It Takes Heart
It Takes Heart is an unmissable podcast where healthcare workers share their honest and unique experiences from Australia’s frontline.
Discover real-life stories of passion and purpose, insight and inspiration from people on the inside and tales that are equal parts heart-warming, heart-wrenching and hilarious. It Takes Heart is co-hosted by cmr | Cornerstone Medical Recruitment CEO Samantha Miklos and Head of Talent and Employer Branding Kate Coomber.
It Takes Heart
Surviving NDIS Changes with My Therapy Crew’s Judy Scott
When the government announced sudden changes to the NDIS with only weeks’ notice, allied health business owners across Australia were thrown into crisis mode. For Judy Scott, occupational therapist and founder of My Therapy Crew, it meant pivoting her business while staying true to the values-led culture she’s nurtured over years of practice.
From starting out in a converted garage after redundancy, Judy has grown My Therapy Crew into a thriving multidisciplinary service with more than 80 staff. In this episode, she shares what the recent policy shifts mean for providers and clients alike – from systemic frustrations that place paperwork over people, to the ripple effects already being felt across the sector with closures, redundancies, and surging referrals to those still able to deliver care.
This episode is for anyone wanting to understand the human impact of NDIS reform, for clinicians navigating a rapidly changing system, and for leaders committed to building healthcare services that balance purpose with sustainability.
It Takes Heart is hosted by cmr CEO Sam Miklos, alongside Head of Talent and Employer Branding, Kate Coomber.
We Care; Music by Waveney Yasso
More about Judy's Organisations of Choice, The Christmas Party Darwin
The Christmas Parties are Australia’s largest events for children with disabilities and complex needs, with the Darwin Party giving up to 1,200 children from Darwin and surrounds the chance to experience the magic of Christmas in a safe, inclusive setting. Free and invitation-only, the event lets kids aged birth to twelve set aside therapies and treatments for a few hours to simply have fun, surrounded by a community wider than their family and carers.
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Follow @ittakesheartpodcast on Instagram, @cmr | Cornerstone Medical Recruitment on Linked In, @cornerstonemedicalrec on TikTok and @CornerstoneMedicalRecruitment on Facebook.
There's been big changes to the NDIS recently, but what is the real impact that these changes are having on allied health businesses across Australia?
Judy Scott:They've made cuts to what allied health providers can charge and it only dropped two and a half weeks before the changes had to be implemented. So as business owners like every single allied health business owner has been frantic, it's pretty astronomical.
Kate Coomber:To hear more of these important conversations, don't forget to hit the follow or subscribe button. And don't forget to follow us over on Instagram for all the behind the scenes fun.
Samantha Miklos:Okay, so today we are joined by Judy Scott, occupational therapist and founder of my Therapy Crew and a strong voice for allied health professionals. Welcome Judy to. It Takes Heart. Thank you.
Judy Scott:I'm so glad to be here with you both.
Samantha Miklos:And I'm kind of excited to have you here because you're our first OT, which is strange, actually.
Kate Coomber:Yes, Apologies to OT, because that's an oversight. I know right, we are the best professions.
Judy Scott:I can't believe you've left us till now.
Samantha Miklos:And the fact that we've, in the first five minutes, we're connected to so many OTs as well, and we've worked with you in the past as well. So there's all these connections with OT.
Kate Coomber:But you trained as an OT. I did not. So for me and for everyone else, what is an OT? What is occupational therapy?
Samantha Miklos:Because don't you think that is like no one ever knows?
Judy Scott:what they do.
Samantha Miklos:Yes and I remember starting the degree and thinking I still don't get it.
Judy Scott:Yeah, 100%. Do you know the start of our degree? We actually spend the first six months learning to define occupational therapy, really.
Samantha Miklos:I must have missed those lessons.
Kate Coomber:I was like you could have been helpful.
Samantha Miklos:I should have stayed on a bit longer, yeah well, I promise you did it.
Judy Scott:Yeah, yeah, I promise you did it. And even like our new grads, I've been asking them and they still do that the first six months of the degree, because we're still so poorly understood. I think if I was naming the profession even though this is super wordy I would call us activities of daily living therapists, because the way we use the word occupation is that it's every activity of daily living that you might do and we're looking to facilitate independence and quality of life. So we want to make sure that whatever you want to do whether it's, you know, eating a meal, sitting in a chair, going out, driving, whatever it is that you can do that as independently and safely as possible. And we look at like sometimes we use, you know, alternative strategies or equipment items to do that. Sometimes we change the environment. So there's heaps and heaps of ways that we facilitate independence. So I guess that's across lots of settings I was just gonna say do you think?
Kate Coomber:you know, I guess I probably first learned about ot was having children and, yes, schools mentioned at once. Yeah, how does that work, you know? So it, yeah, there must be lots of settings.
Judy Scott:There's heaps of places ots can work. It's so, so broad, which is part of what I think makes the profession great, because you can move like you might start in paediatrics with kids and not really enjoy that, and so you could go into a work rehab type role, which is completely different. They even have OTs working out with people in the mines, like it's everywhere. Heaps and heaps of different sectors, so pa, pediatrics, aged care, hospitals, just it's everywhere. Most people, though, won't need an OT unless they've got something significant going on, except for, say, kids doing handwriting, which is the classic where that's like the gateway drug to OT.
Samantha Miklos:You've got a kid who needs help with handwriting. I love it. Why did you want to become an occupational therapist? You're so passionate about it? Yes, I love it. Why did you want to become an occupational therapist? You're so passionate about it? Yes, I love it. Did you go?
Judy Scott:straight into OT. I'm really lucky because, yeah, I did figure it out when I was in high school that that's the one that I would do and, weirdly, one of my friend's siblings was studying OT. So that's sort of how I heard about it. But before that, really interestingly. So I knew I wanted to work in healthcare but I just I didn't know which way I was going to go.
Kate Coomber:I looked at social work was kind of talked out of that. Looked at psychology talked out of that wasn't fit enough. Did you have influence around you? Who worked in health care that made you want to work in health care?
Judy Scott:Do you know, really unusually, no one, not really in my immediate family. My auntie was a nurse and my cousin, who was older than me, was doing social work, but that was kind of it. So I didn't really understand this draw inside of me to go into health care. I sort of worked that out later in life as to how I landed there. Yeah, naturally nurturing yeah.
Kate Coomber:I think yeah what was it?
Samantha Miklos:what was? That, that happened to you.
Judy Scott:Like I am naturally nurturing. But the origin story for me really is that I grew up with a mum who was extremely unwell. So my mum had chronic migraines, and this isn't just where you feel a bit sick, like she couldn't work, she was in bed half the week. Our whole family structure was around my mum and, like mum's migraines, I wouldn't know until I got home from school whether or not she was having a good day or a bad day, and so as I would walk in the driveway I could tell that the blinds were down, so I knew mum's in bed, blinds up, mum's up. But I only worked this out like through years of therapy. It's so funny because I love my mum. I was, so you know, defensive and protective of her and I never really wanted to acknowledge that her being sick had had an impact on my life. And so it was, as I was getting counselling I'm a big advocate for counselling too Like go get some therapy get some help, but it was also your standard right.
Kate Coomber:It was your normal, so you didn't know any different.
Judy Scott:That's exactly right To know that it wasn't typical, definitely Like when you grow up. Whatever environment we grow up in, it's normal for us. Yeah, but yeah, that was going through counselling helped me figure out. Oh, it's actually because I was caring for my mum. I was a young carer, yeah, and that's how I ended up being a healthcare professional yeah.
Samantha Miklos:is there anything now, years on being in OT, that that you think is just misunderstood? Or you think I wish people knew that, I wish I'd known that at uni about being in OT?
Judy Scott:How, just how incredible it is like the difference that you can make in people's lives. Like I think when you go into uni you sort of have this a bit of hope, like oh yep, I'm going to be a health professional, I'm going to be doing something meaningful.
Judy Scott:But actually, particularly in the type of field I'm in, I'm in complex disability you're I get to journey with people through years, like I get to know their families, like I don't know their friends, uncle, like just so many people in their lives, and so it's like you actually become a part of their own, their fabric, yeah, of who they are, um, and that's. It's such a privilege, yeah that's. I didn't really understand just how significant that was the relationships.
Kate Coomber:How did you get to there then? If you didn't understand that, that would be the scope, why? Did you specialise In complex disability, in complex disability, yeah.
Judy Scott:Yeah. Yeah, that's an interesting one too, because again at uni I didn't know what part of OT I wanted to do. I didn't think I wanted to do disability, but you have to do placements. So back when I went through we did four seven-week placements. It's a bit different now, oh is it different now? Yeah, they only do two 10-week placements.
Kate Coomber:Oh wow, yeah, it's really different. There were so many. It minimises the exposure right of different settings.
Judy Scott:And that was also hard too, because there were so many things you could do, but you were limited to just have a little slice of some of those experiences, and everyone wanted paediatrics. Yes, I know it's so strange. I think, though, that's because so we, sam and I, went through the same uni, just different times. I think that's because our head of OT at the time was a paediatric yeah, person, that's why yeah, because it's changed since then a little bit yeah yeah, but anyway we did four placements.
Judy Scott:I did not list disability like on my placement options at all, didn't want to do it um, had more of an interest in, you know, pediatrics and I was like pediatrics occupational rehab.
Samantha Miklos:Yeah, um, I did oncology really, yeah, I really enjoy. I actually really loved working in that when I did did go out and work, it was a combined role of palliative care and pediatrics. That is so fascinating. Yeah, I loved the two ends. I don't know?
Judy Scott:Yeah, interesting, whereas I did two hospital placements out of my four and I hated them, did you, yep?
Samantha Miklos:Isn't that weird.
Kate Coomber:What did you hate?
Judy Scott:about them. To be honest, I had a really I had a bit of a tricky relationship with my first supervisor and it's amazing how much they call it clinical educator now. Amazing how much your clinical educator impacts your experience.
Samantha Miklos:That's very true because my first one was impalliative and she was so amazing and I just I idolised her, yeah.
Judy Scott:Yeah Well, similarly then, my disability placement, which is a placement I didn't want. I adored my clinical educator.
Samantha Miklos:So you end up sorry, we keep jumping. You ended up getting there.
Judy Scott:Yeah, I got a placement there and then loved my clinical educator and then fell in love with the type of work where you actually get to know whole families and stakeholder groups and so, yeah, I got a job from uni in DSQ Disability Services Queensland and I was there for 15 years until I got made redundant. So, yeah, it was amazing, I loved it.
Samantha Miklos:So let's talk about my Therapy Crew, is that?
Kate Coomber:how my Therapy Crew started. Because you started just at home in the garage.
Samantha Miklos:Yeah, I loved when I heard that.
Judy Scott:Yeah, isn't that how every small business?
Samantha Miklos:starts. Yeah, I was in a front room.
Kate Coomber:However, yes, but you weren't seeing patients coming in.
Samantha Miklos:No, I did have that thought just then. I was like, oh, they're going to the garage.
Kate Coomber:It was so insane.
Judy Scott:Look, and when I say that our garage, we got it converted beautifully. My friend happens to be a builder and she did a beautiful job converting our garage into a home office for me, so it looked nice. But yeah, it was the garage.
Samantha Miklos:It's a garage, yeah, which is pretty crazy.
Judy Scott:So had you been made redundant.
Samantha Miklos:Yes, or had this always been ruminating for you?
Judy Scott:No, okay. So I loved my work in Disability Services Queensland and then we all had warning for about three years we were going to be made redundant. That's a really weird way to work like to have a three-year long date.
Samantha Miklos:It's like I'm going to break up with you soon, but not yet. But just wait, just hang in there.
Judy Scott:It was very strange but it was because I loved my job. It was worth it to me to stick it out to the end Like people kind of peeled off as we went, but for me I stayed, you know, until the redundancies came out and redundancies came out and then the only way at that time because OT wasn't the world that it is now where now, there's OTs are just in high demand and can go get a job anywhere.
Judy Scott:That didn't exist yet then, and the only way that I knew that I could keep working with the client group that I loved was to work for myself, and we didn't have anything like non-competes because the government was winding up, so there was no nothing saying you can't work with your clients, because there was nowhere for these clients to go, and I was well known in the industry in Southside Brisbane because that's where I'd been working for 15 years. Yeah, so I had heaps of people who were like my clients, who were looking for a service, and so, yeah, it got made redundant, went on a week long cruise with my family and then came back and it was amazing. I came back to so many emails and messages and requests, and requests.
Kate Coomber:And where are you? Yeah, for work.
Judy Scott:So, yeah, it was a really crazy time. So, yeah, I worked for myself. I mostly I tried to go out to clients because of the fact that it was at my home and did you have kids running around the house?
Judy Scott:Yes, like what phase of life was this, oh my goodness, Because it's a few years ago now. So my kids were. My oldest is now 19. But she, when we started the business she was 14. But I was working for myself before that, so you know they were between 8 and 13,. My kids I've got four of them.
Kate Coomber:Yeah, Sorry, that was a reaction, so busy I've got that reaction.
Samantha Miklos:No, beautiful, are you okay? Oh, my God, I feel like three. I'm so outnumbered, I'm like forever. Like if everyone's got shoes on, it's a win. Yes, oh yeah, yeah.
Judy Scott:It's absolutely a win when everyone's got shoes on. But yeah, it was crazy. So I would have clients come into the home. I'd use my rumpus room as a therapy space. It was crazy, and then, as the business grew because we actually started in the house, so I had other therapists coming into the house. How soon did you bring your first therapist in? I worked for myself on my own for A year and doing some subcontracting as well, yeah, but yeah, working on my own for a year. And then my husband is an accountant and he specialises in small business accounting. That's convenient.
Samantha Miklos:Yeah, Like mine, he does IT and systems. I was going to say it's so similar that you're the opposite. You can do all the things I can't do.
Judy Scott:Yeah, he is phenomenal, yeah. And so he kept saying to me like I think you can, I think we can build a business from this. Yeah, you should really seriously consider employing someone. And I was terrified of the idea. I still remember the first phone call with someone who actually was an allied health assistant so not an OT for the first employee and phoning to him and talking about things like salary, where I just had no clue.
Samantha Miklos:I had to do that with you. I was like I don't even have a desk for you.
Judy Scott:I don't know, I don't know what to do with you. He's like I'll come.
Samantha Miklos:I was like I don't know what to do.
Judy Scott:Yeah, well, it's exactly like that. So I just set up a desk for him in my and you're a clinician.
Kate Coomber:Yeah.
Judy Scott:So you're passionate about the clients and the caseloads? Yeah yeah, and had his desk there and then would go out and see clients, which I'd write up the allied health assistant plan for him and he'd go see them and then I did a post. It's so funny. My sister used to tease me because we used to be called my OT Crew and so, yeah, that's where we started from. And I had a page, my OT Crew, and she would just joke with me. She's like what your crew of one person Back when it was me.
Samantha Miklos:Oh, all right, it's a vision.
Judy Scott:Exactly.
Kate Coomber:I can choose a crew.
Judy Scott:Yeah, and I did a post and then one of my uni friends reached out to me and she's like, hey, I want to know a bit about private practice. And I was like thinking she wanted me to tell her how to run a private practice. And she's like, no, I want to work for you. And I could not, could not believe it in my wildest dreams that someone from my cohort would trust me, trust me enough to. They left a government job.
Kate Coomber:Yeah, to come and work for them. Yeah, and let me employ them.
Judy Scott:But then that started a whole new journey of figuring out how to do contracts. And, oh my goodness, what do you?
Kate Coomber:think it was that people saw in you to go yeah, I want to be a part of that.
Judy Scott:I'm naturally really passionate about the work that we do, like I, I just love the clients so much, you know, and I think they deserve quality services, so it's probably just that.
Kate Coomber:Is it word of mouth? Or were you very heavily on socials Like, how were you getting that message out? How was everyone finding you it?
Judy Scott:was the whole. First three years of the business was just word of mouth. So my first year working on my own and three years of the business, so four years altogether. We didn't pay a cent for marketing or anything. Then we got too big to kind of keep carrying Like by then, you know, I can't even remember we probably had 30 therapists at that point because we've had our biggest growth in the last two years. But yeah, then we had to start, you know, spending money on the Google.
Samantha Miklos:Gods, yeah, seo all of that sort of stuff, you run on the smell of an oily rag to start with, and then it gets to the point where you're like, right, we actually have to really lean in now and do some more. So today is it like 80 staff or something now Yep, Yep we've got just so many.
Kate Coomber:Over how many clinics? Yeah, how many clinics. And where are you? Are you still in the garage, are you still at home or have you now got a house?
Samantha Miklos:running around. Can you imagine if I had 80 people in my house?
Judy Scott:I'm like should we notify the council? Yeah, so we have 80 staff, we're just over and we've got five clinics now, which is pretty amazing All in Brisbane. No, so we've got two to three are in Brisbane, because we've got two Brisbane Southside and then our Brisbane North is all the way up at North Lakes, so it's kind of that gateway like up to Caboolture as well. And then we have the Sunshine Coast and we actually have a clinic in Darwin. Wow, yeah, I've got a few OTs over there.
Samantha Miklos:How did that happen? I was just about to say how did you get to Darwin?
Judy Scott:Yeah, so I'm with us with starting the business with having. So we moved from the house to a big clinic, which was wild in itself.
Samantha Miklos:Yeah, that would have been a really special moment.
Judy Scott:So crazy. So we were up to 14 staff when we were in the house, which is crazy. Just FYI, I didn't know that that was against Brisbane City Council regulations.
Samantha Miklos:I found that out after Just about to say that yeah, I found that out after she stood out to say that, yeah, I didn't know I was up in the kitchen.
Judy Scott:Yeah, details, details, do you?
Samantha Miklos:know what, though? That's interesting, though, because when you do start a business, you've been a clinician and then all of a sudden, you're running a private practice, that's right, it's a baptism of fire and you sometimes fake it until you make it.
Judy Scott:Yep. No one told me I had no idea.
Samantha Miklos:And then, thankfully, surely the neighbours were like what is going on? And then, if you're in and out seeing clients like there's watching cars yeah well, there were cars everywhere, kids.
Kate Coomber:They're just like you know add a few friends, a couple of nannies. They're just used to a lot of people.
Judy Scott:Yeah, our neighbours did work and everything, but we did actually it's so ironic, we moved into the clinic the first clinic and we got a letter in the mail that week from Brisbane City Council saying are you running a business from home?
Judy Scott:No, I am not. Yeah, so big clinic. And then a couple of years ago we had outgrown that and didn't know kind of what to do. We're considering how do we do this because, as the business owner, when I'm so invested and I love you know, love what we do so much I didn't know kind of what to do. We're considering how do we do this Because, as the business owner, when I'm so invested and I love you know, love what we do so much, I didn't know if our beautiful culture would translate over a second site.
Judy Scott:So we tested it out with a small site to start with to see how that went. And then, only a few months later, interestingly, I had a phone call from my mentor and she was just in a position where she needed to stop running her own business and she had about 10 clinics and she asked me if we'd consider buying three of them and what we decided to do. Like sometimes people do that and they keep the original branding. We didn't want to do that. We wanted to fully merge them into my Therapy Crew to make them our brand. To make them our brand Now, like those sites. That was only a year ago now, and those sites have grown so much that there's only you know there's a few original staff members. Most of them have stayed, which has been awesome, but, yeah, they've all been indoctrinated into the MTC way.
Samantha Miklos:Yeah, Talk to us about that. Like the way, like culture seems to be really important to you. That's always been something we've talked about is like different sites, and how do you keep that? What is your culture?
Judy Scott:and what do you do?
Samantha Miklos:to foster that.
Judy Scott:Yeah, so we have really strong vision and values. Anyone who works for us could quote them for you and explain how we live them out. And so our four values are always learning, dependable, contributing and nurturing what we tried to do, because Matt and and I that's my husband um, we love the business so much. As I've said, they, those four values, are really us on paper, like our kids could tell you that they're kind of the blending of our four styles, our styles together, into those four values. Um, and what I found is that if you live out rituals and routines that are connected to the values across all of the sites, then that's how you translate that culture yeah yeah.
Judy Scott:So all of the sites like they've got a little bit of their own flavor, but they would all be able to testify to those values. So we have in-house professional development in every single site once a fortnight. You know things like that. We have one of our ways of nurturing is we put on a weekly lunch for all of our staff. So every single site once a fortnight. You know things like that. We have one of our ways of nurturing is we put on a weekly lunch for all of our staff. So every single site. That means I'm catering 80 lunches a week.
Kate Coomber:Wow, I imagine that's pretty rare in health for someone to have that sort of environment, not even health like other businesses, right, or any business really. It's all that stuff that people go.
Judy Scott:Oh, it's too costly or what's the value in it, but it's those memorable moments. That's it. Well, it's because for me and I know this sounds so altruistic, but it's just part of who I am and who my husband is Like we really want to create a beautiful place for people to work, and that's why we invest in this way. Yeah, I want their memories of their time with us to be that we made a positive impact on them, that my therapy crew made a positive impact on them. Yeah, that's what we're going for.
Samantha Miklos:Yeah, so learning, I was thinking that, and lunches, what else? What are some other great things you do?
Judy Scott:Yeah, we have very consistent supervision. So in occupational therapy, clinical supervision is really important and we have experienced therapists.
Samantha Miklos:Sorry, we're not just OTs now, I was just going to say yeah, I was just going to say Tell me, I know there are uni students now coming out and doing placement with you.
Kate Coomber:Yeah, I mean like that's full circle. Hey, it's not 80 OTs.
Judy Scott:No, it's not Sorry, I neglected kind of that step along the way.
Samantha Miklos:That's all right.
Judy Scott:Talk us through. We have physios and speech pathologists, we have a music therapist, we have behaviour support practitioners and we have allied health assistants and then a really big administrative team. So all of those conversations as well at the start were so big. The first physio that I hired like he was somebody that I knew. I didn't know him well, but I knew him enough to have a conversation, because you've got to be really brave to be the first of your discipline to come in when it's you know, so heavily OT based.
Judy Scott:But yeah, he's done a phenomenal job of growing our physio department. And then same with the first speechy. She was somebody I worked with back at DSQ and she was brave enough to come over and be my first speechy and pave the way our music therapist actually did a placement with us, even though we didn't have any music therapists. Because that's part of how their degree works they have to do a placement in a place which doesn't have music therapy, right.
Kate Coomber:And to try and create something and have a thought of where could I fit? Yeah, absolutely and add value. Yeah.
Judy Scott:So then over time we've now run new graduate programs three years in a row, because I think we've got such great clinicians and. I want to keep feeding into our professions.
Samantha Miklos:Yeah, and that graduate year is so key, like if they've got great mentors if they're with a great team like that's what keeps them really sticky to the profession. Whereas I think, if it's not a great first year, that's where they're gone.
Kate Coomber:Yeah, and are people still choosing OT, like in the same levels that they were? Is it growing? Is it declining? Where is the you know people going into?
Judy Scott:it. It is so much bigger than it was when I studied. Yeah, wow, Like when Sam and I went through. It's like we had 90 people.
Samantha Miklos:I was just going to say we had 90 people in the year. I went through Really.
Judy Scott:Now there's like 10 unis that do it in southeast Queensland or something like that, whereas before it was on the UQ.
Samantha Miklos:Why is there such a? You said earlier like there's such high demand for OTs. Now why? What's different?
Judy Scott:Yeah. So I think it's because, as OT has evolved and people can see, because it's so broad and you can see the real-life application of OT in all these different spaces, it's just it's naturally been in demand. One thing that's definitely driven it is the if you've heard of the NDIS- yeah. Yeah, that's been a big driver in OT because a lot of the NDIS decisions are based off occupational therapy reports.
Kate Coomber:Right, so talk us through NDIS. What is it? How does it interact, I guess, with you and your business?
Judy Scott:Yeah, so what's the role?
Kate Coomber:of the NDIA.
Samantha Miklos:What does it stand for All the people? My mum's listening right now like educator.
Judy Scott:Yeah, I would love to. So we always talk about the NDIS, but there's two different things. So there's the NDIA National Disability Insurance Agency, and that's actually the public service department. Those are like the government workers. And then we commonly just say the NDIS National Disability Insurance Scheme, but the scheme is actually the dollars. It's the money behind it.
Judy Scott:But everyone's just so used to just saying the NDIS. Really, it's the NDIA that we interact with, if that makes sense. Yeah, that's interesting. Yeah, so what they did back when I was in Disability Services Queensland, all of the services for people with disability were run by the states, so every state had a different system. If you worked for the equivalent of DSQ down in New South Wales, you actually tended to work more with people with physical disabilities. In DSQ in Queensland, we worked with people with intellectual disabilities and you had to have an IQ rating of less than 65 to be eligible, so there were heaps of barriers for people getting services. So what they decided to do and they wanted to make it more uniform across all of the country is they reabsorbed all of the state funding back into federal, which is why we were all made redundant, because they had to pull that money back and then they popped it into federal and then spit out this scheme that is supposed to support people with disabilities any kind of disability all around the country, Right?
Kate Coomber:So was that a good thing at the time. Yeah, or how was it? Yeah, was it received? Well, problematic Such a complicated question.
Samantha Miklos:I was just about to say that from your face.
Judy Scott:I was like yeah, it's so complicated because, yes, in principle, yes, it's a good thing, absolutely. So many more people are eligible for services now. We in the state government it was so difficult because there were people that would like only just miss out on being eligible for a service for us and if there was no non-government option for them, they just wouldn't get a service, like they wouldn't receive support and help.
Kate Coomber:And so is this about people being able to pay for the service or even accessing, if they chose to fund it themselves. Was that an option, or this is even to be acknowledged in the service?
Judy Scott:So anyone can pay for services like our business, for instance. We would see anyone. But even back then, back then there weren't really private services, so like there might have been small therapy companies or people would go see physios like physios, have always seen mainstream provided, mainstream services. But you know it would just be like a mum who wanted to get assistance for handwriting for their kid yeah, it wasn't, wasn't the way it is now.
Judy Scott:Um, really, the ndis provides funding for people to receive services and they had their own plans. So where before in state government it was block funded. So I was attached to a house. I was the OT for a region, right? Yeah depending on what team I was in. Yeah, so, if you were in this region. You had no choice about the matter. Judy Scott was your OT. Yeah, you know Whereas now people get their own funding plans and they choose where they get their services from. Right, okay.
Samantha Miklos:So has that lifted the quality of services too, because people are opting to choose their provider? Yeah, I think so.
Judy Scott:It definitely relies on the provider having strong ethics, which I'm proud to say we do. We want to provide a good service. We want quality clinicians, which is why we invest so much in professional development and supervision. Because I want to be confident, it's one of my career objectives to provide quality clinical services to people with a disability.
Judy Scott:So I want to be sure that the therapists I'm sending out who are representing MTC are doing a great job. But, yeah, it's just totally transformed the system. So, even more than just making us provide better services, it's just completely different, because now you have all of these private practices all around the place.
Samantha Miklos:Yeah, so there's a lot of private practice that has evolved and popped up in recent years.
Judy Scott:Like in the five years we've been in business and you know the seven years since NDIS came in astronomical growth.
Judy Scott:Like so some providers were out there before, but because the services like back when I started working on my own, even I had so many referrals, like I was just working all the time because I was the person taking the phone call from somebody and and I love people with disabilities, so I couldn't say no, so I just would work, you know, endless hours because I wanted to fulfill this need. So it's just been astronomical. And then, with the way the NDIS works in, they brought in these things called functional capacity assessments which OTs write, and then they kind of it's like they legislated it like you have to have a current FCA to be able to you know if you need a change in housing in the NDIS.
Samantha Miklos:So there's all of these, all this work yeah, just heaps and heaps of work but then has there been some changes though to the NDIS recently?
Judy Scott:yes, what are those changes?
Samantha Miklos:and what do?
Judy Scott:they mean Was it broken or?
Judy Scott:Well, I think what people see, and it's fair is that the NDIS it does cost the Australian taxpayer a lot of money, you know, and I appreciate that. So they decided to try and reduce the cost to the taxpayer. But the focus that they've taken is they've actually they've made cuts to what allied health providers can charge. This has a massive impact on the allied health industry. So what they did is, they said, for travel, when you're travelling to a client, you can now only charge half your normal rate In our type of work. When you're working with people with complex disabilities, we have to travel to their homes. Yes, we have five clinics, our clinics are beautiful, we have some clients who can come in, but for many, many clients, that's just not the way they can receive services.
Kate Coomber:And what do you think is the idea behind that? It's a very specific cut, isn't it? Of travel? Yeah, Is it just an idea to help with funding?
Judy Scott:Honestly, what I have heard is it's like somebody just threw that around as an idea in the room, it almost feels like the reverse is needed because they can't access Absolutely. Yeah, and in the NDIS all of their online stuff that you can research yourself they actually acknowledge that therapy in the natural environment is best for people.
Judy Scott:So it's ironic because they say this in one way, but then they tell us yeah, you can't if you travel to people's houses, you're only going to be able to charge half the rate, which, for a business, is completely unsustainable. It's had a massive impact on businesses. I think they just wanted to squeeze allied health because by nature and this is me speaking as an OT by nature we're caring people and they're like they're just going to keep going, no matter how hard we make this.
Judy Scott:they will keep going because we love the clients, rather than finding other ways that they could have addressed issues in the scheme. They also most insultingly, they lowered some rates. So they lowered the charge-out rate for a physiotherapist by $10 an hour and I just think anyone with any kind of understanding of business would know this is going to have a huge impact on all of these providers.
Kate Coomber:yeah, are they? Are they not seeing it as a valuable you know? Is it a nice to have service versus a need to have you know?
Judy Scott:is it? Yeah, I can't make sense of it because in within the way the NDIS set up, they're reliant on work from the allied health professionals. We're the only part of the scheme that actually focuses properly on capacity building, so trying to increase a person's independence, and they're reliant on us, like we're the ones who write all the reports to get the person wheelchairs or whatever it is they need. You have to do all of those trials in home or in the community. You just simply can't do it in the clinic. You can't mimic, you can't assess it properly. If I just did it in the clinic, I kid you not the NDIS would write back to me and say where is your evidence that this is going to work in their home?
Judy Scott:So, I honestly think it was just so short-sighted. It must have been. It was so funny because the one that came online actually had errors in it. It had all of these red lines and errors in it and we're like somebody has done this so hastily. It's still in draft. Yeah, it's still in draft form, and it only dropped two and a half weeks before the changes had to be implemented. So, as business owners, like every single allied health business owner, has been frantic, so we've been frantically advocating. So if you go on my facebook page, which I made public, which I never do, um like, there's all of these videos of me just trying to explain what's going on to get people on board to sign the petition. Um, and then we also had to pivot and change our whole business models and we had to communicate those changes to our clients.
Judy Scott:so I had to pay love, to do it but I had to pay my admin staff over time to communicate those changes to our clients. So I had to pay love to do it, but I had to pay my admin staff over time to communicate changes to clients for something that was going to cost us money.
Kate Coomber:And what's the impact of that been for you and your business? I was just going to ask your business, yeah, because when did you have?
Samantha Miklos:feedback. Just recently this only happened. Yeah, so it's been the end of financial year.
Judy Scott:Yes, that's right. It was the end of last financial year, so it dropped two and a half weeks before one july and we had to have it ready on one july and it's you know, it's about a month now. Yeah, so it's pretty astronomical. So I'm sure clients would respond, yes, how? Yeah, well for us, thankfully, with the way that we had set up our business, we hadn't actually pulled every lever that we could, so we just had to quickly make, um, make two or three changes. Things we never oncharged to clients before we now have to on-charge. So we previously didn't on-charge a mileage fee because we were happy to absorb that and we could absorb that before. We can't absorb that now.
Judy Scott:So that gets on-charge to the client, and we also used to absorb all of our preparation time for seeing them. We can't do that anymore.
Judy Scott:So that all gets on-charge to the them. We can't do that anymore, so that all gets on charge to the client. We never previously charged components of return travel. We only charge return travel in really isolated circumstances. So we didn't charge that before and now we're on charging that, like everywhere we possibly can, which it doesn't feel nice, but to stay in business we have to do this, and that is for your clients, right?
Kate Coomber:Yes, it's not even to stay in business. We have to do this for your clients, right?
Judy Scott:yes, it's not even to stay in business for me, it's to stay in business for the community, exactly they will have no services and there are already numerous allied health providers who are closing, and there are others where I've seen they've had to make people redundant, and even others where I've seen they're negotiating conversations with their staff and lowering salaries, which is just awful, wow and that's already in such a short period of time.
Kate Coomber:And you mentioned there about physio rates dropping. What's happening with pay rates across the board? If this is happening and people are having to ask staff to get paid less what's actually happening in? The awards.
Judy Scott:Well, the awards are actually going up, which I don't understand it. I don't, I don't Like. Honestly, I think it's like the government. They just anyway they don't talk to each other. I don't know. It boggles my mind that one part of the government is saying you need to pay your staff more and then the other part of it is reducing our ability to get the income that we need to be able to do that.
Samantha Miklos:Is that going to then lead to a move from staff from private practice who work in the NDIS wanting to then go to government roles? Yeah, definitely. Is that what's going to happen? We'll see a swing there.
Judy Scott:Yeah, so we thankfully at MTC like because you know my husband's an accountant and all the things like we are stable and, like I said, we've pivoted and made the changes. We've reassured our staff that like we are fine.
Samantha Miklos:But some people just can't cope with it and I've already had a couple of people leave to go to government jobs, which honestly, I completely get it, especially if they've got friends in other practices who are being made redundant or you know. It's that fear, right, and the cost of living now is just so crazy, that's right. People want that stability.
Judy Scott:That's right and, yeah, I really do appreciate it. So we try and do everything we can yeah, we absorb as much as we can personally to make sure that we've got what we need to pay our staff appropriately and, you know, provide for them in all the other ways, all the other ways, but there's, there's already, there's so many shifts in the sector now, like, and bigger companies are buying up smaller providers as well, which is, I know, some of these bigger company owners, and I get it because they're, they're seeing a great opportunity.
Samantha Miklos:Yeah, we can absorb those small businesses.
Judy Scott:Yeah, yeah, and at least, then people still have the opportunity to retain a job and also for the clients to receive services. But, because people are going to start transitioning more to government jobs or leaving the sector. I've had people as well like leave altogether. Just I'm done. Yeah, don't want to be a therapist anymore because the stress is too much. Yeah, we will see that there are fewer therapists available. We found just in the last month our referral rate. Through no changes in our marketing, our referrals have increased by 25%.
Judy Scott:And I would love that to be due to our awesome reputation but it's not.
Kate Coomber:It's because other people are closing their doors and not traveling.
Judy Scott:I was speaking to one of my contacts who does vehicle modifications and he was telling me he used to have at least two OTs come in a day to do with vehicle mods and he's had one in the past month because people aren't traveling anymore. So everyone's trying to convert to telehealth and remote ways of working. We made a decision as a business that we were going to minimize, that we wanted our therapists to still be able to go out face to face, because we know that's the better way to practice.
Judy Scott:So, yep, we definitely made some changes, but we're doing what we can to still service the clients.
Samantha Miklos:You talked about some of the challenges there with award rates. Is there other challenges that Allied Health is facing right now? I mean, they're two big ones, but is there anything else?
Judy Scott:In our particular world of NDIS, the really big one is the frustration around dealing with the agency itself. So, as I mentioned, we do all like as an OT, we do all the trials and things for wheelchairs and write up reports and consistently we find that they don't read our reports properly. They've even admitted it themselves, like the previous CEO admitted, that reports don't get read, that we write and yet if we don't write them in this copious amount of detail, they undoubtedly will come back to us asking for more information. So I think that's the biggest thing feeling like we have to become report writers for the sake of compliance rather than actually doing hands-on therapy with clients. We would much rather save that money from the plan for us.
Samantha Miklos:Once we've got the wheelchair, let's go test it out in all the environments and make sure that you're really comfortable. And we've got it well set up, exactly right. Are you comfortable? Yes, all of that.
Judy Scott:But we have to use so much of the funding Like I'm not kidding, my most recent wheelchair report application was over 30 pages and that's me just using the NDIS template I have to use.
Samantha Miklos:Oh, wow yeah.
Kate Coomber:And my.
Judy Scott:HomeMods, one was over 40.
Kate Coomber:Oh my goodness, With the advancements of AI, is that going to help the rapport writing? And you know.
Samantha Miklos:Possibly in some ways yeah.
Judy Scott:We use AI for other things, like if I was creating a visual schedule for a client. There's cool ways you can use AI for that. With the reports, it's difficult because we need to be able to use our clinical reasoning and justification, and so AI can't really yet replace that you know, like our ability to see the person in their environment doing their occupation and explaining that.
Judy Scott:I think eventually, eventually, like there is some assistance coming for note writing, which will be awesome. Um, as therapists, we still have a responsibility to make sure those notes accurately represent the client. But yeah, we haven't invested in it too heavily yet at mtc, but looking into it at the moment.
Samantha Miklos:Yeah, because at the end of the day, like that ability to clinically reason you don't want that to be replaced. That's right, because then where do we go?
Kate Coomber:Yes, I don't think it could. So what's the answer?
Samantha Miklos:What are the opportunities? What are the opportunities for the industry? What's the change that could actually set this off in a better direction?
Judy Scott:I think if the government would meaningfully engage with our peak bodies, so our OTA.
Samantha Miklos:Are you part of OTA Australia? Yeah, are you going to be the president one day?
Judy Scott:You are, aren't you? Maybe Are you on the council? No, I'm not. I've thought about it.
Samantha Miklos:I feel like you should be, because are you practicing clinically?
Judy Scott:Yeah, I still do only with a few clients. But, that's just because I've got a few clients I really love and yeah, there's, you know, a couple of clients in particular.
Kate Coomber:I'll never give up yeah, they'll have to pull me away. That must be great for the team, though to see that too, like that probably really adds to the culture.
Judy Scott:I hope so. I get that feedback from the seniors and leads that they think it's, yeah, really meaningful that I still practice. The main reason, though, why I still practice is because I just love it yeah. I yeah, I can't turn that part of me off completely I think in terms of the answer, yeah, the government needs to engage meaningfully with our peak bodies, because they made this change with no consultation and just the fact alone that we had two and a half weeks to implement it, it just seems so cruel to me.
Samantha Miklos:Yeah, it's a huge change for such a short period with no consultation.
Judy Scott:Absolutely massive.
Samantha Miklos:Especially because, as a body, you might have had some really great ideas in terms of other ways that they could equally get the cost savings and efficiency.
Judy Scott:If they would streamline the report templates we have to use for different pieces of applications to the NDIS. So much of that could be streamlined If we could be talking to a real therapist. There are therapists who work in the NDIS but none of that could be streamlined If we could be talking to a real therapist. There are therapists who work in the NDIS but none of them have that in their title. It's very hidden. So you know you never know. You could be dealing with a planner who used to do sales or you might be dealing with a therapist. You would never know If we actually had a contact in the NDIS who was a therapist, who was you, who was engaging with us meaningfully about our applications and getting some more consistency. I think back to the old applications we did, back in medical aid subsidy scheme, which was the Queensland government one.
Samantha Miklos:Yeah, I remember that they're a lot shorter too from what you just described.
Judy Scott:They were so much shorter. And it's just so funny now looking back, because I used to get frustrated with dealing with maths and now it's like, oh my gosh, bring back maths, frustrated with dealing with maths and now it's like oh my gosh, bring back the maths.
Kate Coomber:Isn't that funny that I would have just assumed that there were therapists sitting in that space and like, yeah, actually dedicated therapists as consultation, like I just assumed that would be a thing you would think so if I was setting up the NDIS.
Judy Scott:I would set it up like that. But it's not set up like that. It's set up as an insurance scheme which, ironically, most of our clients over 60% of them have intellectual disabilities or autism. These are not people that are going to get better. So the whole premise of the scheme is set up based on somebody, perhaps, who has a physical disability, who might end up independent and not needing support, with the right equipment in place or whatever it's rehabilitating.
Kate Coomber:Yes.
Judy Scott:That is not the bulk of the clients who access the scheme is not that type, yeah, so I think they made some fundamental errors when they set it up originally. It's tricky.
Kate Coomber:So today we're going to be donating to a charity of your choice, yep, where can we be doing that for?
Judy Scott:That is so generous of you. Thank you, it's a really kind thing to do.
Samantha Miklos:It's the least it's just and also too like it's an opportunity to shine a light right.
Judy Scott:Some of the charities are charities we've never heard of you know.
Samantha Miklos:So just to give them a moment.
Judy Scott:Well, I'm curious as to if you've heard of the one I've in the Darwin Children's Christmas Party.
Samantha Miklos:No, I love this so this is amazing.
Judy Scott:This is obviously a charity based in Darwin. Darwin for me, it's so close to my heart because it's like an accidental baby that you didn't know you were going to get and then,
Kate Coomber:you just love it. That's like you For me. I was going to say something else, yeah.
Judy Scott:So I really love Darwin and the work that our team do over there is phenomenal. Anyway, last year they volunteered because each of our clinics we had them do a different charity as part of our Christmas thing Christmas giving and they volunteered at the Darwin Children's Christmas Party. And what it is? It's a gathering for children aged zero to 12 who have complex disabilities or some kind of complex social background, and you know they have Santa come and give presents and look after them and treat them to a beautiful Christmas you know children that otherwise?
Judy Scott:might not have had such a thing.
Samantha Miklos:That is incredible. I'd love to support you. It's great to learn about. Oh yeah, we would absolutely love that. Thank you. We've done a few over the years, just internally here. There was one in Brisbane, the Variety Children's Christmas Party, similar thing, and it was just so special being able to give back and, you know, create Christmas you know, for families Absolutely Well.
Judy Scott:I was very proud of our Darwin crew last year when they, yeah, went and volunteered there. That's a great choice.
Samantha Miklos:I love it, judy, thank you. I have just so enjoyed this, and you know, I think learning like we've learned about what an OT is. Maybe I should go back, because it sounds like it's a little bit better, maybe. Maybe I tapped out too soon.
Samantha Miklos:I don't know NDIS too, like there's just so much unknown. So even just to understand that a little bit better and and understand the challenges you know for the allied health workforce, so I really hope that there's some change. I dare say it'll take a little while for you all. But like, get on OT Australia, like you're such an advocate and how lucky your team are to have you as founder for that business. It's just, it's beautiful to hear about how values led my therapy crew is.
Judy Scott:Amazing. Thank you, it's been such an honour being here. Thanks for having me. Thanks for having me.
Kate Coomber:We acknowledge the traditional custodians of the land of which we meet who, for centuries, have shared ancient methods of healing and cared for their communities. We pay our respects to elders, past and present.
