Ep #25: How to Get Paid What You’re Worth as a Clinician (Part 1)

Episode 25, How to Get Paid What You’re Worth as a Clinician.

Welcome to Clinicians Creating Impact, a show for physical therapists, occupational therapists, and speech-language pathologists looking to take the next step in their careers and make a real difference in the lives of their clients. If you’re looking to improve the lives of neurodiverse children and families with neurological-based challenges, grow your own business, or simply show up to help clients, this is the show for you. 

I’m Heather Branscombe, Therapist, Certified Coach, Clinical Director, and Owner of Abilities Neurological Rehabilitation. I have over 25 years of experience in both the public and private sectors, and I’m here to help you become the therapist you want to be, supporting people to work towards their dreams and live their best lives. You ready to dive in? Let’s go.

Hello there, friend. I’m coming to you today in a season of my life – I think I might have even talked about this last week. Maybe I need to listen to my podcast last week and think about that, but that was a whole week ago. Anyways, I’m in a season of my work life right now where I am talking to so many amazing new graduates to so many clinical professions. But more specifically this is a season where newfound OTs, PTs and SLPs are really looking to seek their first position. 

And of course, I always want to be considered for that because as you know this is my dream job and I love working with new grads. And I like to think that we at Abilities, again the position that I work in and the organization that I work in, that we’re uniquely positioned to set up new grads for success. So, one, it’s so fun to talk to people that are so excited to start their professional journey. And I love the idea that we might be the exact next best step that they’re looking for to launch them into an amazing clinical career. 

So, that being said, I often like to think I’m the chief wooing officer as well. So whether you’re a new grad or not, if you are someone who loves working with people with neurodiversities or neurological based challenges, be that pediatric or an adult population or somewhere in between, I want you to send me a DM or email me through our website, abilitiesrehabilitation.com, or you can DM me on Instagram, heatherbranscombe.coaching. And again, I’m going to woo you if you’re anywhere close to a position, but I’ll talk you through what our unique hiring process is to see if this could be an actual good fit for you. 

Now, one of the amazing and also totally understandable questions that I’m getting from new grads and from most people as I am looking to find a hiring fit is talking about compensation. Now, I don’t know you, but I used to hate conversations about compensation. I didn’t like it as a clinician and even as an owner and an employer I often didn’t like it from that side. 

So I thought it was really funny that no matter what side of that conversation I was on it felt awkward and I would do what I could to avoid it. But now it’s honestly one of my most favorite parts of the hiring conversation for therapists or any clinicians that are working with us. So I want to talk a little bit about how I was able to change my mindset on this and how you might change your mindset as well. 

Now, I want to say, first, it makes total sense why it might feel awkward and why you might want to avoid it as a clinician. Because while we do provide, I fundamentally believe that we provide a valuable service, and we can be well compensated for it without sacrificing the client experience and without sacrificing ourselves. But it makes total sense that we aren’t actually in full belief of that because our brain likes to think it’s us or the client or us and the employer. 

So, again, I have a lot to say about this today and I’m really here to help you. So if you are a new grad, if you’re working for someone else, or even if you’re working for yourself as an employer, I think one of the thoughts that I have about this, and specifically around my own transformation about money, may be useful for you to help you to think about how you want to think about compensation and your clinical career. 

In fact, I have so much to say about this I decided to do my first podcast that I’m going to break up into two sets. Yes, you could listen to it together, but I want to give you some bite-size pieces. So today I want to talk more about the challenges why this potentially is a problem for you and to be able to help you to understand and set you up to see what could be possible for you. 

And then once you can see that possibility, next in part two I want to give you some actual tactics and strategies to help you feel amazing about your compensation, again either as a new grad, as an employee in an organization, or as a solo entrepreneur or as an owner as well, to help you to get what you actually want as a clinician. 

So let’s talk about why money might be a challenge for you in your clinical career. I provided a list, this is not an exhaustive list by any means, but I have some ideas of why this may be a challenge for you. Some of this comes from my own experience, so let’s see how many of these things resonate for you. And if they don’t, what else might be coming up? 

So, one, as I mentioned before, we are in this business to help people. And when we think about helping people, especially when it comes to a place of compensation, it makes total sense why we might be thinking that compensation is a win/lose proposition. Meaning if I get paid more as a clinician, that means that the client needs to pay more. Or if I get paid less, then that means that the client is going to have to pay less. 

Or even as an employer, I mean, obviously, I’m in private practice so that’s where my brain goes automatically. But as an owner I could be thinking, if I pay my staff more, then it means that there’s less money to run the business. Or the opposite, if I was an employee working for an employer, there may be a piece of I need to ask for more per hour for me, otherwise, I will get less money. All of those things, just notice that there is this kind of black and white, either or, win lose mentality. 

And then secondly, so many of us that are clinicians are women or are socialized as women. And as women, we often aren’t socialized to ask for what we want. We’re often in this position where we are the nurturers, we are the caretakers, and we’re socialized to put other people’s needs in front of our own. 

Now, again, I don’t even want to say that that’s necessarily a bad thing. But notice how if that shows up in other areas of your life, why that might show up when it comes to talking about money and your compensation. 

And then finally, I don’t know about you, but one of my first areas, actually many of my first jobs as a clinician was in either a public practice place where I’m in a unionized position, or just a position where I was offered a salary and it was kind of like take it or leave it. There really wasn’t a negotiation that was happening there. 

Now again, at the time, remember I thought that money felt really awkward. And I didn’t want to ask for it, so I wanted to avoid it. And so it actually felt easier for me to have this money and to decide whether I wanted it or not because I was able to make a quick decision about it. And then if I felt like the money wasn’t enough, then that just allowed me to judge the other person. Instead of actually taking full responsibility and asking for what I want, I got to blame the other person. 

So of course when we are in these kinds of positions, which again, not an exhaustive list, but of course that’s going to reinforce that system where asking for money feels awkward and where we might want to avoid it. So I know again, for me as a new grad, again, this was a few years ago and so I think there’s cultural implications of being that forgotten Gen X piece as well. What would happen to me is I would take whatever I was offered in the position, and I would just be happy to be paid. 

I would just say yes. And I really had zero concept of actually thinking about whether this is actually what I truly wanted. I would just happily take what I was given and be happy that I didn’t have to have an awkward conversation about what I really wanted. And it allowed me the opportunity to not even think about what I really wanted. 

There was also a place, again, when I was working in public practice, and I’m not saying that this is what happens to anyone else in public practice, this is my experience. Your mileage may vary, and probably well. But my experience in public practice when I’m in a unionized position is that I was able, while I may or may not be paid what I wanted, one, I could give that control to my union reps that were doing the negotiation on our behalf. And I decided that the other pieces in public practice were as important. 

So like the team that I was working with, the contribution I was giving, what I decided was the nobility of working in public practice. And again, all of those are true, and that doesn’t mean that I had the opportunity to be able to think about how much I actually wanted to make as a clinician and then decide how I want to do that. We can make all the money that we want to make and have all the satisfaction. It’s not an either or proposition. 

What I really am noticing and actually love most about the culture of the Gen Z population, and even some of the end of the older, I guess, younger millennial generation, is I’m noticing that those new grads really know what they might want. And because I’m not in that generation, and if you are I’d love your feedback about that, I don’t know necessarily how they have decided what they should be compensated for. 

But I definitely noticed a difference versus my generation that just came and kind of we were waiting to be told how much we should be paid and then we accepted that. I’m not offering that that is a better way, but I notice almost the opposite now. I am working with some amazing new graduates, and not all of them do that but they definitely have some thoughts and a strong belief or understanding of how much they should be paid as a new graduate. 

Now, first, I want to say it’s amazing. What I love about that is that there’s this innate underlying belief about the value that they are creating as a professional in the world. I love that they have that belief. So if you have that belief, I think that is amazing and I want you to harness that. 

What is a little more curious, though, and this is a very, very small part of the population, so take this for what it’s worth. But I find it really interesting every so often when there is a new graduate that confidently tells me that I am under paying in the market. And again, they get to say whatever they want, and they get to have whatever opinion that they want. 

But I find that so curious that they’ve come to this quick assessment, not necessarily understanding my more than 25 years of clinical experience in this profession, as well as our systematic wage review that we do on a yearly basis that includes macro trends in the profession, economic trends, globally, nationally, provincially and locally. We look at the micro trends in the area. We do competitive analysis, and we really do actually understand the value of our therapists. And I think we are actually uniquely positioned to understand how we can help clinicians to create value without always trading time for dollars. 

So, again, just to make sure that I’m clear, I feel very clear about our position about our compensation. But I find it so fascinating that there are some new grads that come in. And I have some ideas of why that is, and it doesn’t even matter. I would just say, as a new grad I love when you have that belief, I love that for you. 

My only one piece of strategy that I would give is, instead of coming from this place of authority, especially when you are working with a professional that has been in the industry, who has owned a clinic for more than 15 years and has been in this profession for over 25 years, there may be an opportunity for you to be more curious and to ask more questions. 

So let’s help you become a little more conscious, a little more mindful and a little more deliberate about what you actually want in a compensation plan. And in that, you get to decide what you are really worth. And we’re going to use that to create a plan to be able to create that for you sustainably in your own life. 

So here’s some questions that can help you to get there. So question number one that I always like to ask clients, a very basic question, how much do you want to make? And I just want to offer, independent of what you know is around and available, independent of what new grads make, independent of what other clinicians make, how much do you want to make this year? And then after that, what values are important to you as a clinician as it relates to money? 

And you might think that values don’t necessarily match as much here. I don’t necessarily mean the value of money to you. What I mean is, what is your tolerance for risk? 

So, for example, if you have a higher tolerance for risk for a variety of reasons, then that might lead you to a plan that might be more suitable to a contractor arrangement. Versus if you’re in a time of your life where you actually have less tolerance for risk, maybe coming out as a new grad you don’t really understand what your budget is going to be, or for whatever reason you have some fixed expenses that you really don’t want to have to risk how much money is coming in on a regular basis, then maybe an employee situation may actually be a better fit for you. 

Also consider the overall plan. Instead of how much you’re making per hour or per client or however per unit you want to think about, how much vacation time is important for you? How much time away from the clinic is important for you? Do you want sick time? And even if your current employer or situation you don’t have sick time, just notice in your ideal world if you would want that or not. And so then we can work on creating that. We’ll work on the how after 

So, again, as you’re asking these questions, your brain is going to want to go to the how, but I’ll explain a little bit more why the how really isn’t important. Let’s forget the how and really just dream here. How much mentoring and support are you willing or interested in having? 

And mentoring and support is interesting because, again, in talking to a lot of new grads, or people that are transitioning into a different kind of practice, whether that’s public practice into private practice, or transitioning into a new area of practice, that’s something that almost universally we are interested in. But it’s also interesting to consider how much do you value that? How much would you be willing to pay for that if you had to pay for it out of pocket? 

And often, especially if you’re working in an organization, you won’t necessarily have to pay for it yourself. But you want to notice how much that’s actually valuable to you and the dollar amount. And that will help you to kind of overall see what the compensation plan in the how, going down the road, how important that is to you and how that fits into the overall compensation plan. 

The last thing that I would say is how much do you want to invest in your education this year? So, again, for some kinds of employees they might be thinking about that, but a professional development amount, an education amount, no matter how you define it, it’s kind of that same piece. You want to have that decision even if you are an independent contractor because that can be helpful to be thinking about how much, again, in this total compensation. 

It’s not just the dollar per hour, but it’s all of those other benefits that are important to you. Medical, dental benefits, extended benefits. Think about all the things that you would like ideally in a compensation plan, and think less about the how. Again, your brain is going to want to go to the how. But we know of course, that that really isn’t helpful. 

So if you want to know a little bit more about why it isn’t helpful, there’s a couple of episodes that I can lead you to. So a couple of episodes on goal setting and why when we’re goal setting we want to focus on the goal, where you’re going and not necessarily how you’re going to get there. A couple of episodes that can be helpful for you, one is episode three, Why Create a Bigger Impact, and also episode eight, One Key To Your Goal. Those are two kinds of things that can be really helpful to you when you’re doing this overall goal-setting. 

But again, there is this opportunity for you to be less attached to the how of the goal and much more attached to the goal itself. So let yourself go wild. Think about the ideal world. If the how was not a problem, what would you want for you? 

And so then, again, next time in part two we’re going to be talking about the strategy and the tactics on the how of how you might determine that first plan of action. Thank you so much for listening. I can’t wait to see what you create with this, and let’s dig more into this next week. See you soon. 

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Thanks for joining me this week on the Clinicians Creating Impact podcast. Want to learn more about the work I’m doing with Abilities Rehabilitation? Head on over to abilitiesrehabilitation.com. See you next week.