Why PTs Are Underpaid (And What To Do About It)

0:00 you're listening to the pt pinecat where smart people in healthcare come to make noise here's your host jimmy mckay thanks voiceover guy uh do you want to say thanks to my friends uh from sarah health the remote care platform helping clinics grow revenue without having to add staff or extra work sarah health automates patient check-ins by text improves follow-through and helps clinics capture rtm reimbursement between visits at sarah health dot com and if you know a sarah there's only two types of sarahs there's sarah with an h and there's sarah without an h this is just sarah without an h sarahhealth.com our guest today built one of the most trusted practices in his market and then made a move that surprised most clinicians he stepped away from treating patients entirely now he spends his time helping pt owners grow businesses charge what they're worth and stop apologizing for creating value.

0:55 We do lead with I'm sorry a lot, don't we? He believes PTs are some of the most underpriced professionals in healthcare and that cash practices may be the path that actually saved the profession from burnout. Let's get Courtney Morse in on the show. Courtney, welcome to the program, man. Jimmy, I appreciate you having me. This is a lot of fun. I've been listening to your show for a long time and I appreciate what you do and I'm excited to be here. I'm just a curious guy. So for background, I came to you're you're you're involved in the head coach for PT biz. And that was something that didn't exist when I met Danny. I think I was still in PT school or maybe I just graduated. And I told him this story.

1:37 And I think it's funny because he had a podcast called Doc and Doc and Danny. Right. Doc and Jock. Doc and Jock. Sorry. He was Doc Danny. And he was asking me about podcasting. And I was like, this was early in podcasting. And I'm like, I don't know what I'm doing. I just talk and sometimes people listen. And he we were having like, I don't know, tacos or something in Virginia. And he was like, I don't know, man, but doing this for a while, I might do this other business thing. And I was like, that's cool. He's like, but that means I'll stop the podcast. And he had just told me he had a mattress sponsorship.

2:17 He got an affiliate code from some mattress. I forget what it was. And I remember being like, you're walking away from mattress money? Bro, I don't know, man. But it feels like PT Biz is probably the better of the two decisions. It's probably harder in the grand scheme of things in that mattress money. But yeah, it was probably the right move in the grand scheme of things. All right. So in your intro, we talked about you opening a practice, growing it, and then sort of walking away from it. What's your superhero backstory? We talked a little bit before I hit record about your background, but I find you find a lot of detail about where someone is from where they were, what they've gone through.

3:04 Well, thanks for kind of asking and bringing this up. And I'm not going to go too far back, but like we mentioned before we started recording, you know, my wife and I, we are from Western Kansas, like our family on both sides. We're like wheat farmers. We're growing up. I was I graduated from physical or from undergrad. and our town is so small i didn't even know what physical therapy was it's like i'm asking all my my uh you know classmates like what are you guys doing with this exercise science degree and they're like we're all in pt school and they're like what is physical like this is how small it is and you know we kind of talk about this and it's kind of this lasting joke You know, like everything good kind of starts on the coast and then works its way into the into the middle of the country.

3:46 And so like it's twenty sixteen and like Wichita's like, hey, food trucks and like food trucks, you guys heard about this. And so like I just had not ever heard about this thing, you know, because in the western side of Kansas, like it's even slower. And so you know i i went to p i didn't start pt school until i was right and so when i graduated uh i got plugged into like it was a fine practice um but it was kind of you know your traditional outpatient ortho things and like all the traditional outpatient ortho things like they're stacking patients on the and they're doing the things that they have to do to survive and four or five years into it i'm like this is it like i i could see the people in front of me and like They're as miserable as anybody else I've ever seen.

4:31 And like, they're just going to write this out. Like at that point, I'm, you know, three, three years old. I'm like, I'm not going to write this out for the rest of my life. And so I had convinced my wife, um, we had a son that was going to be in second grade and we had a daughter that was going to be in pre-K and like, she could have gone into kindergarten right away. Like she's sharp. Kindergarten's easy. And second grade is like, they're not even doing multiplication yet. And so I convinced my wife, like, let's take a year. We're going to get the camper and we're going to go do travel physical therapy. And we're going to go see the country. We're going to go get out of town to go see what this is. And so we spent, you know, six months in Oregon and we were in Tennessee and we were in North Carolina and we, we kind of get all the way back after a year and we get plugged back into a very similar job.

5:14 And I was like, Oh, It wasn't the job. It was the work. It was the setting. And so I actually had a past PRN, like she was a past patient. She said, hey, I heard you're back in town. Do you want to see my patients? My husband's getting transferred out of the city. He's like, yeah, send him over. She's like, no, do you want to see my patients? And I was like, no. And I think this is the case for, you know, a lot of physical therapists in general is like, nobody wants to start their own business. Like we are helpers and we are integrators, you know, like we are conservative by nature. And like the thought process of me starting my own practice, extraordinarily daunting. And she's like, I've got ten people.

5:55 I'll send them to you. I'm seeing them out of this hair salon. you know and it was like just her and her rich white lady friends that she was going to send over to me and like just needle them and she was charging sixty five dollars an hour like well i'm gonna try but that's kind of where it got started was like me treating out of a hair salon with my massage table and subsequently my picture on the first day was that's what got fired me got me fired from the other job i was like okay i'm all in was doing both sides was yeah Really? So you, wait, you doing something after hour, after work hours, pissed off the person you were working for? A hundred percent. And to this day, we still hear this all the time. It's like, everyone knows like these non-compete clauses and whatever else, like they're ludicrous and impossible to enforce, but it still attaches a lot of people to that job.

6:43 And they're like, oh my gosh, like even hiring a lawyer and paying them fifteen hundred dollars to be like, no, this is good. luckily a friend of mine was an attorney and you know we kind of did it on you know i bought him a nice bottle of whiskey and you know send him a nice email and a thank you card afterwards but it's scary yeah why do you think that is is i mean i when my boss found out when i was in radio and found out i was doing voice work at night he helped me build a home studio he was like you can use the station stuff but he's like why don't you build a home studio i remember just being like So why is it that some people get like almost like I don't I heard his phrase once. I forget where it is because I'll give credit when I figured out.

7:25 But it's like people want you to do well. They just don't want you to do better than that. Yeah. we say that to ourselves, but in the grand scheme of things, everybody kind of feels like it's a zero sum game, right? And this is how I got out of this quote unquote non-compete. I was like, I'm not going to the doctor's offices. I'm not taking insurance. I'm not doing any of the things that you're doing. I'm the least likely person that you'll ever be competing with. And so they kind of worked the language to be like, yeah, I guess you're right. So I repaid back or I paid back my sign on bonus and then I was free. That's so... What year was this? Ballpark it. So we started our practice in December of twenty seventeen.

8:07 So we were kind of up and running in twenty eighteen. wow. I mean, so that's, you know, that's a, that's ten years ago, almost ten years ago. And I remember, like, nowadays, or just the people that I talk to, maybe, maybe it's the people that I now surround myself with, where now people will be like, hey, you've got to really, how do we, how can we build this together? Why don't you bring that into the fold? And we'll, let's add to this. How do we grow to get, be an entrepreneur? Yeah, there is more of that. But in the people that we coach every day, there's plenty of the like you can't do that while you're here um and so it still exists it still exists in a pretty big way that's only going to make someone want to leave it's only going to make them stay long enough until they can make the leap themselves yeah that's a scarcity mindset a hundred percent yeah and so this is actually this is the biggest challenge of you know people that come into you know business ownership as physical therapists it's it's their mindset it is you know So how do you explain what PTBiz is to someone?

9:07 Someone sees an ad or hears from someone or reads a book that Danny wrote that he used an F-bomb in. I remember when he wrote that, it caused an uproar. And I was like, now someone writing a book like that wouldn't even move a needle. That was ten years ago. So how do you explain what PTBiz is and who is it for? Yeah. Let me start that with how I got involved in the first. And so we started our practice, like I said, in, you know, twenty eighteen, basically January twenty eighteen. And I was maybe six months into the program. And I think Danny's podcast started maybe three months before that. Somebody introduced me to his podcast and. I am maybe unique in a way where I don't have any problem asking for help.

9:49 Like, if there's something I don't know, please tell me what I need to know. And I want to go figure this out. And so I was in it. And, you know, the Internet then is like the Internet now. There's no shortage of information out there. But I need you to lay out the order and the sequence for me. The example I use now, you know, we're in the United States and we all are football fans. I am a much better quarterback than an offense coordinator. Just tell me the play and I will run the play. I don't always know what play to run. And so I very much, you know, in the rocket fuel kind of setting, like I'm an integrator, a hundred percent. Tell me what play to run and I will run it.

10:30 And so it was six or seven months into the program and they're like, hey, we created this thing, it's called the mastermind. And I was like mastermind number, number nine, right? And we've had a few thousand people have come through it at this point. But it was prior to that, I felt like, you know, I was turning the wheel on a steering wheel that I didn't know if it was attached to the car. I was doing a lot of actions. I just didn't know if it was pointing me in the right direction and doing the things. And so what PTBiz is, it's the coaching program of people like myself and people with bigger businesses than us. And, you know, these guys that have, you know, done impressive things in our industry.

11:10 teaching people like this is the play that you're supposed to do now here is what you're supposed to do now like stop having shiny object syndrome it's this thing and so the the frustrating thing sometimes is you'll get these visionaries and that do come in and they're like oh well how about this like nope i'm gonna reign you back in it's this thing and so it's it's i think really powerful to have somebody that's already been through it like shining you the flashlight through the way like this is this is how we get there and uh i i tell people like we're all on the same path i'm just slightly further than you are right right you're just loaded down so that was the vibe that i got so you got you guys do this twice a year twice a year So twice a year, a couple hundred people who are all together, and we'll get into the specifics too because the rest of the year, they're not in person, but you pair people up based on revenue, Because people in certain revenue brackets have similar problems.

12:11 And who do you want to be surrounded by? People who understand you, that, oh, you're in the same boat. How did you solve that? How did you solve that? And you want to be coached. And that coach can look at you and go, if you're in this sort of bracket, you're in this stage. And this is probably your biggest problem. And they're like, oh my gosh, how'd you know? It's like, well, because we were there or we've worked with hundreds of other people who've gone from there to there. And that was the thing that's done it. So that to me for setup was sort of unique. It didn't treat everybody the same because you had different problems. Totally. And so we will even divide the building in two at times to be like, if you guys are under just a two hundred thousand dollars in annual revenue, your problems are leads and sales.

12:55 Let's go talk to people that are going to help you with leads and sales. And if you're a two fifty to five hundred, you need to hire an administrator to do the work and you need to hire your first PT. And then above that, it's a little bit of rinse and repeat. And then you're building on leadership systems and you're refining it. At that point, it's systems. Right. And it's like, here's how do I recreate this thing? How do I take what's worked well for, you know, somebody over here in a two million dollar business? How do I implement that into my business? What is so all right, let's go back before we go forwards. Before we hit record, you said like how long it takes someone to sort of get into the ecosystem. We do a lot of sniffing. You said before, we're sort of risk averse because we want to help.

13:37 And risk feels dangerous, right? What are the barriers that people need to get over before they go, okay. I know I want to do I want the result. So what it's got to be psychological, right? Like what are what are the barriers that prevent people from saying, let's do this? Yeah. What we were talking about before we hit the record button is our from when you first learn about us, whether it's from an ad or whatever else it is, like when you first learn about it's about six months before somebody comes in here and decides to work with us in the program, which is a really long kind of sales cycle on our side of things. And there's a lot of trust that has to be built in that six months.

14:19 And so we have to go walk the walk and we have to show them these are these little points of trust along the way to show we know what we're doing. And it's not very much different than if you go out and you're trying to find your own patients, if I'm going to go talk to runners, I need to go have conversations with runners that show like, Hey, this is something that we do. We do this all the time. We see this all. And we know how to solve these problems. It's very similar. The parallels that makes my job very easy as a coach, the parallels between running a business and actual physical therapy are very similar. Oh yeah. Point solution, you know, and then it's all these other, you know, continuity and, you know, how many people sit around. And so it just takes that long.

15:00 I think, you know, from a, particularly from a digital standpoint, we're all remote, we're spread across the country, to build trust over that amount of time with digital touchpoints alone. So what is it? Once you're talking to someone, what are the one or two things that prevents them from doing it? Because there's a lot of people who are like, I call it the end of a diving board. They're gonna. They're getting ready. They're soon. Once I know. What are those things? Yeah. There's usually two, it seems like. One of them is things in their own life or their own work or their own business that they're currently working just aren't quite bad enough.

15:42 And like, OK, and so they get kind of comfortable like this stinks, but it's not bad enough to jump. Totally. Yes. And so that's a big part. And then if there is some kind of radical change, like if they do get fired or their job change or private equity comes in and buys their company and now they have all these ridiculous standards, they're like, OK, now we've got to jump. And so it almost takes an external force for them to finally decide like, okay, now I've got to move. I was reading a recruiter the other day on LinkedIn, and he was giving this story about this woman who made a lot of money. She's like high salary, like two to fifty.

16:22 But she hated her job. Job was brutal. And then she's like, I found her a job that we know that we decided we agreed she would love. but it was five thousand dollars less per year. And she would not leave because I can't take a step back. So she said, you're willing to be miserable every Monday for a two two percent reduction. And the person was like and then the point of the article was this was about an emotion. She felt, well, I can't go backwards. For six hundred dollars a month. Right. She's like, but you hate your job. You hate your boss.

17:03 You're on edge because you're getting text messages all the time. You hate this. This is better. And it's five thousand dollars. She's like, you paid me, the recruiter, two thousand dollars to find you a job. What are we talking about? So. the more people give logical excuses for why they don't think things i'm like that isn't it what is the emotional reason and give it to me yeah you have to dig a little bit deeper that that is what actually drew me so there's kind of two things that drew me to ptbiz at the beginning the first one is like i knew that danny worked for kelly's tourette and mobility water and like And Kelly is like on the board of advisors or whatever, Kelly and Juliet both.

17:45 And I've always kind of heard this like, oh, you know, I, when I was, I did a little bit of CrossFit at the turn of the ox or whatever. And somebody handed me, you know, becoming a supple leopard. And I was like flipping through this book. I was reading that, like they spoke a language and it changed how I speak a language. And so knowing that he was there, I was like, one of these days, this is going to pay off. I'm going to go meet Kelly Stratton. And I did, and it was as great, they were as great of humans as I want them to be, which was great. But the other, geez, now I even lost the thread that we were pulling on. Just the emotional barrier, like what actually prevents people from jumping? Yeah, and I think the other aspect of that is in our practice or in physical therapy biz, we we've kind of learned and it's kind of a you know like a well-known trope about entrepreneurship at this point it's like it is the best personal development plan right that you'll ever sign up for and we didn't know that when we signed up for it and and i can a hundred percent promise you like i'm a better better father and i'm a better you know dad i'm a better business owner all these things because i went through and cleaned up my own stuff And most people don't know that they're not diving into that or that's not why they signed up for the thing.

19:08 But very much at the top of PT Biz, like we're talking about, like you put your personal relationships and you put this other stuff first and you prioritize this stuff first. And I know you were there for our kind of closing statements at the end. And I talked about that. I mean, I talk about this ad nauseum. is like you need to you know put your own oxygen mask on first when you're running a business because if not your business can run over you and it leaves you in a like this person that you were describing it leaves you in a very unsatisfied place when it's like this is what you built yourself and so you there's a certain amount of like you have to kind of lead from the front and being like Go fix your shit. Because if you don't, you're gonna have a really bad time with this business for the rest of your life.

19:50 You're gonna create something that you ultimately don't wanna be a part of. You're gonna create a job, not a business that you're stuck in. So what was that thing called? So we were at a table. What was that thing? It was like six categories. What was that called? What was that again? It was like a, we called it a leadership checklist. Like a leadership round table was what the whole thing was. And again, these were the businesses that were over two hundred and fifty thousand dollars of gross revenue. Like they get to go because after that point, it is just all leadership. it's all leadership and it's like how how do i not not only lead myself how do i lead my team now you know other people i'm responsible for other people's mortgage and other people you know putting food on their table and so uh my wife works and works in our business too and i think one of the the biggest selling features about working in our practice is like things are steady at home.

20:43 Like they're always steady. There's always calm. You know, you'll listen to these other podcasts about husbands and wives yelling at each other in work and you're like, oh my God. And so like the fact that, you know, you can use entrepreneurship to solve or go at least give you an avenue to solve some of your internal struggles is a huge selling point that never gets talked about. The thing that grabbed me about that was a couple of things. So it was a table of, I don't know, eight or ten people. And the exercise worked. There was like a bunch of of category six categories and then a bunch of things to rate yourself. Yeah. in these different areas below it.

21:24 And then you'd talk about it. And the cool part was number one, I was like, here's Courtney, who's a coach. So he's supposed to be like, I do everything perfectly. And several times you were like, yeah, I'm not good. I haven't been good at that in the last three months. And I was like, huh? Interesting. And most of the people, cause I like my like two or three questions is like, Hey, how long have you been doing this? Most of the people at our table have been doing it for a while. So they've been doing the same exercises or similar exercises for a while. And they were still listening to other people going, yeah, how do you do that? That was the thing is like, they're literally wearing like their revenue on their tag to be like, I know what I'm doing.

22:04 And they were still like, sitting down and being like, what could I be doing better here? And really most of it was about themselves. It was not an app. It was not a, hey, what EMR are you using or what? It was, what could I be doing or what am I the limiting factor of? Yeah, that's something I think about the community that we've built in general is, the group of people that work inside that room are more generous than any group of people that we've ever met. Like somebody asked the other day in one of my coaching groups, like, hey, I just brought on somebody, our onboarding process is okay. Does anybody else have something? And I was like, yep, this guy just shared one with me. And like, people are sharing things that they worked really hard on.

22:48 And they're just like, they want everyone to be successful in that room. We kind of recognize, you know, if we do well, you know, it helps not only the people in the room, we're trying to help the whole industry, right? We're trying to help all of PT. And so none of us learned how to onboard a new employee in physical therapy school, right? You have the choice to be like a business owner or a business person who owns a PT practice, or you have the choice to be a PT who owns a business. Right. You can't really be both at a super high level. Like if you're going to be a business owner, then you have to lean into it and you have to, you know, learn where your weaknesses are and learn how to be vulnerable and talking to stuff in your groups that is hard.

23:37 But that's that's what this group is so good at doing. It's like bringing up the fact, you know, bringing to the top. Here's here's everything, warts and all. And it's it's a really unique room in that way. Um, when someone comes in and they're coming from someone else's, let's say they're an employee and they're like, they're going to do the sniffing around and they're going to talk to you and bank, you know, bank questions off you guys and see what you're saying, but they're coming from an insurance model. many PTs, myself included, and conversations all the time, PTs will still tie their own value to what insurance pays instead of what patients receive, right?

24:18 Pay for the, you know, your value is the outcome, not what someone's willing to pay you for. How do you approach that? Because many people will, I mean, when I was in PT school, ten years ago, cash PT was like, number one, it was blasphemous. It was blasphemous. And now, I mean, I was sitting in a room three weeks ago with two hundred practice owners who were like, not batting an eye. So like, where does that conversation need to happen? Someone's like, so tell me about this thing that I've been told was not that doesn't work. And you're like, OK, well, I can introduce you to hundreds of practice owners. Does it? How do you start? Because that's a that's a value shift for themself again. Oh, yeah. the mindset shift that we all had to go through, it's profound.

25:01 And some people, they get it right away. And some people truthfully don't ever like really come to terms with that value because it's just baked in so deep. And I mean, When I first started, you know, like I said, I was starting, I was charging a seventy five dollars an hour, you know, twenty eighteen or whatever. And, you know, my first coach, Eve, Gigi, was asked me like, hey, man, you got to be charging one twenty five. And to me, that number was astronomical. And again, that was still probably what Medicare was probably paying at the time. Right. And I couldn't do it. And I would finally get it is like, OK, congratulations. It's actually one fifty. You took so long to change your prices like the market has moved.

25:41 And I had to hire a separate mindset coach externally. Again, we're wheat farmers from Western Kansas. We don't have any prospect on what it is we do. So when I talked to my team and we talked about the value that you bring and the care that you were bringing to the table, we have to talk about a couple of things. And the first one is, imagine put yourself in the shoes of one of your patients who has had back pain or shoulder pain and pick a diagnosis for three months, six months, nine months. And then imagine them sitting across from you and you don't have the confidence to tell them, actually, we work on this all day and we can solve this problem pretty quickly.

26:30 And truthfully, it's only going to cost us about twenty five hundred dollars for me to work one on one with you for the next three months. And like If you told that to anyone, if you told that to any patient, like, hey, I know this has been bothering you for nine months and you've been to the chiropractor, you've been to the massage therapist and you've had an MRI and you've had all this other stuff and you had injections or whatever else, I can solve this problem for you in like three months. And it's going to cost me like sign me up. Where do I start? And so I think the first step of this is we have to have we have to get people to stop thinking about what they're charging per hour. right units or hours or codes right totally it's not like i i i had to think about this the other day because we were talking i think it was you that or you and megan brown were talking about this in one of our circles like we have to stop thinking about how long we work as a billable unit like oh cool twenty three minutes yes all right that's it yeah so What what we have to do is we have to start thinking about outcomes and we have to think about long durations of these things like two thousand dollars for me to solve this thing that's really been bothering me for a long amount of time.

27:33 Like that's pretty valuable. The other thing that I have to tell my team is we know for a fact they're going to get the best care in town coming into our practice. And if we don't convince them that this is the best place to get the outcome that they want, they're going to go look for it somewhere else. They're going to go, they're going to walk out the door and I say, hey, it's going to be ten visits, but I'm kind of squishing on the details. And like you have to know that your plans are good and that your diagnosis and your prognosis is good. And if it is, people say PTs think that they suck at sales. They sell ninety percent of this whole plan of care every single day.

28:14 The last percent is what makes them nervous is ten percent about how much it's going to be money. Right. Here's what it's going to cost. They do. They do the rest of it. And if we don't tell them that confidently, they're going to bounce after three visits when their pain goes away. And then they're going to go look for that solution from somebody else. And who knows what they're going to land on. But I can guarantee you it's not going to get them as good of outcomes in the short amount of time. They're going to go do weird stuff at a different provider, or they're going to be still working on this thing six months from now. They're going to, you know, worst thing is they're going to go have, you know, surgery or whatever it is. And they're going to say, I tried PT. It didn't work for me. So it's an obligation for us to be like, If you know that you can solve this problem, you have to convince them and convince yourself that this is the best place for them.

28:59 Yeah. Because it is. You brought up Megan Brown. She's got a great line. An excuse is a problem that you have decided not to solve. It's such a good line. And I've heard someone else say, if you have a problem that requires a thousand dollars to solve and you have a thousand dollars, you have decided not to solve that problem. And when you start talking in terms of other people's identity or what their work is like, and you're saying, I've searched for nine months to solve this problem. It hasn't been solved. You haven't tried what I do. It'll cost you X. And then you shut up and say, I make suggestions, you make decisions. And if you decide to do here, I can give you this.

29:41 I don't know where that doesn't fall in a class in PT school. This is our basically sales module. It's like you create a menu for them, you tell them which item to choose, and then you shut up. You don't hear a shoulder surgeon be like, yeah, but we could also, or what about this? It's like, here's what it is. This is the solution to your problem. full stop. Right. And so, you know, to a certain degree, like when we're first new, when we're new to starting a business and, you know, we don't have our name out there very much, we do have to build up a little bit of credibility and we do have to build up a little bit of trust. Sure. And so Until we get to that point, it is a little bit more challenging and we do strike out a little bit more.

30:28 But that's the only reason that people wouldn't identify with this and buy this solution, buy your plan of cares, because you didn't confidently convey that in a way that made sense to them. then that led to a little bit of mistrust with them. Your lack of clarity led to their mistrust. We don't need to be taught. There are things that are in our human operating system that you're like, I don't know what's up with this, but I don't... I don't buy it. Or something's off. What is it? I don't know, but I'm out. We love to say we're logical beings, but we're emotional beings.

31:11 We make an emotional decision and we back it up with a logical story to make ourselves feel good. Let me ask you this. If you're meeting with someone for the first time who's like, I think I want to try this. I've heard about PT Biz, right? Friend suggested. What do you look for when you're like, this person... What are some of the attributes that you're like, this person will do well? Are there things that you can spot? As much as anything, and I had this conversation the other day. I do a lot of onboarding calls in both tiers. We have the Clinical Rainmaker, which is our six-month program for people that don't even have a business or they just started a business and they're trying to figure it out.

31:53 And then we also have the mastermind, like we've had a little business for a little while and we're trying to grow this thing. And I do onboarding calls for both. And I have for a long time. We've been doing the Rainmaker for six years. what you recognize right away is those people that are coachable and will implement the thing they're like yep whatever you say coach like those are the people that that you know are going to do well and the people that are that come every single time with excuses or yeah buds or whatever else you can almost guarantee like they're going to struggle in this program compared to somebody that you know we have to do a good job as coaches to Ask them the questions to make sure that they come to that conclusion on their own.

32:33 But when they come to it and they're like, yep, I got this playbook. Now I'm going to run with it compared to like you ask them the question like, I don't know. And then they have ten excuses like those are the people that, you know, they're going to really struggle in any program, I would assume. Right. I make suggestions. You make decisions, right? Like you look for that. You've said before that cash PT could help save the profession from burnout. Why? Yeah. I'll go back to this point Kelly made at one of our events. He said, we cannot change a system as large as healthcare internally.

33:13 Yeah, no way. It's too big. There's too much money in it. We're not a partner. The only thing that we can do is we can provide an alternative next to it. And if we can grow that alternative so big, then the other guys, they have to go make the changes, right? And we're not there yet, but we're making changes, you know, within the industry, but we'll see it locally first. You'll see changes within your town, like more like in Wichita alone, which is where I'm located, We started with one physical therapy practice and now a cash practice, and now I bet there's six or eight, right? And it's just because, hey, there's proof of concept, these other people are doing it. And so what has to happen is there have to be enough people that opt out of the thing.

34:00 And I get it, like insurance, it has to stick around, it has to be there for somebody. But for people that kind of recognize, I went to this thing, the product wasn't very good, and I still had to pay for it anyway. And to a certain degree, sometimes it's more expensive, right? If you go to a particular like hospital system, I heard this on a Rainmaker call the other day. If you go into a hospital system, sometimes they're charging, these hospital systems are embedded with these insurance companies. It's like four hundred dollars a treatment session. And that's with two or three other people. They're like, well, we're not charging that. We're much more transparent about it and whatever else is like, this is a better product, right? On a busy day in our practice, you're going to see six or seven patients.

34:41 A full patient load for us is twenty eight patients in a week. And we know patients. We know people that are seeing twenty eight patients a day. Oh, yeah. It's not a two day. Right. And so, I mean, the pace that we get to work out, the relationships that we get to build, like they're vastly different. And the delivery of it is a lot different as well, too. And so again, if you go back to this person that you were mentioning before that doesn't want to go back five thousand dollars because like that's moving them backwards. Like we find a lot of people that'll be like, yeah, I don't need to make ninety seven thousand dollars a year or one hundred twenty thousand dollars a year if I can just not do notes until ten o'clock every night or if I can come if I can leave to take my kid to the dentist and not have to take PTO every single time I walk out the door.

35:29 And so the That system, it has to be run that way, but we're building the alternative next to it. And it's clearly a better product. Right. Ask, what do you value? I think a lot of big organizations, because I hear from people who are there, well, nobody wants to work. And people have said before, it's like, well, what are you offering? What is the thing you're offering me? Because I've seen people work in practices that autonomy is the biggest flex. And those people come and don't leave and are happy about it because they understood what they were. You're buying a job as an employee, right?

36:09 Yeah. Forty hours a week is a massive investment. Ask yourself what game you want to be playing and then decide to play that game. Well, and Jimmy, you mentioned autonomy, and this is what our practice was built on in the beginning, right? I read a book. It's Built to Sell. Oh, yeah. Daniel Pink? Yeah. And the premise of the book is like, do not be the bottleneck in your business. And so from the very beginning, we were training people how to do the things that I do because I never wanted to be the person that like every decision had to flow through. Right. And so I was only in my business for maybe two years before they asked me to come on and start help coaching part time.

36:51 And so I'm stepping away. The business is running. There's days of the week where it's running without me until I got to the end of twenty, twenty four. And like, we would like you here full time. And I had prepped for that since the beginning. And so I've stepped away. I've never lost an employee unless they've moved out of the state. It's because we've been giving them autonomy, like hire smart people, train them on what to do and get out of their way. And so it was a pretty natural. It was the hardest part was for me stepping away from those patients. But in the grand scheme of things, I didn't miss them as much as I thought I would.

37:32 And they didn't miss me as much as I thought I would. I left them in good hands. And truthfully, some of them I had been seeing for a very long time. This is when I knew I had to step out of patient care, is I'd gotten a little bit complacent on going and learning the new stuff. Because even at, you know, eighty percent capacity, mental capacity, I was still a pretty damn good PT. And it was like, ah, like, so my brain was really leaning more towards the, you know, the business side of things. And, you know, for me, it was impact. Right. I can have a certain amount of impact working one on one with a patient. You know, this person can now go function with their family or in their community or in their church or whatever. Right. If I can train a team, now I have a little bit bigger impact, you know, more ripples or whatever else.

38:15 But if I can go train, you know, several hundred people how to have business like this, my impact is now much larger, right? And that's what it was for me. And so me stepping away from patient care was like, this is how I can continue to feel like I am, you know, contributing and like I get a lot of worth and value from from my career. But that's an identity change. Like that's, that to me is like the big, that's a big internal change, but no one can do it as good as me. And it's not saying that someone can't, but it's like, if I let this go, what am I? Yeah. Then what am I, if I'm not the doer and I'm the overseer, am I any good at that?

38:56 Or do I want to do that? Or, you know, then am I not this anymore? Because I wrapped my entire identity around that. Yeah. if you've ever as a, an employer or a boss or a manager or whatever said, it's just easier if I do it myself, then you're not doing a good job. Right. You have to go learn how to do things. And so the other book that, that was in the back of my head the whole time was, you know, the big leap by Gay Hendricks is like, this is my zone of excellence. I can treat patients all day and I'm there, but what I'm really good at is this other thing. And this is, you know, what he calls like your zone of genius. And it was always in the back of my head. I was like, I think I would be really good at this. And so it was, it was a big leap, you know, our profitability was down that year that I'm out, you know, it was a kind of a crazy year in twenty twenty five.

39:40 But ultimately, like the business still grew or, you know, we had a little bit more stability because I had W two salary and I didn't have to pull out so much from the business on a regular basis. And then this year we're off like a like a, you know, like something that goes fast. What's the future look like for the people that you coach? The vibe that I got, I've only been to one of these, was that it seemed like you were guiding people through places you've been and it sounded like you guys were saying, this is the next thing coming.

40:23 How do we prepare you for this? So what's coming down the line? Yeah, so we always are thinking about in our practices, new patients. I get new patients on the door. Like it's all about new patients. And in the grand scheme of things, the real metric is lifetime value, right? It's okay, so I provided this solution for three months and then they, now they can go back and they can do this thing and we've solved this problem. But in that time period, you've generated so much trust with people. Like it's really challenging to kind of send them else back into the world. And so it's, you know, getting people onto, you know, continuity plans.

41:07 And this is where, this is what insurance-based companies could do now is they bolt after graduation, bolt on some cash training or some small group training or some programming or something else, allow PTs like to do the fun stuff. We always discharge them right when it's getting fun. All right, well, time to go back to whatever. I was like, wow. But this is the part that you really want to do. And so these are the big things for us is helping people, number one, use continuity is what we call small group training or just ongoing visits in a way that's meaningful for them. That's a big challenge. It's always going to be hiring and getting more folks in the door.

41:48 And that means getting more spaces and learning how to manage that. And then the other thing, like anybody else, it's learning how to harness AI in a way that meaningfully tracking your KPIs and your numbers and knowing what to do with those numbers and be like, okay, what am I going to do with that? Right. And again, I can count on one hand the number of people that are in PTBiz coaching that have an MBA. right? It's all, it's none of us. Like we never learned how to be business owners. And so it's, it's so nice to, to have somebody, you know, Danny is very astute on this thing. And our other, you know, one of our other partners Jared moon is runs huge businesses and like to have them guiding us and being like, here's what you got to look for.

42:32 Here's the next thing. It's again, much better quarterback than, you know, offensive coordinator. Sometimes they have to tell me what to do. And I'm like, yep, that sounds good. I'm going to, I'm going to run the thing. And so It's thinking beyond like, ow, my shoulder hurts. Right. There's so much other value that we can provide to our clients. All right. We have a tradition on the show, Courtney. It's called the parting shot. This is the parting shot. One last mic drop moment. No pressure. Just your legacy on the line. Our parting shot brought to you by our friends at Empower EMR. If your clinic is tired of slow software, clunky documentation, Empower gives PTs faster workflows, better notes, and customer support that actually responds.

43:16 Also want to say thanks to USPT, helping clinicians grow careers through mentorship, leadership development, and strong local clinic brands backed by national support. So you got two choices. You can just have your own parting shot and just whatever quote, mic drop moment, or I can give you a parting shot question. Up to you. Hmm. I I'll take the question just because I, I have so many of these that I get to write. All right. So I'll tee up with this one. If a new grad physical therapist, fresh out of PT school said, all right, I've heard a lot about this. I want to build a career that I love and I can afford that works for me and not the other way around.

43:59 What would your sort of one minute pitch be? What would you have? What would you say to him? Yeah, I think the first thing that they have to do, it is useful to go learn how to be a good physical therapist first. And so sometimes that means working in one of these businesses or working in, you know, in an in-network place and go getting some reps and, you know, learning their chops. But, you know, three years down the road is kind of the sweet spot where, you know, it's kind of the Dunning-Kruger effect where like you're just smart enough and also just dumb enough to be like, okay, I can really do this. And so when you get to that three-year spot, like this is when people can really go make it happen. And then at that point, hire a coach and do what they tell you to do. Right. That's it.

44:39 Yeah. So it sounds like get out there and mess up and learn, mess up and learn and mess up and learn. And then once you're at that ceiling, that sort of three-year mark, like, okay, like you said, I've looked around and this is what it is. I understand it. Is this what I want? If it is, great. If it's not, you get to sort of decide. I mean, how many people at that event in South Carolina with PT Biz, like the types of practices were so varied, like different and weird in all the coolest ways, right? So varied. And what's nice about that is in PTB, it's like you are running your own practice. This is not a franchise. We're not telling you what to do. We're giving you best practices.

45:20 And again, it's up to you to kind of go run your own brand and like go create the lifestyle. There are people in there that just want to get busy enough to have a lifestyle practice, never see a patient on Monday or Friday, have five days off every week and whatever else it is. And so you get to choose your own adventure. And how many other jobs in healthcare are like that? Not many. Not many. Not many at all. If someone wanted to contact you, what's the way if they were like, all right, this guy seems cool, but I'm going to test drive him a little bit. Yeah, I would tell them to go to the PTBiz website first and foremost or follow PTBiz on Instagram. You can follow me. There's not much going on. It's just pictures of my kids. It's Cordeon Morse at Gmail or at, that's like Gmail.

46:01 Cordeon Morse at Instagram, but all the real action that happens over at PTBiz. Courtney, appreciate this. Thanks for doing what you do, man. Just standing in that room, it was pretty cool to watch a bunch of people on similar but different journeys at similar but different stages and watching people talk to each other like future version of myself or past version of myself. It was pretty cool. Yeah. It's pretty motivational because you can, you can see where you're at on the path and there's always a way to get to the next one. Or you can, like in Mikey's shoes, you can choose to tread water a little bit. It doesn't have to be a rocket at all times.

46:42 That's the nice thing. Courtney, appreciate your time, man. Thank you. Thanks, Jimmy. That's it for this one, but we're just getting warmed up. Smash follow, send it to a friend, or crank up the next episode. Want to go deeper? Hit us at pgpiecast.com or find us on YouTube and socials at pgpiecast. And legally, none of this was advice. It's for entertainment purposes only. Bullshit! See, Keith? We read the script. Happy now?