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Toni Talks about PT Today

The Whole Package

Published February 8, 2011 11:10 AM by Toni Patt

I finally cleaned my desk at work. In the process, I found a printed version of a customer service presentation. This one discussed the ideal employee. I kept it because it's one of those things I know I'll refer back to since the most important characteristic of an ideal employee isn't what you would think. It isn't competency. It isn't skill or knowledge. It isn't anything related to medicine. According to this presentation, the number-one qualification is being able to get along with everyone.

It states that while skill and knowledge are important, the "whole package" is someone who has those but gets along with everyone. Apparently they want miss congeniality. Because of the change in reimbursement structure and paradigm shift to customer service, they reason the ideal employee should be perfect at customer service. The document states skills and knowledge are important. It is better to have an employee with excellent customer-service skills and average clinical skills than one who has excellent clinical skills and average customer-service skills.

Where did that come from? Did anyone ask the patients and their families about this? I doubt "our customers" are requesting the average therapist who gets along with everyone. In my experience, the first question "our customers" ask is who is best. I can think of three instances in the past few years when therapist assignment was changed from new grad to senior because the patient wanted someone with more experience.

Whether administration believes it or not, our patients and families can see the difference. Obviously you can't put someone out there who picks fights with coworkers, patients and everyone else. Nor can you have someone who looks down on the world and everyone in it. But how do you define "excellent customer service?" More importantly, who decided clinical skills were secondary? I work with some doctors who have absolutely no bedside manner, yet patients flock to them because they are good at what they do.

I can't get beyond the lack of emphasis on clinical skills. First, you should find the best and brightest. Then weed out the customer-service nightmares. There is no logical way to defend the other position. Some examples are in my department. If work ethic was included as a criterion, you could probably eliminate half of the hospital's current staff. But they're nice people and get along with each other so well that the hospital values them.

I'm blowing this somewhat out of proportion. But the issue of which attribute is more important is serious. Compare that to my horses. Their vet is one of the best in southeast Texas. He is very nice but his office staff runs hot and cold. If my horse has to go to the vet, I want the best people to take care of him, not someone who is good with people but not so good with horses. I don't want miss congeniality if she doesn't know how to take care of a horse. My facility seems to feel differently. Customer service is important but shouldn't be the most important criteria for being the "whole package." Skills and knowledge should come first.


More and more research is demonstrating in pediatrics that what matters most in the way service is perceived by parents and the value of it, is the relationship that is built between therapist and caregivers (talking about infants).  In a transdisciplinary program, the program's strength is in the trust and relationships built between team members.  The most skilled in terms of hands is not necessarily the one that is the best team member or the one who fosters the feeling of trust with the infant's caregiver.  Do we want someone who is bright and has the capacity to learn the appropriate skills?  Absolutely...but if you can't share those skills with team members or with parents in a language they understand, in a manner that shows you care about their child, your skills may never be used to their capacity.   A team member who undermines other team members, community partners or caregivers does disservice to its employer.   It is truly about more than skills in the line of infant therapy.  

Sharon , Pediatrics - PT, HVPI February 11, 2011 11:49 AM
London ON Canada

I am currently working in an environment where, as Dr Patt describes, there isn't a balance between the "trifecta" as Janey beautifully pointed out.

This can be very disheartening to those who have honed their clinical skills because the message from management is, "that's nice, but it doesn't matter so much".

The reality is that healthcare is a business, we as a nation have chosen that approach. In that case, customer service is a valid concern, but it shouldn't be the primary concern.

A cohesive team, that supports each other's growth and professionalism, will likely also support the growth of the business as well. The Trifecta.

Dean Meta February 11, 2011 7:05 AM


There absolutely has to be a balance.  Toni and Dean agree on the need for competence.  Joanne and Jason emphasized the importance of communicating well with patients.  I see one additional aspect as being essential for patient care:  the workplace dynamic.

Every clinic has its own personality.  Once I realized how important this was, I never accepted a position - or extended an offer -  without the interviewee meeting with a cross section of the staff.  Every supervisor and every potential hire should be looking at this aspect.  If the interviewee is not a "fit" with the clinic's personality, that should be a dealbreaker.  I've seen clinics turned upside down when this basic wisdom is ignored.  

For me "the whole package" includes a trifecta of competence, customer service, and a "fit" with the department's personality.  If any of those are missing, there will be management issues in the form of staff morale, productivity and patient satisfaction.

Janey Goude February 10, 2011 7:57 PM

I think that we have to expect good clinical skills AND customer service skills.  I don't want someone with excellent clinical skills with only marginal customer service skills.  While the public "wants the best", they most often respond to the customer service skills of the therapist as they cannot always evaluate their clinical expertise.  

As a manager, when a patient has expressed dissatisfaction with a therapist, it almost always relates to a customer service issue - typically some type of communication problem.   Someone with more experience is not always the better therapist - clinically or from a customer service perspective.  I am fortunate to work with a group of therapists that are bright and who have great customer service skills.  Obviously some have more experience or expertise than others but the patients can feel confident that they are being well cared for in both respects.

Joanne , , Director Rehab Services Gottlieb Memorial Hospital February 10, 2011 3:31 PM
Melrose Park IL

I agree, however, a good team player is often more valuable when it comes to keeping the peace in any environment.  Empathy during therapy is also therapeutic in nature and will contribute to a patients well being just as a therapist who is extemely skilled but lacks social understanding of patient care.  Regionally this is apparent when a therapist speaks the same language as the patient and understands the small details of care and compassion and speaking the same language is a building block of trust.  If a more skilled therapist is unable to effectively communicate how can they apply their skills?

Jason February 10, 2011 2:57 PM

Interesting on the timing of your Blog.  I just had all my employees read and comment on an article in the Jan 2011 Journal of the American Physical Therapy Association titled, "Patient Satisfaction With Musculoskeletal Physical Therapy Care: A Systematic Review.    

Take a look at the article and see what you think...

I believe that the approach of "Im a Great Clinician" first, is what keeps us from moving forward in the public venue (as the research points out).  I really dont think anyone is practicing bad customer service....BUT we need to put far more emphasis on what the public WANTS if we want to move forward.

Jerry Durham February 8, 2011 5:02 PM

Agree with you 100% on this one.


Dean Metz February 8, 2011 1:07 PM

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