The Truth About Scaling What No One Tells You About Growth

[00:00:00] I wanted to wake up excited about work. I didn't want to wake up dreading work. I wanted to know my numbers and have financial clarity. Understand exactly like, I know where my money's at. It's not off into some CPT code world and I don't know exactly where it's at or where it's coming and I don't know any of it. I wanted to just kind of know where my money was at.

[00:00:24] Welcome to the Private Practice Owners Club. Your hosts and coaches, Nathan Shields 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.

[00:00:39] 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, just like you, win the game of private practice.

[00:01:03] Have you ever felt like no matter how hard you push, your business just won't grow beyond a certain point? You're grinding, you're putting in the hours, yet somehow you're still stuck. Revenue's flat, your team's overwhelmed, and you might feel like you're spinning your wheels just to keep things from falling apart. And here's the worst part. It's not because you're not working hard enough. It's because the way that you've been taught to grow your business is actually broken.

[00:01:32] And if you keep following that advice, you'll stay stuck or worse, burnout completely. In this video, this is what I'd like you to get. Number one, the three biggest growth myths that are silently sabotaging your business. Number two, why so many practice owners hit a scaling ceiling and how to break through it. And number three, a proven framework that allows you to scale your practice without working more hours, without burning out your team.

[00:02:02] And without feeling like you're chained to the business. If you've been wondering why your growth might be stalled and what you need to do to fix it, this is the video you've been waiting for. Let's dive in. Today, we're going to talk about scaling. Vern Harnish wrote a book called Scaling Up. It's a great book. And he covered a lot of cool principles there. I think that this is going to be for...

[00:02:25] Yeah, what is scaling? It's a good question. To me, scaling means that I am able to grow my business or my life without it occupying more of my time, right? And I can do it in a profitable way. So in the beginning, what happens is you input one unit of effort to get one unit of output. So one input equals one output. One hour of work will give you $100 of reimbursement for Medicare.

[00:02:53] And so there's a one-to-one ratio between input versus output. And the problem is it's not scalable, meaning there's only so much of those types of inputs that you can give in an eight-hour workday or 10-hour workday.

[00:03:07] What scaling does is it creates a model or a system that allows you to get more for your inputs over time, right? So learning how to use leverage, which is either money, people, or systems, to such that whenever you put one input in, you get two outputs or three outputs. So you can scale your impact. You can scale your income. You can scale the value that you bring without robbing you of all your time, okay? That's what scaling is for me.

[00:03:34] And so you can do that whether you are going to go from one therapist to five or one therapist to three or a team of two to a team of 10. So that's a scale plan. You could also do it like if you're going to go from one clinic to 10 clinics, right? So there are levels to this game as well. And today we're going to talk about some of the keys to scaling effectively without getting trapped.

[00:03:58] So why are you here is the question. I just want you to think about that. If you're watching this, whether you're watching it live or whether you're watching the replay, why are you here? Why are you in this group? What has led you here? I don't know why you're here, but if I had to guess, it's probably because you want to grow your business. You want to grow your impact.

[00:04:18] You're interested in creating more value around you so that you can create a business that supports your life so that you can get back to the things that you love most, which is like usually it's like your family, your health. You want to travel and experience the world in a different way. That's why you're here probably. And you want to make some money along the way too, okay? So you started your business with a dream, with a vision and a dream of freedom and impact and financial success.

[00:04:48] But as we grow our business, as we grow our life, so does the chaos around us. And what happens is we start to feel trapped. Whether you're just starting out, whether you're in the middle, whether you're towards the end, we can become consumed by the complexity of business. And what that ends up doing is requiring us to work longer hours, juggling too many responsibilities. You know, we can start experiencing things like turnover with our team, lack of profitability, and just a difficult time finding work-life balance.

[00:05:15] And we told ourselves in the beginning that like, oh, if we scale up, if we create a bigger business, if we see more patients, or if we hire more people, that would give us more freedom. But in fact, it's maybe feeling like the opposite, meaning now that I'm scaling up, I have more problems. And so why is that happening? Why is it such that the busier or the bigger things get around you, the more complicated and busier you get?

[00:05:45] That's what we're going to talk about today. Okay, so the goal of this presentation is to give you three main things. Number one, why the practices that we see, why we see them hit a ceiling, the main reasons why they hit a ceiling. Number two is the three myths about growth that might be holding you back. The three myths that might be holding you back. And number four, I'd like to give you a framework to scale without burning out.

[00:06:10] Like if you're going to grow this thing, if you're going to create a business that's beyond you, at least have a framework, right? At least have some ideas on how you might be able to do this effectively without sacrificing the things that are most important. All right, so my name's Adam. You guys see the name somewhere around here. I'm a physical therapist. And I guess about, it's been five or six years ago, I was working 50 plus hours a week, felt like I was constantly putting out fires.

[00:06:35] I was struggling with profitability, meaning I was working more but making less, right? And I was missing time with my family. I was burnt out. And what I thought was if I work harder, it will get better. If I work more, it will get better. If I just hustle more, I will eventually find more freedom. And I was wrong. That freedom never came. And the problem that I had, it wasn't my work ethic. I was working really, really hard, which I'm sure a lot of you are as well.

[00:07:04] I was working really hard. It was actually my approach or my strategy that was broken. Okay? So I was like going 100 miles an hour. I was just going kind of in the wrong direction. And as soon as I figured out how to channel my focus towards the things that mattered most, that's when things started to change for me. Okay? So I was wearing too many hats. I was wearing way too many hats. My business completely relied on me. Like if I took a day off, things would fall apart. Right? I was the answer man to everybody on the team.

[00:07:33] Patients, referral sources, you know, the accountants, my entire team, the guy that owns the EMR, everybody. I had no systems, no clarity, and no like proven roadmap to get me where I needed to go. And I was just like not a happy camper. And what that meant for me was I was constantly stressed. I like had chronic stress. I was overwhelmed. I had no real freedom.

[00:07:54] It felt like I was already working hard and it felt like I was working, like before I started my business, I was an employee. And I was working harder as a business owner and making less money. Or yeah, making less money. So I basically had a really high paying job. And yeah, I got to a place where I was like, I'm either going to shut the door or get some help. That was me. And does that sound like something that you might be experiencing? Can you relate to that?

[00:08:23] I'm sure that if you're an entrepreneur, if you're here, if you're watching, you've probably experienced that at some level. I got you. I'm with you. I understand what that's like. Okay. And so what I would ask you is like, what is your real ideal scene? Like, what are you trying to create here? What are you really trying to do? All this work and hustle. What are you hoping that comes from this? Okay, let's define it. For me, it was like I wanted to wake up excited about work. I didn't want to wake up like dreading work.

[00:08:50] I wanted to know my numbers and have financial clarity. Understand exactly like I know where my money is at. It's not off into some CPT code world. And I don't know exactly where it's at or where it's coming. And I don't know any of it. Right. I wanted to just kind of know where my money was at. And I wanted to be able to take time off from the business and like truly be present with my family without having to be like having the monkey mind.

[00:09:16] Like, you know, how many times have you guys tried to be really present with your family, but the monkey mind is like you're constantly worried about the business and you can't shut it off. Like, yeah, we don't have that. Okay. And the aha moment I had was whenever a mentor of mine helped me realize that your business will not scale until you become the person who can help it scale. Okay. Nothing will work until you do. Nothing will work until you do. And that was a hard reality for me.

[00:09:43] Like where you are in your business, the situation that you're in, whether good or bad, it's directly related to the beliefs that you have, the way that you're thinking, the decisions that you're making, what you're prioritizing, where you're placing your energy. And so that is the thing that we really need to fix more than anything. Or you lack skill sets, right? You lack skill sets to recognize that there's another option, right? So elevating your skill sets and the way that you do things will produce a different outcome.

[00:10:12] And so the change that I made is I stopped doing 80% of what I was doing. And I just focused on three main things. Write these down. This was in 2020. Number one, building scalable systems, scalable business systems. Okay. Like the decision-making funnel, like came all the way down into, and it all pointed to me.

[00:10:33] And what I needed to do was remove myself from that and put systems that would help those decisions be made without me having to be there. Okay. So systems is really the first problem that you have to solve. How do I create something that's beyond myself? Number two is financial clarity. Financial clarity will help you step out of the emotional decision-making process and more into the objective one. And then number three is leadership development.

[00:10:59] The challenge with leadership is that it requires an investment in yourself, an investment in time, an investment of education, and an investment in some type of mentor. And if the business is demanding so much of you, it's going to be hard to carve out bandwidth to actually pour into yourself so that you can elevate your leadership. Elevating your leadership is the thing that will help you create influence in your organization. It will help you hire. It will help you market. It will help you improve the outcomes of your patients. It will help you enroll people into your vision. All right.

[00:11:29] So leadership is key. So it's systems, finances, and leadership. All right. And in 2020, I actually hired my first business coach. I went from working 50 hours a week to working about 8 to 10 hours a week in six months. And my profit margins were at 20%. And then I eventually opened up two more locations. Literally, like I tripled my personal revenue. I tripled it in six months. All right. Literally tripled it. And shout out to Nathan. He's the one that helped me with that. Okay.

[00:11:59] So that's the framework. That's the change I made. Focus on building your systems. It's like if your plate is really full with patient care and stuff, stop doing that. Take two hours a week and say, you know what? I'm going to build one system this week. Ideally, the system that is going to relieve my bandwidth the most. And if you do that six weeks in a row, you'll have six automated systems that you have effectively delegated off of your bandwidth. Okay.

[00:12:28] You're starting to build control. Hey there, practice owners. Are you ready to elevate your practice to new heights? Join us at the Elevate and Expand, a scaling conference from October 2nd to 4th at the beautiful Hilton Sandestin Beach Golf Resort and Spa in Miramar Beach, Florida.

[00:12:53] Learn how to scale your income, time freedom, and impact in today's economy. Pre-register now to enjoy your early access exclusive updates, discounts, and special bonuses. Don't miss this chance to transform your practice and your life. Go to the show notes now to find the pre-registration link. Mark your calendars for October 2nd to 4th and get ready to scale this year. Here are the three biggest myths.

[00:13:23] The three biggest myths. And these are hard. These are like the principles, right? So if you read Seven Habits of Highly Effective People by Stephen Covey, great book. Check it out. He talks about the principles, right? And so like instead of operating from these like rigid rules in your business, let's start identifying like what are the principles that we want to frame our decisions behind. Okay. The general ideas, the values. Okay.

[00:13:51] Myth number one is that scaling means more revenue, which will mean more work. Scaling means more revenue, which means more work. That's myth number one. More revenue should mean less work if you scale effectively. Okay. So scaling and growing isn't about doing more stuff. It's not about doing more things. It's about instead of doing the work, it's about using leverage to get work done. Leverage.

[00:14:20] Trying to think of a... You guys ever went to the airport? This is the thing that comes to mind. And they have those like... You're like walking to your terminal and they have those like escalator things, but they're flat. I don't know what you call those. Somebody drop it in the comments. It's like a treadmill, but it's going in the same direction as you. That's leverage. That's what scaling is like, right? It's like you start walking by yourself. It's like one foot, one foot, one foot, one foot.

[00:14:44] Then when you input a scalable system, you boom, you jump on the treadmill and then you're moving like 10 times faster or three times faster. Right? Right? That's what it's like to... We have to grow our business with that type of framework so that the more you grow, the faster, the better things are. The easier things are. Okay? And we leverage... The things that we leverage is number one, our systems and number two, our people. And not hustle. Hustle is very like...

[00:15:12] Hustle is like the Medicaid of resources. It's the lowest leverage, hardest thing. Systems and people and leadership, that's like the Blue Cross Blue Shield and the cash pay stuff. Like we want more of that. Right? That's going to get us way more for our time. Okay? Systems and people, systems is... That's going to come from you. It's going to require you to build those scalable systems. And then people, that's where we need to have our leadership. All right? You are in the people business.

[00:15:38] If we don't have good leadership skills, we cannot hire, retain, inspire, and influence our patients, our referral. We can't create movement around our organization. All right? So we have to scale without hustle. Number two, the myth number two is, if I just do more, it will get better. That's probably the worst mistake ever. Yet we do it over and over. Right? I'm guilty of it too. Like I have to catch myself and recognize like, I think I've been doing this long enough.

[00:16:06] You know, maybe it's time to try something different. If I just do more, it'll get better. And in fact, it took a while for me to realize that doing more is what was keeping me stuck. It was exactly the thing keeping me stuck. So growing your business isn't about... And again, like it's not about adding things to your plate. It's actually about subtracting things from your plate. It's about first recognizing when it's time to let go of things that used to be valuable,

[00:16:34] but are no longer serving us and delegating those things effectively so that we can step into higher levels of leverage. Okay? So doing more is keeping you stuck. Scaling really requires you to do less. Okay? Myth number three, I'm the only one that can do it right. That's a big one. And if you believe that, and if you operate that way, your business will always depend on you. This is a leadership piece. And so leadership isn't about like controlling or managing people.

[00:17:03] It's about inspiring them to do more because they want to. Right? It's about building a team that can thrive without you. Like that's the ultimate, you know, Will Humphrey, shout out Will. He says like the purest definition of leadership is to build other leaders. Right? So like leadership is, you know, leadership is doing, is going well for you. You know, you have good leadership skills when you are inspiring others to lead themselves

[00:17:28] well, to do more, to get more involved, to do more hard things. That is what makes a good leader. To do the thing that they don't like, but to act like they like it. Right? Like that's what leadership is. Okay? So with the myth, it's like, number one, we have to use systems and people for leverage. Number two, it's not about doing more. It's about actually doing less. Right? And then number three, I have to inspire other people to do some of the hard work.

[00:17:57] If I feel like I have to do it all myself, then we're never going to grow. Okay? And here's how I did this. So there's a three-step framework that I put together. There's a three-step framework that I put together. This isn't everything. Guys, I got 30 minutes. I can't. I mean, I don't know. I don't have everything. But I do have a three-step framework that hopefully will at least give you something to think about. All right? And step one is to audit your time and attention. I've talked about that endlessly. Check out the past trainings and go to some type of time and attention mastery. How to find more time.

[00:18:26] Like I've talked about that a lot. But your time and your attention is the most valuable resource in the company or in your life. Right? So, you know, write down everything you're doing for the week. Like where are you spending your time? Like objectify it. Actually write it down. And then highlight the tasks that legitimately directly contribute to the growth of your company. And then everything else, stop doing it or delegate it. Right?

[00:18:53] And it's going to require you to like sacrifice that. Like you have to get rid of it. And you're going to have to either hire somebody to help you build a system to automate it. It's going to require some effort from you or a sacrifice of maybe some money. You have to pay a new salary. But that is an investment in your time so you can step into higher leverage tasks. And that's how you grow. Literally, that's the game. That's the game. Right? So, step one is auditing your time and attention regularly. Always doing that.

[00:19:22] Number two, create a scalable business model. The one thing that impacted my ability to grow was always my fear of spending money. And I'm sure you guys can relate. I had a hard time spending money. I couldn't hire somebody because, oh, I can't afford it. Or I can't afford this. I can't afford that. Right? And that is the thing that limited my speed to getting things off my plate. Because I was hesitant about hiring people. And the real reason why is because I lacked financial clarity. Okay?

[00:19:50] So, there's a free KPI dashboard floating around this Facebook group. If you shoot me a DM, I'll send it to you. It's completely free. It's a free tool with a training video to help you set up your finances and to build a pro forma for your business. And what we want to do is make this objective. Just like put it in the spreadsheet and see where you're at and identify how you need to operationalize things. The way you deliver care, the way you collect over the counter, the way you spend your money

[00:20:18] such that you can guarantee profitability at the end of the month. Build that model. Build the model on paper. And then let's scale that. Let's scale the objective thing. Otherwise, if it's loosely defined and it's emotional, you might be scaling a lot of problems. So, scale a solution, not a problem. Okay? So, number two is create a scalable model. Number three is build a team that runs without you. That's the leadership piece.

[00:20:43] So, you want to hire people based on roles and you must, here's the key, you must develop a leadership development framework for your organization. You can outsource that. We have a really awesome outsource solution where we can help you build leaders in your company, but you don't have to do that. You can do it yourself. But if you are not deploying leadership within your organization, you will never grow your people, period. People aren't just born with skills.

[00:21:12] They must be developed. So, you grow your business. You grow your people. Your people grow your business. Okay? So, shift from managing people to leading them. My question for you is, let's just say you decided, hey, I'm going to actually block off some time and I'm going to audit my time and attention regularly. I'm going to create a scalable business model and I'm going to actually build a team, a leadership development program. Do you feel like something like that would align with your business goals?

[00:21:39] Do you feel like that would help you get more of what you really want out of your life? I'm pausing to let you think about that. And what type of impact would that have on your life? What type of impact that had on your bank account? What type of impact would that have with the people that you value the most? Okay? So, here's my pitch. I've taken everything that I've learned. I've worked with probably 15 to 20 different coaches. I hire a coach every year. I'm never not working with a coach.

[00:22:08] I put it into a framework called the CEO Accelerator Framework, where we help you build scalable systems, build your leadership, find financial clarity. My guarantee is that we have to do an interview process. But if we decide that it's a good fit for each other, if you 100% to the program after 90 days, if you're not completely satisfied, you don't pay. We have 100% success rate. Okay? So, if you want to learn more information about that, shoot me a DM. That's my training for today, guys. Here's what I'll leave you with.

[00:22:38] You guys are amazing. You guys are inspiring. You guys are awesome. You guys are worthy of success. You're worthy to make a... You deserve making a bunch of money. And you can do anything you want, especially with a little bit of guidance and support, a little bit of clarity. There's nothing that you can't accomplish. And I would love to see you win and create a business of your dreams. You guys have a great week. Talk soon. Thanks for listening to the Private Practice Owners Club.

[00:23:05] 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. And visit our website, ppoclub.com, to find more resources and connect with us.