Time and time again I notice owners failing to do the most important thing, and that is giving clear, timely feedback.
And more specifically, it is giving feedback to poor performing staff.
It often plays out as such.
You take on a new team member. They don’t quite hit the ground running. Something isn’t going well for them. And you sit there and softly, softly try and nudge them towards your goal. Only for them not to receive the message. Or confusion for both parties. And then you just leave it and hope it improves.
Owners hesitate and hold back.
They don’t want to give negative feedback.
And the clinicians are avoidant too.
They are usually quite fragile when it comes to feedback.
They are sensitive, and that’s ok.
But, that doesn’t mean we shouldn’t give it.
And the best time to give feedback: exactly when it was noticed.
The next best time, today.
Defending your goals by giving feedback.
There’s a player named Steven May, he plays fullback for Melbourne in the AFL.
Melbourne are a 10 goal better team when Steven May plays.
Time and time again, you’ll see Steven May addressing his backline.
Every single time a goal gets scored against them, he’s there pointing fingers.
Asking more from his people.
Setting a benchmark standard for his team.
Giving feedback that is both specific, direct and timely.
It’s not a popular approach.
But guess what?
It’s not a popularity contest either!
It’s about respect.
And when it comes to flying the flag (so to speak).
It’s about demonstrating what you do stand for and what you don’t.
I suggest people be uncompromising on what they don’t stand for.
Let me say that again…
Be uncompromising on what you stand for.
That means when people turn up late for work, you speak to them at the earliest time point in that day.
You tell them it’s unacceptable.
And you ask them to do better.
You don’t wait for your next 1:1.
And start off by giving compliments and then asking if is everything ok at home?
Just hit those behaviours head on.
It’s awkward.
But it’s not unkind.
Unkind is standing by whilst people behave in a way that is detrimental to their own careers.
Detrimental to their patients.
And detrimental to your business and it’s reputation.
Giving employee feedback can be intimidating for all parties
I’ve been described as intimidating, usually by people outside my team.
It’s not a description I’m a big fan of.
I’m not ashamed of it though either.
I’d rather be intimidating than a pushover.
And the truth is, no one in my inner sanctum is intimidated by me.
In fact, these people know that I am there for them at all times.
You can be kind, but also fearsome.
The way you are kind to your children, but also don’t take any of their sh*t.
Kindness isn’t giving them everything they want.
It’s acting as their safeguard and protect them from their own failures.
If you do follow the AFL, you’ll understand why I’m writing this because I support Essendon, and we really need a Steven May.
Dichotomy of leadership
There was a book I listened to in the hustle and bustle of 2020 called the dichotomy of leadership.
It’s a great audiobook, it’s actually quite fun to go through in the car itself.
There are loud explosions and lots of army chat.
But there are some really key insights within the text.
One that stuck with me is around trust and competence.
Marines would always rather someone who is high trust, but low in competence.
Than someone who is high in competence, and low in trust.
It’s something to take into your business setup too.
High trust people are the one’s you can sit with, feedback and train.
And to be honest, most of them will get there if you are giving feedback on regular occasions and they are willing to take it on board.
But low trust people, well, it says it all.
They might listen, but they don’t often reflect.
Usually they are quick to dismiss your commentary, or you’ll notice them joking about it in the tea room 5 mins later.
They can have attitude issues, ego issues.
Toxicity comes in many forms.
And it infiltrates organisations, and starts eating away.
From the inside, out.
Firm, but caring.
The reason I do ‘firm’ on the spot, is because it needs to be said then and there.
Like Steven May.
There’s no point waiting until after the game to talk about “who-was-on-who”.
It’s direct feedback.
No nonsense.
And if people can’t handle a single sentence like “always walk your patients to the front desk”.
They haven’t got much hope when it’s time to give real feedback.
Performance feedback.
Or the worst kind… a physio needing a performance management plan.
Clinicians don’t like being told that they aren’t doing a good job.
And being overly critical of people’s clinical work can have the opposite effect.
Even constructive criticism can undermine a person’s flow.
Make them question too much.
Prevent them finding answers because you are thwarting their process.
Not everyone arrives at the same conclusions.
Not everyone gets there in the same way.
Young staff need to learn to find their way clinically.
Not be spoon-fed and not be micromanaged.
Micromanaging clinicians is not the way to build a positive clinic culture.
There is a time to step in however.
When it comes to adverse commercial behaviours.
I’d say that is easy pickings.
No one gets upset when they’re told to walk a patient to reception.
No one’s ego is on the line here.
But when it comes to clinical.
You ought to ensure that when you do step in, it’s for good reason.
And if you are going to communicate your feedback effectively, make it crystal clear.
As clear as a red flag.
SOP (Standard Operating Procedures)
There was a conversation a few weeks ago on the APA musc group around managing a potential cauda-equina case.
The patient didn’t want to go to hospital as they didn’t have Medicare rights.
Suggestions from respected clinicians included trying to organise the MRI privately, this would save money.
I absolutely hate when smart people suggest this stuff.
It’s well meaning, and expert clinicians are absolutely capable of doing these things.
But junior staff need hard and fast rules.
I often worry that they read these posts, and try to be all superhero.
There is no grey area when it comes to red flags.
This part isn’t about my standards, it’s our legal system.
If you’ve identified a red flag, and then behaved in a way that isn’t necessarily appropriate for your skill level.
You won’t have a leg to stand on in court.
Junior therapists can’t juggle complex cases, especially when there is medical risk.
They are always best to be sent off to an emergency department.
Again, protect the interests of your patient, your practitioner and your business.
SOP’s are a big step towards becoming a premium physiotherapy clinic.
Remember what I said before – be uncompromising.
The snowball effect from not giving feedback
This process actually starts when recruiting physio’s.
The best thing to do is test out how they take feedback in the interview itself… see how they respond…
We all know, new graduates are far more amenable to receiving feedback.
They’ve been students.
They have had to take on feedback over the last few years, whether they liked it or not.
And they haven’t had a chance to build up an ego.
They won’t necessarily get upset when you address clinical errors.
So in many ways your role is simpler.
Your job is actually just to build them up.
Build their confidence in you as their leader.
And build a positive clinic culture that supports their development.
A lot of the time, the skills you really need here are empathy and understanding.
Like with your patients, use reflections, and allow them to find their path.
Be their number one ticket holder, their cheerleader!
Giving effective feedback for seasoned staff
When you take on practitioners from outside roles.
That’s usually when you find yourself in sticky situations.
Usually because you expect them to come in and get on with it.
Unfortunately your first task really is often to break them down.
This sounds a bit nasty.
But if people bring in attitudes or behaviours into your practice that are inconsistent with your values.
And they aren’t addressed early.
Well, look out.
Those little snowballs start to gather momentum.
And before you know it, you can have a toxic team member who’s now been with you for 13 months.
If you’d seen this one month earlier, you still had time to push them out.
If you are in this situation, looking for advice or struggling with a difficult team member, send me a message.
Most of my physio business coaching sessions are about dealing with difficult staff (or ideally preventing said occurrences).
Lets now put on our HR hat
This is a hat no one really likes to pop on.
It tends to sit up the back of the cupboard.
But the more seasoned you get in business, you realise you never take it off.
There are some very key time points from a HR perspective that I really want you to think about.
- The 3 month mark (point easy)
- The 6 month mark (point difficult)
- The 12 month mark (point impossible)
A standard probation period is often 3 months, which can be extended to 6.
Having been burned on this a couple of times, I made the decision to set everyone’s expectations at 6 from the get go.
Three months just isn’t enough time to get an understanding of someone.
But it is enough time for someone to be able to cover up their negativity.
Six months, or 26 weeks, is substantially longer.
And usually peoples’ true nature starts to reveal itself.
It happens around month 4 in fact.
Whether this be seen in tardiness, or lack of attention to detail.
Or in little comments that perhaps just seem to be more than a joke.
Toxicity has a way of revealing itself.
And you should always have an eye out for where it may be coming from.
These time points are crucial however.
If you’ve discovered toxic behaviours in a staff member early doors, you have 6 months and the clock is ticking.
Be uncompromising if you see it.
How to give effective employee feedback
Sit them down and say to them that if those behaviours don’t improve, you will not be taking them beyond their probation period.
Again, sometimes the best thing you can do for someone is to fire them.
It sounds cruel.
But cruel is to tolerate behaviours that will curtail their careers for years to come.
Your job as a leader is to nip these things in the bud.
And if they don’t respond to you early in their career, you haven’t got much hope after probation is over.
The period between 6 and 12 months remains dicey, and that’s when HR process’ really need to be watertight.
If you haven’t got them down pat already, I’ll give you a brief summary of what the gold standard physiotherapist performance management process looks like.
It’s the rule of 3’s.
Three meetings, three times, three parties (ideally this is you and another leader).
Document an invitation to a meeting to discuss their performance.
- Open the discussion and share feedback.
- Have a second meeting to tease out the key points.
- And a third meeting to conclude all of the above, with mutual agreement and sign off.
You can do it over three days, it’s tedious af.
Rinse and repeat two more times in the same 12 month period.
And then, and only then, have you done enough to consider exiting someone (This is not HR advice, talk to a professional if you are in this situation – see disclaimer).
The sh*t sandwich
Don’t open up a difficult conversation with praise.
It makes people anxious.
Ask someone to do it to you, you’ll see.
If you want to give praise, do it publicly.
‘Praise in public, criticise in private’.
I was reminded of this by this article in HBR, a worthwhile read.
Today’s blog is very much about the uncomfortable stuff though.
We need to balance it with the fun stuff -(ironically, I’ve written this post like a sh*t sandwhich!)
Spend as much of your time giving positive praise.
Every staff meeting, in a public forum.
This is why weekly (if not daily, #culture) team huddles are important.
It helps to set standards.
Like Pavlov’s dog, it conditions your people around what you expect.
And it’s a great opportunity to share your kinder, personable side.
Remember to get around everyone and share the love on a daily.
That makes it a lot easier to get the dirty jobs done.
Nothing good comes easy
Giving feedback in the workplace is a skill.
Giving feedback to anyone is a skill.
Knowing what to say, how to say it, and when to say it.
And it’s something worth practicing, especially when the stakes are low.
Most of you err on the side of too little, too quietly and too infrequently.
I’d encourage you to err on the side of too much, too often and… neutral tone lol.
You know your message is getting through when you’ve said it that many times, everyone else is sick of hearing it.
So be a “hardass” (but always kind, compassionate and empathetic).
Be uncompromising on what’s important to you.
Never apologise for that.
Build a team that respects their practice, respects their workplace and most importantly, respects their boss.
Once you have those 3 components, physio profit looks after itself.
Then you can all go about chasing your true purpose, together.
Disclaimer: The information provided in this blog post, including all text, images, and other material, is for informational purposes only and not intended as a substitute for professional advice. While the strategies and tips shared in this article are based on industry experience and best practices, they should not be construed as legal or HR advice. Each business situation is unique, and laws and regulations change frequently. Therefore, readers are encouraged to consult with qualified professionals, such as legal counsel or HR experts, for advice specific to their circumstances. The author and gunphysioacademy.com assume no responsibility for errors, inaccuracies, or omissions in these materials, nor any liability for damages arising from the use or reliance on the information provided in this publication.
