Magnolia Physical Therapy: Responding to the COVID-19 Crisis with Planning and Execution in Align

The coronavirus shutdown put much of Magnolia Physical Therapy‘s business at risk. As they adapted to treat patients safely, the tools that had helped the business thrive and expand now worked to keep them afloat and prepare to bounce back stronger than ever. Align helped Magnolia create focus and drive execution during a tumultuous time.

Beth Winkler and her business partner, Lisa Taglauer, are no strangers to managing through a crisis.

They co-founded Magnolia Physical Therapy in August 2005 in their hometown of New Orleans, and creating this business together was a dream come true.

Unfortunately, August 2005 would be a tragic month in New Orleans. Just two weeks after they opened their tiny one-room clinic, Hurricane Katrina hit the region, flooding the city.

“But just like our city,” Beth says, “we fought back, too.”

Over the next 15 years, Beth and Lisa grew their initially small practice into a model of excellence — an independent, female-owned physical therapy practice with as many as five state-of-the-art clinics serving patients all across the metropolitan area.

Beth calls Magnolia’s work “a hands-on approach to rehabilitative health care.” Patients are drawn to the one-on-one, in-person therapy provided by the practice’s team of experienced physical therapists.

Recently, however, their approach has run up against another crisis.

In response to the spread of COVID-19, governments have required that residents shelter-in place, and citizens across the country are practicing social distancing. These mandates were especially notable in New Orleans, which emerged as one of the United States’ first coronavirus hotspots.

How can a business operating in such a “hands-on” industry survive a pandemic?

A Common Cycle

Years before anyone had ever heard the word “Coronavirus,” Magnolia Physical Therapy was going through the same growing pains as many small businesses.

As recently as five years ago, Beth remembers the company’s idea of a big strategic meeting.

“The Executive Team rented a beach house in Biloxi, Mississippi,” she laughs. Beth says they’d sit in a hot tub with beers and come up with “astronomical goals” for the next year. “It might have been more organized than that, but certainly not by much.”

Many business owners will recognize the cycle Beth describes:

“You set these massive goals — ‘hey, we should do that!’ — and you get off to a great start in January when you’re motivated. But then you forget about it. It isn’t until you’re having the same meeting next year that you admit how far short you fell on the ‘priorities’ you set.”

For a while, though, Magnolia steadily grew despite the company’s strategic planning and execution challenges.

But Beth remembers the moment that ended. They were doing the same things they had always done to grow, but now they were losing revenue instead.

“Our processes and systems weren’t working anymore,” she says, admitting it wasn’t just one thing they needed to fix.

“It was a lot of things,” she says. “We needed help.”

Building Organization

That help first arrived in the form of a book Beth and Lisa learned about, called Scaling Up. It’s a compilation of author Verne Harnish’s’ “Rockefeller Habits” — the guiding leadership and management principles thought to make John D. Rockefeller and his Standard Oil one of the great success stories in American business history.

The book’s methodology focuses on strategic planning, prioritization and execution — all elements Beth wanted to improve at Magnolia.

They hired a Petra coach to help guide them, and their coach strongly suggested they use Align strategic planning software as a tool to hold the business accountable while they implemented the Habits and pursued their priorities.

Beth says Align made a huge difference.

“Now we had a process in place for our entire management team to get together and create longer term priorities,” she explains. “And, maybe most importantly, we had a tool in Align to help us track daily toward accomplishing those priorities so there was no way we could forget about them. They were the center of what we did as a business.”

Using Align and the Rockefeller Habits, Beth says the company’s leadership team was able to prioritize and solve persistent challenges that had dogged them for years. For example, they were able to settle on roles for executive team members that were, both, interesting to each member and didn’t overlap.

“Why was I wearing the CFO hat until then?” Beth wonders. “I loathe numbers and spreadsheets and Lisa likes them! It seems obvious, but Align gave us a platform and the organizational will to work through our challenges.”

A Pandemic Strikes

This freed up Beth to focus on the team she was assembling at Magnolia. She was excited to embrace her role in making her physical therapists’ experience a more positive one.

One way in which Beth hoped to do this was to improve their onboarding process.

“When a new employee would start with us, we’d hand them a big, fat manual,” she laughs, mocking, “Here you go! Here’s your overwhelming manual.”

With Align, she made shifting elements of the onboarding process to an online system a priority. She made goals for herself to choose a platform, to produce three demos, and to create five lessons.

Things were going so well, in fact, Beth considered moving all of onboarding online.

That’s right about when COVID-19 spread through New Orleans, effectively shutting the city down for months and counting.

“All of a sudden, our only priority was deciding whether to keep Magnolia open or not,” Beth explains.

Magnolia and other physical therapy clinics were declared an “essential business” by the government, because physical therapy has an essential role in the post-surgery recovery of patients. After a surgery, physical therapy can help minimize scar tissue development and maximize flexibility and range of motion.

Beth recognized the integral part her practice plays in keeping patients from returning to overwhelmed emergency rooms, and her physical therapists took on that job bravely. They’ve welcomed patients into their clinics.

But many of Magnolia’s patients weren’t recovering from surgeries. Many see a physical therapist for important — but less urgent — matters. And a majority of patients are older, making them more susceptible to serious COVID-19 symptoms.

As a result, Beth says their practice lost 70% of its clientele. They had to lay off some of their employees and even close down one of their five clinics.

“We’ll need to find a way to do more with less,” Beth says, explaining how the company will look different at the end of the pandemic. “It’s an opportunity to find ways to be more efficient than we’ve ever been, and that’s exciting. But we’ve had to lose employees, and that’s a very sad part of all this.”

Getting Organized

After making the decision to stay open, Beth says the next step was to reevaluate their work and priorities.

“We had to decide what we wanted Magnolia Physical Therapy to look like moving forward,” she says, “and Align was essential to that work.”

Align showed the team was falling behind on their priorities, and at first, her leadership team would simply blame the pandemic. After years of adopting and instilling the Rockefeller Habits, it suddenly felt like Magnolia was running in place.

But Beth and Lisa had dealt with crises before, and they weren’t going to let this one derail them.

“I finally told them nobody’s allowed to use that excuse anymore,” she says.

With the help of their Petra coach, the co-owners led their team through each priority. They marked some with a “pause,” doubled-down on others they thought they could still achieve, and even created new priorities they had been waiting to address for years.

Magnolia has expanded their virtual physical therapy, for example. Beth says the in-person, hands-on work is a major part of what they do — and something patients really value — but she also believes a lot of the vital steps of their practice can take place virtually, as well, whether in one-on-one online sessions, or by more general videos they release.

“The biggest part of what we do is getting our patients to understand the value of the exercises that will help them heal,” she says. “That’s what makes the recovery stick, and we can help them with that without them coming to our clinic.”

Beth has also used this opportunity to build on her pre-COVID successes developing an online onboarding system.

“I’ve really put that priority on steroids now,” she says. “I was supposed to create five videos, but it’s working so well, I’ve expanded my priority in Align to make it 15.”

Building a Team

Staying organized and on the same page is more important than ever at a time when Coronavirus keeps us separated from many of our coworkers.

Beth chatted recently with her Chief Medical Officer, who said he felt scattered and was having a difficult time staying organized with all the pandemic-related changes.

What was Beth’s advice to him?

“I told him to put everything in Align! The bigger priorities, of course, but the smaller tasks, too.”

Beth admits she’s also had a tougher time than usual staying organized.

“The key for me is to have all of my priorities and tasks in one place, which gives me way more peace of mind than the sticky notes I used to use,” she says. “When I go to Align I can see everything I need to do — from that largest priority I’ve been putting off, to that email I forgot about.”

In fact, it’s been so helpful for Beth and her leadership team, that she’s recently decided to put every employee at Magnolia on the software. She’s already seeing much of the same benefits she saw with her leadership team.

By having everyone’s tasks and priorities on Align, the entire company is able to see what’s supposed to be happening on a given day. And that kind of transparency also creates accountability.

Not only can Beth, Lisa and managers see when an employee is letting a task fall behind, but fellow employees can see, as well.

“No one wants to fall behind on work,” Beth says, “but Align isn’t about the fear of being held accountable. It creates transparency that lets our organization react quickly and catch up, rather than fall further behind like we used to.”

Having the entire team on Align is also building increased engagement among Magnolia’s employees. Beth says that when the entire team can open up the software and see the organization is on-track with their priorities, it’s motivating and encouraging.

She says Align’s dashboard also allows employees to see how their individual tasks are aligned to even the organization’s largest priorities.

“When I give someone a task related to the online onboarding system we’re building,” she explains, “they can see how that task is essential to us doing something big.”

The platform also saves Beth — and all of Magnolia — a lot of time.

In the past, Beth says she may have emailed an employee asking how progress on a specific task is going. The employee would stop what they were doing and write back. This back-and-forth (which would probably continue past two correspondences) is one of dozens of such conversations that happen each day, taking up hours of time in a week.

With Align, communicating this way is no longer necessary. Beth can go into Align to see the status of a task, and if she still has a question, “there’s no reason to email, because I know I’ll see them in our 10-minute Huddle later that morning. I can just ask then. It saves so much time.”

Building a New Future

Beth believes Magnolia will emerge from this crisis more efficient than they’ve ever been. They’re already learning to do more with less, and — with the help of Align — that process is just getting started.

“Our therapists are healers of the body, but they’re also emotional support for our patients,” Beth explains. “Those who aren’t able to come into our facility miss it. That’s our motivation to learn how to connect and serve them in different ways than we have before.”

A lot of these new initiatives weren’t just thought up as a response to the Coronavirus pandemic. They’ve been ideas Beth, Lisa and their team have been thinking about for years, but haven’t had the opportunity to fully pursue.

With the help of Align, Magnolia Physical Therapy has been able to quickly reevaluate their priorities and pivot a unified and motivated organization to new goals that will continue to allow them to grow to scale.

“We’d be a much more scattered organization, and I think our team would be operating in the dark at a moment like this,” Beth says. “Align’s given us the capacity to communicate and innovate better in a time of crisis, and I think that’s making a big difference serving the patients who need us most.”