Part I: Employees
We are continuing a dialogue on all things employee-related in healthcare but particularly in #physicaltherapy given the shortages and efforts in recruiting, retention, and turnover. The plan is to continue this to include posts on the differences between what employees want vs. employers and then get into hiring right. All of these have tons of research around them. For those that are new, please see prior posts starting with this one and the ones after it go further.
Let’s start with some basics. Physical therapists and by extension all licensed clinicians (PTA’s, OT’s, COTA’s) have to be treated as partners first. Then, and only then, can you be assured that they will drive value and service to your patients. Partners in this context doesn’t mean financial equity. It means emotional equity-there is an investment by both parties into mutually beneficial outcomes for all stakeholders: employee, employer, and most importantly, the patient. You don’t drive a company’s economic success directly, you do it obliquely (future post). For the employer, it starts with a fundamental understanding of what employees want. I have tried to distill the research and concluded that it revolves around four areas-all being with “C”. The goal of any company is not to be an employee-first company but a company that delivers what employees want first company!
In order to do this effectively, you have to fulfill four critical essentials that form what we will refer to as an implicit social contract, a written or, in some cases, only discussed psychological obligation between you as an employer and your partner teammates as employees. I prefer the written. Said differently, you have to make firm, unwavering, and unconditional commitments before you become an employee. In the Jewish Heritage, this is referred to as a Katubah. This is fundamentally different from a pre-nuptial agreement that defines who gets what during a break-up. By contrast, this is a bilateral agreement of what each party will bring to the relationship. As we will detail later in hiring, this commitment has to be two-way and is a great correlation to longer-term employment. A major no-no in hiring is if they do not agree to sign this type of agreement, effectively denying both party's commitment to the employee/employer relationship. This is far different than an employment agreement or for that matter even a residency commitment that might involve economics or a payback. An implicit social contract doesn’t need a lawyer, an employment or education agreement does.
When this social contract is fulfilled, they perform better and outperform, and you gain a strategic competitive advantage; when breached, people become less contributors, less committed, and less satisfied, and the result is underperformance.
4 Employee “wants” Essentials:
- Career. The first is the inherent need to have a job that allows one to utilize their strengths, interests, and skills that contribute to the overall enterprise value. A career is highlighted by autonomy-self-directed behavior and an environment that promotes learning and development. All of these are at the heart of intrinsic motivation. Lots of work in the literature about the difference between a job, profession, and career. Job is what you do to satisfy your needs and living expenses. Profession is the skills that you’ve earned to do a job. A career is the combination of those above two, which you take for your entire life. The employees that talk about careers are the ones you want (more on that later).
- Cause. This is about meaningful, purposeful work, the desire to impact and align with the company’s mission which fundamentally must represent that it does some good in the world. The net effect of this is Source of Pride as in “I am proud to work here”.
- Community. Defined by people coming together where they are respected, cared about, and recognized by others. Culture and community are intertwined. Result is on-going connection and belonging. Diversity is often described as having a seat at the table, inclusion as having a voice, but belonging is having that voice be heard. Belonging is important because we don’t want to know we can survive at work — we want to know that we can thrive. While everyone experiences periods of self-doubt, your young therapists are more likely to feel alienated at work if they sense they don’t belong.
- Communication. Intentional, clear, and in cultural language. People want to be informed, feeling part of the group, and “in the know”. This communication must be varied-internal newsletters, restricted and open channels, and social media. In my experience, communication on surveys will always show up as the biggest strength and the biggest weakness of most organizations. It takes ongoing work and intentionality to count communication as an on-going asset.
The interesting insight is that despite emphasis on work-life balance, employees want at work what they want when they are not at work, and is classically described best by Steven Covey: “To live, to love, to learn, to leave a legacy”.
I am interested if this is consistent with views and experiences of others.
Thoughts?
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larry
