How Sharp is Your Saw?
Mike Billings, Chief Strategy & Development Officer

This month marks my 31st year in healthcare – 23 of those years with Infinity Rehab. Upon reflection, I can recall many internal and external forces that tested my resolve as a professional over these years. Early in my career, I was trying to find where I fit in the physical therapy profession. I practiced in several settings, including acute care, outpatient, and home health. I quickly discovered that I enjoyed working with older adults, so I jumped at it when I saw an opportunity to become the rehab director for a skilled nursing facility in Portland, OR. Never mind that I had zero leadership experience. How hard could it be? It turns out very hard. I now know that leadership development is a lifelong pursuit – one where you never really cross the finish line.

External forces were plentiful. In the mid-1990s, therapy practice was rocked by the emergence of managed care, especially in Portland, OR. We were unsure we could adjust our practice to succeed with these new payers, but we did. Then, in 1997, Congress passed the Balanced Budget Act, which completely changed how therapy services were reimbursed in skilled nursing services from cost-based reimbursement to prospective payment. Many felt this could be the end of therapy in SNFs, and it felt that way for a while. However, within five years, therapy was in high demand and going strong again.

The first twenty years of the 21st century saw periods of severe therapy labor shortages and many changes to the reimbursement and practice rules we operate under in skilled nursing. However, the most significant adjustment occurred at the end of 2019 when we transitioned to the Patient-Driven Payment Model (PDPM). That alone was enough to shock the industry, but little did we know that the World Health Organization would declare COVID-19 a pandemic five months later, on March 11, 2020. In my 31 years in the industry, I cannot recall a more trying period.

The constant insults to one’s psyche throughout a career can drain the joy from work. At no time has this been more apparent than during the past two years. Everyone has their strategies for managing stress, and no one solution works for everyone. Yet, it’s critical to have ways to recharge your battery.

My strategies include turning to social support from family and friends. I’ve also learned to lean on books and articles for inspiration during trying times in my career. As a leader at Infinity for 23 years, I have discovered the importance of resilience to get through these trying times.

But how does one maintain resilience in the face of constant challenges? I’m sure it differs for everyone. As far as books, I repeatedly turn to one I read early in my career, Stephen R. Covey’s, The Seven Habits of Highly Effective People (1989). His seventh habit, Sharpen the Saw, resonated with me and got me thinking early on about work-life balance. I discovered right away that work-life balance does not have to be a 50-50 proposition and that it is more of a sliding scale depending on the demands in my life at a given time. And that’s OK as long as the pendulum swings in both directions and doesn’t get stuck in one position. The Sharpen the Saw habit consists of four dimensions of renewal:  physical, spiritual, mental, and social. Renewal of these dimensions increases our ability to live the other six habits.

I’ve spent much of my adult life trying to work the dimensions of renewal into my daily life. The physical dimension involves caring effectively for the physical body. As therapists, we care for our patient’s physical dimensions daily but often ignore our physical well-being. The physical and social domains come most naturally to me and are my go-to strategies. I especially enjoy combining them, like going for a hike with my wife or a long bike ride with a friend. Being active outdoors with friends and family re-energizes me every time.

Renewing my spiritual and mental well-being is more challenging. Physical activity certainly plays a part, but it’s only part of the solution. I’m thankful for Infinity’s employee assistance program and the access to qualified mental health counselors it’s provided my family and me. It is a challenge for me to sharpen that part of my saw, and it’s comforting to know there are people that can help.

I don’t have all the answers to surviving challenging times like we’re in, but I intend to keep refining my strategies. Likewise, I don’t have all the answers to bringing joy back into work, but I know sharpening my saw and recharging my batteries is a prerequisite.

How do you sharpen your saw?

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