Why PTs Were Never Taught to Succeed in Business

0:00 You're listening to the PT Pinecast, where smart people in healthcare come to make noise. Here's your host, Jimmy McKay. Before I get started, I do want to say thanks to Brooks IHL. That's Brooks Institute of Higher Learning. They've been supporting the show for, I should know this, it's two, three years. We'll say two plus years, more than two years. The place PTs go when they're looking to level up their clinical game, they've got residencies and fellowships in pediatrics, geriatrics, orthopedics, neuro, all of the things pretty much. If you're thinking about it, some people are like, well, do I get paid during these things? Some of them can. At Brooks, you do. brooksihl.org.

0:40 That is brooksihl.org. Guest today walked away from corporate leadership and started a PT practice in a very, very high-end area from the back of his car. Look where he is now. Now he's helping other rehab entrepreneurs grow their business by teaching what most PTs just weren't taught. You can't say someone's bad at something without coming to their defense and be like, well, they weren't taught. So it's like, you can't really fault them for that. Not forever though. You can say like, you weren't taught, you got to get into it. So they weren't taught this in school, probably not, maybe not in the clinic, how to think like a business owner. Cause that's what some of these things are. You're an employee or an owner, right? So with a focus on real world advice today and belief that character, not just knowledge is what builds success.

1:24 Our guests today reshaping what is possible in private practice. And today he's half of another podcast, right? as well. We'll get into it. Owen Campbell on the show. Owen, welcome to the program, man. Dude, I'm pumped to be on here. That intro made me sound like every other business advisor on LinkedIn. Is it though? It sucks because I wrote it. Or at least I gave you the information. So I'm hoping to differentiate myself just a little bit, like you said. I'll come to your defense. I'll come to your defense, not just because you're sitting in front of me and I'm supposed to make you feel welcome because you're a guest, but i'll start conversations with people um because i meet people a lot right as i'm sure you do and lots of people do and i'll start and i like to start with like sort of a week like what's your background is like i don't know it's a it's a normal question i'll go what's your superhero origin story because number one it sort of makes them think i don't want a holstered response I want them to think.

2:19 And they go, oh, I don't really have one. I go, well, first of all, we all have an origin story. That's why superhero movies are great. It's not the CGI. It's this person had this and then they became this, right? And we all sort of have that, which is that Phoenix moment or the Deadpool moment where I was this and then I became this. So let's start with the trunk of your car because that's a cool like Phoenix. You have my attention, right? Like got my attention. And I talk to people a lot. Start at the trunk of your car. What made you walk away from, we'll say corporate career, but let's just say like what it really is. Safety. You walked away from something safe to do something different. Why? And what's the origin story there?

3:00 Well, I think it comes a lot down to that whole like burnout versus passion argument that you see online a lot. And essentially what I started out with is I think in my first year when I was in New York, because I treated in Manhattan for like three years before I moved out here in Arizona. And I think the first performance review three months in, she's like, well, what do you see yourself? I'm like, I want your job. And I knew I wanted to run a clinic. So I was an assistant manager like six months in, right? And by want, not by necessity, which a lot of people have to do. And then I got a taste of business and then I moved out. I realized New York was fun in your twenties, but you're not going to build a life there easily. Right. And I said, well, the West is cool.

3:40 West Coast is expensive. Let's go to Phoenix. And I met this entrepreneur and she is a rock star when it comes to marketing. But she had six clinics. They were struggling, not struggling. There's like three that were killing it. But then her expansion was not awesome. so she said you've run a clinic before save this one right and she gave me one in like kind of the middle inner city right we had a lot of medicaid but we also were right next to one of the most expensive real estate so big big swath and you know we i built it right we we went from three people who wanted to get the hell out of there to seven people and we opened another clinic down the road right in the course of like a year or two right so i was like oh okay well I have a talent for motivating people and getting people all on the ship and all that stuff, right?

4:25 So then fast forward, I become regional manager as we grow. We get some small time investors, but nothing big. And then she sells for mid eight figures to one of the big chains. And we had twenty five clinics and that was over seven years that I was there. Now, I had a VP of operations above me. I'm not taking credit for all that, but I had a region of six clinics and we doubled revenue in three years over the pandemic. So I was like, okay, I can do this business thing, right? So then I went to a bigger fish, right? And I went into their corporate program and I did the whole like, you know, corporate meetings and you fly them out to the headquarters and this is how we, you know, all that.

5:06 And they're like, hey, you're awesome. But the only opening we have is in Iowa. And I was like, well, that's not going to work. So then I decided, well, if I'm as good as I think I am, I should probably prove it. So we had twenty K in debt because we just put an air conditioner on the house. Kids are in a obscenely expensive preschool, but it's the only one that I don't have to drive an hour away to. And yeah. I was like, well, guess what? I started my own company, babe. And my wife wanted to shoot me. But the only way to do that is in my situation and what most PTs have is you buy a table for four hundred bucks, you get some insurance, your overheads, you start across maybe two thousand dollars and then you just really better be good at getting people better and telling people about yourself.

5:48 And I thought, well, if I could do it at a corporate level, I should be able to do it now. So then I just started out. So we glossed over something and you don't need to go into the nitty gritty, but when you took over that first clinic. Yeah. There's the tipping point, right? Because would you see what was missing? Or I also like – I forget who I was listening to. Maybe Seth Godin, one of those smart people. A lot of times people want to add, and I forget. I don't know if it's Scandinavian or Japanese. Their first thought is take away. What does it mean to be there first? So what did you walk through – yeah yeah yeah addition by subtraction right but but for some reason myself included i'm like what do we need to add here it's like hang on a second do we have too much like if we're a boat let's make sure we don't sing so what did you see there and what was the secret i'm using air air quotes because most of the time the secret is actually just the basics which are important parts right hundred percent basics it goes back to like personality stuff and you ask questions what were your parents like what you grew up doing what lacrosse team were you on whatever right and but essentially what it came down to is we had four clinicians right it was a market where uh still like it is today the clinician had the power right we were we were begging for good pts but not as much as you do now right um so i kind of came in and i said look there's four clinicians one does not want to be here sitting in the corner moping about everything if he saw seven people he said he was overworked and he didn't like the fact that they couldn't afford to like have a second car in the

7:19 home to be able to get to physical therapy he thought that was that problem so i was like okay you got to go i'm going to make it as uncomfortable as possible in a legal legal way to make sure that you find some other opportunity for yourself and just pause there for people listening yeah You will spend time, effort, and money, in my opinion anyway, and you tell me if you disagree, you will spend time, effort, and money trying to convince or motivate that person, and it will always be a negative ROI. Yeah. Yeah. I mean, he's one of those that you walk in. I mean, if he's listening, awesome, but I really don't care. I said it to his face. That's the next part of the story. That person is an Eeyore. That's what I used to call them. That's an Eeyore. They'll find the pain in every success. Yeah.

8:00 And that's it. So I spoke with them. I said, this is unacceptable. This is how we, you know, I'm running this now. This is how we treat. get with it or get off the bus, right? You have a week, right? And then that's where he, you know, didn't. And he got mad. Cool. Now he was very close with one other person. She was awesome. She kind of understood where I was coming from, but at the same time, she was way more attached to him than me. So she found other work, right? And then the owner of the company said, hi, we just flew you here three months ago and half your staff left. What the hell is going on? but addition by subtraction. Yeah. And I said, no, no, no, no, no. Trust me. Like you haven't spent time with these people. I've been in good clinics. Like this is not it. Right.

8:41 So like, okay. But like, you better find somebody good fast. So hiring, we got some great people on the bus. There was already a rock rockstar there who literally he went and He made his own clinic and he's been wildly successful in Phoenix about two or three years after I got there. Like I managed to keep him. I was very much like, hey, dude, you're awesome. How do I make your life better? Yeah. Right. The other person who stayed, she was really good, too. She was newer. Right. But she was very much a team player. So I was like, great. Awesome. We hired and we just got lucky. I want to say we got lucky with like who we brought in, how we trained them up, how we made it a team vibe.

9:21 Right. We also faced a big challenge with Medicaid in Arizona where it was a fifty percent cancellation rate with initial evals and we did one hour treats. Right. So we had a huge demotivation problem with people just not showing up. So PTs would say, what the hell, man? Like, I want to help people and they're not here. So we had to find kind of ways around that. And I can go into how we fix that. Well, how did you how did you go? What was what's in your mindset? Like, hey, man, I'm new to town and I just lost fifty percent of my staff. How did you do? What did you do to find people? Because you're new, like you have no roots. Well, the nice thing is, so we had, you know, there was an HR who they were putting out, you know, they always had people that they were kind of doing their whole like HRE thing.

10:05 Right. But I was the one that had final call on if they were on the staff or not. Right. And honestly, I was just, I was looking for characteristics. I look for, did you have bartending experience? Have you worked in retail? Have you done anything where you have to smile in the face of a pissed off customer? Right. And those people tend to be at least moldable. Right. They at least understand the downsides. PT, I don't know what it's like now, but when I came out, there were the kids who got in because they were smart. Then there were the kids who got in because they could afford med school, but they couldn't. Do it. Right. So they came from a lifestyle where nobody ever told them to eat. You know what? And remake my steak.

10:45 Right. So I'm not saying I wanted to go from that because there are people from that background who definitely could handle it. Right. But that was one of the primary things I looked at. And then as we broke it down, I would ask questions that would push them to kind of more like customer servicey because I thought I can train you to be a good PT. You're going to be forty hours a week with me staring at you. You're going to be good right now. That might have been cocky because I was three years out and I was twenty seven. But but at the same time, you know, I had I had the faith in myself that I could good coaches before I could coach somebody. So hiring characteristics. Got it. So what came next? What was that now that you've got, because if you don't have people, if you listen to Marcus Limonis, he's like, it's one of the three Ps, people, product, process.

11:32 So you got some bad out, you got some good back in, that's the people. Our product is always dependent on, for ours, we're a service. Yeah. Right. So our product is sort of dependent on our people. Those are a little closer. So what else did you do to change in a market like that? You mentioned sort of culture, like, what did you do to flip that? Well, you got to look at what every new grad wants. So they want to get better at what they just spend a lot of time at, right? They're really hoping their first job is like, I'm going to learn stuff and I'm going to be a badass. I call it a badass PT, right? Where I could fix anything. I can see a pro athlete and then I can see grandma and both of them are going to get better because I know what I'm doing. Basically, I pushed into that.

12:13 I was like, how much do you want? We brought in probably our second or third hire was awesome. She wanted to treat that population. She already went through residency. She wanted to start a residency program with a company. I was just like, how can I make you more of you? Everything you want to do, cart launch, as long as it doesn't lose us money. That sort of is... what a manager's job is. Like that's what people think. Like, well, I'm a PT. Now I run a clinic, which means I treat and then I jump back and forth and that's what I do. But really your job is to, my dad taught me and he was a fireman. He's like, I work for the, I work for the guys. I work for my firemen.

12:53 Like, so you flip it instead of like, you do what I say. It's like, I'm, what do you, what do I, what do you say you need? And what do I think you actually want or need? And it's my job to deliver that to you in some way, shape or form. Yeah. It's service-based leadership. And that's why all the, you know, fricking headquarters say this is the support center when really it's the headquarters. Right. And that service-based leadership, I will give props to my first job in New York. Very high volume because of, we took insurance in Manhattan. Right. But the owner, she drilled us on all like the top business books. So like seven habits and like good to gray and like all these other things, like we had really good leadership training.

13:35 What was the, what was the place? Uh, it was sports PT. Now I think a professional bought them right as I left. Who was your manager? Give her a shout out. Uh, Lynn Steenberg. She was the CEO of upstate and downstate and my direct managers. I had two of them, Alana and, uh, Alana Pekorski and Amy Alexander. And they were very like, I mean, Amy was the OCS. Alana was very good at like, you know, how could you have handled this differently? Like with the front desk, like I pissed off a front desk one time because I was like, well, why didn't you do this? And then she's like, okay, come here, let's break it down. You know, so that type of stuff. So I got very fortunate in that, right?

14:17 Yeah, huge. so that's a good thing i mean the good and bad of high volume it's stress and stress is how you make stuff right so um so yeah then then basically we grew we got to like seven full-time pts uh we were able to manage the medicare issue just by great communication like if somebody got it we would we would double book right and knowing that one of those insurance types had fifty percent cancellation and then we just basically all agreed look if they actually show then we all help each other out Right. But I think we did. I took the numbers and I actually made it because they had to see. They thought, my God, we're double booked all the time. And these guys are trying to rake me over the coals with money.

14:58 And then at the end of the month, I said, look, you're double booked once out of forty opportunities. Like, it's not that bad. And after about five or six months, everyone's like, boom, teamwork. Let's go. Let's get these people off our schedule. Right. So using numbers to motivate helped when they trust you, when they know that you're not going to be like, hey, I did everything. And these guys sucked at the next like board meetings. Right. So I'm already getting rewarded by the money, you know, so I don't need to be rewarded by like, you know, being like the fanciest guy. Like I want to always say like these guys are doing it. So you got to, it's, we could, I mean, we could do eight podcasts on this, but you've said that PTs actually have the skills to be good business owners. But in the intro, I said, Hey, listen, if you weren't taught that, so skills, skills are, and talents, you might have them, but if you don't know the, framework to execute, you're going to sort of waste those skills.

15:50 So what are we missing most of right now? And I'm talking about PTs who maybe aren't business owners yet. Where's the, oh God, I can't believe I'm saying it. Where's the gap? I know you wanted to say Delta and Synergy and all that other stuff. All right. So essentially what PTs don't realize is that they're salespeople. You have to sell somebody on a home program. You have to sell somebody on showing up and doing hard stuff that's not a pill, that's not an injection, that's not a surgery, right? You have to take the long road. It's got good evidence behind it, but someone has to get you through it. So you have to sell, right? That as an initial business owner is massively important, right? Like it's pretty much all I'm doing, reading about all that my first two years in cash practice.

16:34 um and then the other thing is we manage right i have a buddy who he was a pt with us and he gave it all up once i got his mba in villanova and now he's like a senior consultant with deloitte or whatever level of but he's doing well but he's not doing pt right and i said well how'd you do that and he goes honestly i was already doing it right with selling programs and managing people managing patients like all that stuff and he got up i think he was a manager clinic director a regional director um but he said it didn't help me at all and you know nobody gave me a job because i was a pt and an mba he said but once i got a job because i was an mba then i dominated everybody because i already did that stuff right so um yeah a lot of it is confidence and understanding that like failure is not destruction right so like you're not like if you don't close uh you know five new patients in your first month it doesn't mean that that was wasted time it just means that you just happen to have bad probability right like you're you're gonna close one out of every five patients in person one out of every ten and cold calls and cool you got the nine and the four in your first three months right so keep trying I explain it a lot.

17:45 People will say, I'll design a campaign or help them design a campaign. And they go, how well is this going to work? And I just go, locks and keys, man. And they go, what does that mean? I go, we just created a bunch of keys that we think are going to unlock people. But people are walking around on the interwebs or in person. And there are all these different locks. This is the best guess we have based on the information to make this campaign land. Same thing whether you're trying to hire. It's like, I'm going to give you my best idea. and I hate using the word pitch, but I'm going to communicate this as clearly and concisely and consistently as possible. And if it lands, great. And if it doesn't, I had the right key because I was telling the truth. You're just a different lock, man. Like, all right, well, good on you. And it doesn't, I like what you're saying.

18:26 That doesn't mean a failure on you or them at that point. Yeah. And I mean, well, what did you have to do to pass to get to the next, next, you know, year in PT school? Eighty percent or better. You know, we are we are failure averse. Right. And that is absolutely not what you can be if you want to own a business. And that's probably the hardest thing. is that you're like, well, I don't know if I should spend this money because I might lose it. And then Brian, who my co-host, who has six clinics doing two million in revenue and all that stuff, he's just like he's been doing it for nine years. And he's like, dude, I failed so many times. It doesn't matter. Right. He's like, you just get numb to it. And I think that's probably the biggest thing is building up that. I now recognize I used to not understand it.

19:09 I now recognize when I'm talking to someone who's going to hire me for communications, there's that pause and it's sort of this stare. off usually they look up into the right or the left or whatever i used to think it was because i wasn't clear and they're trying to understand me i now now i understand it's they understand me they're just quickly do they're like quickly looking into the future going okay hang on let me let me see how many it's almost like dr strange let me see how many different timelines i can see and okay seventy percent of the time that i've looked into the future this is a success and that math math's because seventy is pretty good they go okay i used to think i had to keep going and keep yep Throwing words. And the answer is shut up their thinking.

19:50 Let the other person think. Stop talking. Well, they say that in sales too. Stop talking. Don't talk past the sale. And again, what are we doing when we're educating? do this, do this, do this. Patient might ask a question, but like, honestly, kind of sometimes we don't want them to talk because we don't need to hear about their fourth present at their birthday party or whatever, right? We're like this, this, this, this, this. So again, we have to be like, okay, this is my price. pause, right? And then go from there. Cause you don't, I mean, there's, there's so much stuff you don't know, do not assume situations. So you have to, you know, being comfortable with that uncomfortable pause is one of the hardest things I've noticed.

20:32 When reels and shorts first started being a thing, I was like, all right, I've watched for a while. And then I'm like, all right, I'll try. What's my version of this? And I did one where I was like, let me take great advice from other people and remix that. And I did one from a former boss. And it was like, and it got a gajillion views because it was simple. And it was this. People understand what you just said when you're not talking. So maybe pause once in a while. And the analogy the boss would give me is like, you ever feed a baby? I'm like, yeah. He just sort of shoveled food in his mouth. He goes, no, you don't. You give it food and you wait. Otherwise, you're going to choke the baby.

21:13 That's how our brains work. It's like you just said a bunch of stuff. Now I'm going to chew on that. Okay. Now more food. Keep going. But we hate silence. So we fill it with words. And now it's just, you know, look at your patient or your baby. She's got food all over their face. Like, Oh, you got all the food on me. I just didn't get any of it in my mouth. Yeah. And that's the same. I would say that's the biggest change, right? Where if a business owner, I think that's where PTs get frustrated where they're like, I can't control. my clinic right i can't control how the owner decides i just did a linkedin post on this we had three clinics in phoenix and major chains one was ours if you couldn't see through that um the second they we were we were no ptas no techs i think we averaged at best nine and a half visits per day right oh i did thumb something yeah um and uh the next competitor, they did like twelve and they used the tech, but mostly for cleaning and like all that stuff.

22:13 And then the other was straight mill. It was one PT, two tax go nuts. Twenty five is a good day type of thing. Right. And all of them made generational wealth. right? When they exited or sold part of their business or whatever. So having that lack of control as the PT who's delivering that value, I think was the most frustrating thing for me is I would come up and say, we should do this. We should do this. We should do this. And even in the one that, you know, was very kind of one-to-one or as close to, you know, PT only care as you could be, there were still times where I was like, Why can't we do that? What's going on? Right. And that's what drove me to business ownership. And that's where I think my passion, the whole passion versus burnout.

22:53 I work way more now than I ever did. I think I was like thirty hours and then I was, you know, there. Yes, I'm working, but really it was patient cancellations and stuff. And I wrote notes, terrible notes, you know, so it's not like I was writing an essay. So I'm working like fifty hours and I'm like gone in it. So you said, hey, listen, and I've heard this before, retail and food service, it just makes for some pretty good DNA. It doesn't mean if you don't have it, you can't be good, but it is a pretty decent predictor anyway, anecdotally. So that's the incoming to PT. Let's go to a parallel. Why do you think, or maybe I'll ask even non-assumption. it feels like or how we talk internally as a profession that other professions like and i'll just cherry pick two dentists and chiropractors have it figured out faster than us why is that well originally if you really want to go back it's because they got out of managed care in the seventies right and they're like So, you know, dentists are not on health insurance plans for a reason, right?

23:54 They're also very cosmetic. So they don't have as much of a like burden of, I mean, they don't have the insurance company, basically dental insurance is a savings account, right? It's a coupon. But like, they also don't have the burden of like, professors in school being like if you don't do it it's fraud and if you don't if a person has a little bit less white but they can still use their tooth and chew then if you treat them you're an a-hole money grubbing whatever right so they're they have that cosmetic side right and chiropractic to a part they do with the whole like everything is posture thing But chiropractic was, again, on the outside of that kind of tower of like, it's the alternative medicine.

24:37 The ACA had to sue them to make sure that the AMA didn't tell them you can't go there. So they have it down because they had to get it down. Our issue is we were a branch of nursing. We've always been in the tower, right? So now we're trying to break out of it when everybody before us has said, wait, hold on, but they're just going to use their insurance, right? Or this doctor I'm really good friends with, I'm going to do this. So it's hard because you have seasoned clinicians. Like I've been working. Fifteen years. Right. New clinicians. And then even more seasoned clinicians, like thirty years out. Some of them get it there. You know, they'll think outside the box and they'll understand it.

25:19 Others will be like, what are you doing? You're an idiot. Right. And that's like the push to, I don't want to say cash only because, you know, cash is just a way to get paid. Right. It's like, it'd be like saying Home Depot's credit card only. It's kind of like that. Right. I agree. But at the same point, you know, having to say to somebody, okay, just because your knee hurts. Right. doesn't mean, and you can walk, doesn't mean you're living your best life and getting your best outcomes you're gonna want in twenty years. You wanna hike, you wanna play golf, you wanna do all this stuff, and your insurance tells me you can't do that, so we're gonna go for it on a cash-based level. know but even having that of like the insurance says we can't do it i think limits us right we don't have that like you know me versus the gym owner down the street who has a weekend certification i'm probably going to give you better advice right on how to move right but we still say like well i don't know because that's wellness and this because of this is we just weren't a lot that wasn't approved before If you get us all at a bar, throw a few pints on us, and we're going to say, dude, we totally know how to do that better, right?

26:26 So I think we're gun-shy. Yeah, I agree. I want to say thanks to Empower EMR. They've been supporting the show. We'll see them at CSM as well. The platform helping clinics simplify documentation, improve patient engagement, and get their time back. Really, it's the piece of software, maybe outside of texting, that you're going to touch the most in your day, unfortunately. you might as well like it. So pick the tires. I understand there's a pain or a fear of loss aversion of like switching. It's almost as bad as switching banks. I mean, God forbid we had to switch banks. That'd be crazy. They understand this. They'll walk you through the whole demo and they'll help you switch. EmpowerEMR.com. That is EmpowerEMR.com. So you've helped a lot of practice owners scale what's a blind spot that you see over and over again because when you i mean we're just big pattern recognition computers that's after a while right what's something that you're like when you walk in you're like i bet they're not looking at this so the the biggest well okay blind spot within the owner right because we do we do a q a session once a week it's like a hundred bucks a month and we just got on a zoom call and everybody which is such a which is such a ridiculously good idea Yeah, we're busy.

27:36 We got our own businesses. Let's zoom into this. Don't skip past it. So once a month, you do a Zoom session. And if a clinic owner, what is it? Once a week? Once a week, a hundred bucks a month. Okay. I might steal this model for comms people, which is like, hey, if you think my time's valuable and you're going to show up, you should probably pay a little bit for it. And then so who comes and what do they get? So they're business owners. We tend to it's hard because we don't want to shy away people who are like maybe thinking about owning a business. Like we're never going to tell them no. Right. Because it's a big group. Like anybody can ask questions, all that stuff. But people tend to come to us when they're stuck, right?

28:17 When they're stuck at a scale issue. So Brian has six clinics that he built, again, out of the back of his car nine years ago. And they're doing like two and a half million, I think last year. And I scaled for someone and then now I, and he's fifty-fifty. He just does fifty like fitness slash cash and then fifty insurance, right? Then I scaled this and now I did cash PT out of the back of my car. And the second year I made like one hundred forty K. So it's like we know what we're doing. Right. We know how to build things. You've stepped on landmines. You've then not stepped on the same landmine. And now you can help people not step on the same landmines. and that's it and we don't want to be a coaching business right like obviously if you pay us enough money we'll find an hour every week right but we're not trying to do that we just want to very much set it up to be like look we're running our own businesses we're trying out ai phone answering you know like call setting like all that stuff you're doing the thing while you're teaching it you're not exactly so you're not like i've got it all figured out it's like dude we're building the semi we're changing the tires on the truck as we're going down the interstate exactly so we have to keep it at a like one hour a week thing but that's why we don't charge you know thousands a month right it's just like look a bunch of people you can submit questions all that but essentially it's uh business owners trying to scale right so we have everything from like someone who has a full location three people and they're a cash practice and they're looking at okay how do i get myself a little bit out of this practice right because cash margins are better than insurance so she's trying to do it with one location all the way down to somebody who's like i just had my first year

29:49 under my belt with um you know, an insurance practice. And now I think I need to hire, what do I do? Right. And then it's that edge of a diving board that can cost you money and stunt growth because simply you're like, do I jump or not? And if so, what direction? And the wrong one could cripple you. So we do that stupid paralysis by analysis thing. Well, and the hardest thing is what we saw in the market is there's people who've made big businesses that are giving their advice. Right. But that's all they're doing right now is they're giving their advice based on the business they created five, ten, fifteen years ago. Right. And then there's people who did what I'm doing. Right. And they kind of stopped about where I'm doing.

30:29 And then they started teaching people who don't have businesses to have businesses. Right. And we looked at it and we said, but there's nobody doing the stuff now. Right. That's helping people get out of that like kind of danger zone between one million and three million in revenue each year. Right. It's a little bit different for service practices, probably about five hundred thousand to like two million a year. But that's the zone where it's like I'm working a lot in my business. And because I don't know how to scale to get to the next level, I'm miserable, right? So that's the kind of zone where, yes, somebody who's done it and, you know, sold their company like my old boss, she could definitely do that, right? But then they won't know anything about what's going on with AI. They won't know anything about what's going on with all the newer stuff that's coming out and what, you know, how I have to negotiate high rocks, you know, or something like that, right?

31:16 So, yeah. Yeah, we just saw like a gap and we're like, well, honestly, I think we did what you did. We're like, we should start a podcast. Yeah, honestly. So I'm walking through my first cohort of a podcast course, which I avoided because I didn't want to be a teacher, but I liked helping people. And then, you know, Tony and Dave were just like, we'll just do like a handful and then just talk to them. Like people want their handheld. You could go to Google and get this information on how to do it. That's not what they're looking for. They're looking for that thing that they can't get somewhere else. All right, so back to my original question before I derailed my own question. You're good. What are the blind spots that you typically see that the owners just they don't even see it? don't realize that they have to pivot to being a manager earlier right so they get to their business success one man show great marketing everyone knows them they love them right and they don't realize how important managerial skills are until they've lost like their third or fourth person right and that's expensive they're asking questions like well should i be pay per pay per patient or should i be salary and should i be this and of course again you the reason you join these groups is so you can take someone else's experience and fast forward your mistakes right so we'll be able to say don't do pay for patient you need salary so you can tell them what to do when they don't have a patient and you know like those types of things based on the business obviously but um you know that that blind spot of switching from a marketer who's the man

32:47 or the woman the rock star to the what we were talking about earlier in the pod about pushing everyone up and making sure that you're not the one and being able to do that now it's much harder in cash practice than it is an insurance um it can be done but you just your goals are going to be smaller in cash practice like i haven't i don't know maybe you know way more pts than i do like i don't know if i've ever seen a cash practice that's scaled past like five look or even three or four locations yeah that isn't the question is like what are you selling are you like are you selling are you are you the show because if you're the show scaling you is hard right exactly right so your job is to create more stars so you can you know and then manage them like you know gary v would say the goal would be to make these people so great they eventually leave or get poached like wouldn't that be great your people are so great someone wants to steal your people Well, and that's one of the biggest things.

33:37 So when I was in my corporate, the proudest thing I am, the proudest fact on my resume or whatever, is that I think nine of my managers are practice owners now. Or the PTA, she runs a practice for someone else. That's like being a college basketball or football coach and then being like, you know, all these guys are legit. You're playing your former assistants or former players in the NCAA tournament. That's got to be the goal. Yeah. And I mean, there's a intrinsic, like, you know, it's always nice to give to charity. It's always nice to help other people. Right. But at the same time, if you can say that, right. And somebody is looking to buy your practice, they can say, Oh, look at all the leaders here.

34:19 If he goes and, you know, screws off to some beach in Puerto Vallarta or whatever, I have eight more people or the people here could be the next people who open their own practices. And if I pay them enough money, they won't do that. They'll work for me. You know, so those, those types of things, it can be a beneficial thing. People always think it's like, well, why would you shoot yourself in the foot? And it's like, no, it's, it makes you way more valuable. Well, it's that whole line, like, well, what if we invest in these people and they leave? It's like, what if we don't and they stay? Exactly. Like, now you've got a team full of B-minuses. It's like, well, you rise to the level of your incompetence. That's as high as you're going to go. Like, I know Brian, he encourages all his PTs to have an Instagram, right? Like, to have a social media.

35:00 And he knows, like, yeah, one or two of them might leave, right? Because they're so good. At least I'll have an opportunity to keep them. Early in social media, and this makes me sound ancient, like, hey, before the social media times, kids, when it was popping up, I remember because I worked for a large corporate radio station. Now, I was in charge locally, but I was still owned by whatever. And the edict came down that... Official channels were only... We were only supposed to have a radio station Facebook page and a radio station Instagram that our people were on, where I was like, everybody should have their own. I remember CBS and stuff like that.

35:42 The lower third, whenever so-and-so reporter is out, whatever, and there's their name and then whatever. It was always like, follow us at CBS New York or whatever. And now if you look at it, it's like... cbs mike stevens right it's like they recognize that people follow people people kind of follow the brand and it's like now that's sort of a non-negotiable if you're a what if you're a pt my my view would be i have no problem combining our success attention wise while we work together but this is my ip and when i leave it comes with me Yeah. And that's the thing is as an owner, you have to, somebody who was always fighting the other guy down the street for getting all the referrals from that CrossFit gym or whatever, it is very, very hard for them to mentally shift to, I have to help other PTs get more patients.

36:31 And I have to put this person who really likes ballet, right? So I focus on golf in Scottsdale, right? That's my practice. I mean, that's right. To be fair, there actually weren't that many PTs who were doing it. They were like, Oh, we treat everything. And also golfers. And I was like, I only treat golf. Let's go. um so um yeah yeah a quick quick word to anybody thinking about a niche if there wasn't many people taking the golf pt in scottsdale niches are available uh so you're um but anyway they they don't they they're afraid to build up their people right and i don't know it's just It sucks because it's such a pivot. They actually call it the founder's paradox in business teaching.

37:12 And if you look at Travis Kalanick at Uber, Mark Zuckerberg to some extent could be this, where they were so good at building this monster. And then they had to hire like Asacha Nadella. Or somebody whose entire job is to keep everyone happy and let's not write that Facebook post and let's not do all that, all the stuff that got them to the top. So everyone faces it. But that's probably the biggest thing we see when we get to that sort of five hundred thousand to two million or one million to three million revenue is that that person isn't comfortable doing that. Yeah. You've said that business isn't necessarily intellectually difficult. It's more about character. Like, help me understand. What do you what do you mean by that?

37:52 So intelligence is just rate of learning, right? So if you are someone who has a high IQ and like a lot of PTs, right? I'm sure if we put them all through an IQ test, I don't even know if they do those anymore, but I'm pretty sure we would skew to high, right? The thing is, it's rate of learning. So like if I take someone who is a box of rocks, right? They are not the person who has a high IQ level. But if I show them the same thing, twenty times, right? But I show the high intelligence person zero times, that person's gonna get it, right? Now it's gonna take them a long time, right? Or if you take something more abstract where everyone knows, okay, I gotta learn pricing or I gotta learn this, right?

38:36 An intelligent person should take two or three times reading that book to really get it and understand it, right? Or seeing it in real life, right? But if that intelligent person is lazy and they don't read the books, and they don't take the risks but that unintelligent person it takes ten times for them to do it they're like cool got shut down next call cool got shut down next call i'm going into this gym down the street that i've never even heard of but whatever here's my card they will learn faster right so that's not the case when we're talking about tests that have to be done in two three minutes or sorry two or three days from when you get the information and a patient where you have to have pattern recognition over a long period of time you know and you're a new grad right intelligence really helps with that i have the books i have two or three things i'm super intelligent you only have to tell me two or three times i'm good so i'm gonna hard work beats talent when talent doesn't work hard Yeah, exactly.

39:28 Thank you for diluting two minutes of me rambling to one note. The thing is, I'm like, someone said it. I'm really good too. I could not for the life of me tell you who said that, but I'm good at remembering quotes, but not remembering who to quote and give credit to. So I always go, I can't remember who said this. It wasn't me. I'm not trying to take credit. That's why you're the communication guy. Essentially, LeBron would have been pretty good, but if he didn't work, there's people who say if he didn't work, even his talent was that big, you might not make it to the NBA because there's guys with less talent. I've heard this one. There are stupider people than you making more money simply because they just decided not to quit and no concept of failure. Just going to do it again. Going to do it again. Going to do it again. Yep. And you can add about that.

40:08 Yeah. No concept of failure. All right. Last thing before we go to a game, what's one thing a physical therapist listening right now could do today to start thinking more like an entrepreneur if they're not one already? man, I would say, honestly, books really helped me like reading the business books. Like everyone makes fun of them, but like, those are guys it's, it's, I mean, again, now it's YouTube podcasts, things like that, but essentially it's just, it's either written or it's, it's verbal. That's really where it is. Take the guy who's done it and written it down and then learn from that. So then you don't have to make that mistake.

40:49 You mentioned Jim Collins, Good to Great. You mentioned Stephen Covey, Seven Habits of Highly Successful People. What else is on your short list? I always like collecting book recommendations. I always give Crucial Conversations to my managers. Who's that one? Oh, God. Don't ask me that question. It's a famous one, so Crucial Conversations. That's a, that's one that I would always give to a manager because when they don't want to have that kind of that performance conversation, they don't want to be personal. They have to figure out how to objectify it. Those are my, like probably honestly my top three that I give to people. And then just kind of whatever I'm reading, like it depends on the person. Like, There's all kind of the greatest hits and all of them have good advice. You know, atomic habits is what everyone says.

41:30 Right. So that one wasn't bad. I mean, that one, I can distill that one down, which is like build one habit, repeat it, repeat it, repeat it. Once it's a hat was takes thirty or sixty days, something like that to build an actual habit when wire rewire your brain. We know this. We know this. That's the funny part is it's just putting words to the thing you probably don't know. Like, what's that quote? The results you're looking for are hiding in the work you're not doing. It's like, you know, you should be doing that, but you just leave that in the corner. So you don't do it. And you're like, I don't know why I'm not getting successful. It's like, hmm, I got an idea. What's that pile over there? Well, and this is the problem. There are a lot of people who basically, they consume all this entrepreneurial content. They can tell you, this is what you should be doing in this. But honestly, if you were to ask, I mean, to distill my best piece of actual advice, like outside of read books, right?

42:15 Just do it, right? Like just freaking do it. My accountant told me this. I was like, so what do I need to do? Like set up an LLC and like blah, blah, blah. He's like, dude, just go earn money. I'll tell you what to do later, right? And I was just like, okay. Then I called my wife right afterwards, right? So now that looks different for people, non-competes, things like that. You can find a different avenue, right? Do a wellness thing. Do a fitness for golfers, right? While you're a PT at the local hospital and start saying, hey, can I sell this, right? Can I do this, right? That's the nice thing about the US. No one's going to fault you for trying to start a business, right? Like it's pretty much encouraged. So yeah, I would just say get out there and get your reps in.

42:56 Here's a game we're going to play. We're calling it Growth Guy Gut Check. I'm going to hit you with some rapid fire growth scenarios. You just give me your gut reaction. Sentence or less, right? Got it. A PT says, I hate selling. What do you respond with? Do you hate getting people better because you're doing it every day? There you go. Perfect. Clinic owner wants to scale but won't delegate. um how's that burnout feel yeah i like this you got a thousand dollars and you need to get ten evals and all you have is the trunk of your car where are you going you gotta be you gotta you gotta get you gotta earn a thousand dollars by five o'clock today or we kill your puppy what are you doing to get you have to get ten evals oh okay so i was gonna say the best thousand dollars i spent when i started was bni group uh referral based networking local business group um If I had to do a thousand bucks to get patients, I would buy a very big stick and start hitting kneecaps.

43:47 I don't know. Like I would, I would probably put myself in a very, I would do guerrilla marketing. I would just put myself in a very high area, high volume area and just say hi to every single person I knew. And that sounds ridiculous. I would buy the merchandise. That sounds ridiculous, but that's all we do on the internet anyway, right? That's a high traffic place. We try to stay high as much as possible. These things make sense. Three more, three more. What's a red flag higher in a growing clinic? Um, I would say a red flag hire in a growing clinic is someone where they don't completely check the teamwork boxes. Right. And it's, it is very hard to do that because everyone says they do.

44:28 Right. Um, and that's why you have to ask the questions, you know, in their history, what have they done and, you know, all that, but that vibe of, you know, this doesn't, this seems like it's, he's the, he or she is going to be a me first person is like the last thing. And sometimes people are trying to like get know i'm awesome look how good i am so you have to ask questions to break that down but yeah got it two more uh quick test is your clinic owner mindset uh strong or soft is it strong or is it soft skills which one's more important clinic owner mindset Oh, soft skills. Cause anyone who tells us PT doesn't have a market to BS. Like if you were in a very competitive market, uh, where there was a lot of people doing the thing like fitness, right?

45:12 You have to be hard. It's like, you gotta get out there, sell. Everybody can do this thing. Barrier entries, low, all that stuff. Honestly, the people who succeed in our business are the people who have really good soft skills that can keep therapists happy for a long period of time. Agreed. All right. Uh, last one, favorite mindset or business quote from any of those books that like you pull out that's in the holster. It's actually a history book. Okay. John Lewis walking with the wind in the epilogue. He wrote, you just got to outwork them. That's it. Yeah. And to have someone who got the absolute crap kicked out of him for something he believed in saying that, like the way I got there is I just did more. Yeah.

45:52 really kind of, it's so succinct and so tight that you're just like, well, if he can do it, then I can, I can go give my business card to this business owner, you know? So yeah, you got to outwork them. I'm sure millions of people have said those words together, but that was the one that stuck. Yeah. Hard work beats talent. Talent doesn't work hard or be so, Steve Martin, comedian, be so good. They can't ignore you. Like, all right, how do I get better? I don't be so damn good that they're like, who's the best? Like, I don't want to tell you it's him, but you know what? He's so damn good. It's him. All right, last thing we do on the episode is called the parting shot. This is the parting shot. One last mic drop moment. No pressure. Just your legacy on the line.

46:33 So I might have made this hard because I just asked you to give a great quote. This is a spot for either a quote, mindset, or just something you said before you want to repeat, which is what's the last thing you want to leave with the audience today? Business is not conceptually hard. It's a try hard thing. It is very much a thing where be afraid, don't be, well, I shouldn't say don't be afraid to fail, but just get out there and do it. If you're burnt out, it's not everyone's a business owner, but don't look at burnout as a quantitative thing, how many people I see. Look at it as, am I happy? Do I have autonomy? And if you don't want to do that in a business, find it somewhere else in your life.

47:14 Love it. All right. If someone wants to reach out, what's the, where do you want them to go to find you? Like if they're like, Hey, that weekly thing sounds cool. Like where am I going to find that? So our company called is called physio growth. Instagram is at the physio growth guys. Cause physio growth was taken. The, we have a school page. You just search physio growth on school and website physio dash growth.com. And our podcast is the front row back row podcast presented by physio growth. because one of you sat in the front row in PT school. I, I loved when I saw your podcast as a side note, because I started out saying in PT school first year, I was in the front row. Cause I was like, if I'm in the back, I'm never, and I'm paying for this and this is expensive.

47:55 I better be paying attention. And then by the third year, I don't even know if I was in the back row anymore. I think I was just standing in the back of the room. Cause I was like, okay, get me. I want out like, okay, I'm ready to go guys. I agree. Let's just do it. I appreciate the time, man. Thanks. Thanks for this. Love it. 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 pgpinecast.com or find us on YouTube and socials at pgpinecast. And legally, none of this was advice. It's for entertainment purposes only. Bullshit! See, Keith? We read the script.

48:35 Happy now?