing every single one on that list and checking it off and doing a mundane task versus being there present for a patient and walking them to their door and being able to greet them. That's what brings the passion back. That's what brings you back to, I'm here to do what I wanted to do. I'm here to give quality care. I'm here to give a good experience at the front desk instead of some of these mundane tasks that take time and are just brainless. Automate that. Use technology for that. I think we're getting a little bit towards the end, so do wanna make sure that we take some q and and be able to answer some of these questions. So Pedro, I'll let you jump on some of those.
Pedro: Yeah. So we got a lot of great ones here. I'll start with. Anything that surprised any of you with regards to burnout?
There's all the obvious stuff. Is there anything that you didn't expect it to either affect that, you know, part of, therapy or organizations or interpersonal relationship? Who knows what, but any surprising things that have come out, around burnout from anyone?
Nick: Yeah. I've been surprised by some of the stuff that we take for granted that we think people are okay with, just your human nature and your human understanding of humans should tell you otherwise.
So things like people who are driving an hour one way to get to the clinic. Can you, Hey, are you good with that? Yeah, it's great. It's fine. It's fine. And, you ask them that over and over again until it's not fine. And, I've had an experience where I even asked someone a couple of weeks before and then they quit because they didn't want to drive two hours to work and round trip to work.
And in my head I had told myself that what they're saying is fine. It's fine. You should know better, you should know things like that, that people aren't naturally gonna want to do that. So just not avoiding that kind of natural order of things, what people are naturally gonna want. just because they say it's fine. You gotta remember that we're leading people and people are emotional and they're gonna want to make the people they work for happy and they're gonna want to express happiness. And they don't want to be the person that has to, complain and be the one that things get changed for. because of that complaint. So that's one thing that I've found that I have taken for granted in the past, that I try to address that on the front end before it becomes a problem.
Pedro: That's good. Didn't think about that one either. I also just wanna mention, there's going to be, before folks sign off, one question, quick poll, about, familiarity with, oh, here, it's popping up for me now. familiarity with prompt and friction health and see if there's anything else that folks would like to learn more about. So I just wanted to give folks that context, as we go into some more q and a here.
Ben: I would just add too much surprise as far as burnout and things that probably aren't talked about enough, if you have to protect your culture.
Like it's the most important thing in the world, and that burnout can, if you have somebody burning out, you also have to look at the rest of the team. Some of the things that we've been looking at really closely this year is, you can have that one person on the team that is creating burnout for everybody else.
And it's really important to know that even on the clinical side, as desperate as we all, I know everybody can add another clinical person to their staff tomorrow probably and have no issue that one addition of person that maybe is a bad culture fit and it, maybe it's not that they're a bad person or a bad clinician, it's just not a good culture fit for the company.
It's not that they're bad, not a bad clinical person or a bad fit. They may be a great person for another company, but you've gotta protect your culture like it's the most important thing that you're focusing on a daily basis because that can trickle down that one person that maybe is burnt out can very easily be caught in crazing burnout for three, four, or five other people.
Marla: Yeah, I think you have to focus on the clinician experience just as much as the patient experience. 'cause your people are what your whole entire business is built off of. So I agree with that. The culture, the clinicians, and what you're doing to make sure that you are satisfying their needs and making it easier for that.
It's awesome.
Kallie: Yeah, I would echo that, Marla. I actually, we just read a book as our leadership team and all of our clinic directors, it's actually called Patients Come Second. and it was great. It really did challenge that idea of if you, we joke at Movement for Life that we only hire unicorns, but it challenges you to think if you hire unicorns, but you treat them like draft horses, like either one, they're going to leave you, which has an impact on your team that's left behind, Or worse, they're going to stay and you're gonna crush their potential, which hurts you as an organization and probably that team around you too. And so that was another thing that I just wanted to echo exactly what Ben and Nick said is that's been the most surprising is seeing people disengage from things that we think they would want or engage in.
But it's really about you having to build the people and protect the people, protect the culture before you can make a lot of the down the road changes that you want to.
Marla: Yeah. And one of our, one of our last questions when it was gonna be, what advice do you give practices struggling to retain clinicians?
I think that is the best answer I've heard is your patients come second and your clinicians come first. but would also just like to throw it out there for everybody else. If there's one piece of advice that you would give to other clinicians, other owners, what is it that you think they could do for retention and burnout?
Nick: For me, I think be proactive in giving people what you know they need or can use to make their job easier. That is putting the clinician first. If an AI scribe tool will make their job easier and get what they want, which is more time with their patients, do your due diligence.
Make sure you're looking for what, find the right tool that's for you, and do it. Don't drag your feet on it because, like Ben said this, AI is the future of any, every industry, probably in America, and we are not immune from that. Be looking at that because that's what they're also gonna be looking for in other potential employers is what are they doing that can make my life easier that my current employer is not?
Kallie: And I would say just be really intentional about how you're going to individualize your. your ways that you're going about treating those humans in front of you, have really structured ways or training, pathways that your leadership team and your clinic directors are going through for how to recognize, address and prevent burnout.
So how are they seeking feedback from their team members? At what structure and what time? What are they asking? What are their opportunities for? We have an employee assistance program, what are the ways that they can battle the different elements that may contribute to burnout. and then we also do a fair amount of teaching for our new employees coming into our programs in their new hire mentorship program.
Like we have a whole segment called Burn Bright, not out like. How do you spend the time with those new people learning about focusing on what are those things that like, keep that flame lit and how do we make sure that you're spending the time? Another great book, I know I'm throwing the author or book club.
We'll do that next. Prompt and PredictionHealth. We'll do book club. But the other book that we read recently was, Love and Work and it talks about you really only have to spend like 20% of your time in those, like in that flow state or that, those tasks that you really love to have.
Way more resilience and grit for some of those times that are harder, are more challenging or some of the tasks that don't light your flame. 'cause I think none of us are going to spend a hundred percent of our time in that space and we need to be comfortable setting that expectation with our team, but also giving them the tools, resources, and power to live in their best 20% as often as they can.
Marla: Yeah. And I think that all of our values and missions really align and that's where Prompt and Prediction Health are really trying to help the industries. We wanna create that value and those tools to be able to make sure that there's that seamless ability that clinicians can treat front desks and can do what they wanna do best, and take away some of those tasks and make them more automated by using AI and integrating together.
So we're really focused on that and really appreciative that all of you guys are utilizing that. 'cause a lot of people don't jump into it. So it's nice to see and hear the clinics that are using it and how you are experiencing it.
Pedro: Yeah. And I'll just also throw out a thank you to the Prompt team.
They've been really wonderful to work with and very like quick and adaptive and it allows us to do I think some really special, nice things with regards to the integration, which means wonderful experience for the clinicians using the combination of the two things. So I really appreciate the prompt team being so wonderful to work with so that we can deliver a great experience to you all.
Thank you.
Marla: Yes. And for anyone that we didn't answer your question we will absolutely go ahead and follow up with you or have our panelists follow up with you and get that answered as well as we will be sending this out as a replay. So you will have a recording. Please share it with your teammates and colleagues as well. and we did ask that question earlier, so if you did express interest in learning more about prompt or learning more about Prediction Health or the integration of both 'cause there really is a wonderful seamless integration there, then we will follow up and make sure that you're with the right person and you're able to dive in and deep dive more about your questions.
So thank you all. Couldn't be more appreciative that you joined us today. Especially our panelists. You guys are all fantastic. and really leaders in the industry by doing some of these scary, let's call it, but at the same time, needed implementations so that you can provide a better experience to your patients and to your clinic.
Pedro: Thank you all.
Nick: Absolutely. Thanks for having us.
Pedro: Thanks
Ben: for having us guys. Appreciate it.
Pedro: Thanks.
Kallie: Thank you guys so much.