Maximizing Cash Flow, Increasing Profits, And Eliminating Patient Balances With Kristi Plunk, DPT

[00:00:00] So it made you decide to finally take a stand and say, hard line. We're going to collect

[00:00:04] at the time of service every time you're going to have a credit card on file. What was that final tipping point?

[00:00:10] I've always had pretty good collection at the front desk but everybody is human so if somebody walks away from the front desk or say there's two people waiting and somebody leaves and they didn't get to hand on their card then you're going to miss some. Even if patients have the best intentions and your front desk is really on top of everything.

[00:00:29] I felt like we had our systems down pretty good but there's still just that element that you're always going to have some mist in terms of collecting.

[00:00:41] Welcome! You've entered the Physical Therapy Owners Club podcast where your hosts Nathan Shields and other successful PT owners and leaders share their experience and insights on how to build successful PT businesses.

[00:00:53] 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.

[00:01:00] That's what the PT owners club is all about, greater freedom and more profits. There's plenty of room for you as well so come on in and join the club!

[00:01:11] Hello and welcome to the Physical Therapy Owners Club podcast I'm Nathan Shields and I've got my friend and coaching client Christy Plunk from Beyond Physical Therapy and Wellness.

[00:01:21] Yeah technically our IRS name is Beyond Therapy and Wellness but our logo always cut it down to Beyond Physical Therapy.

[00:01:29] Oh okay, Beyond Physical Therapy out of Fort Worth, Texas Christy thanks for joining me today I really appreciate it.

[00:01:34] Yeah happy to be here!

[00:01:35] I wanted to highlight Christy today because she does something that I would say probably a minority of physical therapy clinics do not do and I really wanted to highlight it because I think it's something that every physical therapy clinic should be doing.

[00:01:51] On a regular basis and that is first of all collecting the copays, co-insurances, deductibles at the time of service no matter what all the time and secondly having a credit card on file to do.

[00:02:04] And Christy does it on a regular basis collections have been significantly better I'm assuming revenue has also increased because of it and so I wanted to highlight simply that practice today and to get into it what was the impetus for you to decide you know what?

[00:02:19] I'm not going to collect after the fact anymore. I'm not going to have any more of those awkward conversations at the front desk when I'm trying to charge a cancellation fee or whatnot. What was the impetus?

[00:02:30] It has been a little bit of an evolution of the current policy that we're at right now that really started at the end of 2021.

[00:02:39] We had a really great year that year better than we had ever done even though co-ed was still very much prominent in impacting how people went out and about their lives.

[00:02:49] But I had an interesting conversation with a patient that was physical therapy manager at another clinic and towards the end of 2021 we had a significant spike in the percentage of cancellations and this was like I'm 10 years into it and then had this crazy cancellation rate that I'd never seen before.

[00:03:08] And so I assessed what are we doing differently what's playing a role in this and then I have this conversation with this other PT manager and it was like our growth and our cancellation rate was almost identical that year.

[00:03:23] And I never met her before we are specialized in pelvic health and lymphedema they are outpatient ortho clinic so having that conversation with her made me start thinking okay the psyche of people is different now.

[00:03:36] The way that people think about going out the way people think about other people responsibility for things maybe that they'd signed up for commitment to help getting out of the house.

[00:03:51] All of those things play into a psyche changes that happened with COVID so that was my first inkling that okay our brains are different now like we've been through this kind of traumatic event and it definitely obviously has had impacts on our business.

[00:04:05] And I believe one of the things was a significant number of cancellations not just related to illness because that had been we've been experiencing COVID then for a year and a half already.

[00:04:20] So that was the start of it and then that next year I had a started losing money that year and honestly that year 2022 I lost more money than I ever lost a loss more money than what it took me to open up my clinic in the first place.

[00:04:36] And still related to the cancellation rates.

[00:04:38] I don't think it was just related to the cancellation rates. I think that was part of it but another significant factor that I think was probably the primary player was that Google algorithm changed so before that because we're pelvic floor and there's not many pelvic floor providers we got or in the Dallas Fort Worth Metroplex there's millions of people here working the center of the Metroplex.

[00:04:59] So we would get people from traveling in to come see us so our SEO was fabulous everything was going great most of our referrals were self referrals not necessarily position referrals and then Google change their algorithm.

[00:05:14] So if you were not in a location that was like a certain distance to your clinic then Google wasn't pulling up those options whenever you were when you were looking so our SEO taint and I didn't necessarily know this was happening for it took me like a couple months to figure out what was going on but significant drop in referrals.

[00:05:34] And so at that point I decided I definitely have to do things differently this is not sustainable so there's been many things that I've done since that time one of them being working with you in Adam which has been I just kicked myself that I didn't start coaching sooner in my careers a business owner.

[00:05:53] So I also started working with practice promotions and they now manage my SEO they stay up with any algorithm changes to protect us from that in the future because that's not my area of expertise, I can't have to hire the experts for that but on top of that I also realize we had to do something different with collections so.

[00:06:12] I'm not unique in the fact that if we don't collect everything up front and there's a bill at the end of the month when people pay that bill were excited because.

[00:06:21] People don't pay their bills that's true they're medical bills anyways and I actually had a friend that was I think people believe that they don't necessarily have to pay their medical bills I think they don't believe that it goes on their credits so I think there's like a whole incorrect thought process that they are just as a side note we actually don't send anything to collections I'm just.

[00:06:41] I've just personally never create about doing that but I think people do have some thought in their mind that they don't necessarily have to pay their medical bills and it shows up in the statistics I saw a study by McKinsey which is a prominent accounting for my believe but for every dollar that's not collected at the time of service you'll lose up to 50 to 60 cents on that dollar trying to collect it afterwards so that goes to your point patients.

[00:07:09] If you when you if they're not in front of you you're not going to get as much money as you can at that time of service that's why it's imperative especially when you lay out that anywhere from 10 15 maybe 20% of your entire revenue is patient copays and chances and deductibles and to lose 50 cents on that dollar is just that's a lot of profit to be lost in a given year.

[00:07:34] Yeah absolutely especially with deductibles being higher now I think we're close to 30% is collected from patients of our total revenue 30% comes from patient payments deductibles or their co-entry.

[00:07:46] Yes you have to be on top of that or that's a huge hit to your profit margin yeah absolutely so it made you decide to finally take a stand and say hard line we're going to collect at the time of service every time you're going to have a credit card on file yeah what was that final tipping point.

[00:08:03] I've always had pretty good collection at the front desk but everybody is human so somebody walks away from the front desk or say there's two people waiting and somebody leaves and they didn't get to handle their card then you're going to miss some even if patients have the best intentions and your front desk is really on top of everything.

[00:08:22] I felt like we had our systems down pretty good but there's still just that element that you're always going to have some mist in terms of collecting and then we also have this I've had a cancellation policy in place where we charge $40 for saying big cancellations if it's not made up in the same week.

[00:08:38] I've had that in place for years but collecting is very difficult having that conversation they come in the next time you're like like got a charge for your cancellation that you missed last time and then you have this confrontation with your front desk person in the patient and everybody's uncomfortable and your front desk doesn't want to do that so.

[00:08:57] Give me your credit card so I can charge you the cancellation fee please and they're like I don't want to give you my credit card if that's the case.

[00:09:05] Yeah pretty much every human being is going to want to have a conversation about this charge that they're getting for no service yeah I felt like we just had to change the process.

[00:09:16] Storing credit cards I know my dermatologist makes us have a credit card on file and it's a $50 cancellation fee you cancel the same day but they won't even see the first time as a new patient without a card on file so this we're not breaking new ground here yeah.

[00:09:33] This has been done it's very normal and the massage therapists are doing it and the hairdressers I have like my hairdresser charges gosh definitely more than $80 different definitely more than $40 if I cancel saying.

[00:09:46] Day which I've had to do before they're like don't worry about it I'm just going to charge a card with the smile and that's how it should be.

[00:09:54] Don't want that confrontation yeah I decided we have to do something different decided to store the credit cards and initially I started with square because we didn't have it integrated in our EMR so square does have a higher percentage credit card fee

[00:10:11] and I would charge half of that so I would take charge 2.5% when we use square which was a different bad almost people were understanding of it but you do get a little bit more of a conversation with people it's a little bit tangential but I have no problems with it and I'm pretty sure it's okay in most states if not all for you to charge the immersion services fee and so if you are collecting a deductible of say $150

[00:10:41] even if it's a 3% merchant services fee that's significant and so you say okay we're going to charge it but if we're going to charge it we have to charge the merchant services fee and if you're going to do that of course I'm sure you haven't posted there as well that you're charging the services fee as well for any credit card transactions so yeah it can be done I would just recommend that it be posted and patients know about it and that's not a surprise

[00:11:11] but having that there and available is really helpful as well otherwise you're taking a 3% hit on everything you collect and again that's just taking money out of your pocket and the possibilities you can do to invest back in your company.

[00:11:23] Yeah absolutely and we didn't have too many people have an issue with that it was you just have a conversation about it of course I've in your paperwork like you said so we started doing that and implementing also that we were charging any balances at the end of the month

[00:11:41] automatically on that card that we had on file so not just having the card on file for a copays and deductibles at the time of service and send same day cancellations but we're also going to charge any balance that's due at the end of the month and so we have this

[00:12:00] Now that's a cool little nuance because I highly promote to if you have a cancellation fee yeah I have number one heavy credit cards on file but charge the cancellation fee and make sure you're collecting at the time of service but you did something you took it a step further and so if there is a patient balance remaining that obviously hasn't already been sent to if it's still in the works going through insurance then that's not going to be charged them but if there's a balance to the patient after it's been through insurance

[00:12:27] then you have it in your financial paperwork that you're going to charge that at the end of each month

[00:12:33] We do yeah and surprisingly we haven't had an issue with this with patients we let them know it's all on our paperwork that we will notify them a week before with their balances so that they have time to call and have any conversations that they want to about it

[00:12:49] and then we let them know the date that their card will be charged for that balance

[00:12:54] And I did play around a little bit with the text message that goes out at that week before just to give it a more positive light

[00:13:03] Now we're very thankful for your business and I think I've got the right verbiage now because we really don't have any issues with it

[00:13:11] and we're now on top of it so people initially we started that there were the AR was there's people that had balances from six months ago or more

[00:13:22] And so they're getting these messages and they're like wait this is a long time ago but now we're communicating this and we're collecting within 30, 45 days of when their visit was

[00:13:34] And it has not been it's people understand and it's worked very well

[00:13:39] Yeah as people get some distance from the care that they provide they're going to discount the services that you provided if it's a year later

[00:13:46] What did you guys do for me again? I don't even remember and you're coming out of them with a bill of $600

[00:13:51] They're like why am I paying this $600 again? I don't understand

[00:13:54] Whereas if along the way you're month to month you're saying hey this month we're collecting $85 towards your balance for physical therapy

[00:14:03] We really appreciate your services, thank you so much

[00:14:06] Do that a number of months over a row over time while your services are fresh in their mind either they're still receiving services are just gotten them better through a full plan of care

[00:14:17] Then that's much easier to swallow for the patients I'd imagine and then it's also easier for you to collect the money

[00:14:24] Oh my gosh that's a huge game changer

[00:14:27] As you created the paperwork for that is that something that you sent past the compliance agent or a lawyer or something like that

[00:14:36] How did you draft the paperwork?

[00:14:38] I did a lot of research

[00:14:40] Good, alright. I did not yeah

[00:14:42] And if you stole it from somebody that's fine too

[00:14:45] I don't know exactly where I came up with it but I got to a point where I figured out okay that's what has to be on there for this totally glee take place

[00:14:54] Yeah, you have to have the last four digits and then their card code and billings up in a signature on it and of course their name

[00:15:05] Over the many years of my physical therapy clinic ownership one of my biggest fears was that one of my PT's was suddenly up and quit

[00:15:12] I hated being in that position that position of fear and weakness

[00:15:16] That's why back in the day my business partner will Humphrey's and I decided that we were going to change the narrative

[00:15:22] And always be hiring always on the lookout forget it

[00:15:25] We weren't waiting for the next provider to quit and then start up the hamster wheel to suddenly replace them as soon as possible

[00:15:31] We were going to be on the lookout always for the next rock star of PT

[00:15:36] Since that time I personally witnessed Will Humphrey's build a bench of willing rock star PT candidates for our clinics

[00:15:42] Such that at any time if our providers wanted to believe we had not only a suitable replacement for them

[00:15:47] But someone that we were super excited about

[00:15:49] He did this not only during some of the most difficult times to find physical therapists but also in some of the most difficult parts of the country to recruit and hire PT's

[00:15:57] Now Will Humphrey's has developed a program for UPT owners called rock star recruiter

[00:16:02] To show you exactly how to find the next rock star physical therapist for your clinics

[00:16:06] Physical therapists that don't just fog a mirror and treat patients but physical therapists that are excited to join your practice

[00:16:12] And are looking for opportunities to grow and lead in your company

[00:16:16] It's exciting to see that what Will had done so masterfully in the past is now providing to owners like you across the country

[00:16:23] To help you be in a position of power versus fear of the next resignation

[00:16:27] Bringing on quality physical therapists via Will's rock star recruiter program will open up opportunities for you in the clinic that you never would have imagined

[00:16:35] And I've seen it myself

[00:16:36] Reach out to him now at Will at unlockhba.com

[00:16:42] Will at unlockhba.com or column text him directly for 8 0 248 5 1 1 9

[00:16:57] And is what's your EMR does that store it for you now at this point are you still using that separate third vendor?

[00:17:02] Yeah, so wonderful progression for web PT they do have a merchant services vendor now that integrates with the with the EMR

[00:17:13] So whenever you check in the patient you can in that same screen

[00:17:17] You can store the credit card and then just charge their card every time when you check in the patient

[00:17:23] So they have it set up to where you can't miss a payment if you've checked somebody in as long as you've put in their payment what they owe at the start of their setup

[00:17:34] Gotcha did web PT have some paperwork for you that to recommend to for them to fill out and sign off on or anything like that

[00:17:42] Did you get a template from web PT at all?

[00:17:44] No, I did not. And they use a third party. I think it's world pay

[00:17:49] And that would make sense that they would provide some paperwork guidance now that you mentioned it.

[00:17:55] They might have it.

[00:17:56] storing the credit card. Yeah.

[00:17:58] Or if you ask their customer service I'm sure they direct you in the right way either directly towards world pay or something on their website

[00:18:05] I'm sure they'd have something but I know as owners are listening they're thinking how do I set up that paperwork what does that look like?

[00:18:12] And what does it say so that I can do that legally?

[00:18:15] You just did some research and you found some stuff Google as a massive treasure trove of opportunities to steal from other people

[00:18:24] And if you're still feeling uncomfortable about it as an owner then yeah just talk to a local lawyer spend the $300 to $500 for them to review the paper and say yeah this is legit and you can do this in our state.

[00:18:36] And then do it but don't use the lack of the paperwork or I don't have that paperwork to not move forward on this because you're losing a ton of money the longer you don't keep that credit card on file.

[00:18:49] I agree. And I would add that I would think probably the hesitation is also not wanting to have those conversations with patients like how do I say I'm going to charge you automatically so I think a copay

[00:19:04] is pretty easy to say all right we have your card on file but before talking about charging at the end of the month or the cancellation fees I can see where there might be more avoidance of those conversations.

[00:19:17] And what we do and what has worked well for us is that it's all in our paperwork it's all in our initial paperwork so they don't know what's yet this is the paperwork to get started with us there's nothing personal going on here

[00:19:32] and lining it up at the beginning like that has really been very smooth for us. And I do have it on two different forms I have a credit card form where it says when we're going to charge your card and then just our policies and procedures and our policies and patient consent form.

[00:19:49] I have it on there also and have a initial so they're really signing off in two different places. So there's really no way people could miss this. And that's not something people say I didn't know that was going to happen yeah you did because you had to hand us your credit card on the first visit even if people don't owe anything we still have that explanation that we have their credit card on file for same day cancellations.

[00:20:12] And now add one more thing that I figured out with charging the same day cancellations that may has made it smoother is I have started charging those on Fridays for the entire Friday or Monday for the entire week.

[00:20:30] What I found was my front desk they're hearing all of the things on the phone and they're providing sympathy to the patient about whatever is going on or whatever reason it is that they can't make it same day.

[00:20:43] And the charges that they still weren't charging for same day cancel they were doing everything they could to move the appointment but they weren't charging for same day cancel just because of that merciful heart which is great but health care isn't a very different way to do it.

[00:20:59] Very different climate now reimbursement is not what it used to be everything's more expensive.

[00:21:06] Unfortunately I felt like this was an area where we had to take some emotion out of it and just do it had to be done so I ended up just taking that back on my plate looking through anybody who had a cancel on that same day.

[00:21:22] I was probably sounds harsh but I just I charged the fee no matter what if they call back and they complain about the fee then I've advised my billing manager to just refund it.

[00:21:35] You don't have to argue about it just refund it it's not worth like a big back and forth go and refund it but would I find whenever we charge that fee at the way from that time of less emotional time when they can process it and say okay yeah that was the fee.

[00:21:51] That was the fee that was their policy then I find that it hasn't we rarely get a call about it we really don't even have to have a conversation about it which is ideal because yeah the front desk person having a conversation on the phone you know come in today I'm going to charge your card.

[00:22:06] That's going to escalate emotion right there exactly and it doesn't necessarily get them to come in everybody knows that the policy is there and if they ask am I going to be charged for not coming in today then the answer is yes.

[00:22:20] But we're not provoking a conversation and trying we're trying to minimize emotions on this isn't personal it's about us being able to maintain a financially responsible business.

[00:22:34] Exactly that's right I love how you said that that's exactly right because you have to have that and I'm assuming your front desk person an ideal front desk person is unemotional about the financial conversations as well.

[00:22:49] This is just what it is like it I'm assuming there's going to be maybe some pushback on number one people handing over their credit card.

[00:22:57] I know here in Alaska.

[00:22:59] There's a lot of people who are conspiracy theorists and they're like I don't want anyone to have any of my information ever and I don't know why she didn't know where I live because I'm just going to attract by the deep state.

[00:23:10] So that front desk person just has to be very unemotional about it and say this is just how we do things and we keep it on file if you don't own anything we're not going to charge anything.

[00:23:21] So that's simply our policy and try to be good about it but until I'm assuming in this situation your front desk person is rather mature is not afraid of financial conversations not afraid to take people's money because it is their copay that they've signed up for.

[00:23:39] With their insurance that they have I'm assuming there in that place or at least have that personality yes absolutely yeah she does a great job with those financial conversations up front but.

[00:23:51] Gosh the cancellations are just so tricky because anybody can be sick and that's why say it can't be personal it's just gotta be we saved this time for you and I'm not even going to say that actually we're not going to get into why we call it as this air.

[00:24:08] You just don't you don't say anything you don't say anything you just say that's just our policy if you want to learn more I can show you my financials and how I have to pay my physical therapists whether you show up or not I still have to pay them something yeah I get it.

[00:24:23] But she's still getting that she has to be somewhat sympathetic but she has to be kind to individuals on the phone with her calling saying I've got an emergency or yeah so she's got to play that role.

[00:24:36] Yes I understand gosh it's you started off with your story about looking at your clinic from a different lens because the cancellation rates were poor you are losing money at the beginning of 2022 do you feel like implementing this particular process was significantly helpful in turning things around yeah absolutely 20.

[00:24:57] Do you think you really helped the cancellation rate yes yeah we do have a lower cancellation rate on average

[00:25:04] and at least they've made it more tolerant tolerable you can swallow the cancellation rate a little bit better if you're collecting something yes

[00:25:15] and we do somebody has to move an appointment we do get people calling like a couple days early

[00:25:21] and we actually say 48 hours on our paperwork but we charge at 24 hours so we do have people calling earlier so that gives us time to get somebody in off the wait list

[00:25:32] and so that's been yeah we get more notice now I would say.

[00:25:36] And so it sounds like it was a number of factors that help you turn around things financially it wasn't just the implementation of this particular credit cards on file payment at the time of service collecting balances at the end of the month

[00:25:50] that was all super helpful I'm assuming in getting your numbers back but it wasn't the only factor is what I'm hearing.

[00:25:58] Yeah absolutely gosh my mindset changed quite a bit just was starting to work with you guys and just how I was leading the clinic

[00:26:08] and my expectations for the staff and what the clinic was doing changed pretty significantly in the past year with working with you guys

[00:26:17] and I did get a renegotiated rate with United Health Care which I'm going to actually ask for another increase again and we'll see what happens

[00:26:28] but yeah multiple factors for sure have definitely turned the clinic around and had my best year right next to my worst year after yeah just getting realizing that some dramatic things had to happen.

[00:26:46] So you improved yourself as a leader you found a way to hold your team more accountable to production is what I'm hearing but also implementing systems in place so that you are collecting at the time of service and not letting that extra cash potentially fall through the cracks

[00:27:02] and what I'm and I just imagine that your are aging report like the hundred and twenty plus is next to nothing if it's not there aren't any patient balances sitting out there I'm assuming right.

[00:27:15] That's correct yeah yeah aging report looks pretty good I've got somebody that does an amazing job with our billing and pretty much has down how all the different insurance works yeah the AR that's definitely something we didn't have to.

[00:27:30] The only issue is the collections yeah yeah but it's just collections from insurance companies at that point if you have the credit card on file and you're collecting at the time of service and then collecting their balances at the end of the month there's nothing more to collect and where am I missing something no that's absolutely right yeah.

[00:27:47] So you're on top of that for patient balances you guys are crushing it and I can't say that for a lot of PT clinics out there there's a lot of patient balances that are just sitting on the books in that probably half the time are not going to get collected based on the statistics right.

[00:28:03] So it's a great formula that you put in place to get things set up you did share with me in emails some of the your cancellation policy and how you charge credit cards.

[00:28:16] I question whether or not I'm willing to share that with owners simply because I don't want to say that we're promoting some kind of legal advice for anything like that but I would recommend people consider looking into talking to compliance officers if they have to maybe we can.

[00:28:33] So I think that's a great formula for me to talk to you guys about the

[00:28:35] business of BCMS about keeping cards on file what paperwork they might need to have check with their EMRs.

[00:28:40] Talk to an attorney if they have to once they have some paperwork and some things together and just make sure that and also check with the see what's online and see what other people are doing for their clinics and I think that just getting started can make a huge difference and did you as one of my last questions is as you implemented this initially did you do that.

[00:29:01] So I think that's a great question.

[00:29:03] And I can say that you guys are not going to be able to have a direct conversation with your clients as you implemented this initially did you initially get some pushback or did you find the patients were pretty understanding and okay.

[00:29:11] Yeah, so scary initially implementing it and what I told my staff was if we don't if someone will not put their card on file then we won't see them.

[00:29:23] So I don't have any gray area there because there's always going to have be if somebody wants to have a conversation about it.

[00:29:30] Like then the front desk is in this back and forth with them and then they're like all right, this person didn't want to do it so we didn't so I felt like starting out I had to make it a hard like a black and white either you have it and you can start treatment or we don't have any can start treatment.

[00:29:47] So I didn't know how it was going to go. I didn't know how many people we were going to have turn away and not do therapy with us because of this and it turns out very few I would say less than 1% so a few people maybe a few people the vast majority of the time people don't blink and I because it is more common now like I said massage therapist is doing it hair stylists is doing it some doctors offices are doing it yeah and more doctors offices should well.

[00:30:17] Especially physical therapists as but as often as we see patients as well completely different compared to a doctor who you might see once every so often but if I'm going to see you one two three times a week on a regular basis and have to collect that copay over and over again then yeah let's just keep the credit card on file make it easy especially when it comes to children and I don't know if you see a lot of children but.

[00:30:42] There it's left to the children to bring in the credit card from their parents and all my mom forgot to give me my credit card today and so I can't play the copay yeah good luck collecting on that later on yeah absolutely.

[00:30:55] I will add in I had a boss before I open my own clinic and I can't remember the conversation but what he said to me was physical therapist you all have this piece core chain like you all want to give away services for free and he's completely right I don't know what it is about our.

[00:31:12] profession whether that's just what like we're drawn to physical therapy and we have that as a nature initially or if our schools do it to us that's part of it yeah yeah I think that's a mistake on our part we have to understand our value and not feel bad about collecting for services totally we want to be liked and I our profession shows that the way our profession interacts with other professions is.

[00:31:40] We're willing to be subservient we want to be liked and we want to play nice with everybody instead of taking a stand and say no we want to be viable and we want to survive and there's nothing wrong with that and we want to be profitable and there's nothing wrong with that either and just taking the stand so I love how you took.

[00:31:57] That challenge or that problem that you faced in 2021-2022 and then turn that into a great turning point in your clinics and you can look back on that and see the significant differences made from your clinic in 2020 to now 20 might not be a good one to measure off of but you know what I'm talking about your clinics completely different than it was before

[00:32:23] assuming financially and also culturally and production wise and all those kind of things it's a different clinic and it's probably because you went through some of those hard times congratulations thanks so much for sharing today your experience I wanted to highlight that like I said at the beginning be simply because so many owners I don't I like I said I think a minority of PT owners aren't are doing it and more of them need to be if not all of them need to be so thank you so much for sharing your experience I really appreciate it.

[00:32:52] Yeah thanks for having me it's been great are you willing to share any how people can get in touch with you whether it's your social medias or email or anything like that sure email would probably be best and it's Christie at beyond therapy and wellness dot com so K R I STI at beyond therapy and Andy wellness dot com all right cool thank you so much I appreciate it.

[00:33:21] Absolutely thank you.

[00:33:25] Thanks for joining us today in the physical therapy owners club the resource for stability and freedom in your PT practice reach out and join the network today subscribe to our podcast get links to social media and access all of our episodes with show notes at ptoclub dot com