Leadership Development, Expansion, and Growth - Practice Owners Manual Series, Part 9

[00:00:00] Leadership Team

[00:00:30] Welcome. You've entered the Physical Therapy Owners Club podcast, where your host Nathan Shields and other successful PT owners and leaders share their experience and insights on how to build successful PT businesses.

[00:00:42] They'll share the stories of their paths to success and show you how you can also obtain greater freedom and more profits from your business.

[00:00:50] That's what the PT Owners Club is all about. Greater freedom and more profits.

[00:00:54] There's plenty of room for you as well, so come on in and join the club.

[00:01:00] Hello everybody, and welcome back to the next episode in our series of the quintessential bulletproof practice owner's manual for success.

[00:01:09] Hopefully you appreciated the previous episode, took lots of notes, did some homework.

[00:01:14] Now get ready to do some more work on your business. Get out pad and paper and let's go.

[00:01:19] Hello and welcome to the Private Practice Owners Club.

[00:01:24] We are on our final episode of the Practice Owner Manual Series.

[00:01:28] This is episode number 10 of that series, part nine.

[00:01:34] And today's focus is growth and expansion slash leadership development.

[00:01:41] So Adam, this is awesome man.

[00:01:43] Thanks for coming in again.

[00:01:44] Yeah, dude.

[00:01:45] Happy to be here.

[00:01:46] All right.

[00:01:47] So you've listened to us for a number of episodes up into this point.

[00:01:51] Hopefully you got into this point and laying out a foundation for your company that you're got some solid pieces in place.

[00:01:58] You've got some processes in place.

[00:01:59] You've got them number one written down, number two, you're following through on them.

[00:02:02] You've got other people following through on them with you went through a lot of the basics and what and you're thinking, all right, I've got this opportunity.

[00:02:09] I've got such and such building has a vacancy now.

[00:02:13] It's a perfect part of the city.

[00:02:15] There's a ton of traffic.

[00:02:17] I want to open up over there and I've got to do it now.

[00:02:20] Today we're going to talk about if you should or not essentially.

[00:02:25] This is what we're going to talk about.

[00:02:27] So hopefully you've gotten a lot of value from the previous episodes.

[00:02:31] This one will kind of wrap a bow on it and I'm sure we can add more to it as we get down the road.

[00:02:36] And as we get feedback from you guys as to what more you'd like to hear about, but we'll focus on these 10 for now and package them

[00:02:43] for you. I mentioned it in the first episode that we did with these is that Adam's going to be putting these together in a special package for members of our clientele,

[00:02:54] our coaching clients and making it part of our vault.

[00:02:58] We have a, Adam has built out a huge robust vault and congratulations by the way, Adam, that's pretty awesome for people who are looking for all the specific

[00:03:06] risks of the things that we've mentioned, all the nuts and bolts and details, the job description, the templates, the name that can help with your policy and procedure creation

[00:03:16] and how you interact with your team.

[00:03:19] He's put a ton of that together in our vault that is available to our coaching clients and this is going to be a big part of that and taking people

[00:03:25] from startup to the growth and expansion phase.

[00:03:29] So number one, congratulations on putting up this all together, Adam.

[00:03:32] Thanks man.

[00:03:34] Yeah.

[00:03:34] But number two, this is going to be a big part of that.

[00:03:37] So as we're looking at growth and expansion, I think one of the things we want to talk about first and correct me if we should start with different

[00:03:46] tactics here, but that is looking at developing out leadership in your team.

[00:03:51] Do you want to start there?

[00:03:52] Do you want to go somewhere else?

[00:03:54] Well, if you haven't listened to the previous episodes, then I think that's where you start.

[00:04:00] So like this is going without saying and we'll get into that, but it's going like you have a marketing plan in place.

[00:04:07] You have policies and procedures.

[00:04:08] They're ring ring effectively.

[00:04:10] They're you're hiring.

[00:04:11] You have a hiring process.

[00:04:12] You have all the recruiting systems down like all those things are done for the like they're done.

[00:04:17] They're complete.

[00:04:17] They're efficient and you're not doing all of them.

[00:04:20] Right.

[00:04:21] So yeah, I think leadership is a good place to start.

[00:04:23] Yeah.

[00:04:24] Let's talk about leadership.

[00:04:25] Yeah.

[00:04:26] We haven't really discussed that much because we talked we banged the gong a lot policy and procedures and creating

[00:04:31] SOPs and job descriptions and that kind of stuff.

[00:04:33] And those things are very helpful in making sure that your clinic is running based on policy and not by people.

[00:04:42] You know, I mean, it's a policy run organization is a much more effective and productive organization than a

[00:04:48] people run organization because a people run organization is going to be dependent upon the people

[00:04:54] and whether or not they want to work today or if they're productive or their opinions versus what needs to be done

[00:04:59] versus a policy run organization, which is run by policy no matter who's there running it.

[00:05:05] And that can be effective, efficient, consistent.

[00:05:07] You name it.

[00:05:08] So building out leaders then on top of that is an essential role in your expansion because at some point for you to move

[00:05:18] up in the organization and seeing yourself on the organizational chart and moving to the next box up above it and

[00:05:25] not filling in all the boxes down below from janitor to front desk operator, then it requires you to build

[00:05:32] out some leadership, some teams of leaders that can do some of this work and you can delegate some of these

[00:05:38] issues to people.

[00:05:40] So I think one of the things that we've talked about in the past that helped me a lot because a lot of

[00:05:47] people don't know where to start.

[00:05:48] So I want to have a leader on my team.

[00:05:50] Maybe that person is a leader over the front desk personnel.

[00:05:54] Maybe that's a leader over the clinic director per se, but where to start is like, do I just give them a title

[00:06:04] and send them off on their way?

[00:06:06] That's what I would have done in the past and told them kick them out of the nest and say here figure out

[00:06:11] how to fly.

[00:06:12] But a much better way is to be a little bit more intentional about leadership development and growing

[00:06:18] leaders on your team.

[00:06:20] So one of the first things that I like to consider when I'm considering leaders are, okay, I have my core

[00:06:25] values in place and I have some productivity metrics.

[00:06:29] Who are some of the people on my team that pretty well follow our values and align with our

[00:06:37] purpose all the time?

[00:06:39] They do a really good job with it.

[00:06:41] They fit into the culture.

[00:06:42] They work well with others.

[00:06:44] The business is better because they're there.

[00:06:47] I would enthusiastically hire them again if they came before me.

[00:06:52] They're really good at producing.

[00:06:54] Like producing is not a concern of theirs.

[00:06:58] That's the first place I would start.

[00:07:00] Tell me what you're thinking of as you're thinking of how to differentiate and find those

[00:07:04] initial leaders in your company.

[00:07:06] I think that's exactly right.

[00:07:08] That's perfect, right?

[00:07:09] Just imagine like you're in the clinic and something really terrible happens.

[00:07:14] Maybe not too terrible, but something that's just kind of like, oh, it's disruptive.

[00:07:18] It's not fitting into my schedule.

[00:07:20] There's one person that you're going to call.

[00:07:23] Who are you going to call?

[00:07:24] That's probably your leader, right?

[00:07:26] The person that's just dependable.

[00:07:28] They show up.

[00:07:29] They're consistent.

[00:07:29] They're dialed in.

[00:07:31] I always like to use what is this like on the horizontal axis?

[00:07:34] It's it's maybe it's production or no, it's value alignment.

[00:07:38] I mean, vertical axis is value alignment on the horizontal.

[00:07:41] It's production, right?

[00:07:42] And you want people who are maximally value aligned and maximally productive.

[00:07:47] Those are your A players.

[00:07:49] The upper right quadrant of people.

[00:07:50] The upper right quadrant, right?

[00:07:52] Those are the people that are like, hey, they're going to get it done.

[00:07:55] And you know what?

[00:07:55] They're going to they're bought into the culture.

[00:07:58] Start hanging out with them a little more.

[00:07:59] And as it retains the growth and expansion, it's really hard to do

[00:08:03] that without those type of type of people on your team.

[00:08:05] It's impossible.

[00:08:06] Like there's only so much heavy lifting that you can do by yourself, right?

[00:08:12] Heavy lifting, meaning like doing the hard things, making the hard decisions,

[00:08:16] doing the hard things, doing, putting in the hard hours, right?

[00:08:20] You can't do that all by yourself forever, especially maybe one clinic.

[00:08:23] Maybe, but like definitely not to you're going to need somebody who's

[00:08:28] who wants to pick that boulder up with you who's picking it up and like,

[00:08:31] hey, I got you.

[00:08:32] Yeah, because at some point you become the hurdle to the company.

[00:08:36] Correct.

[00:08:36] If it's all on you, you're the weak link.

[00:08:38] Yeah, you become the weak link.

[00:08:40] Honest and what's interesting is people will say that, but they don't

[00:08:43] actually believe it because they want to think that they're the exception

[00:08:45] to the rule.

[00:08:46] And I've got all the time.

[00:08:48] I don't have the money.

[00:08:49] I know all the answers and it's easier for me to just do it myself

[00:08:53] than to have someone else do it.

[00:08:55] Good luck with that.

[00:08:57] That won't last long.

[00:08:58] No, it won't.

[00:08:59] No.

[00:09:00] And so what do you say to people might be saying, what if I don't have

[00:09:04] any of those people on my team right now?

[00:09:06] Yeah, gotta find them.

[00:09:08] I would say that you probably have the wrong people in the bus.

[00:09:11] You know, there was a time when we were coaching you were coaching me

[00:09:14] and I had it all in place.

[00:09:16] I was like, I've got two or three pts on my team.

[00:09:20] I had my front desk.

[00:09:21] You know, I thought I had it all in place, but I had enough in

[00:09:23] place to where I was happy.

[00:09:25] I was like, hey, I'm ready to start thinking about clinic number

[00:09:26] two, but we weren't growing.

[00:09:28] You know, like we weren't really growing.

[00:09:29] Like we were just kind of stagnant.

[00:09:31] And I was like, Nathan, like what's going on?

[00:09:33] Like what do I need?

[00:09:34] And you said something really that really hit me.

[00:09:37] And you said your pts just aren't that good.

[00:09:40] Sounds like you just need some better pts and that really resonated

[00:09:43] with me.

[00:09:44] I realized like, oh my gosh, like I don't have anybody on my

[00:09:48] team who can help me at that capacity.

[00:09:51] I have a bunch of staff people on my team.

[00:09:54] Guess what?

[00:09:55] I had to go recruit and find an A player and replace them.

[00:09:59] And through that process was unlocked so much possibility.

[00:10:02] I went and found two A player pts hired them opened up two more clinics.

[00:10:05] Right.

[00:10:06] Yeah.

[00:10:07] Well, go back and listen to the last episode about recruiting.

[00:10:10] Yeah.

[00:10:12] And the one before that about hiring and onboarding and focus

[00:10:15] on that if you don't have those people on your team right now

[00:10:18] because that's one of the reasons why we were always hiring

[00:10:22] add out for all of our positions.

[00:10:23] We are always going through that process simply because

[00:10:26] the best way to grow is to get a bunch of A players.

[00:10:31] And the best way to stay stagnant and not go anywhere is to

[00:10:35] tolerate C players and you'll stay in business, but it won't be

[00:10:40] fulfilling.

[00:10:40] You'll have a culture that you don't enjoy.

[00:10:42] You'll have people around you that you don't enjoy spending

[00:10:45] a majority of your life with because you're there eight to

[00:10:48] 10 hours a day.

[00:10:49] Yeah.

[00:10:50] Go out and recruit and find some more people.

[00:10:52] Honestly, it's a hard pill to swallow because that's like,

[00:10:54] oh crap, that's a lot of work.

[00:10:56] Yeah, it is a lot of work.

[00:10:57] It is a lot of work.

[00:10:58] But if you have aspirations for hire, it hit me when I heard

[00:11:02] it the first time and I say it all time.

[00:11:04] The people who have gotten you here are not the people that

[00:11:08] will get you there.

[00:11:10] You have to replace them.

[00:11:11] Even the good ones even the good ones and what I found

[00:11:15] is the ones that like the front desk people that stuck

[00:11:18] with me when I was at 50 visits a week and then I grew

[00:11:21] to 150 and I wanted up a second clinic and I started

[00:11:24] implementing policy and procedures on how things should

[00:11:27] get done.

[00:11:27] When I didn't have those struck that structure in place,

[00:11:30] that person that I swore by that I would live and breathe

[00:11:34] and die with and wanted to be on my team for the rest of my

[00:11:37] life when they got to 150 and they started seeing changes.

[00:11:41] That person was expendable.

[00:11:43] They couldn't follow the policy and procedure.

[00:11:45] They acted out.

[00:11:46] They didn't follow the values and that just speaks

[00:11:49] to the people that got you here are not the people

[00:11:51] that will get you there.

[00:11:52] You need newer skill sets.

[00:11:54] You need greater capabilities.

[00:11:55] You need to develop leaders and the sooner you do it,

[00:12:00] the sooner you'll be able to grow and expand well because

[00:12:03] as you find those people that are value aligned, buy into

[00:12:07] the culture, help you establish it.

[00:12:09] The policy and procedure lead out on the team and are

[00:12:13] looking to produce and do more with you.

[00:12:16] Those are the people that are going to lead you to further

[00:12:18] growth and expansion.

[00:12:20] That's right.

[00:12:21] If you've done or implemented everything up to this point.

[00:12:24] Well, you should have a team clinicians.

[00:12:26] They're fairly productive.

[00:12:28] You've got a clinic that's growing.

[00:12:30] It's profitable.

[00:12:31] Everybody's pretty organized and at some point it's time

[00:12:34] for you to start stretching your team.

[00:12:38] Right.

[00:12:39] That and that came from a from a mentor of mine.

[00:12:41] It's like your job is to stretch your job is to get

[00:12:44] not average results out of people.

[00:12:47] Your job is to get extraordinary results out of

[00:12:50] people help them become the best versions of themselves.

[00:12:54] They got to be willing to do hard things.

[00:12:56] And if you want to find out who wants to be an A player and

[00:12:59] who doesn't start stretching them a little bit and they'll

[00:13:02] tell you really quick who wants to step up and do it and

[00:13:05] who doesn't.

[00:13:06] Yeah, because the default is if I've got this experienced

[00:13:09] PT who's got maybe some managerial experience over other

[00:13:12] PTs has been a clinic director in the past and is super

[00:13:14] productive and just assuming that they're going to be

[00:13:18] great in this manager capacity in your company.

[00:13:22] That's a huge you're leading yourselves to a potentially

[00:13:26] huge problem.

[00:13:26] They could be great, but they need to learn leadership the

[00:13:30] way or they mean to learn how you do things in your

[00:13:34] company, how you lead others in your company, which could

[00:13:38] be totally different than what they came with.

[00:13:40] Now what they came with and experienced in the past.

[00:13:44] Your by all means welcome to bring that forward and

[00:13:48] say, well, we did this over here and I think that worked

[00:13:50] rather well.

[00:13:51] Do you want to do that here?

[00:13:53] Yes or no.

[00:13:55] And then that's up to you as the leader to say, I appreciate

[00:13:59] that, but I see it this way and I'd rather do it this

[00:14:02] way.

[00:14:03] So you appreciate that experience and you appreciate

[00:14:06] their experience in terms of brainstorming and bringing

[00:14:08] solutions to the table, but you need to still be the

[00:14:11] ultimate determinant because sometimes a good B player

[00:14:15] that is productive is not the best leader.

[00:14:19] There are some people who are just meant to be worker

[00:14:20] bees and they just want to be worker bees and they can

[00:14:23] do that.

[00:14:24] But what we're talking about is growth and expansion

[00:14:26] and moving forward.

[00:14:27] Those people could have a place on our team, but it

[00:14:30] was understood that they really weren't going to go

[00:14:32] anywhere that their responsibilities outside of

[00:14:35] treating patients or run in the front desk were

[00:14:38] not much.

[00:14:38] Maybe they were more superficial about leading out

[00:14:41] on the charity drive right or on the birthdays

[00:14:45] making sure everyone got a birthday card on their

[00:14:47] birthdays and they had other responsibilities that

[00:14:49] weren't necessarily leadership roles.

[00:14:52] So there are those people and that's the default is if

[00:14:54] I'm going to find a leader, I need to find that person

[00:14:56] who has a ton of experience and is super productive.

[00:14:59] That's not totally true.

[00:15:01] Right.

[00:15:02] It starts with are they value aligned?

[00:15:05] One of my best clinic directors was a PTA.

[00:15:09] She grew up with me from a really small clinic.

[00:15:12] I don't know why, but she was super loyal to me

[00:15:14] and she stayed with me through all the hard lessons

[00:15:18] that I had to learn and all the crap that I put her

[00:15:21] through.

[00:15:22] But once she got some, we gave her some structure.

[00:15:24] She was a great clinic director.

[00:15:26] Man, they could produce.

[00:15:28] It was amazing because she wasn't the best PTA.

[00:15:31] She was a productive PTA, but your skills weren't

[00:15:34] necessarily there, but she was a great leader.

[00:15:36] As people loved her.

[00:15:38] And so there are those people that you've got to

[00:15:40] find that they're just not default to the most

[00:15:42] productive, most experienced persons.

[00:15:44] I guess if that's what I'm trying to say.

[00:15:46] Yeah, I would say my experience working with owners

[00:15:49] is it's usually that one clinician who's just like

[00:15:54] rock solid.

[00:15:55] You have a training in place.

[00:15:57] You're training other.

[00:15:58] They're helping you train other therapists.

[00:16:00] They're helping you keep them productive.

[00:16:02] They're almost acting like a director.

[00:16:04] They're helping you lead out on the team meeting some.

[00:16:06] Right.

[00:16:06] They're really, really active and then so that person

[00:16:09] whoever that is in your in your practice and then

[00:16:12] very much likely that front desk person who's just got

[00:16:17] the whole front desk figured out and they're maybe

[00:16:20] helping you train other front desk people.

[00:16:23] And then maybe they're they're helping you with payroll.

[00:16:25] They're helping you with your account and they're

[00:16:26] kind of tied into some of your personal things that

[00:16:29] and they have access to some of the personal

[00:16:31] things that maybe not everybody has access to.

[00:16:33] Those two people, I mean, that's kind of like

[00:16:35] your first leadership team.

[00:16:36] It's you and those two you have you, your administrator.

[00:16:38] Right.

[00:16:39] And then you have your client director.

[00:16:41] Right.

[00:16:42] And so it's like, Hey, this is the inner circle.

[00:16:45] Right.

[00:16:45] This is the leadership team.

[00:16:47] So step one, like let's establish a meeting rhythm

[00:16:50] where we can start talking about things outside of

[00:16:53] the team meeting some of the bigger topics, some of

[00:16:57] the bigger plans and start having that leadership

[00:16:59] meeting outside of the other.

[00:17:02] Yeah, definitely.

[00:17:03] And I think when when you're looking at leadership,

[00:17:06] we talked about onboarding, I think two episodes

[00:17:09] ago, and you need to consider that coming into a

[00:17:12] leadership position like this also requires its own

[00:17:15] onboarding.

[00:17:17] Like so I've mentioned this numerous times in past

[00:17:19] episodes, but the last thing you want to do is

[00:17:22] to give somebody a title along with the salary bump

[00:17:25] and then start training them.

[00:17:26] That's the wrong way around.

[00:17:28] So for us, the clinic director meant they

[00:17:31] initially got there was an agreement.

[00:17:33] We decided on this person.

[00:17:34] They agreed with us.

[00:17:35] Hey, I want to become I want to path the

[00:17:36] leadership great.

[00:17:37] Okay.

[00:17:38] All right.

[00:17:38] So we're going to put you in the leadership development

[00:17:40] program and while you're in the leadership development

[00:17:43] program or at least at some point during the

[00:17:45] leadership development program, we're going to give

[00:17:48] you a title of clinic director in training.

[00:17:50] Right?

[00:17:51] No salary increase, but you're going to start

[00:17:52] learning what it means to be a leader in our clinic.

[00:17:55] That includes this leadership program, which might

[00:17:59] be reading some books that we agreed to.

[00:18:02] I think we've done a full episode on this

[00:18:04] before because this sounds familiar.

[00:18:06] Look back somewhere in the last eight months or so.

[00:18:09] I'm pretty sure we've done something like this.

[00:18:11] Read some of the same books that were influential

[00:18:13] to the owner.

[00:18:14] Here are some of the trainings.

[00:18:16] Here are some of the meetings that were expected.

[00:18:19] Maybe give them some homework, lead out on a meeting.

[00:18:22] Here's a problem in the clinic right now.

[00:18:24] Bring to me two or three solutions on how

[00:18:26] you would handle it.

[00:18:27] Hey, here's a charity drive.

[00:18:29] You want to lead out on that?

[00:18:30] Give them some opportunities to lead.

[00:18:32] Watch how the team follows them or not.

[00:18:35] Right?

[00:18:36] Let them implement solutions and walk them through it.

[00:18:40] Coach, this is where you become the coach.

[00:18:42] Right?

[00:18:43] I'm coaching you to become a leader.

[00:18:46] And how are you going to handle this when so-and-so

[00:18:49] is not productive?

[00:18:50] What are the KPIs that you're going to track?

[00:18:52] And how often are you going to track them?

[00:18:54] And how are you going to report them to me?

[00:18:56] Your supervisor, your direct report.

[00:18:59] So developing out a leadership program is the next stage.

[00:19:03] Once you've identified that person, they've been on your team.

[00:19:05] You've noticed their value aligned.

[00:19:07] They're productive.

[00:19:08] Now you engage them into onboarding to leadership through

[00:19:12] your leadership development program.

[00:19:13] And it doesn't have to be long and exhaustive, but you got

[00:19:17] to be able to have them show themselves that they are

[00:19:19] leaders in some capacity with a little bit of coaching.

[00:19:23] Absolutely.

[00:19:24] And you've got it.

[00:19:25] There's nine episodes of material to pull from.

[00:19:30] It's like, you talk about your purpose and values and what

[00:19:33] it means and why it's there and why we have a sales process,

[00:19:37] what it means and why we market and what marketing is.

[00:19:40] Right?

[00:19:41] What's the board and the onboarding process and the

[00:19:44] hiring process?

[00:19:45] What is the policy and procedure?

[00:19:46] How do we do it?

[00:19:47] How do we do a team meeting?

[00:19:48] This is how we lead it this way.

[00:19:50] And you really want to create mini CEO, right?

[00:19:55] Somebody who's a mini version of yourself that's inside

[00:19:58] that clinic who can think and act similar to you, you know,

[00:20:02] and maybe they're not the true CEO, but they can behave

[00:20:04] as if they are a CEO of their world.

[00:20:07] So they need to know those things.

[00:20:09] Right?

[00:20:10] And I remember doing not my first clinic director training,

[00:20:14] but the second one, once I polished it up really, really

[00:20:16] nice, it was really, really cool to hear them say,

[00:20:20] wow, this is really awesome.

[00:20:22] I really understand why we do some of the things that

[00:20:24] we do now, right?

[00:20:26] And then once, once they understood the why we actually

[00:20:29] talked about this in the meeting that we had with our

[00:20:32] team just before this, but like once they understood the

[00:20:33] purpose and how this all fit into the big picture, man,

[00:20:37] the buy-in and the drive that they had and they really

[00:20:40] owned it.

[00:20:41] Right?

[00:20:42] Just helping them see that and then coaching them through

[00:20:44] how to apply it to their day to day.

[00:20:46] Six months later, you have a great leader who can help

[00:20:48] you do some of the heavy lifting.

[00:20:53] Hey everybody, we finally did it.

[00:20:55] Finally, we're doing our first in-person event,

[00:20:58] the Private Practice Owners Club first ever in-person

[00:21:00] conference, September 20th and 21st in Clearwater Beach,

[00:21:03] Florida.

[00:21:04] Adam and I are super excited.

[00:21:06] Really can't wait to finally meet you in person.

[00:21:08] This entire time I've been preaching, reach out,

[00:21:10] step out, network, and I can now provide that to you,

[00:21:14] not just virtually or via podcast, but in person.

[00:21:17] We'll have speakers that speak on leadership and

[00:21:19] growth.

[00:21:19] We'll answer questions to your current issues.

[00:21:21] We'll provide you opportunity to network with like-minded

[00:21:24] individuals and obviously gain inspiration and energy

[00:21:27] from being in the room with the same people.

[00:21:29] You'll be able to literally reach out, step out, and

[00:21:32] network all in one weekend, September 20th and 21st at

[00:21:35] the Hyatt at Clearwater Beach, Florida.

[00:21:37] I would really love to see you there.

[00:21:38] In order to register, go to ppoclubevents.com,

[00:21:44] ppoclubevents.com and register to sign up for the

[00:21:47] event.

[00:21:48] Also, early bird registration ends July 31st.

[00:21:50] So to get a discount on the registration fees,

[00:21:53] make sure you sign up, get your room between now

[00:21:56] and July 31st.

[00:21:57] Otherwise, prices will go up.

[00:21:59] So go to ppoclubevents.com.

[00:22:02] Thank you to all of you who have listened for so many

[00:22:04] years.

[00:22:05] I would love to find me a tune person.

[00:22:21] That was going to be my next question.

[00:22:23] How long do you think a leadership development

[00:22:26] program should take?

[00:22:27] I mean, it's individualized because some people might

[00:22:29] catch on a little bit faster.

[00:22:31] Maybe they have some experience in holding people

[00:22:33] accountable or the KPI metrics and your dashboard

[00:22:36] and whatnot, but what's your expectation in terms

[00:22:38] of that leadership development program and how fast

[00:22:41] they get through it?

[00:22:42] Six to 12 months.

[00:22:43] Yeah.

[00:22:44] It's kind of up to them.

[00:22:46] Yeah, I think it's the way that we do it is it's

[00:22:49] self-paced.

[00:22:50] Right.

[00:22:51] We don't push any type of checklist.

[00:22:53] Things have to be done in a certain time frame.

[00:22:56] It's self-paced and we try to incorporate ways

[00:23:00] that they can improve the culture, be proactive

[00:23:02] about improving the culture.

[00:23:04] Right.

[00:23:05] Identify one way that one gap that you see

[00:23:07] in our culture and create a plan to help improve it.

[00:23:11] What a great assignment, right?

[00:23:12] You want to get them thinking about like, how do I get

[00:23:14] my team happy?

[00:23:17] What a great assignment.

[00:23:18] Like I would probably write that down.

[00:23:21] And that's a great thing for you to do with them

[00:23:23] and you can't create culture problems.

[00:23:26] Those are things that just kind of happen

[00:23:27] organically.

[00:23:27] So it's hard to put a timeline on that.

[00:23:29] Yeah.

[00:23:29] How much do you pay them for this stuff?

[00:23:31] I don't pay them anything.

[00:23:32] That's right.

[00:23:33] Nothing.

[00:23:34] I think that we just kind of block off a little

[00:23:36] time on their calendar.

[00:23:37] So they can start meeting with us individually

[00:23:39] and we can start actually having real authentic

[00:23:41] conversations around that stuff.

[00:23:44] And that's it.

[00:23:46] Yeah, you have to recognize there has to be some point

[00:23:49] before they get into this leadership development program

[00:23:51] that they've expressed the desire to become a leader

[00:23:53] in your company.

[00:23:54] Right.

[00:23:55] And you also equally want them to become a leader

[00:23:58] in your company.

[00:23:59] So you are going to set aside some time for them.

[00:24:02] But the pace at which they get through the program

[00:24:05] is essentially dependent upon their desire.

[00:24:08] You can't force that upon anybody, right?

[00:24:12] If they want to get through it quickly, great.

[00:24:14] If they want to take their time, okay, maybe there

[00:24:17] are some external factors.

[00:24:19] I think one thing you have to recognize that might

[00:24:22] kick somebody out of that program is their inability

[00:24:26] to follow through on things that they're committed

[00:24:28] to, their inability to garner the attention

[00:24:33] and the commitment of other team members and inability

[00:24:37] to follow through and communicate with team members

[00:24:41] in a positive and productive and uplifting way.

[00:24:46] And maybe their solutions to problems just are different.

[00:24:50] I mean, outside of what you would expect, maybe they

[00:24:53] don't represent the values or how exactly want to get

[00:24:55] things done.

[00:24:56] Right.

[00:24:57] Have you ever had to like usher someone off of the

[00:25:00] leadership development track and what were some of

[00:25:02] the things that they were doing that led you that way?

[00:25:04] Just a lack of focus and a lack of excuses.

[00:25:09] Yeah, lack of significance to the importance of why

[00:25:12] the program is there.

[00:25:14] And those are indications that some people just don't

[00:25:17] want to grow with you.

[00:25:19] Yeah.

[00:25:19] And the last thing and then this goes back to the reason

[00:25:21] why we give them the clinic director and training title

[00:25:24] without the salary bump is because of this right here.

[00:25:27] If things go awry, it's easy to take off that in training

[00:25:31] portion and or the clinic director and training title

[00:25:35] and just put them back where they were before without

[00:25:38] creating some kind of upset where you essentially have

[00:25:40] to let them go.

[00:25:41] Right.

[00:25:42] You don't want to embarrass them in that regard.

[00:25:43] So that's exactly why we did it that way.

[00:25:46] Well, there's really three main products to the leadership

[00:25:50] team.

[00:25:51] Number one is going to be developing an unmatched

[00:25:55] patient experience.

[00:25:57] Number two is facilitating a thriving company culture.

[00:26:01] And number three is going to be growing profitability.

[00:26:06] That's your job as a leader, right?

[00:26:08] That's your job in this company.

[00:26:10] Whether you're a director or director of admin or director

[00:26:12] of recruiting like your attention should be on one of

[00:26:14] those three things, right?

[00:26:16] If not all of them and yeah, it takes a CEO mindset

[00:26:20] to do that, right?

[00:26:21] It's not an employee mindset.

[00:26:22] Those are two different things.

[00:26:24] Right.

[00:26:24] Exactly.

[00:26:25] Someone who really takes ownership for their position,

[00:26:27] whatever it is at the time.

[00:26:29] Right.

[00:26:30] So thinking back to when you opened your second clinic,

[00:26:33] do you think it was imperative that you that clinic

[00:26:36] director in place or were you able to get by without it?

[00:26:38] Oh, no, I had to have it in place.

[00:26:41] Yeah.

[00:26:41] And some form of policy and procedure I'm assuming as well.

[00:26:44] Yes.

[00:26:45] Some form of accountability.

[00:26:47] I would assume that it's probably possible to do it

[00:26:52] without it.

[00:26:53] Probably not going to be fun.

[00:26:55] It's probably going to be way more challenging.

[00:26:57] Huge headache.

[00:26:58] Huge headache, right?

[00:27:00] But one of the greatest paths to getting wealthy or success

[00:27:06] is your ability to learn how to let go.

[00:27:09] And that was a quote shared by a mentor of mine and

[00:27:12] the only way you're going to truly be able to let go is

[00:27:16] if you have people that you trust who have demonstrated

[00:27:19] the ability to do the heavy lifting with you, right?

[00:27:23] And if you don't have that, you're going to find

[00:27:25] yourself gripping way too tightly to things that you

[00:27:29] shouldn't be any longer and you're just going to be

[00:27:32] divided, you're going to be stretched.

[00:27:33] You're not going to be able to be effective as a

[00:27:36] leader in your company.

[00:27:37] It's going to be really hard.

[00:27:38] Yeah.

[00:27:38] It's one thing for you to be able to drive production.

[00:27:41] So some of the growth statistics that I often

[00:27:44] reference are your utilization rate.

[00:27:47] You want it to be above 85% utilization rate being

[00:27:51] the number of appointment slots that you have on

[00:27:53] in your calendar across all providers compared to how

[00:27:56] many are actually filled during the course of the week.

[00:27:58] And you want that percentage of filled slots to be

[00:28:01] 85% above on average.

[00:28:04] And if you're especially looking at bringing on another

[00:28:06] provider or going to another clinic as a whole, you

[00:28:09] want that to be 90% if you can, but at minimum 85%.

[00:28:14] Right?

[00:28:15] And you also have to consider financials.

[00:28:17] So that clinic that it has that utilization rate is

[00:28:21] maximally profitable.

[00:28:22] Right?

[00:28:23] Now, there are other things to consider.

[00:28:26] Yeah, you might want to open a second clinic, but if

[00:28:28] you want to really push the maximum productivity out

[00:28:32] of a certain square footage, then you take that square

[00:28:35] footage divided by 10%.

[00:28:37] And that's your average visits, PT visits per week.

[00:28:40] And this is dependent upon demographics, but like in

[00:28:43] New York where it's super tight, these people blow

[00:28:46] that ratio out of the water.

[00:28:48] But if you have a 2000 square foot clinic, 10%

[00:28:51] is 200, your max capacity is about 200 visits per week.

[00:28:55] Then you also know it's probably time to grow.

[00:28:58] Find more space, move on, get another bigger space or find

[00:29:01] a second.

[00:29:02] Right?

[00:29:02] So those are some of the growth KPIs to go off of.

[00:29:06] But to go back to my point, it's one thing for you as

[00:29:09] the owner to drive those productivity numbers and get

[00:29:11] that production.

[00:29:13] It's a second thing at a completely different skill

[00:29:16] set to have someone that's not the owner drive

[00:29:19] those numbers and hold them where they need to be while

[00:29:23] you're looking to grow and expand.

[00:29:25] And so that's what we're talking about here is leveraging

[00:29:27] others to continue to improve production and thrive

[00:29:31] where it's not you because if you're looking at a

[00:29:34] second location specifically, you're going to be tied

[00:29:37] up in the construction of it, the lease negotiations

[00:29:41] of it, the equipment purchases, yada yada, hiring

[00:29:47] team members for that second clinic, getting them

[00:29:51] trained up and on boarded.

[00:29:52] Maybe you're pulling from the other clinic.

[00:29:54] So you got to train them in for the first clinic.

[00:29:57] All those things are going to be required of you at

[00:30:00] least at this stage and to do that while you're also

[00:30:03] trying to maintain productivity at the first clinic

[00:30:06] is just it's a lot.

[00:30:08] Yeah, it's impossible.

[00:30:10] It's really cool to hear that being able to lead

[00:30:14] your team is kind of like level one of leadership, right?

[00:30:18] Or maybe level two, right?

[00:30:20] But being able to lead a person who can lead the team.

[00:30:26] That requires another level of leadership from you.

[00:30:29] Like you've got to be more clear, more explicit, right?

[00:30:32] More you can't show up and cuss everybody out at the

[00:30:36] team meeting, right?

[00:30:37] Can't be all stressed out.

[00:30:39] You got to be able to listen more and there's a lot

[00:30:40] of leadership skills that you have to be able to develop.

[00:30:43] But yeah, like being able to get work that kind of work

[00:30:46] done through people is requires something different from you.

[00:30:51] Yeah, I think that's especially necessary for that second clinic.

[00:30:55] Now as you get to a third and a fourth clinic and you've

[00:30:57] experienced this, that's where you can as you started

[00:31:00] develop an even greater leadership team.

[00:31:03] Now maybe you have a marketing person, maybe you

[00:31:05] have someone they're full time or part time.

[00:31:07] Maybe you have a recruiting person or a person over HR

[00:31:11] and maybe they're part timer full time and you have a clinic

[00:31:14] director in place and you have higher level meetings.

[00:31:16] Now you can start handing some of these things off to your

[00:31:19] leadership team when they have a couple of clinics underneath

[00:31:22] you and start having them help build out that third and

[00:31:25] fourth clinic as you grow further.

[00:31:27] But this is just that we're talking right now just about

[00:31:29] the germination of that leadership team.

[00:31:31] But this is where it starts is when you're starting

[00:31:34] to think about really growing up as an organization

[00:31:38] transitioning from mom and pop to enterprise, if you will.

[00:31:43] And so not everything is run according to Nathan, but

[00:31:45] everything is run according to policy and procedure.

[00:31:48] Right.

[00:31:48] I think we follow standard operating procedures and we

[00:31:51] don't just ask Nathan for all the answers.

[00:31:54] Let's get out of that as soon as possible.

[00:31:56] And when you're able to do that, you tell me, but

[00:31:59] that's when you probably you saw a level of freedom

[00:32:02] in your first clinic when you had a clinic director

[00:32:04] maybe a couple of pts underneath it.

[00:32:06] Maybe you hit that magic four or five provider mark

[00:32:08] that seems optimally profitable, but it just you reach

[00:32:13] another level.

[00:32:14] You take on some greater purpose as an owner.

[00:32:18] And you also develop another skill set, but you also

[00:32:22] develop a different level of freedom to where now

[00:32:25] you're you're separating yourself so much further away

[00:32:27] from the day to day and just working exclusively with

[00:32:30] your leadership team.

[00:32:33] So the way that I like to recall that experience in

[00:32:39] my head was my unit of measure used to be patient

[00:32:44] visits per week.

[00:32:46] And then once I kind of had that first clinic operating

[00:32:51] without me being there, like I had a director, I had

[00:32:54] a leader there.

[00:32:55] I wasn't in the team meeting anymore and I was really

[00:32:58] able to like go all in on like my stats and my pro

[00:33:02] form and my financials and really kind of see on a

[00:33:05] deeper level how things worked from a metric standpoint.

[00:33:09] Then my unit of measure became I have a clinic, have

[00:33:13] another clinic.

[00:33:13] I have another clinic right.

[00:33:15] I was able to zoom out a little bit further as a leader

[00:33:18] and see how the big picture was right.

[00:33:20] The percentage of productive clinics.

[00:33:22] Yeah, like the vision expand it's like, oh wow, look

[00:33:25] at this unit right.

[00:33:26] And then so it's like once you develop that, you

[00:33:28] know, step one having that leadership team, it's

[00:33:30] like, okay, how do I, how do I create a pro forma?

[00:33:34] How do I create this again?

[00:33:36] Right.

[00:33:36] The pro forma, the policies of procedures, the systems

[00:33:39] right and create a playbook on how to create that so

[00:33:42] I can so I can package number two.

[00:33:44] Right.

[00:33:45] Yeah.

[00:33:46] And you have some of that for clients.

[00:33:48] Don't you in the vault?

[00:33:49] Absolutely.

[00:33:50] I do.

[00:33:52] Absolutely.

[00:33:52] They don't have to figure this out by themselves.

[00:33:55] Right.

[00:33:55] But the game becomes different.

[00:33:58] Now you're playing the real game of being an owner.

[00:34:03] The real game of being an owner is not like hiring

[00:34:05] and firing and that stuff.

[00:34:07] Right.

[00:34:07] The real game is like opening and expanding your business.

[00:34:12] That's the real game that everybody else is playing.

[00:34:14] Welcome to the real game.

[00:34:17] Could you have ever imagined back at least I wasn't this

[00:34:21] way.

[00:34:22] I think you might have had a different mindset than me,

[00:34:24] but I could never have imagined back when I was treating

[00:34:27] patients starting my clinic and even when I was getting

[00:34:29] to like 100 150 visits a week.

[00:34:31] That was my goal initially if I could get two providers

[00:34:33] at 150 visits a week, that was like dreamland.

[00:34:36] Right.

[00:34:37] I was in La La Land.

[00:34:38] Maybe I had a PTA or two and whatever, but that's

[00:34:42] all I needed.

[00:34:43] I would constantly tell myself if I'm just treating

[00:34:45] patients like this in the future and having to deal

[00:34:48] with all the business stuff, I'm going to get burned

[00:34:50] out really quick.

[00:34:50] I really need to find someone who runs the

[00:34:52] business for me so I can just treat patients all

[00:34:55] the time.

[00:34:56] And could you have ever imagined that you would be so

[00:34:59] far away from that at the point that you are like, I

[00:35:02] never even thought that that something would could

[00:35:05] replace my passion for patient care.

[00:35:07] Yeah.

[00:35:08] Yeah, you grow.

[00:35:09] Did you have some of that?

[00:35:11] Yeah.

[00:35:11] I think that I've and I can't really put a whole

[00:35:13] lot of words to it right now, but I think I've

[00:35:17] experienced this journey of like, man, I want to open

[00:35:20] a clinic if I just had a clinic with that was mine.

[00:35:23] Oh my gosh, that would be amazing.

[00:35:26] And then you do that and you're just treating and

[00:35:28] then you're as you learn and grow and evolve and

[00:35:30] become see more possibilities than your perspective

[00:35:34] changes changes right like your purpose changes

[00:35:36] and you start seeing like, wow, maybe I could.

[00:35:39] What if I could do this and what if I could do

[00:35:41] that and it just keeps going.

[00:35:45] It just keeps going and going.

[00:35:46] It's like, what if I had two clinics?

[00:35:47] What if I had three?

[00:35:48] What if I had 10?

[00:35:49] What if I started a coaching company?

[00:35:51] What if I was coaching others and just keep

[00:35:53] challenging yourself and you keep seeing new

[00:35:54] possibility for yourself?

[00:35:56] I mean, I opened up my clinic 22 years ago, almost

[00:36:00] 23 when this episode comes out and I would have

[00:36:03] never imagined I'd be where I'm at right now.

[00:36:05] It's just crazy.

[00:36:07] But I think that's I bring that up because this

[00:36:09] is what we're talking to people about podcast

[00:36:11] and why we put together this series of 10 episodes

[00:36:16] regarding the practice owner manual series and

[00:36:19] how to build a successful clinic is because

[00:36:21] there is so much more.

[00:36:23] PT owners can be so much more do so much more

[00:36:26] than they are and they just need a little bit of

[00:36:30] guidance as I told you in the last few episodes,

[00:36:33] you have to get a coach of a consultant of some

[00:36:35] kind if you listen to this and you haven't

[00:36:38] reached out to us or someone else.

[00:36:40] I don't care.

[00:36:41] You have to have some kind of support and

[00:36:43] guidance because there is so much more on the

[00:36:45] other end of this on the other side of things.

[00:36:48] Yeah, you could be a PT all your life and

[00:36:50] that'd be great.

[00:36:51] Frankly, let me tell you the truth.

[00:36:53] I don't personally see a lot of fulfilled

[00:36:55] 60 and 70 year old pts out there that are still

[00:36:58] treating patients full time.

[00:37:01] There's so much more to it.

[00:37:02] And if you're an owner that allows you to see

[00:37:05] new vistas create new things, build new skill

[00:37:08] sets be more even finding a different purpose

[00:37:11] is what I found.

[00:37:12] I've got a completely different purpose than

[00:37:14] I did 20 years ago.

[00:37:16] There's so much more to be fulfilled.

[00:37:18] And that's where coaching consulting has to

[00:37:21] become a part of it.

[00:37:22] And it's so simple as just reaching out book

[00:37:25] a call with us, book a call with Adam.

[00:37:28] No swings attached.

[00:37:29] We'll help you with your pain points and help

[00:37:31] you out through that call that you need to find

[00:37:34] someone for help and especially with the

[00:37:37] pressures that we have in the industry at

[00:37:39] this point, inflationary pressures, upward

[00:37:42] pressures, the downward pressures of reimbursement.

[00:37:44] Got to have someone that can help you navigate

[00:37:46] through that stuff, man.

[00:37:48] Totally agree.

[00:37:49] Not only that, you got to want it.

[00:37:51] And a lot of people say they want to be an

[00:37:53] owner until it's time to do owner stuff.

[00:37:55] You know what I mean?

[00:37:55] It's like you got to want it.

[00:37:58] I've got sons that want their own businesses

[00:38:00] and when we tell them what they need to do

[00:38:02] a month later, we're like, so how'd you do?

[00:38:04] Yeah, you know, I'm still thinking about it.

[00:38:07] Yeah, I'm still thinking about it, bro.

[00:38:10] We'll give you the flyers that you need

[00:38:12] to pass out.

[00:38:12] Did you pass any out?

[00:38:14] You know, I'm not sure.

[00:38:16] Yeah, you got to want it.

[00:38:18] You can't make excuses, right?

[00:38:20] Yeah.

[00:38:21] So I want to just kind of package this up for

[00:38:25] our manual creators if that's okay, because

[00:38:29] you have your pen and paper out and on the

[00:38:30] top it's what is this chapter 9, chapter 10

[00:38:33] and it's growing and scaling under that is

[00:38:37] step one is develop, assuming you have

[00:38:40] everything else in place and everybody's

[00:38:42] productive.

[00:38:43] You have some type of leadership development

[00:38:46] process in your clinic via identifying a

[00:38:50] players on your team and pushing them through

[00:38:54] a leadership development process via the

[00:38:55] books that you've read and the things that

[00:38:57] you've learned.

[00:38:58] Ideally somebody who can help you on the

[00:39:00] clinical side and the administrative side

[00:39:03] such that you can completely exit.

[00:39:05] You don't have to treat any patients anymore.

[00:39:07] Right?

[00:39:08] So that's kind of you could write that down.

[00:39:10] Doesn't have to be complicated.

[00:39:11] We've referenced so many books in this podcast.

[00:39:14] How many name four or five books that were

[00:39:17] really influential to you, right?

[00:39:18] And build a program around them from there.

[00:39:20] You can start managing your practice more

[00:39:23] remotely and more hands off by taking a

[00:39:27] really a much deeper dive into the

[00:39:29] statistics statistical performance of your practice.

[00:39:32] Right?

[00:39:33] How do I manipulate the production and how

[00:39:35] do I operationalize what I'm looking for

[00:39:37] in that practice to create the profit

[00:39:39] margins that we need, right?

[00:39:41] And then from there you can create a playbook

[00:39:44] on how to copy what you've created and

[00:39:48] paste that into multiple locations.

[00:39:50] And then from there you can train people

[00:39:53] on the playbook and then you can

[00:39:54] can further exit the practice, but

[00:39:56] that's the true game of growing

[00:39:58] and scaling your practice.

[00:40:00] Right?

[00:40:01] Exactly.

[00:40:02] Coming from experience.

[00:40:03] This is the best way to do it.

[00:40:05] You can always open to say I've opened

[00:40:06] a second location too early before.

[00:40:08] I'm surprised that it thrived.

[00:40:10] We I did, but I invested in the right person

[00:40:14] and went on a wing and a prayer,

[00:40:16] but I gave them zero support and almost

[00:40:18] crashed and burned, but I was thankful

[00:40:20] for that person to pull it through.

[00:40:22] So shout out to Will Humphries,

[00:40:24] but this is the best way to do it.

[00:40:25] If you want to survive some headaches

[00:40:27] and really grow in a substantial

[00:40:29] and fulfilled way that's not

[00:40:31] leading to a ton of stress and anxiety

[00:40:33] and stress on your family and marriage.

[00:40:35] This is a good way to do it.

[00:40:36] The best way to do it.

[00:40:38] Yeah.

[00:40:39] Even if you get a coach, it's going to be hard.

[00:40:41] So it's true.

[00:40:42] You can't get rid of that.

[00:40:44] Yeah.

[00:40:45] All right.

[00:40:45] Well, reach out to us.

[00:40:47] Nathan at PTO Club, Adam at PTO Club

[00:40:50] and let us know what you think about the series.

[00:40:52] If like I said, if you think there are other topics

[00:40:53] that we might have missed,

[00:40:54] we thought it might be pretty comprehensive,

[00:40:56] but of course there might be holes in it.

[00:40:57] But thanks for going through me

[00:40:59] on this journey with me, Adam.

[00:41:01] It's been good to cover all this stuff

[00:41:03] and hopefully it's valuable

[00:41:04] to people that are listening out there.

[00:41:06] Appreciate it, dude.

[00:41:07] For sure, man.

[00:41:08] It was really cool.

[00:41:09] Maybe we'll think of some other ideas and we'll do them.

[00:41:12] That's right.

[00:41:12] All right.

[00:41:13] Thanks, man.

[00:41:14] All right, brother.

[00:41:17] Thanks for joining us today

[00:41:18] in the Physical Therapy Owners Club,

[00:41:21] the resource for stability and freedom

[00:41:23] in your PT practice.

[00:41:24] Reach out and join the network today.

[00:41:26] Subscribe to our podcast,

[00:41:28] get links to social media

[00:41:29] and access all of our episodes with show notes

[00:41:32] at PTOClub.com.