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Learning Objectives


  • Identify compensation and benefits costs.

  • Compare the types of employees.

  • Prepare a job description for a physical therapist.

  • Analyze staff mix and productivity decisions based on job analysis.

  • Critique tools for recruitment and for retention of staff.

  • Review hints for interviews.

  • Address the challenges of performance evaluation.

  • Set performance goals for a given person using observable behaviors.

  • Investigate approaches to staff development.

  • Discuss the management of employee grievances.


Healthcare managers devote a great deal of time and effort to staffing responsibilities. Having employees who consistently cooperate and collaborate to provide the expected level of quality of care is essential to achieve an organization's goals. Numerous factors influence staffing in contemporary healthcare organizations, for example, recruitment of healthcare professionals who are in short supply, ongoing education and training needs, reduction of services provided, increased technology to support work, reorganization of work flow, increases in ancillary or support staff, and the resulting adjustments of the healthcare skill base.1

Managers are held accountable for the use of overtime, on-call, and per diem expenses; staff vacancies; turnover rates; understaffing; and on-the-job injuries. They must attend to the motivation and satisfaction of employees for patients to be satisfied. Patient satisfaction may depend on how clinicians and others do their work as much as on the actual outcomes of the work they do. For most patients, their interactions with staff members are their only impressions of an organization.

Because of its dependence on employees for achieving patient outcomes and overall organizational goals, a healthcare system's most powerful asset is its staff. Protecting and sustaining staff to provide 24/7 healthcare services is a major focus of managers. Although opportunities may be limited for some people, employment is generally a matter of voluntary free choice. To be the employer of choice reduces staff turnover and recruitment costs while increasing an organization's reputation. This chapter introduces several of the key staffing responsibilities of managers in contemporary healthcare.

Staff Mix

Managers of physical therapy practices may not have a great deal of flexibility in determining the mix of physical therapists, physical therapist assistants, and non-licensed personnel on staff because of legal constraints, reimbursement issues, the availability of potential employees, and related costs. In some jurisdictions, the ratio of physical therapists to physical therapist assistants is regulated. Most third-party payers and many jurisdictions recognize that only services provided by physical therapists or physical therapist assistants under their direction or supervision can be billed as physical therapy.

As a result of reimbursement constraints, the duties of any other support personnel (aides or techs, for example) typically do not include direct patient care. In many states, practice acts include precise regulations about support personnel. Generally, however, the expectation is that supportive personnel are trained to perform only very specific tasks that are related to ...

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