Creating Value Beyond the Treatment Table

Authored by Cody Lee, PT, DPT

Most clinicians think impact only comes from patient outcomes, but that's not true. Sure, it's the job, but it's not the only lever you have.

Two weeks ago, I wrote about learning to speak the language of policymakers if you want to influence where healthcare is heading. This week we're zooming in closer to home.

The same principle applies inside your own organization. Whether you want to grow internally or position yourself for a nonclinical role elsewhere, the path is the same.

Learn to create value beyond the treatment table, and start seeing the organization as a system.

You already think in systems

If you don't naturally think in systems, that's okay because as a clinician you've already been trained to. Think about this for a second. When you were being trained as a healthcare provider, whether that's a physical therapist, physician, nurse, or any other allied health provider, you were taught to think in systems. At least I hope you were.

When you are evaluating a patient, you are likely thinking about many factors that influence them. That could be their anatomy, function, psychological factors, social support, housing, transportation, stage of healing, etc. All of these factors play a role in the person who is in front of you. We might call this the biopsychosocial model: a way of thinking about what factors influence the person in front of you. You have been trained to think in systems and how each individual system could have an effect on another, how they work together, and the ability to tease out the most important problems.

Systems thinking simply means that structure drives behavior. Everything is connected and connections have consequences. Inputs equal outputs which then become inputs into a feedback loop throughout the system. And so the process goes.

For more reading on systems thinking, here are a few pieces to get started with:

• Systems Thinking

• Kahneman on Thinking

• Mental Model: Feedback Loops

Now let's connect this to your organization. Think about your clinic, the environment you work in, the people you work with, and the complexity of it all. If you think about it for a moment, you will find problems that exist, feedback loops that are broken, systems that can be improved, redundancies, bottlenecks, and manual tedious work that could be solved by technology. But to spot these you have to take a step back, zoom out from your caseload, and observe what's around you.

An example I noticed recently was our reporting process within our department. We track several metrics that most clinics probably track: visits, evals, units, worked hours, and productivity. They're lagging indicators that can be helpful in the decision-making process, but the way we gathered this data and transferred it between formats was 100% manual.

After a recent conversation with a colleague and the fact we just got access to Copilot as well as Power Automate, I knew I could figure out a better process that would reduce the manual work and improve the work of our leadership team. I realized that we had some of our highest paid team members doing some of the lowest tier work in manual data entry. Rather than spending that valuable time on leading and doing only what they can do, they were having to manually transfer data from one spreadsheet to another.

Although this isn't a clinical problem, it is a real problem. Poor efficiency and a waste of resources.

Solve problems that create leverage

Not all problems are created equal, but this one was worth solving.

When I think about work, whether with a patient or in this capacity, I think about creating value. Find the work your leadership dreads and make it disappear. I realized that this problem was causing a significant drain on energy, time, and resources. Our leaders were spending hours on manual, tedious data entry.

So I looked for a way to "manage up" in this scenario. I knew I could figure out a way to improve the work of my leadership, increase the efficiency of the data collection, and create value by solving this problem.

You don't have to wait for authority, a title, or permission to solve these problems. Find where the friction is and remove it. Create value for those around you. Make their lives easier.

Use the tools available to you

Here's what I did.

First, I identified the problem and scoped it by figuring out what exact metrics we tracked, why we tracked them, where the data needed to flow, when it needed to flow, and who needed it.

Then I used Copilot as a literal copilot to develop 8 Office Scripts for our Excel workbooks and used it to develop the Power Automate flows. I had never had any experience writing Office Scripts or using Power Automate. However, I was able to automate the reporting process from 100% manual to approximately 10-20% manual.

I do have experience using LLMs effectively and have used Zapier as well. Pair that with resourcefulness and you can figure out most things. You can too.

It took me a total of 20-25 hours over a couple week span to get this done. I'm currently refining the process as it is now live.

Learn to speak their language

Being able to solve problems, identify inefficiencies, or improve processes is one thing, but to truly get your admin or leadership to see your value, you have to translate the work into the terms they care about. You have to learn to speak their language.

I like the way Sam Hinkie put it: "You have to build the API into the other person's brain."

An API (Application Programming Interface) is a set of rules and protocols that allows different software applications to communicate with each other. Think of it as a digital messenger that takes a request from one system, tells another system what to do, and brings the response back.

Meaning you need to understand what motivates the person you are communicating with, how they will best understand what you're telling them, what matters most to them, and why your solution is important.

For my example in automating our rehab reporting, here's how I framed it: Four roles were spending a combined 155 minutes per day on manual data entry. Across 260 working days, that's roughly 670 hours a year, and that's before accounting for time spent fixing errors. At an average labor rate of $50/hour, we're looking at over $43,000 in annual cost tied up in copying numbers between spreadsheets. The automation took me about 20 hours to build. Payback period: six days.

That's the difference between "I automated some spreadsheets" and "I redirected 860 hours to higher-value work with a 50:1 ROI."

Framing the solution and speaking the language of those you want to impact or influence is the most crucial piece of the puzzle.

So if that's the case, you have to think hard about what is important to those you want to influence. It's the same as when you are working with a patient. You don't just spit facts about anatomy, exercise, or behavior change. You figure out what truly matters to your patients and frame your solution for them in a way in which they will be receptive. It's the same process here.

If you've demonstrated before that you can solve problems for your boss, be dependable, and understand what truly matters to them, then the trust they have in you will go farther.

Remember, you don't need a new title to start

This isn't about leaving clinical work or even getting promoted, although that may be the byproduct. It's about expanding what you think your role can be within your organization. Having an even bigger impact than only in patient care.

I didn't wait for a title or leadership role to start solving problems within my organization. When I was an access specialist (front office), I recognized that we didn't have any standardized processes. Our systems were fragmented and we all did things a little differently. There was a lot of room for improvement. So I wrote a 128-page access specialist handbook that standardized our processes and onboarding. It gave us a source of truth to point to on our SOPs and improved the front office experience.

Another time I realized that although we did track appointment statistics, referral sources, and our financials, we never synthesized these together to get the full picture. So I created a 48-slide state of the clinic report that pulled together 4 years' worth of financials and appointment statistics to influence a change in KPIs, give a more accurate picture of where our clinic was, and give us better metrics to track.

Don't wait for the title to solve these problems. They are hiding in plain sight. You just have to look for them.