Today’s O&P Workforce: Meeting Needs and Challenges Through Better Workplace Culture

When you ask employees in the O&P profession (or just about any occupation) to give their impression of what it means to have good culture in the workplace, you’ll likely receive a host of applicable answers. A workplace culture can be described as the attitudes and behaviors of those within an organization and between management and employees. A company’s culture can set the stage for how workers perform their jobs and adapt to challenges in their profession. “It’s a continuous piece of business building,” says Jessica Norrell, CPO, MBA, owner of MOZN Solutions, who has more than two decades of experience in the healthcare field. As O&P faces demands from documentation requirements, staffing shortages, and stress from mismatches between salaries and the cost of education, creating a healthy, positive company culture can go the distance in helping to alleviate these pressures, as well as reducing burnout and improving employee retention. We asked a handful of O&P professionals in varying stages of their careers and roles to share some of their strategies on work and workplace culture. What Is a Good Workplace Culture? Norrell says she believes a good workplace culture starts with how employees are perceived. “If the owner treats their employees like they are an integral part of the business, not only will the employees feel essential, but everyone else will treat them as such,” she says. “When certain roles are minimized, we create a feeling of ‘less than’ and that can lead to a very domineering environment.” Norrell gives the example of an owner of an O&P practice with whom she works who planned a surprise breakfast, made by the practitioners, for the administration team. Each person also received a handwritten card and a few other surprises, Norrell says. “The impact on the team was immediate,” she says. “This not only boosted moral, it showed the entire team how important the admin staff is to the organization.” Norrell also noted that the event was not just a “one-and-done act.” “This is something that was done in conjunction with treating the team well on a day-to-day basis,” she says. Michelle Hall, CPO, lead prosthetist and O&P residency director, Gillette Children’s Hospital, Minnesota, and 20-year veteran in the O&P profession, says a good company culture exists when staff and leadership work together through shared decision-making. “The staff provide the ideas for projects important to them and their patients, while the leadership provides the guardrails in which the staff can pursue that project. This empowers clinicians to improve their workplace and ultimately leads to greater job satisfaction.” A great workplace culture is one where employees feel inspired to bring their best selves and talent to work each day, says Kelsey Troy, senior vice president and chief human resources officer, Hanger, a role she started in March. “They feel excited about the work their team is doing and where the organization is going, and, just as important, valued for their contributions,” she says. However, for that to happen, Troy says open and transparent conversations with employees and leadership are critical—so leadership can prioritize what employees need to be at their best and employees can feel excited and committed to the company strategy. A good workplace culture not only provides the proper scaffolding and support to increase the capacity for risk and reward, but is flexible to value the individual differentiating characteristics of the employee, says Gerald Stark, PhD, MSEM, CPO/L, director of clinical affairs for Ottobock Patient Care, Texas. “It isn’t enough to just provide economic benefit for clinicians who desire to be effective and valued among their peers,” he says. “Money is only a motivator in that they want to trust that the organization is fair and has taken care of them. They also want to know how the culture is investing in their careers at a personal level.” Continuous Change The working world is changing in some ways for the better, and the opposite in other ways, our experts agree. “The workplace dynamics are constantly changing,” says Norrell. “The more business owners realize that how we work is going to be in a constant state of evolution, the more prepared they will be to accommodate those shifts.” Norrell says one of the best examples of the workplace in a state of flux came during the pandemic. “The COVID era certainly exacerbated the workplace shifts in some respects,” she says. “Take working from home, for example—prior to COVID, we were already seeing trends in more remote jobs, but COVID certainly accelerated that for most businesses.” Social media and electronic means of communication are other examples, according to Hall. “It’s double-edged sword,” she says. “It allows for quicker, more frequent communication, but it may also allow more room for misinformation.” Workplace frustration often occurs through miscommunication, which may be amplified through electronic means, Hall says. “The fact that we can now easily hop on a virtual call with video has been a great way to get to know the staff better who are not at my location. It’s better than a phone call or an email.” Across the healthcare industry and beyond, Troy says she believes companies are challenging the norms of the past that have shaped the working world—from working nine-to-five to the philosophy around hybrid work. There’s good news in that aspect: many companies are prioritizing work/life integration, which is causing the workforce to find new and different ways of working that ensure people are living their fullest lives, she says. Then there’s the not-so-good news, Troy says. “One potential downside is that many employees across different industries may be starting to feel a little less connected to each other in the work environment,” she says. “While employees are proving to be very productive individually in new working arrangements, the negative corollary may be a decline in collaboration, relationship building, and connection to work overall.” Stark says he sees a more transient workplace with employees staying for two to three years before moving on, unless they enjoy the work. “The family social structure is also changing where the work life may be a more stable environment than the home life,” he says. This creates greater ambiguity, says Stark, because the workplace must seek overall economic benefit for the organization. “Challenges arise when you need to furlough your ‘work mom,’” he says. Stark adds that some of the tools that are available to manage one’s benefits and time are much more available so that there is greater flexibility for remote working. “However, remote working makes many employees feel more isolated so the collective system cannot help moderate the anxiety that work inherently generates,” Stark says. Quiet Quitting and Burnout The term quiet quitting, roughly defined as the practice of doing the minimum amount of work required for one’s job, no longer going above and beyond, is somewhat controversial, says Stark, who believes there are multiple levels of meaning within the expression. “There are those who say that employers created the term to call out employees who are not giving extra effort,” he says. Finding work/life balance, for example, is not a form of quiet quitting, but crucial, Stark says. According to surveys Stark has conducted on the matter, O&P employees who have worked between 16 and 20 years report higher levels of quiet quitting their job. “Which is really striking a balance since the years of 11 to 15 have the highest burnout rate,” he says. The more troublesome level of quiet quitting, however, is those with eight to 15 years in the profession who have cut back 30 to 40 percent of their efforts, Stark says. “They know they are underperforming and expect others to compensate for them,” he says. “They may be clinically depressed or simply choose not to contribute.” Stark also says that owners have higher rates of burnout, but lower levels of quiet quitting. “Because they are owners, they simply do not have any options,” he says. “This may be the key factor. When people feel they have ownership and autonomy, they show lower levels of quiet quitting.” Quiet quitting means that employees are shutting down and doing the least amount of work they can. Hall says, for example, in O&P this may mean they are seeing the patients they’ve been assigned, but not helping beyond that. “They are not engaged professionally and are doing only the bare minimum to stay employed.” Hall says one way to remedy that situation is for employers to work at engaging their staff. “Determining what excites their staff and then encouraging them to do those things is key for maintaining job satisfaction and avoid quiet quitting,” Hall says. Norrell says what needs to be realized about quiet quitting is that it is not an “instantaneous decision by an employee.” “They have been making this decision over a period of time and have had several instances that have led them to this point,” she says. Norrell also stresses that if company leadership sees evidence of quiet quitting in their staff, someone should “call one of your past employees and ask them for honest feedback. Quiet quitting can be avoided if the company wants to do the hard work of understanding why. Sometimes it is truly an employee problem, other times it starts with leadership,” she says. Burnout in O&P is at least as common as any profession. Justin Pfaff, CPO/L, MBA, regional vice president, Hanger, says he views burnout affecting employees in two separate career stages: first, those trying to balance young families and aging parents. “The pressures of both home and clinic life can be trying at times for this group,” he says. Second, those who are on the waning end of their career and have seen the industry burden of documentation and administrative duties increase to a level that doesn’t resemble how they were able to practice a few decades ago. “These individuals begin to question their purpose, which can lead to burnout,” he says. Hall says stress and exhaustion can come at any point in one’s career. “For me, it ebbs and flows with how many challenging things I decide to take on clinically, educationally, and professionally,” she says. When all the deadlines coincide with busy times clinically, which Hall says she has experienced frequently during her career, she begins to feel burned out. “It’s individual circumstances and one’s tolerance for load that dictate when burnout occurs,” says Hall, who also believes that autonomy in one’s work is a key mitigator. “I have been lucky enough throughout my career to have some level of relative autonomy in my clinical and professional activities.” Trends in the Workplace Current trends in business and technology show that the way employees work—where they work, when they work, why and with whom they work—have and will continue to change over the next decade, and likely will bear little resemblance to work as it stands today, our experts agree. Company leadership will need to be aware of these effects on employees and the workplace culture and adjust accordingly. What many know as the traditional nine-to-five will likely become a thing of the past, says Pfaff. “We’re seeing this already in many industries,” he says. Technology will continue to change how O&P documents the services being provided and will modify the framework in which those services are provided, Pfaff says. “Payers will continue to place the burden of proof on us and reporting successful outcomes will continue to be the measuring stick used to guarantee payment,” he says. “Our service model will continue evolving to be more focused around the patient experience as patients leverage their choices as consumers.” Lastly, Pfaff says, the industry needs to adapt its service model to accommodate a clinician/assistant model, as already evident in other areas of healthcare. “The shortage of clinicians will only continue to challenge the industry, and with retirements increasing, staffing appropriately to care for patients will be the key to sustained success,” he says. “This will cause us to evaluate how care is being provided and who is doing what work.” Stark says clinicians will remain tied to serving a patient’s physical needs, so the way in which one will be able to do that may require greater specialization and support from assistants. “However, there remain two main business models of low-volume to high-volume differentiation and high-volume to low-volume differentiation. The issue is you cannot exist in the middle,” he says. “Each model will require different types of assistants and support staff. New positions may evolve where there are greater amounts of anxiety such as billing and reimbursement to accelerate documentation.” One of the most important aspects of having and enjoying a successful, thriving career in the future will depend on the employee’s ability to learn new skills and reinvent themselves, Pfaff says. “Technology and efficiency will continue to advance rapidly, so remaining viable and competitive in the workforce will be measured by the ability to absorb, implement, and learn new information in succession.” A Better Place to Work—Finding Balance There are also concerns about the future workplace, our experts say, especially when it comes to finding balance and improving the work environment. It’s imperative that employers be flexible as well as provide a system of equity, not necessarily equality, Hall says. “Not every employee flourishes with the same resources. It’s important that each employee has what they need to be successful in their job,” she says. “Workplaces that balance this well tend to keep their employees.” Employers need to listen to their employees as well as invest in their managers, Troy says. “Listening to your employees is crucial to know what’s important to them and how you can create the best environment for them to do their best work,” she says. “As the work world is changing, our managers are critical to ensuring employees understand expectations, get feedback on their performance, and receive investment to grow their careers.” For Stark, in addition to increased compartmentalization and isolation, one of his biggest concerns centers on the O&P practitioner, specifically that they remain focused on the central needs and goals of the patient achieving their highest level of functionality. “This can be done in a variety of ways,” Stark says. “But the innovations or processes must continue to have the mission of providing the highest levels and the best outcomes for the prosthetic and orthotic user.” For Norrell, finding the right balance will be the key. “Being able to balance a culture of connection and collaboration with a work-from-home environment [is crucial],” she says. “As someone who has worked from home for 11 years now, I can attest to the need for in-person connections. The key is finding a balance for your organization.”

Today’s O&P Workforce: Meeting Needs and Challenges Through Better Workplace Culture

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