Sanjeev Bhatia
PT & CRO at Clinic Accelerator
Whether you're a new Physical Therapist (PT), Chiropractor (DC), Registered Massage Therapist (RMT), or in another outpatient healthcare profession, embarking on a career as a clinician is a journey filled with challenges and opportunities. Wondering about the earning potential or the typical career path for clinicians? At the beginning, having a mentor is often deemed more important than the paycheck to tackle imposter syndrome. While money might not be the top concern for new graduates, understanding how much you can earn can really shape your career.
In this guide, we’re digging into the different stages of a clinician's career and exploring the balance between getting paid and the broader concept of earning potential. It's important to note that these are not the same thing.
Compensation is the nitty-gritty details of what you get paid for your job—like your hourly rate, signing bonus, or incentive plan. On the flip side, earning potential is about the various career levels you can reach as a clinician, each with its own pay structure.
And here's a tip for clinic owners: when you're trying to recruit a clinician, the talk about pay should cover not only what they'll get right away but also the different earning potentials your health clinic can offer.
Now, let's dive into the different career paths that clinicians can take.
Different Career Paths for Clinicians
For clinicians, it is valuable to your future self to know your earning potential and actively pursue it to match your lifestyle needs and wants.
But, doing this is challenging because how many people genuinely plan for where they want to be in a year? Three years? Five years? It is only when life ‘happens’ that one realizes you need to take home more money. You want to buy a house, pay down (school) debt, get married, have a baby, have a family member to take care of, make investments to leave to your children, etc. Life changes and earning potential have a funny way of showing up at the same time.
If you find yourself, and you will, in a scenario where life has ‘changed’ and your compensation no longer meets your needs and wants, it is tempting to focus on your fee splits or hourly wage. It’s the easiest thing to talk to the owner about. However, merely increasing fee splits may not substantially raise your weekly take-home pay. It’s excellent for ego but not for more money in your pocket. A higher take-home pay from a raised fee split won’t necessarily increase your weekly take-home pay enough to make much of a difference in the life change you are going through. It’s not a silver bullet.
As a clinician, there is a basket of seemingly small things (I call them ‘configurations’) that can sum to a significant change in your weekly take-home pay:
- Fee split adjustments
- Increase your PVA (patient visit average): Do this through even better treatment planning
- Minimizing your patient fall-offs
- Adding more treatment hours: Add a Saturday treatment day just for one quarter (12 weeks) to see a spike in your patient caseload and, in turn, your pay for that time
- Seizing seasonal demand opportunities: For example, don’t go on vacation during the busiest months of the year, e.g. people using their benefits in Oct, Nov, Dec
- Integrating product offerings: Learn how to fit custom braces and/or include products in your treatment planning so people buy from you, not Walmart, Amazon, etc.
- Developing marketing strategies: Learn how to market yourself to your community, which leads to more patients asking to see you specifically
- Implementing price changes: Talk to the clinic owner about price changes each year, either two small changes per year or one big change per year
- Acquiring new skills: Add a higher level skill such as pelvic health, concussion, vestibular, etc., where the price per assessment/treatment is higher, which means your pay, at the same fee split, will be higher. This is one of my favourites. You can’t go wrong learning a new skill and how to monetize it
- Treat at one clinic only: You will have more compensation negotiating power and can focus on keeping a full, consistent caseload with low patient fall-offs. There is more to say here, but if you are treating at multiple clinics, it can lead to lots of patient fall-offs. In short, you are not at one clinic for enough hours for patients to get the dates and times they want with you
- Get an incentive plan in place: For instance, fee split increases at different billing levels or referral fees for helping find/hire another clinician
Overall, don't be misled by the 'fee split game'; numerous configurations contribute to maximizing compensation. Many more configurations (as I call them) than mentioned above go into maximizing your compensation at this level.
The role of a Clinician & Business Developer offers a unique blend of clinical expertise and entrepreneurial spirit. This dual responsibility involves delivering exceptional patient care and actively contributing to the growth and success of the clinic. The Clinician & Business Developer role offers a unique advantage with its flexibility. I believe, along with many other clinic owners, that having someone qualified to deliver results is highly valuable. This level allows you to negotiate compensation for your business development efforts and augment your income alongside your treating hours.
Here's an in-depth look at how clinicians can navigate this path to maximize both their impact and earning potential:
- Patient Experience & Clinical Excellence: Maintain a strong focus on delivering top-notch patient care. Your clinical expertise is the foundation on which your role as a business developer rests. Satisfied and well-cared-for patients contribute to the clinic’s growth and positive reputation.
- Training and Mentoring: Take on a mentoring role to assist new graduates in acclimating to the clinic environment. This not only benefits the incoming clinicians but also showcases your leadership abilities. Consider creating a structured training program to ensure consistency and excellence in patient care.
- Community Engagement: Actively engage with the local community to build relationships with doctors, healthcare companies, and community groups. Attend events, set up informational sessions, and participate in health fairs to increase the clinic's visibility.
- Event Coordination: Organize and coordinate community events or clinic events. Workshops, seminars, or wellness events can attract new patients and strengthen ties with existing ones.
- Social Media Management: Leverage your clinical and personal expertise to manage the clinic's social media presence. Create engaging content, share success stories, and interact with the community online to attract new patients and reinforce the clinic's brand.
- Business Strategy: Collaborate with clinic owners and administrators to contribute to developing business strategies. Provide insights into market trends, patient needs, and potential areas for growth.
- Financial Incentives: Negotiate financial incentives for taking on additional responsibilities. Incentives could include a percentage of the clinic's revenue growth attributable to your efforts, project-based bonuses, or other performance-related incentives.
- Continuous Learning: Stay informed about business development trends, marketing strategies, and community engagement practices. Attend relevant workshops or conferences to enhance your clinical care and business development skills.
By embracing the Clinician & Business Developer role, you position yourself as a valuable asset to the clinic, contributing not only to the well-being of patients but also to the sustained growth and success of the business.
Consider the path of Clinician & Assistant as a combined level of responsibility incorporating both clinical and mentoring responsibilities. However, one should only entertain this level if they’ve maximized their earning potential at the clinician level and experience fulfillment from teaching and working with another person as a team.
This role could also be controversial as there is a debate on using assistants and the impact on patient experience. But, one thing that is not debatable is that the number of patients seen per hour or day directly correlates to your compensation. The trick is using an assistant that helps you see more patients per day/hour while maintaining or increasing the patient experience. There is a whole methodology and structure for leveraging an assistant. It’s too in-depth to cover adequately in this article.
If you do that, your compensation on this path can be high. Let’s do some math.
- On average, treating as an individual clinician, you can see two patients per hour
- You work a 7-hour day (disregard one hour for lunch/breaks)
- Then, you can see a maximum of 14 patients per day. But this is rainbows and unicorns. It’s not going to happen
- You want to be 80% of the maximum (14 patients), which is 11 patients. Doing so will help account for assessments being an hour, appointment duration times, having some white space in your calendar, etc.
- The average treatment cost is $80
- Your fee split is 50%
- So on that one day you make, 11 x $80 X 50% = $440
- For five days a week, that is 5 x $440 = $2,220
- For four weeks in a month = $8,800
- For 12 months in a year = $105,600
- Now, with an assistant, you can see four patients per hour and offer a similar or better patient experience with the right methodology and structure
- That means, in one seven-hour day, you can see 7 *4 = 28
- At 80% of the maximum of 28 = 22 patients
- 22 x $80 at 50% split = $896 for that day
- Over 5 days = $4,480
- Over For four weeks in a month = $17,920
- For 12 months in a year = $215,040
Heads up, the assistant is paid hourly. The clinic may cover part or all of the assistant’s pay.
You can redo these calculations with different values for % of the maximum, average treatment cost, number of patients per hour, and fee split.
A clinic director is less about your clinical skillset and more about your ability to run and grow a team. Some of the responsibilities include:
- The onboarding and success of new hires
- Helping clinicians build and maintain a full caseload
- Clinical mentorship
- Meeting one-on-one regularly with each clinician to hear feedback, offer support, and conflict resolution
- Helping recruit clinicians
- Compliance with patient experience processes and systems, e.g. treatment planning, fall-off procedure
- Driving the culture, values, and mission of the business
For this role, you can be compensated hourly for between 4 and 8 hours, specifically a dedicated half-day or full-day each week. But, the real earning potential in this role is revenue sharing. The owner and clinic director can set a profitability baseline, and anything over that baseline, the clinic director shares a percentage, say 30%. For example, if a clinic has a $50,000 profit each year before you were clinic director, that can be set as a baseline. In the first year as a clinic director, you help jump the profitability to $80,000 for the year. That is a $30,000 increase above the baseline, of which you share 30% or receive $9,000.
The Clinic Director is a prerequisite to being a managing partner. A managing partner buys into the current valuation of the business at a certain percentage. If the clinic is valued at $500,000 and you buy in at 20%, that is $100,000.
In this scenario, you share the business's profitability each year and its future equity when it sells. With your help and leadership, if the business increases in value to $750,000 and sells, your equity is worth $150,000. That means you get your initial $100,000 investment back plus $50,000 and any profitability shared with you over the years of growing the business.
Being a managing partner is being an entrepreneur with less risk.
In wrapping up, exploring diverse clinician career paths is vital to informed decision-making. From clinician to business developer, each avenue offers unique opportunities. For personalized advice, reach out — we're here to support you!
