The Professional Decision I Most Regret: Choosing Revenue over Staff Leadership

By Anonymous

I own a multi-disciplinary pain clinic in Calgary.  Young professionals move here for the proximity to the mountains as well as the quality of life their high paying jobs afford.  They tend to be weekend warriors, sitting all day during the week and then going all-out on the weekends.  The demand for help with sprains and strains is high.

During the last oil boom, we grew our clinic by accumulating therapists to meet this demand and thereby increased our revenues.  Therapists are typically paid a percentage of 60% of the service they provide; I supply the patients and they supply the service.  The idea is that if a therapist wants to earn more money, they need to see more patients.

I had one therapist who worked harder than most, had a great attitude and even worked Sundays for her clients without a receptionist working the front desk for her.  She was trustworthy and loyal to me and our clinic.  She worked Wednesday to Sunday, rarely took time off and if she had to take time away she always gave a lot of notice.  She was good at her job and she cared a great deal about helping people recover quickly from their injuries.  Her positive energy was consistent and she was in great physical shape, representing the lifestyle we promote for long term health.  She typically produced $8000/month in services where she earned $5000/month and generated about $3000/month for the clinic.

At about 3 years of working in my clinic she asked to pay a smaller percentage – 30% instead of 40%.  I told her I would think about it and after running some numbers I realized that I would lose $500 per month.  At the same time the oil boom was slowing as was patient demand for our services.  I told her that I wouldn’t make a change in her percentage.  My excuse was that if I did it for her I would have to do it for all therapists.  Later my accountant reinforced that she was fortunate to work in such a busy clinic and that if she wanted more money she should work more.  He said I was being reasonable.

Things changed after that.  Patients we co-managed seemed to pull away from my schedule.  Her attitude remained professional but we no longer shared in casual conversation and her body language demonstrated that she was uncomfortable around me.  She was still producing money for the clinic but she began to avoid me.  The demeanor of all of our therapists became somber and quiet conversations went silent when I came around.

It took me a while to realize my error and her influence.  Not giving her a raise had saved me a little money – $6000/year – but it was costing me more than that.  I asked to meet.  At that meeting I agreed to the change.  There she informed me she was leaving.  Her demeanor was cold.  I noticed new business cards on her counter.  I realized that she had already gone.

Within 8 months none of the 5 therapists from that era remained.  Her patient load left with her despite our great location and convenient hours, excluding Sundays.  The clinic revenues fell by around $15,000/month.

In retrospect, I had no awareness of how much a happy colleague means to a clinic or organization.  I also didn’t realize that her seniority was a barometer to others about the stability of the clinic.  She knew her true worth and I did not.  Of course, my accountant is all about the numbers and the bottom line and not the culture of a business.  I have noticed over the years that he has regular staff turnover too.  Mostly, I wonder why I failed to see that stability is worth her making a better living and the clinic measuring success by more than just revenues.




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