*Overcoming Aversion to Numbers & Data

[00:00:00] I could tell you that this is a complex problem. It's not just a hard skill, right? Like people know how to use a calculator and there's going to be some logistical or technical systems and processes that you'll have to implement in order to extract the data that you need. Welcome to the Private Practice Owners Club. Your hosts and coaches, Nathan Shields,

[00:00:28] scaled his practice and exited for millions, while Adam Robin went from working 60 hours a week in one clinic to scaling to multiple clinics while working less than four hours per week remotely. This podcast is meant to share with you exactly how they did it and how you can build a business that supports the lifestyle that you truly desire. And don't forget to join the Private Practice Owners Club community on Facebook, where we are obsessed with providing even more resources that help owners,

[00:00:55] just like you, win the game of Private Practice. We're being live streamed. Here we go. Yeah, we're up and going. Nice, man. So we're talking about metrics mindset. We did a podcast on this just a, I think it just got released a few weeks ago, and it got a lot of views. You know, we had a spike up in viewership on this because I don't know why.

[00:01:21] Maybe there's people are, maybe they're averse to metrics. They're not sure which metrics to track and that kind of stuff. But it's something that as we're bringing on new clients into the coaching program, that don't you find that a lot of them don't know their numbers or don't know what numbers to track? Yeah, for sure. I think I know why. I don't know if it's a... Or is that a tease? It's a tease. You got to swatch to the end to find out. You have to watch another five minutes before you tell me.

[00:01:51] If you watch for the whole time, you might walk away. I'll tell you at the end, the next 45 minutes. Well, I could tell you this. I could tell you that this is a, it's a complex problem. You know, it's not just a hard skill, right? Like people know how to use a calculator and there's going to be some logistical or technical systems and processes that you'll have to implement in

[00:02:19] order to extract the data that you need, right? But people know how to do that. Or people, they're capable, right? Business owners are capable of doing that, which is why a lot of this is the mindset piece, right? It's like, why are we avoiding it? Why are we having a hard time actually confronting it or being willing to do that work? Yeah. Which is maybe the bigger overarching reason why it usually kind of, it's kind of like that, um, that treadmill that you bought

[00:02:50] that, uh, is in your room and you start, you have this idea. I'm going to work out every day. I'm going to run on it. Like we know how to use the treadmill. Yeah. It's like you plug it in, you press the green button and it goes beep, beep, beep. And then you start working on it. Right. And if I do it every day, I might get in shape, but for some reason we don't do that. Clothes get

[00:03:14] thrown on it and it becomes something that doesn't seem to be a priority for whatever reason. And I think maybe that's the real challenge that we have to try to figure out how to, how to solve. Yeah. I think I was thinking the analogy of there's some noise going on underneath the hood of my car and I'm not quite sure where it is or what it is. And me not knowing anything about car engines, like what am I going to lift the hood and start looking around? Like all I'm going to,

[00:03:44] I know how to pull out a dipstick and see if the, how the oil is doing. I know how to check the air filter, but outside of that, I don't really know how to diagnose what's going on. And so sometimes it's just a little bit easier to keep the hood closed and hope it goes away or just think, well, as long as this thing runs, then I'll just keep driving it. I can, I can turn up the radio and I

[00:04:12] don't, don't have to hear that. It's good enough for now. It works for now, right? Until you actually need it, then you're in real trouble because it breaks down. Right? Yeah. So, and I probably shared this on the podcast, you know, owners, they open up a practice, but they don't know, they don't inherently know the metrics they need to track. You know, some of the obvious ones that are easy to track, how many visits per day, how many visits per week, how many new patients,

[00:04:43] that kind of stuff, how much money is my bank account is like one of the least useful metrics you could even look at, but that's what we use because we don't know. And so that's where I tend to go with it. They have, they haven't been told what it is, what to look for unless they've had some kind of leadership roles in the past. And so, um, number one, learning what metrics are important. And then number two, once you know, the metrics, like looking, once you look under the hood,

[00:05:09] well, what are you looking for? And how do you know what's, what looks good and what looks bad? Right. How do I know that something that the fan belt is loose? Well, uh, if I don't know how to check and see if the fan belt is loose. So I think people, even if they have access to their numbers, they know that it's going to take some diagnostics, take some further work to determine what I need to

[00:05:35] do. And who knows, maybe people are afraid to look at those metrics after all, because, uh, if they do find a problem, maybe they don't know what to do about it once they find the problem. Like that's all I need is one more thing to worry about. Um, because that metrics in the red, right? I've got my own issues. I'm dealing with other things. Right. So it can be a little bit overwhelming. And, and for some

[00:06:02] people, it really is overwhelming just to start pulling the data, but there's more to it behind just pulling the data. Yeah. But it's all hard though. It's all overwhelming. It is. Yeah, it is. And, but it, and that's where you and I and all the other coaches are out here trying to preach, like you need to know, you need to become a business owner. You need to learn how to run a business and

[00:06:27] you need to know what the metrics are that run the business so that, you know, which levers to pull when things are going askew. Right. Yeah. Well, one of the things that, uh, that I kind of think about when you talk through that is that we typically underestimate what we can learn in 20, in a 20 hour

[00:06:49] period, you know, five, four hour blocks of time of dedicated, uninterrupted, deep focus on something will probably put you 60% there. You know what I mean? Like, or more like it's, it's enough. I don't know. I'm not just kind of like pulling that out based off my own experience, but a lot of

[00:07:19] the engines making noise. We sit around for months worrying about it and feeling the impact of it. When, if we would have just spent dedicated 20 hours of time, like you could probably get in there with some YouTube videos and some colleagues and ask some questions and dig, and you'll be blown away with how much progress you can make with solving any problem in your business.

[00:07:47] What not just metrics, right? But we, we spend years avoiding the 20 hours of deep work that we need to invest. Does that make sense? Yeah, totally. And that's because this is when I started, when things started changing, my practice is when I set aside those four or five hours, one time a week to actually do the work. And you had to struggle with that as well. That wasn't like,

[00:08:12] like, you're going to tell me to step away from the treatment table for five, five hours, one day a week that let me count how much money I'm losing by stepping away from the treatment table. But one of the first things to do when you do that, and you set aside those four hours is let's look at the dashboard. What is my dashboard telling me about my engine? What are the metrics

[00:08:35] that move and getting used to those and looking at those on a regular routine basis? Are they going up and down compared to the last four to six week trend? Are they hitting benchmark? Are they above or below benchmark? Are they where they need to be in the, are they at the expectations that I have for my providers and my team members to make sure this runs profitably and efficiently? Right. And so that's one of the first things when you set aside those four hours is to look at your metrics.

[00:09:04] Are they on par or do I need to do something about it? Or do I need to talk to somebody about doing something about it? Right. Yeah. And that's one of the first things you need to do with some of those extra hours that you have in a week. Yeah. I'm going to, um, I think this is the first time we've done this live video. So we're kind of figuring out what this is going to look like, but in my mind, I'm going to try to put together kind of a blueprint or a sequence of things that owners can do to

[00:09:31] actually create a little bit of momentum around this. And it sounds like the first step to this is just recognizing the need and the impact of your metrics, right? It's like, you just have to there's no amount of emotion or timing or if, but when there's nothing, there's no excuse other than

[00:09:55] some type of emergency life threatening emergency that is going to ever make it okay or make it reasonable for you to be a business owner and not focus on your metrics. Right. Is that fair? Right. I mean, there's a reason why the big companies have to file quarterly all of their metrics. It's just a principle. It's a law. It's a part of business. It just is right. It's just, we have to accept that as truth and it doesn't mean we have to like it or doesn't mean it's convenient.

[00:10:24] It doesn't mean it's easy. It's just law. Okay. So boom. Okay. We have to accept that reality. Okay. And now, now at that point we have an option. Are we going to act in accordance to that reality or not? There's the fork in the road, right? There's the fork in the road. Are you going to align your behaviors in alignment with the truth or are you going to align your behaviors

[00:10:51] in alignment with whatever feels urgent or whatever limiting belief you have? Right. So both are okay. You know, you can do whatever you want at your business. There's no, there's no wrong answer unless your goal is to actually create freedom in finance. There is a wrong answer. If you want to have a good business, right? But it's, you know, some people are like, you know what? I don't care about my business and that's fine, but you probably don't want to listen to this anymore. You know, like you'd be happy just

[00:11:20] being a solo practitioner with underneath your own shingle. That's fine. You're awesome. We can do beers. Yeah. Don't complain about the business and your profit margins. Right. Just keep your head. You just can't have both, right? Like you can't have, you can't have the convenience of not confronting the truth and have a thriving business that gives me freedom. Right. Okay. So step two is going to be, I would say define the behaviors that will get you closer to

[00:11:49] actually becoming more competent with your metrics. And that first behavior is blocking dedicated time, right. To actually diagnosing and running your metrics. Would you, would you agree? Totally. Yeah. I have to have the time to do it. Yeah. And like you said, time for you to not only just look at the metrics, but really dive in, look at the trends, like study the metrics. Don't just

[00:12:15] read the metrics. What is, what are the metrics telling me? Because they will tell you an objective story about your business that is free of emotion. And so you just have to sit with it and look at it. And diagnose what direction is this going in now? What do I need to do? Totally. Yeah. And listen, the people that are going to watch this are smart people, you know, like you, we've learned how to do all kinds of things in our life so far. We've learned how to cut the

[00:12:43] grass and we've learned how to use a pressure washer and cook and all these things, right? Raise children. Yeah. Right. Like it's not because we were born with all these, like we knew how to do it. Like, Oh, we're smart. Like you don't become competent. And then you start, you start dumb and you start looking silly and you start overwhelmed and you start anxious and you start feeling inadequate.

[00:13:09] And then you build competence and confidence through your commitment to, to actually learning. Yeah. Right. I remember that. And I, if you think about it, a lot of the EMRs out there that we use, one of the weaknesses of all of the EMRs, when we were looking to change EMRs, like 12 years ago, it was like, none of them had good property business management reports. None of them had good ones.

[00:13:35] And some of them, bigger players, one of them in particular still does not have good business management reports. So they put a decreased emphasis on that. So the owners didn't feel like they needed to because either you couldn't trust the reports or they didn't emphasize it. So we won't emphasize it. And then, um, as they've gotten better, now we're starting to think, okay, I need to look at my business reports, but now we really don't know what to do.

[00:14:00] And so I'm just saying, what I'm trying to say is that the industry hasn't necessarily guided an owner in any particular way. Not that the industry owes us that education, but the industry has also minimized the importance of those reports in the past. And there are some EMRs out there that people are using. We had a client, uh, I remember maybe six, eight months ago, they were in an EMR system. Like you guys, we, uh, in our coaching program, we, we require you to fill out your KPI

[00:14:30] dashboard. And they're like, we don't know how to get these KPIs from our EMR. And they're like, we don't, we can't find these things. And their EMR just didn't have it. It was an EMR that I hadn't heard of. And so we're like, well, you need to change your EMRs if you're going to run your business. Well, and they said that was life-changing when they went to an EMR that now has the manager reports and the KPIs that they need to track. They're like, Oh, this is how we run our business. This

[00:14:56] is what KPIs look like. And it's a super valuable information, but unless you have an EMR that you can trust the metrics, then you're really behind the eight ball. Yeah. Which it brings me to the real, maybe the ROI in committing to finding clarity around your metrics is it forces you to actually confront the problems that are actually holding you back. Right. And in this case, it was the EMR.

[00:15:26] Yeah. Right. So if you would have never made the decision that, you know what, I'm going to, I'm going to commit to building a business that actually has data that I can trust and rely on. And I'm going to block time and commit to that. I'm going to put my energy behind that. If you don't take that step, you would have lived with that EMR for the next decade. Right. But you did. And it forces you to solve the real problems because the real problem isn't

[00:15:52] reimbursement rates. Those are problems, right? Or other external things that are circumstances that are outside of, that are causing you to struggle. The real problem is that you're not really focused on solving the right problem. Right. Because you're, because you don't know. Right. And so, which kind of, I guess maybe kind of brings us to the next really important point,

[00:16:18] which is once you start having your data, it actually helps you make quality decisions, helps you make actual quality decisions. I was talking to a practice owner yesterday and she was a typical, right? Hey, Adam, we've got 8%, 7, 8% profit margins, right? We have declining reimbursements. We're struggling. We're having a hard time paying our team. Right. And

[00:16:46] she had the data. She had the data. The data was up. The data was clear that based on her current reimbursement levels, she couldn't afford to compensate her team the way that she was compensating them. Right. That lends to making some hard decisions that people might not want to confront if they know the data. Right. Right. Now, there's a lot of different ways we can attack that problem,

[00:17:13] but now let's actually solve the problem. Yes. Right? Let's actually solve the problem. What can we do to raise reimbursement rates? Can we drop low payers? Can we renegotiate? Can we create a productivity incentives? Can we write there's there's okay, here's the problem. Let's solve it and let's use data to actually drive. And, you know, so we kind of came to that reality,

[00:17:40] came to that conclusion because her goal was to walk away with, from our call with clarity on what I needed to be focusing on. And she's like, well, I need to get a new biller and I need to get it. No, no, no, no, no, no, no, no. Right here. It's you on the other end of this call. Right here. You know? Okay. Yeah. But I've got some AR money out there. Yeah. But it's not going

[00:18:06] to make a big difference for you. You know, this is the big needle mover for you. And so we confronted that and then, and here came the butts, right? Here came the butts. Yeah. But our models like this. Yeah. But one of the things that separates us is the way that we do this. Yeah. But yeah, but yeah, but yeah, but yeah, but right. And that's an interesting point. Can I dive into that a little bit? Yeah. So that's the next thing that we have to solve right there. Like those are two,

[00:18:34] two purposes that are coming up against each other. Right. Like we treat this way to get the results that we want, because that's how we expect our patients to be treated under XYZ clinic. Then the other purposes, this model isn't making us money. We're going under. We're going, I can't live a life of

[00:18:58] happiness and freedom because I'm awake every night trying to figure out payroll. So a profitable company butts up against the purpose and the way we do things of our organization, you're at a flexion point there and something needs to give. That's where, I mean, that's really cool that you used to have that experience because she came to the realization that there's one metric in particular

[00:19:24] that's ruining her company. And if without looking at her numbers, I would propose it's probably her compensation ratio. For sure. Which is 90% of the problem in the industry, by the way. This is true. I was going to say, if we didn't get through this without me listing some of the metrics that you, that are like high level, make the most impact in your business, that would be remiss of us. But the one, the one that I'm thinking of right here, and it comes off the top of

[00:19:51] my head for almost everybody is that compensation ratio. What is your compensation to employees, including all benefits, paid time off con ed, um, health benefits, et cetera, all of that compensation in relationship to your gross revenues. And it's, if it's over 60%, then you're going to have a really hard time making a significant profit. And you have very little wiggle room.

[00:20:16] If anything goes South, even the small blips once a month really ruin things for the rest of the year. So that 60% ratio has to be met. If you're bumping up against 60 on a regular basis, you might be doing okay, but it's going to be really hard. You just have to push it below 60. And, and you said there, you, you mentioned all the ways that you can, well, there's only two ways that you can fix it. It's

[00:20:41] either somehow decrease the amount of, well, there's a few ways you can fix it, but is decrease the pay of your employees or make those people more productive. But maybe some of those people are running at like 80, 85, 90% utilization slash efficiency rates. Well, at that point, then you're just seeing a lot of unprofitable contract payers when you're coming through your clinic. So that's

[00:21:09] when you have to renegotiate or drop some payers. Um, if you haven't already assessed are your billing practices and making sure you're maximizing your, your billing practices for every payer. So that can be really tough. I had an audit that said the same thing. I did this audit a couple of months ago on someone. And I want to say their compensation ratio is in the seventies, maybe 70,

[00:21:31] 74%. And like that right there is why you're making 2% margins or 5% margins. Like there's nothing else to work on now. Like that's your sole purpose in life is to change that metric. And if you don't want to figure out your compensation ratio, make it as simple as what is my average reimbursement and what is my average cost per visit? And how do I separate those two as much as possible to generate a sizable

[00:22:00] margin, right? How do I increase my reimbursement per visit? And how do I decrease my cost per visit? And I, we laid out exactly how to do that, but that's one metric when you're talking about ROI on the time spent in your business, that's where it pays off right there. Yeah. But Nathan, I gotta, I gotta, I gotta market that. I gotta go market. I gotta go market. I gotta get more new patients. I need more new patients. No, no, I gotta get a new EMR. It's the EMR.

[00:22:27] I gotta get a new EMR. I gotta get it. Yeah. But yeah, but yeah, but yeah, but let me not avoid, let me avoid the hard freaking frog that I gotta buy. Oh yeah. You know, let me tell you one way in which it paid off. So I did an episode with, oh, who is our man from Arkansas that came and spoke at the conference last October? He has like 20 clinics in his, Oh, you're talking about, you're talking about

[00:22:55] Lance Gross, Lance Gross. So I did an episode with him and he was coming up against this. Like he was kind of seeing some of this in his metrics and he's like, how do I increase this margin? And then he was starting to play with like, what are the billing practices in our team? What are, what is our average skilled unit per visit? What CPT codes are we using? Are we using Medicare and AMA? Are we only

[00:23:18] using Medicare guidelines across all of our billing practices? And he said he spent about 40 hours, maybe 40 plus hours building out a curriculum for his team to follow on how to best bill best billing practices to maximize the value of the services they provide and the subsequent documentation that goes with it, put in 40 hours. And he's got a big corporation. He's got like 17, 20 clinics. I'm

[00:23:45] probably adding more at this point that turned into an additional $1.4 million in revenue in the next year. It's incredible after. So he put 40 hours into it. He dispersed it out to his teams. He made sure everyone got trained through it. The leadership teams were holding people accountable to following those practices. Everyone, every new provider that came on, got trained in those

[00:24:07] practices of how to bill optimally and ethically and turned into a $1.4 million increase in revenue, all expenses staying the same, meaning all of that down to the bottom line profit, right? Just by spending that much time. And so that's what you're talking about when you're talking about the ROI on the time that you spend in your metrics is things like that real impacts on your business

[00:24:35] that float to the top line and ideally show up on the bottom line just as well. And then change that seven or 8% profit margin to 15, 18, 20% profit margins. Yeah. And I think that the hard part about it is it's nobody's going to come and do that for you. I think a lot of them hope that, that, that it's not going to happen that I was in that boat. I was, I am too. I have to remind myself just if someone, if I could get that office manager,

[00:25:05] right, that perfect office manager to come and take away the metrics and tell me what's going on. That would be a dream, but you know how many times I've seen clinic owners get screwed over by that office manager that takes over the metrics and tries to run the business. Yeah. Just like, I don't more often than not, they're losing. And I made the same mistake tens of thousands of dollars, maybe hundreds of thousands of dollars by trusting other people with my metrics. We kind of sit around and we think

[00:25:33] like maybe Medicare will eventually give us a raise or maybe, you know, like I'll get them Scott Gardner. Yeah. Yeah. Yeah. You know, you PTA go, go talk to some people on the Hill. It's like at the end of the day, business in order to be a good entrepreneur, you have to be good at solving problems. Yeah. Is that right? And you will get paid to the degree in which the level of problems

[00:25:58] that you actually solve, you know, and there's only one person in the universe that can solve your problems in your business. And it's you, it's not your wife. It's not your husband. It's not your team. It's not, it's not anyone. It's you. And one of the things that really resonates with me when I hear you talk about your story is about how you, you remember you had that turning point where you were like, I am in control of my own life.

[00:26:22] Like I am the one that has to create this. Right. Right. And you have to become a person who is competent and who can solve bigger problems. Period. Period. Otherwise you will continue to live the same life for a decade. Right. And so this is kind of like the Hill that I'm, that I've been dying on lately. Like you got to pop the hood and find out what's squeaking. You know what I mean? Like period.

[00:26:50] Period. You know what I mean? And if you need to go hire a mechanic or hire a business coach or fine, even better, that can get you there faster. You know what I mean? But the experts will figure it out and help you for sure. Correct. Correct. But you got to pop the hood and you got to become a student of the thing and you have to learn the thing and dedicate time and energy to the thing. And you will never, ever, ever, ever solve the problem. If you are buried in stuff and priorities that do not help you solve the problem, like a bunch of patient care and admin work and

[00:27:20] putting out fires all day and all that stuff. Like we have to carve out bandwidth and dedicated amounts of time and energy to wrestling with these things, to wrestling with these things. And that will be the thing that will help you learn and grow and ultimately be able to solve the problem. I want to really quickly bring it back to this practice owner because you mentioned like the purpose is budding. Oh yeah. The conflicting purposes. Yeah. I want to make money, but that's

[00:27:47] not, but this is how we treat patients and it's not profitable, which is the next prop, which is the next bear, which is the next bad guy. Right? So in the beginning, the first bad guy was deciding I'm going to focus. I'm going to stop treating patients so much and I'm going to focus. That was the bad guy. You had to make a trade. You had to make a trade. Right. And you got a good ROI on that trade because that helped you realize, huh? My EMR is not going to get me there. That one decision

[00:28:17] helps you build leverage for the next decade. Boom. Switch my EMR, get my metrics. Oh, but I got to switch my EMR, Nathan. That's going to be a big thing. It's going to cost money. Yeah, I know. Welcome to business. Let's freaking go. You know, make the decision. Let's move. Right. You make the trade, you get the EMR, you get the, you get the metrics and you, you realize, huh? I'm building a model that doesn't work profitably. Right. Right. So now I got to make another trade, right? I got to

[00:28:44] decide where can I wiggle? What do I need to let go of and at what capacity in order to carve out a little bit more possibility in the business somewhere else. And that trade-off will allow you to grow. And so I don't know if that, I don't know if there's anything to add. No, I like, if I'm thinking about this person that you're working with, I don't know how you coached her or whatnot, but I'm, I'm thinking eventually has to come down to, okay, she gives,

[00:29:14] she says the, but, but, but, but, but then, all right, maybe there's a way in which your current practice model treatment model can make money. That's where you need to figure it out. How can we keep doing this and live this purpose so that it does not come in conflict with running a profitable business? Love it. Right. So that's, she needs to figure that out. And there is a way, right? I mean,

[00:29:42] to just spit ball, she can go all cash pay. She can drop every single payer, except for some of our clients have like blue cross and Medicare, because those are the highest payers and that's all they see. And they're overrun by patients, but you have to make some hard decisions at that point. And that, and the overlying question is, what do we have to do to keep our treatment model in order to run a profitable business? And if you're not willing to face that, then you have to look the other way and

[00:30:11] say, how do I run a profitable business? And in order to do so without making all those hard decisions, how do we change our treatment model? Like one's something's got to give and they need to confront that and then make the decision and move forward. But if they do that sooner rather than later, life will be significantly better this time next year if we confront it. But if they don't confront it, they're just going to have continued issues and hope and dream that things change around them. I want to give one more tip. And then I want to talk about our conference in October,

[00:30:41] because I know that's really important. I also want to share a few KPIs that people should just make sure they're tracking so they go away with some understanding of concrete examples. So one thing that's really helpful, that's been a good filter for me, for those who are still watching this, you will find limitations through the metrics, period. Right? Like usually through the metrics, it's going to reveal the problem

[00:31:08] more than it's going to reveal all the answers. Does that make sense? So it's uncomfortable to look at the metrics because you're actually going to be confronted with a problem, right? And problems bring emotion, problems bring fear, yeah, buts, this and that, right? It brings the feeling of overwhelm that usually causes us to stall and hesitate or avoid.

[00:31:35] And a lot of times we mistakenly, guilty as charged here, we will try to find what's comfortable first and then try to figure out how to make the metrics work within our comfort zone. Yes. Right? And so we put the cart in front of the horse, right? It's like, let me be comfortable. And then I'll try to finagle the numbers and make it work financially. Yeah. And I've never seen that strategy work. You can try it, but I don't want to be your business partner.

[00:32:07] Love you, but I don't want to be your business partner. But it takes a little bit, it's a business principle and it takes a little bit of courage to say, you know what? I'm going to build this objectively first, right? I'm going to build the math problem first, and then I'm going to find ways to make it comfortable. Does that make sense? And so if you can just practice that when you're, when you're building your metrics, I think that you'll find, like Nathan mentioned,

[00:32:36] a way to align your conflicting purposes and yeah, you'll be able to solve the problems that matter. So that's all I wanted to leave with. Yeah. I was the metrics. I I'm just trying to think, and you should share as well, because I know you've been diving into your metrics a lot more this year, right? Yeah. What are some of the real needle movers? One that doesn't get tracked enough that I share all the time at the very top of the list. And the easiest one to track is over the counter

[00:33:04] collections. If you're not tracking that on a daily basis, what was collected versus what should have been collected from the people that came that day. Every copay estimated co-insurance estimated deductible paid at the time of service. It's an easy way to make more money. You lose money. I don't need to get into the metrics, but you lose money every time someone walks out of the clinic, having not paid for that day's service, if they have a co-insurance copay or deductible.

[00:33:32] And so that right there, if you're not tracking it, will probably increase your revenues at least five to 10%. I'm pretty confident within 30 days, right? And just maintain that on a rate, have that accountability in place, have that mindset that every, that everyone pays at the time of service. And the easiest way to do that is having a hundred percent of your patients have credit card on file. I'm assuming that made a big difference when you did that last year, right?

[00:34:00] Yeah. I'd say there's really two primary metrics you want to, we all kind of look at this through a similar lens and we, and we, we do it differently, but really the two metrics that I like to run at the front desk are over the counter collections, right? And schedule utilization, right? Like I need to know my pro forma, I need to know my break even. Therefore I need to know what my productivity levels are for each provider. And I need to create a utilization metric that is in alignment with that

[00:34:28] pro forma or that profit margin. And I need to hold that line, which is really where a lot of that employee expense ratio is managed is at the schedule utilization, assuming all your financial touch points are dialed in, right? Yeah, exactly. Well, that was the other metric is what is the provider utilization rate, right? Right. For, for the clinic as a whole on an average, and for the individual providers themselves, that needs to be at or about 85% utilization rate every

[00:34:53] week. Right. And the utilization rate, if you don't know is simply how many visits were actually attended out of how many were available. If there are a hundred appointments on the schedule and 85 of those got filled here in an 85% utilization rate. So it's pretty much that simple. And what we find is if you really want to move that metric without doing anything, and the metric that I'm talking about is the employee compensation metric, that 60% expectation.

[00:35:22] If you really want to move that below 60%, you just get your people more productive. See more patients. They've got to see more patients in the time allotted. You got to figure that out. And if they already are, then that's a different conversation. Right. So over the counter collections, utilization rate, employee compensation ratios, those are huge. Right. And then I firmly believe that skilled units per visit is a huge one as well. I've got someone,

[00:35:48] a friend who's relatively productive, but they've got a provider that's billing like two point something units per visit. And I'm like, and I told her, honestly, you will never make a profit with someone like that on your team. And she wasn't, she was like negative for a few months at a time. And like, they either need to be trained up or trained out quick. Like you can't wait another month to have that conversation with them. Um, well, you could, if you want to just lose money for

[00:36:16] another month. But I said, I seriously told her like, how much longer do you want to lose money? She's like, never ever. And I was like, then before you leave the office today, you have a conversation with that provider and tell them this is what the expectation is. Right. Yeah. And then the last one I would say, we did a whole podcast on it and that is break even points. So, um, we did a whole podcast on it. I'll even leave it in the comments section of that podcast

[00:36:43] about the importance of break even numbers, but people need to know their break even in terms of dollar revenues and visits that are needed to hit that break even mark. Well, I feel like we nailed it. I think those, those are some super important takeaways. I love how you brought up like mindset, the importance of mindset and committedness to it. Um, I was glad that I could also throw in there some of the importance of particular metrics that really move the needle in your practice.

[00:37:12] And that's a lot behind, I'm sure you're looking at a lot of these as you're building out that CEO dashboard right now. Right. Yeah. Specific. Yeah. I'll drop in the comments for those that are listening. There's really two, there's two tools that I recommend using that. I mean, the fundamental tools to help you actually track these things. Uh, one is your, uh, is a KPI dashboard, right? You just a simple spreadsheet doesn't have to be complicated, but you want to look at a KPI

[00:37:38] dashboard to help you measure the lagging indicators inside of the business, right? Um, this is the, the picture of what happened. And then the other tool, which I feel is more important is a pro forma, something that will help you anticipate and predict revenue generation and expense lines so that you, you should ideally be able to say, if I can collect at this over the counter rate with this arrival rate

[00:38:03] and schedule this many visits, I know exactly what my profit margin will be. You should be able to, you should be able to build that and predict it. And so the pro forma is huge. So I'm going to drop a link in the, in the comments. Um, we have a free, free KPI dashboard and pro forma tool. It comes with a video training. All you gotta do is plug your numbers in. It's yours. Yeah. Make sure you ask questions in the group. If you have any questions around for sure. Yeah. That's awesome stuff. Yeah.

[00:38:31] And then you talked about the conference. Yeah, man. Conference is exciting. We're going to be talking about a lot of this stuff at the conference, um, how to run a profitable, um, exciting business. In fact, the high performance practice, high performance practice, let's go high performance, balancing purpose, profit, and freedom. Right? So that's October 15th and 17th. I'm going to leave

[00:38:56] the join the wait list, um, link in the comments as well, because that's where you can say, Hey, raise my hand when something, when registration starts, when the hotel bookings become available, please let me know. And I'll leave that for you in the comments as well. So people who are interested there can join the wait list and figure out exactly when things are happening.

[00:39:21] Well, I want to say two things about the conference. Number one, this is one of Nathan's passions, the idea of getting people together, uh, in a room, you know, his, his mantra has always been reach out, step out and was a network. Yep. Right. And so like, just to see Nathan be able to do this and put this together for everyone is you can rest assured it's going to be really good. It's going

[00:39:51] to be a lot of energy behind it. And I've seen the agenda, the proposed agenda, and we're going to have breakout sessions. There's going to be stuff for leadership teams, for management, for operations, for marketing. There's going to be pediatric breakouts. It's going to be super cool. Um, and so I want to leave you guys with that. The other thing is last year's conference was incredible. It was very good. If you don't believe me, ask anybody who attended, it was awesome. It was super

[00:40:20] cool. The, the room was electric. The sponsors were incredible. They poured into us. We had free diner rounds. The sponsors took everyone on a party bus to eat and drink and network and talk business. It was a beautiful environment, but that's all the fluffy stuff. The real thing is for me personally, I walked away with one or two key decisions that I implemented in my practice

[00:40:43] business that have transformed my leadership and my ability to build my business because of a few key speakers that were far ahead of me who were solving that next big problem that I didn't quite see. And listen, I'm not the world's greatest practice owner. I think I'm pretty good at it. And I do know that if I literally got value from it, I know you will. Right. So get to the freaking

[00:41:08] conference. If, if you feel like you just want to try to rally behind a bunch of people who are going to help you solve these hard problems. The networking is huge, right? That's one of the, the most important things about it is for owners to network with other owners. But, uh, to add to it, you brought some of your leadership team this time. What was their experience? What did they say about it? They loved it. It was incredible. And not to mention like the level of commitment that they show this, the company now, when you, when you're able to invest,

[00:41:36] When you pull back the curtains a little bit, this is what ownership looks like, man. You can be a part of this. Yeah. Yes. You know, we've all seen, we've all experienced those really darker moments in ownership where, you know, you kind of feel beat down and you feel hopeless, you feel lost. And sometimes you have to find the will to escape that moment, to escape that season. And it's through those seasons that help you build resilience and confidence. Right. And unfortunately it's,

[00:42:05] it's a requirement for growth and leadership. And what I see in my team is that they're willing to do that now. Like they're willing, they're, they truly take full ownership of their role and they're willing to absorb some of that. And so I actually have a team where I'm not the one in the dark having to carry everything. And I feel like bringing them to a conference like that is, was a really big part of the reason why. And the cool thing is they got so much out of it from last conference and we didn't have anything

[00:42:34] specific for leadership teams. Like we do this conference, it's October 15th and 17th in San Antonio. And I've got breakouts specifically meant for now, if they go to them or not, that's up to them, but specifically meant for your leadership teams to learn how to like hold people accountable, how to have clarity conversations with their team members, how to drive production as a team lead,

[00:42:58] as a clinic lead, those kinds of topics are what I'm putting out there for that leadership track of breakouts. So stuff that they can get trained on and walk away with specific action items for their job description. So exciting stuff. All right. So we're going to be doing these more often. So if you're still sticking around, you're, I mean, if you watch to this end, you're one of us. Welcome to the club, right? We're with you. We're going to be doing these more often. I think

[00:43:26] we're kind of going maybe weekly, bi-weekly Thursdays. Yep. Yeah. And we really want these to be more action oriented ideally. And so you still got the podcast going and you might hear this on the podcast. Yeah. But if you're on the Facebook group, drop your comments, ask your questions, use the KPI dashboard. Like let's solve these problems. It's kind of a live podcast versus just the canned one. All right, man. Anything else? We're good. All right,

[00:43:53] guys, I'm signing off. Wishing you guys best of luck. Go swallow. Go eat the frog. Go eat the frog. Get it done. We'll see you next time, guys. Bye. See you, man. Thanks for listening to the Private Practice Owners Club. If you enjoyed this episode, would you mind doing us a huge favor and leaving a review? This helps us get the podcast out to more clinic owners to help them create greater freedom and profits so they can own their future.

[00:44:18] And visit our website, ppoclub.com to find more resources and connect with us.