What to Wear to Work?

I remember way back when studying physiotherapy, it must have been third year when we went into clinical placements and I was assigned to St Vincent’s Hospital in Melbourne. I was so excited, not because I was finally being let-loose on unsuspecting patients, but because I got to wear a white coat.

No, not a coat. We had white lab coats for anatomy dissection and physiology labs since first year. This was a white jacket. It was like what my dentist wore – half length, button up front at the side which continued to the neckline. A proper medical, clinical, ‘I know stuff’ type of jacket. It must be like when med students are handed their first stethoscope to hang around their neck announcing them as a doctor.

The difference was that, once graduated, I never wore the white jacket again. Whereas medical students continue to wear a stethoscope for their entire medical career or until they become specialists. And not only in the wards, they wear their official ‘Doctor Scope’ to the café, to meetings, when driving home and even (while still students of course) on public transport. Just so they do not forget they are a doctor.

Apropos of that, I have been thinking of what physios wear when working in private practice. I have written about this before in relation to how you present yourself to clients, referrers, and staff as a function of what you expect to be paid. It is probably time to update that, but this article relates to the current pandemic situation.

Do you wear your street clothes while treating patients? Do you travel to the clinic, pick up a coffee, fuel the car, drop the kids at school and then start treating patients in the same clothing? Then return home via the supermarket, bottle shop, child minding facility and resume your domestic life in those same clothes? How does this fit with COVID level hygiene practice? Your hands might be clean due to repeated washing and sanitising, but how any times per day do you touch your clothing? And does your clothing contact patients or other equipment in the course of your work? Are you potentially bringing contamination from work into your home and family?

While not wanting to seem alarmist or paranoid, maybe it is time to consider separating our street clothes from our treatment clothes on the basis of hygiene or perceived hygiene.

A simple white jacket (or pastel blue or navy) over the top of street gear might be the simplest strategy. Wear it in the clinic for a day or so then launder (may need a few of them). Or a uniform that you change into on arrival and remove before departure from work. Or scrubs. Seriously, scrubs?

Scrubs are the new stethoscope. Wearing scrubs says, ‘I can save your life’. On the USA show ‘The Doctors’ the medicos wear scrubs to sit in a TV studio and discuss health issues. Physios working on the wards in many hospitals are now wearing scrubs. They come to work, change into these strikingly fashionable garments, do their day’s work, change out, bin them and head to the pub.

I am not advocating scrubs in a physio private practice, but then again – why not? They allow comfort and flexibility when moving from plinth to gym work and with clear branding (company) and name tagging they establish the professional role and associated behavioural expectations. Additionally, the time saved every morning when deciding what to wear would be considerable.

What you wear is up to where you work. It may be determined by climate, nature of the client base, image of the practice or simply historical habit. You may be instructed to meet a dress code standard, provided with a uniform, or just left to your own professional judgement. Now might be an opportune time to evaluate the role of your treatment clothes in the patient/therapist interface in terms of hygiene and protection for both you and the client. Don’t even start me on bandanas and footwear.

Strategy – more than a plan

Is a business plan enough?

Business plans are important tools for any owner, and in my role as a QIP practice surveyor I have seen many such plans – some brilliant and some in need of work. Not a lot of work, as most are pretty close to the mark and just need firmer time frames and outcome measures. But none of them was a strategic document. None projected a longer term vision of the business or demonstrated a purposeful system of achieving it. 


It has been said that strategy is more than a list of goals and actions to achieve them – more than a plan. Strategy is more deeply rooted in the DNA of the business, the owner and the organisation. It is the combination of behavioural patterns, customer management, competitive advantage and the philosophy of adding and delivering value.

Well, so say the academics in the field of strategy. Like Mintzberg who listed no fewer than ten ‘schools’ of strategy, or Sun Tzu (‘The Art of War’) whose work has been commandeered by business coaches and consultants often with good effect. And of course Michael Porter, a more recent guru who insists that strategy is focused on a unique mix of offerings that enhance competitive advantage.

If you would like to develop a strategy for your business that provides direction and perspective in turn generating a purposeful business plan, HR plan, marketing plan, earning plan and exit plan you will need two things. Firstly, an open mind toward how to analyse, structure and drive your business; and secondly, a day with me to guide you through the process.

Developing a strategic plan is not simple, nor is it absolutely necessary to have a narrow strategic focus. In fact, the best strategies are often flexible, responsive and able to adapt to changing circumstances. Too rigid a strategy can be counterproductive when the internal or external business environment shifts unexpectedly. 

That said, it is still useful to have a point on the horizon on which to navigate your progress.

Some can develop their own strategy in-house, using the collective knowledge and wisdom of the team. Others go outside and engage consultants or advisors to steer them. More often there is a blend of these two methods. The end result is the measure of success. Not the actual plan that is constructed, but the achievement of the milestones inherent in the plan that show you are making strategic progress.

Take a moment now to envision your ideal business in around five or so years. In your mind take a walk through and see the layout, talk to your team members and maybe your new business partner, get a feel of the culture of the organisation and the marketing signals given out by the quality of fittings, people and service. Write it down, distill the essence of the outcome you want, including your role, time commitment and investment in this business. Afterwards you can back track on the key elements and what needs to be in place in three years to enable the five year plan. Then what needs to be in place in one year, six months, next week. These steps are your key performance indicators of strategic success or need for adjustment.

How can I help?

Two of my workshops include strategic planning. One is an introduction as part of a multi-stream day. The second is a full day devoted to developing a strategic plan for your business.

Remarkable Practice

Three topics across a one day workshop: strategy, marketing and leadership. We look at fee setting strategies and other important starting points before moving onto the other two streams. Ideal for newcomers to private practice or those looking for a boost to their business enthusiasm.  Check the event list at www.redsok.com for when this event is next scheduled.

Remarkable Strategy

The aim for you at the end of this workshop is to have a strategic plan to enable your business to outperform in terms of market share and profitability.

My strategy is for you to leave the workshop with:

  • A clear understanding of how strategy arches over every business decision you make, service you deliver and product that you make.
  • Knowledge of where your specific competitive advantage lies and how to maximise it.
  • Ideas galore to transfer to your business plan to ensure your strategic intent is reflected in your activities and outcome measures.

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  • Examples of implementing strategy in your finance, HR, team building and leadership activities.
  • Finally, a renewed enthusiasm for your business and your ability to actively manage it to success.

Is all that possible in one day? Probably not, but you have to start somewhere.

Check the list of events at www.redsok.com to see where and when Remarkable Strategy is next hosted.

The Dangerous New Person on the Team

You’ve done it. You have seen the need for more talent in your team. You have taken the bold step of advertising or letting people know you are hiring. You have screened, interviewed, interviewed again, worried, calculated, negotiated a remuneration package and agreed on a start date. All done.

Except for the ticking time bomb that is the new hire.

For the past few weeks you have been focusing on your candidate. Now you are focused on the orientation process and setting up the workplace for the new person. Admin are sorting the payroll and appointment lists, other clinicians are making space in the office and fridge and some are having to reschedule their hours to fit around the hew hire.

Day One: orientation, light work load, problem solving and hovering by you (rightly) with all the attention on the new arrival. Introducing them to clients, referrers, work mates, baristas and other essential components of the business.  You monitor and provide feedback on a daily basis helping them get used to the way things are done around here. They feel special, important and vital to the enterprise.

Meanwhile your troops on the ground are curious, concerned and perhaps a little worried. They may welcome the additional help but it might also challenge their professional and personal comfort.

Change is generally uncomfortable, especially a change over which we have little influence. I remember being a young physio in a hospital department when a new hire arrived full of confidence, skills, post-grad training and I realised my place in the pecking order was up for resetting. It all worked out easily as the new physio was happy to acknowledge my ‘seniority’ and share her knowledge freely. But it doesn’t always work like this. I have seen situations where the new hire imposes his or her presence on the new workplace with little regard for other clinicians or admin staff, perhaps as an overcompensation for their own apprehension (in which case it can be down-trained) or just a personality trait reinforced by their recent success of getting the new job (harder to reconcile).

While you are busy with on-boarding the new hire, your existing staff are looking for signals of their status in the new line up. As many of them are human all it takes is some mindfulness on your part to include them in the bedding down process and reassure them publicly of their ongoing value.

  • As you introduce existing staff to the new hire, reinforce their importance and unique contribution to the clinic. Don’t be vague, be very specific regarding their special skills whether they be phone conversions, ability to sell products, consistent rebooking of clients, go-to person for difficult cases or whatever.
  • When finding physical or diary space for the new hire, try not to displace anyone else without them being part of the decision.
  • I find it useful to have a new clinician to spend an hour or so watching and listening at the reception desk to learn how complex and demanding this work-space is and also how things are done around here.
  • Utilise relevant skills in existing staff when on-boarding the new hire. Share the load and show how much you trust the team you already have in place.
  • In the first staff meeting after the new hire starts, be sure to recognise other staff members for their work rather than focus only on welcoming the newbie.

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Exciting times – a new staff member bringing new competencies and increased capacity. Don’t mess it up. No point welcoming one and alienating others.

The Numbers That Count – what happens next?

EOFY – End of Financial Year – a time for checking how your practice is traveling. The one time per year (for most of us) when we take an interest in the financial numbers of our business.

No longer a physical transfer, we deliver the electronic shoe box of invoices, bank statements, receipts, petty cash vouchers to our accountant where the alchemy occurs and columns of figures are produced which will mystically reveal our financial situation.

Well sort of.

Typically the financial reports will include a profit and loss statement, a balance sheet and a cash flow statement. These will form the basis for your company and personal taxation reports. Sadly they won’t tell you much about your financial future or the likely state of your business in three, six or twelve months.

The balance sheet will tell you about your debts and assets including cash holdings. The profit and loss will tell you how you arrived at this position, and the cash flow statement will inform you as whether you can afford to service your debts and finance your business growth. Or not. Mind you, most of as are only interested in the final number – how much tax is due and where can we find the cash we have allegedly accumulated to pay it.

These reports are historical in nature and necessary for financial compliance. However other numbers will be more useful for business planning and stability.

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There are some numbers hidden in your business data that may be more accurate lead indicators of future business growth than these financial compliance reports. You probably already record these numbers but may not be giving them the credit they deserve. And thus not allocating resources toward developing them.

For about five years I tried to measure as many variables in my physio practice as possible (much to the frustration of my long suffering staff). I measured attendance figures, referral patterns, satisfaction scores, cash flows, conversion rates, re-booking rates, medical record compliance, appointment saturation rates, work in progress indices plus many, many more. And then I looked for links, congruence and patterns. I analysed the raw scores and then indexed various scores against each other to search for hidden relationships. This search had a few goals but one was to identify key numbers that would predict ongoing work levels and thus cash flow and business growth.

I wish I could tell you I found a complex equation that I have trade marked and will sell you. But is was much simpler than that. And being a good bloke I am happy to save you five years of analysis and tell you the two of the critical numbers that best predicted how busy our clinic would be in the next three months or so. Not a long lead time, but it was a start.

Two simple numbers, easy to find, that correlated positively with appointment saturation rate and cash flow several months later.

It must be pointed out that for one of these numbers to operate as a lead indicator there is a condition to be met: the current number of treatments per episode of care must not decrease. Or if you are not in that type of industry, the current spend per customer encounter must not decrease.

So the two numbers:  here is the big reveal –

Firstly – the breadth of referrers. The more sources of new client/customer/patient referral on a consistent basis the more likely new work will continue to arrive. For most of us word of mouth referrals from satisfied clients is the best source and thus it is a constant for all practices and disregarded. But what about all the other sources of referrals? Not just medical but all sources. The more of these that are active the better your business is insulated from variations in any one or two of them. In other words, the less reliant you are on any single source. To qualify as a referrer the source must contribute at least two new clients per month.

Secondly – the number of new episodes of care commenced each week. These can be either new clients or previous clients returning for a different or recurring problem. This number depends on the number of clinicians in the clinic and you need to determine it for your own situation. As an example, when I had four physio and one massage therapy providers this number was 26 new episodes per week. Fewer than this number for a couple of weeks would result in a down turn in work about five or six weeks later. Knowing this gave me few weeks to crank up our internal marketing, ensure letters to referrers were up to date, put out a topical e-newsletter, review our return rates, remind staff of their KPIs in this area, schedule time off for me or one of the other physios in four weeks or so, or some other intervention that might arrest the decay or utilise the down-time.

These are just two of several really valuable numbers to monitor in your business. I share others in my various Practitioner Business Academy workshops but for the moment you have enough to work with.

All the best in your prosperity,

A/Prof. Craig Allingham APAM, MBA
Director, Practitioner Business Academy

Men’s Health Tip for Health Professionals


As a health professional there are two singularities when working with men that amuse and concern me. The first is their ability to understand all the good health messages (exercise, nutrition, sleep, etc) and the risks associated with non-compliance yet continue to engage in a fierce campaign of non-compliance. The second is their concept of what exactly comprises being healthy.

Taking the second one first, it seems to me that for a bloke, being healthy is simply the absence of death. As long as he can function in his life to some degree he sees himself as ‘in good health’. As demonstrated by the first response to the standard clinical interview question, ‘and how is your general health?’, to which he inevitably replies, ‘pretty good’. Only to reveal later (once rapport and confidence have been established) that he has type II diabetes, high blood pressure, sleep apnoea, two coronary bypasses, kidney disease and an unexplained tremor on movement. None of which have anything to do with health in his mind because he is still walking, breathing and working. The message for us is – don’t believe him! Dig deeper on health matters and try to get him to see how his current state is the end-game of his lifestyle decisions.

Back to the first issue on non-compliance. This is a second defense mechanism deployed by his male ego filter which may acknowledge at a cognitive level the links between lifestyle decisions and the prevalence of non-communicable diseases but seeks comfort in the fact that this only applies to other men. Every bloke believes he is outlying data – the exception, the maverick, the hero. Compliance is for those other men who are at risk, and as ‘I am not at risk I have no need to change my attitudes, thoughts and behaviours’. This is the blank canvas upon which we try to paint a treatment plan. Until the man acknowledges his risk he is not able to make vital changes. Note: acknowledges risk, not just understands it. Sometimes our job may include scaring the invincibility out of them to over-ride the ego filter defense. For example you could try this, ‘I had another client like you who did well for a while then it all went belly-up and his stroke left him totally disabled. If only he had done the exercises…….’. This line is best delivered while gazing into the distance over the client’s shoulder and gently shaking your head. Then pause, and make eye contact until he looks away.

The Huddle

American sports utilise the Huddle extensively: the action is interrupted by meetings of the participants to review and implement strategy. For example, in basketball there is the time out and in American football the quarterback calls a huddle pretty much before every play. In golf the player and caddie huddle all over the course. The business Huddle is an extension of this concept.

Key Points for Effective Huddles in the workplace:

  • Meetings are short, no more than 15 mins
  • Stand, don’t sit
  • Timing is up to you – first thing, or later in the morning when all are in. eg. 11.45am
  • Huddle is high priority
  • Everyone must speak. Who first? Vary it.
  • It is not an interrogation – it is a communication tool
  • Honesty is critical
  • Stick to facts not opinions
  • Huddle time is NOT for problem solving. Identifying yes, but not for solving
  • What to share:
  • Project updates
  • Client updates
  • Wins – celebrated
  • Roadblocks
  • Individual priorities for the day
  • What you achieved yesterday
  • Review couple of team or company metrics

 Not all these are part of every huddle, but the list provides examples to get it flowing

  • Problems identified are flagged for follow up meetings
  • Discussions are shut down – this is reporting only
  • Off site team members can join via skype – as it is NOT a discussion they can make their contribution and also hear from others

How do you know if Huddling is working for you? (Give it six months at least):

  • Your KPI metrics will improve: check them
  • Your team awareness of strategy and projects and how they fit together will improve
  • Your leadership will improve as you have a clearer grasp of all the elements
  • Stuff gets done on time, accurately and profitably

Post Holiday Desk

How did you feel arriving back to your work desk after the holiday break? Did the sight of it fill you with excitement for a clean start for the new year? Or were you confronted by the unfinished work of last year?

Client files waiting for discharge notes, letters to stakeholders, follow up calls, reports to insurers or a half completed file waiting for the most recent client encounter to be documented with all the accuracy a ten day break can generate.

I wise mentor once described to me the presence of ‘heart sink’ patients. These are the clients who when you see their name on the day list your heart sinks. I believe you can get the same lack of joy from a desk littered with unfinished and non-prioritised tasks.

To ensure you begin every year, month and week in a better frame of mind and clarity of purpose try this one sneaky trick – complete the paperwork as you work with the client. Simple but difficult, especially if your habit is to make cursory notes and fill in the details later. If you are an employee you are probably donating your private (unpaid) time to get this done. If you own the business you most certainly will be donating time that does not generate income. Neither is acceptable nor necessary.

For the details, I refer you to a post from 2010 (yes, you could have been doing it better for years). Click here for a short read that may gain you up to an extra one hour per working day.

5 Hints for Successfully Managing People

Human Resource Management evolved from personnel departments which were previously called common sense. However the gradual  disappearance of common sense from modern life has allowed a new professional body to arise who are experts in managing humans for improved performance.

My experience working at the pointy end of sports science and medicine for twenty years brought me into contact with coaches who are masters of this dark art and other who were technically skilled in their sport but could not bring it out in their teams or athletes.

So in an effort to short cut your learning process in Human Resource (people) management here are five key points to take on board.

  1. People generally don’t or won’t manage themselves. Never assume because a person (employee, partner, contractor, patient, referrer) is intelligent, conscious and cooperative that they will manage their efforts in any way to your advantage.  You will need to provide a structure and systems to ensure their performance is contributing to your goals as well as their own.
  2. Hire attitude over talent. It is much easier to teach skills than it is to teach personality. When looking for staff be very clear on the skills you are seeking and once the base line for those has been met turn your attention to which remaining candidate possesses the right balance of values, aptitude, attitude and capacity to deliver within your organisation.
  3. People don’t leave jobs, they leave people. The most common reason for loss of quality staff (the only ones you will miss) is some conflict or discomfort in the workplace. It may be a workmate or it might be you. Recognise the problem and if you can’t change the dynamic to the advantage of both parties one of them will leave. Be very clear who you want to keep and why.
  4. Workers contribute to their maximum when they feel valued. Not when they are valued, but when they FEEL valued. If the first acknowledgement of value appears in an employees departing reference it is way too late. Shame on you. Take the greatest care not to be so busy with your own tasks and roles such that you don’t see and remark on the ordinary efforts your team puts in day after day. And if there is an extra-ordinary effort CELEBRATE it in front of everyone.
  5. Money is rarely the strongest motivator for improved performance. There is no doubt money is important as we all need to meet our obligations, but  beyond a certain level more money won’t create engaged, motivated and high performance employees. A fair compensation package will bring adequate performance, but add some of Number 4 (above) and you will see a greater return from your human resources (people).

Across all professional disciplines that I have worked with (allied health, legal, finance, personal care) the common woe is how to manage the people in their business. How to recruit, train, manage, engage and dismiss the right people to ensure the business grows and the day to day worries are reduced. This is not easy, and it is not a skill business owners are trained in. But if you are interested in improving this area of your business I believe you will get great value from my workshop on herding cats. To find out if this workshop is scheduled soon go to www.redsok.com and check out the upcoming events column.

Why do they leave? This is a good place to work.

I was chatting with a respected, long term physio colleague recently and he pinned me with the question, ‘How long do you expect physios to stay?’ Meaning, what is a realistic expectation for professional staff turnover? I asked him some further questions and it seemed a more common problem with recent graduates (one, two or three years out of uni) and he told me he does exit interviews.

‘What do they reveal?, I asked. He indicated some move onto formal post-graduate study which necessitates leaving the area but the others seem to feel they have exhausted their learning opportunities at the current practice. One departing employee said, ‘I feel like I have learned all I can here, and need to move on.’  One reason she can move on easily is she had no ties to bind her geographically: no partner with a job nearby, no children in school or other family nearby.

We observed that recruiting staff a little further along their life journey provides some of these anchoring factors that aid retention, perhaps up to around 5 years as opposed to the 1-2 year expectation for the more recent graduates. I guess I felt that the curiosity and mobility of youth was a fact of life, probably not limited to physiotherapy and resiled myself to it being an unalterable tenet.

However, on further reflection this may not be the case, at least in all cases. Over the first year or so of being employed by an experienced colleague there is a steady knowledge transfer from senior to junior. This tends to be intense at first and gradually tapers as the lessons are passed on. There may reach a point of equilibrium where the teacher runs out of new material and the learner has the skills and knowledge close to that of the teacher; and being hungry for more, starts to look elsewhere.

What can be done to encourage a longer tenure in such a situation? Perhaps we need to be counter-intuitive and reverse the roles somewhat, helping the learner become the teacher and the teacher open their mind to the learner.

Lovely words – what does it mean?  I distinctly recall having talented employees who could have taught me much but my ego and inflexibility blinded me to this opportunity. They were ready and able to teach, but I was unready or unwilling to learn.

Developing talent is a wasted process if once developed it is not deployed where it can make the greatest contribution. In our mini-case-study, what may have eventuated if the physiotherapist who had filled her learning quota had been asked to take over the development of staff for a year or so? Including the principal. Not by re-teaching the same stuff, but by adding from her unique knowledge and experience base, by bringing in new information to the organisation, by developing leadership and development skills in her role and by being rewarded for this contribution.

Sure, she may still leave even after this extension of her role (and tenure), but she would be leaving a more enriched organisation behind and leave as a more accomplished practitioner and employee. She would also have contributed to the training of those who followed her.

As employers we often see how much we give to our teams and resent any feelings of not being repaid by output, loyalty or even simple thanks. Step back, stop giving for a while, and ask what you might receive if you realised everyone has something to teach. Have you ever asked your reception staff how they ‘read’ clients?  Asked them to explain how they manage to multitask with phones, computers, people, money, files, letters, reports and the rest? Or asked your cleaning staff how they know when they have done a good job? Or your professional staff what skills and knowledge they may have that can be adding value to the organisational goals or client outcomes? In order, these represent customer service skills, time/task management skills, self-managing team skills and self-knowledge/development skills.

The answers to such questions may surprise you (as much as being asked may surprise them!) and potentially restless staff may even stick around to see if you have learned anything from them and are prepared to put it into practice. Who knows, you may discover your eventual replacement and they may discover a career path.


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Strategic Learning – Do You Have a PD Plan?

I recall in my early days of practicing, I pretty much did every PD course available. Which was not difficult and probably only took three or four weekends per year. My how times have changed, you could fill every weekend now if you set your mind to it.

We are spoiled for choice with a huge range of professional development opportunities advertised every month. So how do we select what is most appropriate for each of us?

Do you go for new topics? Or base your selection on the presenter? Are some topics fashionable (think dry needling or fascial planes)? Each course involves significant outlay in terms of cash, time and energy so it makes sense to select wisely.

Your workmates or employers can offer guidance based on your current role or aspirations, but it is based on their opinion of what you need or what you can bring to the workplace. But is it the right fit for you?

Strategic Learning is a practice of aligning your professional development with a longer term strategy of where you want your career to go. Or at least to give you the tools to respond to career opportunities that may arise.

To be strategic, you must first have a strategy. To have a strategy you must have some overarching idea of where you and your career are going. The old ‘where do you see yourself in five years’ type of exercise. Or ten years. This is a difficult exercise to do on your own without input and challenging from a trusted mentor or panel of advisers.

I like the option of reverse engineering a strategy by starting with the end in mind, asking ‘What would be my ideal job at the time of my retirerement?’ and back track a strategic course from that end point. Like any good strategy it can be modified and adapted as the career landscape changes.

Once you have developed your strategy you can then evaluate PD opportunities based on how they align with your path. Do they add knowledge, skills, networks, contacts or connections to advance your strategy? When you see an event advertised ask yourself these three questions:

  1.     Will this event contribute toward my long term professional pathway?
  2.     Will this event deliver skills to improve my understanding or performance in my current role?
  3.     Will this event enrich me as a person?

The event should get at least one tick, if it gets more than one it is starting to look like a good investment. Three ticks and it is a ‘must do’. If you are not certain from the advertisement you should contact the provider and seek further specific information to make a considered choice.

Still going ahead? Great, now there are two more questions –

  1.     Can I afford to attend?
  2.     Can I afford NOT to attend?

The first one relates to resources (money, time, logistics) and is a totally practical decision. The second is a more important consideration in terms of the cost of not pursuing your strategy. If you have a strategy and the event is well aligned you are retarding your plans if you don’t attend.

As a provider of professional development I have a vested interest in you as a potential client. In my experience the best teaching happens when the learner is truly engaged in the topic, the process and the long term outcomes of the knowledge exchange.

Think carefully when evaluating PD options. Understand your long term strategy not just short term needs. Plan your learning to align with where you want to arrive rather than where you starting from and you won’t go far wrong.