The challenges of opening a second or third clinic in your PT practice aren’t the same challenges that you face when opening the first clinic. As you scale, the need for more robust systems and processes increases. In this episode, Nathan Shields and Adam Robin discuss what they wish they had done differently in their ownership journey, especially as it relates to expanding beyond the first clinic. Going into an expansion, a Physical Therapy Clinic owner may have an "I don't know what I don't know" mindset. Let this episode (and a trusted coach) guide into some of the things that you haven't foreseen. The opportunities and the growth are great, and pitfalls should be expected along the way. But there are ways to see around corners – let this podcast be one of those ways.
[00:00:00] Welcome! You've entered the Physical Therapy Owners Club podcast where your host Nathan Shields
[00:00:08] and other successful PT owners and leaders share their experience and insights on how
[00:00:13] to build successful PT businesses. They'll share the stories of their paths to success
[00:00:18] and show you how you can also obtain greater freedom and more profits from your business.
[00:00:23] That's what the PT Owners Club is all about, greater freedom and more profits. There's
[00:00:28] plenty of room for you as well, so come on in and join the club.
[00:00:38] Hello and welcome to the Physical Therapy Owners Club podcast. I am Nathan Shields, got my
[00:00:43] partner in crime, Adam Robin with me today. Good to see you again in a new year. Well,
[00:00:47] good to get back together. We just had an episode a few weeks ago that got posted on
[00:00:52] the podcast where we talked about how to plan out for the next year. Our strategic
[00:00:57] planning session, we broke that down so everyone can look at that, go back a few
[00:01:01] episodes and check that out. Today we're going to talk about, I brought up this idea
[00:01:05] to Adam that maybe we talk about what he's learned from opening his clinics. At this
[00:01:10] current stage, Adam, you've just opened your third clinic?
[00:01:14] Just opened number three.
[00:01:15] Yeah. You've gotten to this point and there are lessons learned at each stage
[00:01:19] and there are vital things to know at each stage that maybe you knew before or
[00:01:25] now you know. I thought maybe it'd be cool to just talk about what you've
[00:01:29] learned along the way. Of course, I'll share my insights as well as I open multiple
[00:01:32] clinics too. Let's start from zero to one and we can work our way up. I know opening
[00:01:39] a third clinic is fresh in your mind but I don't want to work my way backwards and
[00:01:42] I don't want to get too confused. Let's go back to zero to one. You opened up
[00:01:47] a clinic a number of years ago while you bought into a clinic. Going into that
[00:01:51] experience, and I can share my experience because I didn't buy into one. I made it
[00:01:55] from scratch but talk to me a little bit about what you learned going into that
[00:01:59] first clinic that you wish you knew now.
[00:02:02] Well, I actually opened number one with a partner.
[00:02:05] Right.
[00:02:06] So I learned a lot about partnerships. I probably learned the same lesson that
[00:02:11] everybody who's ever had a partner has learned. A bad partner has learned.
[00:02:14] I learned that not all partnerships are created equal and there's a right
[00:02:17] way on the wrong way to do that. It's a lot more of an intense
[00:02:20] relationship than you might think.
[00:02:22] Well, talk about that a little bit before what you learned about the clinic
[00:02:25] itself but some people are looking into opening clinics with partners or they
[00:02:29] have partners now. Plenty of them have gone sideways. I've been fortunate enough
[00:02:33] to have partners that were great relationships and I consider Will Humphrey
[00:02:36] is one of my best friends and business partners. What did you learn
[00:02:40] about partnerships that you wish you had known at the time?
[00:02:43] Well, I think it was less about partnerships and just more about
[00:02:45] people.
[00:02:46] Okay.
[00:02:47] Learning how to work. I mean, I was out of school two years when I opened my
[00:02:53] clinic. I was a little whippersnapper. You know what I mean?
[00:02:56] Like I didn't know what I was doing. Had a lot of grit and determination
[00:02:59] and I was going to get it done. But you can't force your way through
[00:03:04] to success. It's a dance. It's an art and you have to be patient.
[00:03:08] You have to listen and you have to do a lot of those things.
[00:03:10] So the main thing that I learned about my first partnership was
[00:03:14] that getting alignment with that person on day one is like super,
[00:03:20] super key. Specifically about like, what's the company going to look
[00:03:24] like? What is your role going to be in the company? What are your
[00:03:26] expectations? What are my expectations? What does a win look
[00:03:30] like and what's the exit plan? Like what's the exit plan? Like
[00:03:35] what's the buyout going to look like when there is a buyout? How
[00:03:38] are we going to value the company? Right? Just getting out ahead
[00:03:42] of those types of things.
[00:03:43] Yeah. Talking about their sharing each other's visions for what
[00:03:46] they want to see. What does that look like? I like getting pretty
[00:03:51] granular. You know, we set up a partnership and I want to get as
[00:03:55] specific as pot as you can reasonably with like you said roles
[00:04:00] like you and I we've talked about it. We did our own impact
[00:04:03] filters, you know, that Dan Silvin's impact filter that we
[00:04:06] got online to say this is what needs to be true for me to be
[00:04:10] happy or successful with this venture and share that with each
[00:04:13] other and talk about it. What does that vision look like? What am I
[00:04:16] doing that brings fulfillment? What are you doing that brings
[00:04:18] fulfillment? And then talking about roles and responsibilities,
[00:04:21] like you said, who's going to be in charge of what because
[00:04:24] if you're both in charge of everything, then it really
[00:04:27] gets muddy really quick. I thought you were going to do
[00:04:30] that and you thought I was going to do that.
[00:04:31] It's a bunch of expectations that are unmet by both parties
[00:04:34] and everybody's got it's just a mess leads to disappointment
[00:04:37] and frustration right? Right. So getting really clear about
[00:04:40] who's responsible for what and when and where and talking
[00:04:43] deadlines and there's a big part of it on the financial side,
[00:04:46] like distributions, like if you're going into it and sharing
[00:04:49] equally on the financial aspect of it, you know, sure 5050
[00:04:52] financially that's fine. But there needs to be other
[00:04:55] contingencies like what if you come at a deadlock and who's
[00:04:58] going to break that tie? So deciding on someone that you
[00:05:02] both agree with that would break out a meaningful tie that
[00:05:06] you have regarding the future of the business and agreeing to
[00:05:09] that getting it and writing, putting your signatures to it.
[00:05:12] And if we're going to do some technical work that's expected
[00:05:15] out of us that we get appropriately compensated for that.
[00:05:19] Like I'm not a big believer in sweat equity.
[00:05:21] It happens yet. We're putting some work into it for
[00:05:24] something greater down the line, but I don't want someone
[00:05:27] coming back on the back end saying, Hey, remember all
[00:05:30] that work that I did for the past two years? It's time
[00:05:32] to pay up like no, no, no, no, let's talk about that
[00:05:35] at the front end. If you're going to do something
[00:05:37] for free, we're going to agree that you're doing it for free.
[00:05:40] Or we're both agreeing that you're doing this work now
[00:05:43] so that we can get an equal distribution later on.
[00:05:46] And if it's not worthy of an equal distribution later on,
[00:05:48] then let's pay you by the hour for that technical
[00:05:53] work that you did or let's just get that in writing,
[00:05:55] get that figured out because I don't want someone coming
[00:05:58] back at me saying, Oh, you owe me because I did this
[00:06:01] and I put in more time than you and watching each
[00:06:03] other's time clocking in clocking out.
[00:06:06] There can be a lot of issues and frustration with all of that.
[00:06:08] And that's where a lot of partnerships start falling apart.
[00:06:10] And I think it probably starts because of that lack of communication.
[00:06:14] And then they just gradually do less and less
[00:06:16] communicating to the point where that I know there's plenty
[00:06:19] of partnerships out there that just don't talk to each other.
[00:06:23] But there's still partners, right?
[00:06:24] Yeah. I mean, bottom line is like, I just didn't have any experience doing anything.
[00:06:29] Yeah. I mean, I was so like, I had nothing
[00:06:33] so much to learn about just working.
[00:06:37] You know, it's like, but I'm super grateful for the experience.
[00:06:41] Yeah, because it was a challenge I learned from.
[00:06:42] And you know what?
[00:06:43] Me and my old partner are still friends and we still communicate with each other.
[00:06:47] And I think we both agree that it was a great learning experience.
[00:06:51] Yeah. And then some of the other things, partnership or not,
[00:06:53] all the legality stuff that I had no clue existed.
[00:06:56] OK, establishing the LLCs and getting the articles of organization in place
[00:07:00] and, you know, using someone a trusted lawyer, spending the money on a lawyer,
[00:07:04] spending the money on an accountant to get your financials set up appropriately
[00:07:08] from the get go and building on a budget and pro forma.
[00:07:12] I would go back now and tell myself to do some of that stuff.
[00:07:15] 100% leverage whoever you can teach you how to open up a business
[00:07:20] and make sure you set it up right and all that kind of stuff.
[00:07:24] And getting a trusted commercial real estate broker
[00:07:27] who can help you understand leases and what you're responsible for
[00:07:30] and really talk you through it as if you were a fifth grader.
[00:07:34] Just say, teach me the vocabulary, the word, verbage, the you name it.
[00:07:38] So I can really understand this lease that I'm signing my life to
[00:07:41] with a personal guarantee that I didn't know existed until after the fact.
[00:07:46] So all that stuff is those are all things that you need to take the time
[00:07:49] and spend the money on to invest in a business.
[00:07:51] Yeah, 100%.
[00:07:52] It's a scary venture going to number one.
[00:07:54] There's a ton to learn.
[00:07:56] And I think that I can probably group all of that together to say, like,
[00:08:01] the biggest lesson that I learned with number one is you're not going to be
[00:08:04] able to control everything, like you're going to have to let go of things
[00:08:08] like collections. You might not get paid for every visit.
[00:08:12] Like, that's a hard thing to freaking learn.
[00:08:14] You know, like you might not get a referral.
[00:08:20] You might not phone might not ring.
[00:08:22] You know, you might not be able to find a PT.
[00:08:24] You know, your partner might not do their job.
[00:08:26] You know, you might fail.
[00:08:28] So like there's a lot of things you're going to have to learn
[00:08:30] to be OK with not controlling everything.
[00:08:34] Yeah, some of that's just like a learning tax, right?
[00:08:36] When you open up a clinic, I would highly recommend you outsource your credentialing.
[00:08:41] Yeah, at the very beginning, I'd actually highly recommend you find
[00:08:44] a quality biller instead of learning it on the ropes.
[00:08:47] I think that's just tough to do that for a new owner.
[00:08:51] And it could be a real distraction.
[00:08:53] When your most important thing when you open that first clinic
[00:08:56] is to get patients in the door.
[00:08:58] You don't want to be worrying about collections.
[00:09:00] You don't want to be worrying about credentialing.
[00:09:02] You should be out marketing, marketing, marketing.
[00:09:05] And then when you have some extra time, do some more marketing.
[00:09:09] Do some marketing, build some relationships,
[00:09:12] build relationships, get out there and work hard to get patients in the day.
[00:09:15] It's all about quantity at the very beginning, right?
[00:09:18] And so getting that sped up helps out a ton
[00:09:21] when you can offload the third parties initially.
[00:09:24] And this is a kudos to you.
[00:09:25] I know you got some coaching with me pretty early on into your ownership.
[00:09:29] And I know we're going to recommend coaching.
[00:09:31] Did you I'll put it this way.
[00:09:33] Do you think you got coaching early enough
[00:09:35] or should you have gotten coaching earlier than you did?
[00:09:38] That's a great question.
[00:09:40] I don't think that it's too soon ever too soon.
[00:09:43] I think that, you know, like as soon as your 30 days out from opening
[00:09:48] or so and you're looking to put together some marketing material
[00:09:52] and some things like that, like it's probably appropriate
[00:09:55] for you to start considering working with a coach or some type of mentor.
[00:09:59] It's a lot, man.
[00:10:00] It's a lot to learn.
[00:10:01] And the thing that a coach like you provided me was direction,
[00:10:05] was just direction and clarity on, hey, just take this one step.
[00:10:10] This is the right step.
[00:10:11] It's going to be fine.
[00:10:12] Just take that step and you can trust it's going to be fine.
[00:10:14] And then I could take a step.
[00:10:15] But what happens is when you're that brand new owner
[00:10:18] and you've got a lot of grit and determination with not a lot of direction,
[00:10:21] you're just like, you're running around crazy.
[00:10:23] You're not sure what the priority is.
[00:10:25] It's all overwhelming.
[00:10:27] It's like billing collections, hiring, firing, taxes, payroll.
[00:10:30] The printer is not working.
[00:10:32] Patience. And you're like, I don't know.
[00:10:35] My head's about to explode.
[00:10:37] And it's a super stressful time when you don't have a lot of clear direction,
[00:10:41] especially someone like me who was so young out of school.
[00:10:44] I was only two years out of school.
[00:10:45] I didn't really have a whole lot of experience.
[00:10:47] I wasn't a clinical director for five years before I opened the clinic.
[00:10:50] You know, I was doing home health.
[00:10:51] You didn't know your KPIs. You didn't know.
[00:10:53] I didn't know KPIs. I didn't know like what's a unit?
[00:10:56] What's a unit?
[00:10:58] You know, like a lot of things to figure out.
[00:11:00] Yeah. And we had a few members of the coaching program that are like brand spanking new.
[00:11:05] Oh, yeah.
[00:11:05] And I'm actually a little bit jealous of those guys.
[00:11:07] I mean, they're not going to have to learn the crap that we had to learn
[00:11:10] because when you're in the painting, you can't see the painting.
[00:11:13] Right. Yes.
[00:11:15] And so a coach.
[00:11:16] I totally understand exactly what you're saying.
[00:11:19] Exactly.
[00:11:20] So the coach can say, hey, don't worry about that right now.
[00:11:23] Just focus over here.
[00:11:24] This is what you need to do.
[00:11:25] Yeah. So like I'm going to just call out Zach Randolph right now.
[00:11:29] He's going to watch this.
[00:11:30] He's he's one of them killing it.
[00:11:32] I mean, the guy doesn't know, realize what he's doing.
[00:11:35] Like it's just a brand new owner and just crushing numbers.
[00:11:38] It's a great.
[00:11:38] He's been open for like two months.
[00:11:40] He's got 140 visits on the schedule.
[00:11:41] You know, come on.
[00:11:42] And he's like, man, you know, he goes to the call and he's like,
[00:11:45] you know, man, everybody just kind of does.
[00:11:47] Everybody comes to work
[00:11:49] and they're kind of just doing what they're supposed to do.
[00:11:50] Like I don't really need to worry about systems.
[00:11:53] And I'm like, he's like, yeah, like when you told me to ask everybody
[00:11:56] to start writing things down, they just started writing their own things down
[00:11:58] and they just started kind of doing their thing.
[00:12:00] I'm like, exactly.
[00:12:03] Yeah. That's amazing.
[00:12:05] Like you've got people on your team actually writing down their job descriptions.
[00:12:08] That's why it's working.
[00:12:10] It's so like that disconnect of like he doesn't have that experience
[00:12:13] of like going through all that pain and agony.
[00:12:16] It's just like it's happening so naturally for him, which I'm so I'm so excited for him.
[00:12:19] That's so cool.
[00:12:21] Well, and that's a good transition point because after you get established
[00:12:25] when you start seeing some patients, then this is my opinion,
[00:12:28] but for most owners, they get distracted with patient care.
[00:12:31] Oh, yeah. So they fill up their schedules, they get full time
[00:12:34] and they stop thinking about the business
[00:12:37] and they start thinking more about the patients.
[00:12:39] And I don't blame them.
[00:12:40] That's what they open the clinic for.
[00:12:43] And that's what they studied for for decades from elementary school
[00:12:46] all the way through to getting your PT license was to be a full time
[00:12:50] physical therapist treating patients the way you wanted to treat them.
[00:12:54] But once you become an owner, that goal becomes a distraction.
[00:12:58] And the mindset if it hasn't shifted before getting becoming full time
[00:13:03] patient care, it's a hard transition to make
[00:13:06] after you've gotten full time patient care as an owner.
[00:13:08] And so there are things that you need to save time during your week
[00:13:13] to work on regards to the business.
[00:13:14] Otherwise, your business suffers or becomes very static, stagnant, doesn't grow.
[00:13:20] You're not able to provide the vision.
[00:13:21] You don't have the time to develop the culture that you want to see in your team.
[00:13:24] You could be hiring people left and right,
[00:13:26] but the culture is just going the way of the wind.
[00:13:29] Whoever's the biggest mouth in the or biggest presence in the clinic
[00:13:32] that becomes the culture of the clinic.
[00:13:34] If you're not intentional about it and you're distracted with patient care, right?
[00:13:39] Yeah.
[00:13:39] That's one thing that I didn't understand until 10 years in to ownership
[00:13:44] that I needed to set aside that time to work on my business.
[00:13:49] Yeah, I love like watching you talk about it
[00:13:51] because it brings me back to that experience and not all owners,
[00:13:56] but a good majority of owners kind of figure out how to hustle up some new patients.
[00:14:01] Right. For the most part,
[00:14:02] most people can figure out how to hustle up some new patients
[00:14:04] to at least fill their schedule.
[00:14:05] Right.
[00:14:06] But there's so much fear around how many new patients do I need to get in this
[00:14:12] building to keep the bank account going, right?
[00:14:14] So they're constantly obsessed with the new patients and the referrals coming in
[00:14:19] for like a year, for two years, three years, 10 years.
[00:14:22] Pull visits.
[00:14:22] Yeah, visits and new patients, visits and new patients, visits and new patients
[00:14:25] and cancel rate. Oh, crap.
[00:14:27] Right. So, Lynn, that's all they know.
[00:14:29] They know more new patients equals good, less new patients equals really, really bad.
[00:14:33] And so asking them to say like, hey, let's not worry about that right now.
[00:14:38] And let's actually make that priority number two or three.
[00:14:42] It's a hard thing.
[00:14:43] It's like this is all I know.
[00:14:46] This is the only way I know how to make this work is to worry about new patients
[00:14:50] and see more patients and to see more patients.
[00:14:52] Right. So it's like, get him in right now, cancel my appointment.
[00:14:54] I'll be there, cancel my lunch, put him on my lunch break.
[00:14:56] Right. Like I'll get him in right now.
[00:14:58] And like, that's a hard thing to break.
[00:15:00] Well, especially if you have visions, aspirations for growth.
[00:15:04] If you're just the one man PT clinic and that's what you want to do
[00:15:06] and you want to treat one on one for an hour and especially if you're like
[00:15:10] cash pay out of network, whatever.
[00:15:13] And that's what you that's your dream.
[00:15:14] Great. But I don't think we're talking to those people.
[00:15:16] We're talking to people who want to do more than themselves, right?
[00:15:20] Want to become more than themselves.
[00:15:22] And I think what we're transitioning into right here is that time is necessary
[00:15:27] not only to work on your current business and that's clinic number one
[00:15:31] and make sure it's humming, right?
[00:15:34] But it's absolutely necessary to get your clinic humming to even consider number two.
[00:15:39] Oh, yes.
[00:15:40] So working on your business and making sure that's humming.
[00:15:43] And when I say humming, written out policies and procedures, right?
[00:15:47] And I opened up clinic number two without these things.
[00:15:50] Right. And it went fine because I had an awesome partner in Wilhelm
[00:15:54] Fries and he took it upon himself to run that clinic as if it was his own.
[00:15:59] But he could tell you that he was not fully supported by me at that time
[00:16:04] because I didn't have any policies, systems and procedures in place.
[00:16:08] I gave him the software that he needed.
[00:16:10] And but that's probably about it.
[00:16:12] You know, we talked every few weeks, maybe here's a key to the building.
[00:16:16] Here's the keys. Good luck.
[00:16:17] So.
[00:16:19] Like through the keys in there and close the door behind me. Good luck.
[00:16:22] Yeah. Yeah.
[00:16:24] But he ran it like that.
[00:16:25] And I'm very fortunate that he did.
[00:16:26] But going back and telling myself what I could have and should have done better
[00:16:29] policies and procedures in place that are running the front office
[00:16:33] that run how we treat patients, how we bill, how we schedule,
[00:16:37] you name it, having billion collections dialed in.
[00:16:40] And the first clinic, ideally,
[00:16:43] that first clinic is running at 80 to 85 percent capacity
[00:16:46] before even consider that second.
[00:16:48] And when we say capacity,
[00:16:50] I've shared it a number of times on the podcast, but I'll share it again.
[00:16:53] And that is 10 percent of your square footage should be as your max capacity.
[00:16:58] And this is true for most demographics.
[00:16:59] They outrun this by a mile in like downtown New York City.
[00:17:04] But 10 percent of your square footage is your max visit capacity per week.
[00:17:08] So if you have a 2000 square foot office, 200 visits per week
[00:17:12] is about your max capacity.
[00:17:14] Are you seeing about that in Mississippi?
[00:17:16] Yeah.
[00:17:16] And so that's 100 percent capacity.
[00:17:19] So you want to be running with those numbers,
[00:17:21] you'd want to be like 160 170 on the regular
[00:17:25] before you even consider a second clinic.
[00:17:27] Because then you know that it's running, it's financially stable,
[00:17:30] it's healthy and it's running because the last thing you want to do is open
[00:17:33] a second clinic and then get distracted by that second clinic
[00:17:37] such that the clinic number one starts to Peter and Falter
[00:17:40] and becomes financially strapped.
[00:17:42] Now you've got two struggling clinics, one that's brand new
[00:17:44] and one that's just older but struggling.
[00:17:47] And you don't want to be in that situation.
[00:17:49] Yeah, I always say the way that I've described it in the past was
[00:17:53] when you open a second clinic, all your problems double plus commute.
[00:17:56] Yeah, all your life's challenges double plus commute.
[00:18:00] So it's like it's a huge undertaking.
[00:18:04] It really is like my experience as I believe in coaching
[00:18:08] and I've always surrounded myself with really smart people,
[00:18:11] people who are smarter than me.
[00:18:12] And I was fortunate enough to like gear up
[00:18:16] as good as I felt like I could to get into number two.
[00:18:18] Like I had policies and procedures, I had my stats,
[00:18:22] all the stats throughout the entire company systems.
[00:18:25] I had my clinical directorial built out all my training built out.
[00:18:28] That person was seated, performing in her position.
[00:18:32] I had a recruiting machine running.
[00:18:34] I had all of those things front desk position was dialed in.
[00:18:38] Everything was dialed in basically built up the operational capacity
[00:18:43] as if I had two clinics, but I was only running one.
[00:18:45] Like I had my VAs in the background running.
[00:18:47] So once I had all that support and safety,
[00:18:50] then I decided to jump into number two and it was still hard.
[00:18:55] It was still hard.
[00:18:57] Well, what did you not foresee in clinic number two?
[00:19:00] Well, everybody's journey is a little different.
[00:19:03] But listen, our first clinic is amazing.
[00:19:05] I mean, we're seeing four hundred fifty five hundred visits a week there.
[00:19:08] I mean, it's like we're rocking.
[00:19:09] So like the confidence is supreme at that clinic.
[00:19:13] So I'm going into this new clinic thinking like,
[00:19:15] I'm just about to go in there and dominate.
[00:19:17] We're just going to do another five hundred visits a week.
[00:19:19] Just going to do another five hundred.
[00:19:21] So like within three months, I should be making one hundred
[00:19:23] fifty more thousand dollars a year.
[00:19:24] Like I had all of these like expectations.
[00:19:30] And then what happened was that didn't happen.
[00:19:33] It was like, wait a minute.
[00:19:36] Then I had like turnover at the front office
[00:19:37] that had turnover and a couple of therapists.
[00:19:39] And then I found myself kind of pinging back and forth a little bit,
[00:19:43] kind of not quite sitting on the high horse like I had thought I was going to.
[00:19:48] So that was the big lesson that I learned.
[00:19:50] It takes more than you think always.
[00:19:52] It always takes more than you think.
[00:19:54] And you're talking about the operations, but the construction alone,
[00:19:57] the T.I., the build out, you got to be able to at the drop of a hat.
[00:20:00] You got to be over at that office space
[00:20:03] because someone some subcontractor is waiting for you to make a decision on blank.
[00:20:08] Right. And you've got to be there and figure it out.
[00:20:10] ASAP, otherwise they're just going to be standing around waiting for you
[00:20:13] or take off and not be back for a week.
[00:20:15] Right. And then it's going like you said,
[00:20:17] it's going to drain your bank account because it's cash flow heavy.
[00:20:21] Right. And it needs cash for that T.I.
[00:20:24] Yeah, you could leverage line of credit, get a construction loan.
[00:20:28] You name it, that kind of stuff.
[00:20:29] But it's going to take some cash
[00:20:31] and you better have some reserves in place before you open that second clinic.
[00:20:35] Right. Mm hmm.
[00:20:36] Plenty of it.
[00:20:37] Yeah, so there's plenty of that.
[00:20:39] Maybe doesn't get appreciated
[00:20:41] prior to going into that second clinic.
[00:20:43] Yeah, no, for sure.
[00:20:44] It definitely doesn't get appreciated.
[00:20:45] They just like, oh, yeah, I'm a pop up another clinic.
[00:20:47] All your problems are going to double plus commute.
[00:20:50] It's a lot more than you think.
[00:20:52] The other thing that I would also like to bring up is that your team
[00:20:59] is going to be stretched a lot more than you think
[00:21:02] your administrative team,
[00:21:04] even your clinical director that you think's got it all under control.
[00:21:08] When you're not there nearly as much,
[00:21:11] things are a little bit more stretched for that person.
[00:21:14] The marketing person is a little bit more divided.
[00:21:17] Right. So everybody, you know, my administration person
[00:21:19] is trying to train the new front desk person kind of virtually.
[00:21:22] So everybody's stretched and dealing with new challenges.
[00:21:26] So like the tension in the big transition amongst the team is a lot harder.
[00:21:31] Your second clinic now is a success, right?
[00:21:34] Yeah, man. You might not be at 500 visits, but.
[00:21:37] But it's just successful.
[00:21:39] What would you have done differently?
[00:21:41] Or what would you tell your previous self?
[00:21:43] I don't know if there's a whole lot that you could do well.
[00:21:47] Is there a way you could have trained your team to be prepared for the extra effort?
[00:21:51] Is there anything like that that you could say,
[00:21:54] well, I could have should have been aware of blank
[00:21:56] or could have made your team aware of that stretching that they're going to do?
[00:21:59] Yes. You know, I would say
[00:22:01] I feel like on paper we did all the right things.
[00:22:05] Sure. You know, because I was coached up on it.
[00:22:08] And I think the only thing that we really were missing is just the experience.
[00:22:13] You know, like you got to learn the lesson.
[00:22:15] You got to take your hits, you know?
[00:22:16] And now obviously looking back and debriefing that experience, it's like,
[00:22:20] yeah, but now I have that experience of like, hey, team,
[00:22:23] remember when we opened up clinic number two?
[00:22:26] Remember that? Remember how that felt? Yeah.
[00:22:28] That was called hard. We're about to do it again.
[00:22:30] And so like, what are three things that we can do this time?
[00:22:33] Oh, I love that. Right. Leverage your team.
[00:22:35] Yeah. So like, what are three things we can do this time to get out of head?
[00:22:38] Let's write down the big issues that we had and let's solve those.
[00:22:42] Right. So I can only do that now because I went through that.
[00:22:45] Because you did it. Right.
[00:22:47] So you can say, hey, what went well?
[00:22:49] What didn't go well?
[00:22:50] What do we need to have in place before we open this next one?
[00:22:53] That's right.
[00:22:54] Do you think that conversation would have worked with your first one
[00:22:57] going into the second one?
[00:22:58] Or do you think they having not had the experience,
[00:23:01] they wouldn't have been able to really figure that out?
[00:23:04] No, I definitely think it could have figured it out.
[00:23:06] You know, I mean, there's some things
[00:23:07] they're just not going to know because they hadn't been through it,
[00:23:10] including me, right?
[00:23:11] Like once you start building that middle management piece,
[00:23:14] clinical director, director of administration,
[00:23:16] yeah, you get separated at a higher level from the culture.
[00:23:21] Right. Right. So there's a lot of mindset challenges
[00:23:25] that you have to develop as an owner at that level,
[00:23:27] because I don't think you're ever going to completely
[00:23:31] get rid of the challenge of wanting to jump in and fix things.
[00:23:35] Right. So learning how to sit a little bit higher
[00:23:38] in the organization is its own challenge as the owner.
[00:23:41] And I think this goes back to you having not had that experience
[00:23:45] before and going from one clinic to two clinics.
[00:23:48] Is another reason why get an experienced mentor coach consultant?
[00:23:52] 100 percent.
[00:23:53] If you're about to open up another clinic, just get a coach.
[00:23:56] Like learn from someone else.
[00:23:58] Right. If you're going through a big transition,
[00:24:00] like get you a coach, man, like you're going to bring on a new thing.
[00:24:04] You're jumping into this new valley of unknown territory.
[00:24:07] Just like get the coach and just you will save yourself so much time
[00:24:12] and energy and money and money.
[00:24:15] You can either pay for a coach
[00:24:16] or you can spend probably 10 times the money in stupid tax
[00:24:21] and lose your health and the extra hours that you have to put into it
[00:24:25] to just learn it from a coach and just save the time and money.
[00:24:29] Right. Oh, Sarah has the question in Facebook.
[00:24:32] Top three pitfalls of opening multiple locations.
[00:24:36] Well, you bring it up to me all the time.
[00:24:38] You hate opening up new locations because all of a sudden you have no money.
[00:24:42] OK, that's a big one.
[00:24:43] It's cash flow heavy. Right.
[00:24:45] Yeah, everybody that's got listen, all you crazy PT owners.
[00:24:49] Freaking psychopaths.
[00:24:52] It's going to cost some money and you're going to have to get comfortable.
[00:24:55] You think your margins are thin now?
[00:24:57] You're going to have to get very comfortable with like we're talking
[00:25:00] like single digit margins for a while.
[00:25:02] It's going to be tight.
[00:25:03] You're going to be looking at your wife or your husband and saying,
[00:25:05] hey, we might not be able to go out to eat for a little while kind of thing.
[00:25:08] So like save the cash, like have way more cash than you need,
[00:25:11] but also expect to spend it and prepare yourself mentally
[00:25:15] and emotionally, like develop the coping mechanisms, if you will,
[00:25:19] to like go through that because it's going to put some financial strain on you
[00:25:22] and not just you and your business, but your family as well.
[00:25:24] Well, looking back over the years, it used to be
[00:25:28] and I've been out of the business for a few years, I admit,
[00:25:31] used to be 60 to 70 thousand bucks could get you an open clinic.
[00:25:34] Right. If you're that doesn't include TIs and stuff
[00:25:38] that you're going to do to change the layout of the office space.
[00:25:41] Would you still say it's in that range for, say,
[00:25:43] a 24 hundred square foot space, two thousand, twenty five hundred square foot
[00:25:47] space or is it closer to seventy to one hundred thousand dollars now?
[00:25:50] I would say it's a lot more than that.
[00:25:52] Well, this is not including construction.
[00:25:54] Yeah. Well, you also have to factor in the months of negative cash flow
[00:26:00] that you're going to have, you know, like you're going to have
[00:26:03] like your first month, it's going to be negative fifteen grand gone.
[00:26:06] At least. And then month two is going to be negative fourteen.
[00:26:09] So now you're at thirty grand.
[00:26:11] You know what I mean?
[00:26:12] And hopefully the money starts coming in and on six three to six.
[00:26:15] Right. So like if the credentialing is going well, all in and out of obviously
[00:26:19] this is going to factor on location, but like all in hiring a staff,
[00:26:23] getting your clinic built out nice, it's going to cost you two hundred grand.
[00:26:26] You're including construction costs, including construction costs.
[00:26:29] Yeah, you're going to spend two hundred grand.
[00:26:30] Yeah, I got it. Yeah.
[00:26:31] If you've got a proven business track record,
[00:26:33] you could probably get that in a line of credit.
[00:26:35] I'm not sure if you want to use a line of credit considering the interest rates,
[00:26:38] but they are there.
[00:26:40] Maybe you can get some kind of construction loan for the T.I.
[00:26:42] I can't really speak to that experience, but that's one pitfall.
[00:26:45] What's a second pitfall of opening multiple locations?
[00:26:49] Second pitfall is going to be the next thing that's going to be
[00:26:53] the biggest challenge is your ability to maintain the culture across both locations.
[00:26:57] I was thinking the exact same thing.
[00:26:59] Your physical presence was so much of the culture in clinic number one
[00:27:04] that without you being physically present, can the culture and the systems
[00:27:09] and processes run on their own without you being physically present?
[00:27:13] And that's a real challenge.
[00:27:15] And so that's why it's so important to have value aligned employees,
[00:27:19] especially in the leadership levels who agree with you on how things get done.
[00:27:24] Yeah. You know, I think the biggest mistake you could make is just pick
[00:27:29] a productive therapist and make them the clinical director just because they're
[00:27:32] productive or throw them in a new clinic because they're productive.
[00:27:35] Right? It would be kind of like going back to the partnership piece.
[00:27:39] Like it would be like, oh, yeah, you're really smart.
[00:27:41] Let's be a partner, you know, and which is a piece of it.
[00:27:45] But there's this whole other like emotional and value alignment piece
[00:27:50] that is probably more important, to be honest with you.
[00:27:53] Yeah, exactly. So like there's a lot of headaches if you can just be aligned.
[00:27:56] You're going to have pivots in your culture and it's going to affect your team.
[00:28:01] There are chances that you may even experience a little turnover
[00:28:05] that you weren't anticipating or maybe that hire that you were like, oh, yeah,
[00:28:08] this is going to be the person that gets me there.
[00:28:10] I didn't quite work out in the middle of construction.
[00:28:13] Right? So like culture, culture.
[00:28:15] I think that we're kind of going into number three now.
[00:28:18] Right. I think the most important thing at this point for me is that leadership team.
[00:28:23] Like what does it mean to be a director?
[00:28:25] What are our values?
[00:28:26] You know, not just words on the wall, but like what are they?
[00:28:29] And like I need to know that, you know, when to raise your hand,
[00:28:32] when to take action, when to not take action, how to behave in the clinic,
[00:28:35] how to represent this company well, how to provide that experience.
[00:28:39] I need to get to a place to where I can lean on that very,
[00:28:42] very heavily and not be worried about it.
[00:28:44] I think that speaks to a third pitfall.
[00:28:46] And so I'm not transitioning to a different topic entirely,
[00:28:49] but I would say a third pitfall.
[00:28:51] It's a quote that you put in our slack channel with the coaching group
[00:28:54] earlier this week, but it's the people who got you here are not the same
[00:28:58] people that will get you there.
[00:29:00] Perfect. So if you are in clinic number one thinking,
[00:29:03] I've got this front desk person, they're going to be with me forever.
[00:29:06] I'll move them up into middle management.
[00:29:08] You know, we've got this family and it truly becomes that first clinic
[00:29:11] becomes like a family, right?
[00:29:13] It's really but those same people, you're going to have some people fall away.
[00:29:17] They just can't handle the added responsibility if they moved up in the leadership.
[00:29:22] It gets hard, man.
[00:29:23] They can't handle.
[00:29:24] Honestly, some of them can't handle you not being present all the time.
[00:29:27] And having that direct link to you, when you put someone between that front desk
[00:29:32] person and you, when you started off, it was just you in that front desk person.
[00:29:36] And now you put a mental manager between the two of them.
[00:29:39] And that front desk person thinks they can go around the manager
[00:29:42] and just text you directly and you have to say, talk to your supervisor.
[00:29:45] Oh, they don't get along.
[00:29:47] Maybe it's a different vibe, right?
[00:29:49] You're a visionary, they're an integrator.
[00:29:51] So like, you got to be like, OK, wait a minute, she's an integrator.
[00:29:54] And you got to like, but that's good.
[00:29:56] Like, see how it's different.
[00:29:56] You got to like, handle all those things.
[00:29:59] You've got to handle but also be ready to let go of some of those people.
[00:30:02] Oh, for sure.
[00:30:02] They're not going to get it and to go from a mom and pop.
[00:30:05] And this is exactly what you're doing.
[00:30:06] You're going from a mom and pop to an enterprise.
[00:30:09] And some people can't handle that going from mom and pop to enterprise.
[00:30:13] That's right.
[00:30:13] You're just going to lose some people along the way, unfortunately.
[00:30:16] Yeah. So Sarah is a rock star, by the way.
[00:30:18] Her and I have been chatting a little bit in the DMs.
[00:30:21] She's killing it. She's doing great.
[00:30:22] That's cool.
[00:30:23] We're going to get her on, learn her story one day.
[00:30:25] Yes. So we talked about money.
[00:30:26] We talked about culture and leadership.
[00:30:29] I think the third.
[00:30:30] Well, that's where I was saying the third is just understand
[00:30:32] you're going to lose some people.
[00:30:33] Yeah, unless you had another one that you wanted to add.
[00:30:36] Yeah. No, I think that's a good piece.
[00:30:38] You know, I can talk a little bit more about that losing people.
[00:30:41] I think you should always have a plan for everybody to quit,
[00:30:44] you know, like once a quarter, like really build your team out
[00:30:48] and just kind of like, or you can even delegate to the leadership team.
[00:30:51] It's like, OK, what if Billy quits?
[00:30:53] What are you going to do? Boom, boom, boom.
[00:30:54] OK, what if Joe quits?
[00:30:55] What are you going to do? Boom, boom, boom.
[00:30:56] Like have it ready because it's going to happen, right?
[00:30:59] It's going to happen and you want to just be able to press play on that
[00:31:03] and move forward as opposed to like all the pieces coming down.
[00:31:07] When you get to your level, you've created this.
[00:31:09] You're already living in it, but you have to build.
[00:31:12] You have to have built and maintained systems
[00:31:15] that are running in spite of you, right?
[00:31:17] So when you're clinic number one,
[00:31:19] it's all you all the time spinning all the plates.
[00:31:21] But to get to a third clinic, you can't spin all the plates anymore.
[00:31:24] And you need to know that you have someone else
[00:31:27] that is manning the recruiting program.
[00:31:29] You have someone else that is manning the marketing program.
[00:31:31] You have someone else that's manning the HR issues, right?
[00:31:36] And someone else that's manning the productivity piece.
[00:31:39] But you can't do all those things anymore.
[00:31:42] Your job is to make sure people are in place, trained,
[00:31:46] know what's expected out of them and what their roles
[00:31:49] and responsibilities are to make sure all those plates are spinning.
[00:31:52] And then you're in constant communication with them.
[00:31:55] Constant.
[00:31:56] You know, I tell my team all the time now,
[00:31:59] don't ask me what to do.
[00:32:01] Tell me what you did by building that culture of like,
[00:32:04] I don't want to answer any questions.
[00:32:06] You know what I mean?
[00:32:06] Like I cannot answer all the questions.
[00:32:09] So it's like, hey, Sarah asked for a raise the other day
[00:32:15] and I just wanted to what do you want to do?
[00:32:18] And I'm like, hey, listen, deserve the raise?
[00:32:20] Yeah. OK, then tell me that you want to give her a raise.
[00:32:23] Don't like you tell me why she should get a raise.
[00:32:26] You know what I mean?
[00:32:28] And like developing that routine, that rhythm of having things reported up
[00:32:32] as opposed to like you reporting down is something that just takes practice.
[00:32:37] We knew there was a weakness in our systems when we had questions like that.
[00:32:41] So we would start getting those from our clinic directors
[00:32:44] to the point and just for example's sake, we decided,
[00:32:47] you know what clinic directors have the responsibility
[00:32:51] to decide whether or not someone gets a raise or not
[00:32:54] based on the parameters we give them.
[00:32:56] So here's a pay range for what you'd call a staff team, physical therapist
[00:33:03] and based on years of experience, there's a scale.
[00:33:06] There's a scale right backed by research that you did with the Bureau of Statistics
[00:33:12] or indeed you name it and what surrounding salaries are for front desk
[00:33:18] for PT, for PTA, for tech, for you name it for clinic director.
[00:33:23] And so here are the pay you can give them any pay you want
[00:33:27] in these pay ranges as long as you can justify it.
[00:33:30] And you just report that to us and we will give you a thumbs up or thumbs down.
[00:33:35] Thumbs up or thumbs down?
[00:33:36] That's all I want to do.
[00:33:37] Thumbs up or thumbs down?
[00:33:38] We went through the gyrations once and we might review them next year.
[00:33:42] But we did all that so that you had the autonomy to figure that out yourself.
[00:33:46] Yeah. So don't come to me with a question or a problem without first having done
[00:33:51] the homework or look to see if there was a system or a process in place
[00:33:54] already for that and then make your own decisions.
[00:33:57] And even then, if it's not in the systems of policies and procedures,
[00:34:01] then come at us with a couple of solutions.
[00:34:03] Don't give us more homework, please.
[00:34:07] My job is not to do.
[00:34:08] Yeah. So like I think right now, what we're doing is we're getting into clinic
[00:34:12] number three at this point.
[00:34:14] Like clinic number two is like you've got that leader in number one and you're
[00:34:17] developing that leader number two.
[00:34:19] You're still a little bit of an answer man in some capacities.
[00:34:21] Yeah.
[00:34:22] Once you get to three, like now I'm starting to experience what it's
[00:34:26] like to be with three different clinics.
[00:34:29] I can really feel myself like I do like two things in the company now.
[00:34:33] Like I lead out on one meeting and I do recruiting.
[00:34:35] That's really it.
[00:34:37] And I don't have the bandwidth to hire everybody, fire everybody.
[00:34:42] Do you guys want to do a lunch with Dr.
[00:34:44] Smith? I can't make all those decisions.
[00:34:46] You know what I mean?
[00:34:47] You have a budget.
[00:34:48] Figure it out.
[00:34:49] Figure it out.
[00:34:50] Just tell me what you want to do and why and like.
[00:34:52] And make sure the numbers are going in the right direction.
[00:34:54] I'll be like, cool.
[00:34:55] You know, like, and that's a hard thing to let go of as an owner
[00:35:00] because there's layers of like as your company starts to grow,
[00:35:04] you start to realize that what I focus on becomes the priority.
[00:35:08] And the most important thing to manage is my ability to focus
[00:35:11] on what's important, right?
[00:35:13] So like as you get to number three, it's like you've got to get
[00:35:16] more narrow and like because you have to shed more so that you
[00:35:20] can focus on the one to two things that are most important.
[00:35:23] Well, and the one or two things that you are expert at.
[00:35:26] Yeah, that you're the best at.
[00:35:27] And hopefully they bring you a lot of energy.
[00:35:29] Right.
[00:35:30] Hopefully those are the things you want to do.
[00:35:32] Like that's the beauty of having your own company is when you're
[00:35:35] really at your place of fulfillment and freedom is you are doing
[00:35:40] the things that you truly want to do and that bring you energy.
[00:35:44] And everything else is delegated off to other people so that you can
[00:35:48] live in your sphere of influence or sphere of expertise, right?
[00:35:52] And that's where you truly want to go.
[00:35:54] It's hard to do that until you get to such a size.
[00:35:58] You could have it in one clinic.
[00:35:59] And if you had one clinic and 20 providers in that huge location,
[00:36:04] that yeah, you can get to that point.
[00:36:06] Most people can't do that.
[00:36:07] So you'll see that in terms of number of clinics.
[00:36:10] Once you get to a certain number of clinics for you to optimize your time
[00:36:14] and your energy, you really have to start focusing exactly like you talked about.
[00:36:18] Yeah, you got to niche down, man.
[00:36:19] You know, niche down and then comma, you get further into the future.
[00:36:23] You know, like in clinic one, it's just like day by day clinic two.
[00:36:27] It's like quarter by quarter year by year.
[00:36:29] Clink three, it's like two years by two.
[00:36:32] Like you're getting further out.
[00:36:34] So it takes energy to see that far ahead.
[00:36:37] You got you can't have blinders on.
[00:36:38] You can't be distracted.
[00:36:40] Like you got to see the stuff coming down the pipe
[00:36:42] way before everybody else does.
[00:36:44] Yeah, you got to be at the front of that.
[00:36:46] I got to recruit now for my fifth director
[00:36:48] who I'm opening my fifth clinic with.
[00:36:50] Right. I'm going to start looking at properties down there
[00:36:54] for 2026. You know what I mean?
[00:36:56] Like you got to get way out.
[00:36:58] Yeah, exactly.
[00:36:59] You can't be worried about, you know, the little things.
[00:37:02] It was really interesting when we got to a point
[00:37:04] we had five clinics where there were people that were getting hired
[00:37:08] and I didn't I'd never met them until they were like three to four months in.
[00:37:12] It's like, oh, hey, nice to meet you.
[00:37:14] I'm the owner, by the way, but it's glad to have a team or hey,
[00:37:18] what happened to so and so? Oh, yeah, we had to let them go.
[00:37:21] Oh, that's too bad. I liked them.
[00:37:23] And to learn about that kind of stuff after the fact is that
[00:37:26] it's an interesting place to be in.
[00:37:28] But you know, things are going well if people are following your processes
[00:37:33] and procedures and your statistics are going the right direction.
[00:37:36] That's exactly what you want to see.
[00:37:38] Mm hmm. Yeah, I have gotten to where
[00:37:41] therapists are being hired without my direct involvement.
[00:37:45] I haven't gotten quite to the firing part yet.
[00:37:48] I'm still doing all the firing.
[00:37:49] Oh, OK, I got you.
[00:37:50] So that's one of the things I got to let go of this year.
[00:37:53] Yeah, you got to train someone who likes to fire people.
[00:37:55] I feel bad for him because it's such a hard thing to do.
[00:37:58] Like, I still hate it. Oh, yeah.
[00:38:01] I know it's such a hard.
[00:38:03] Well, it's such a hard thing to do.
[00:38:05] Yeah, it's so much easier for me.
[00:38:07] And I know this isn't the topic for discussion today, but just to say it,
[00:38:11] it's so much easier for me to let go of someone
[00:38:14] when the objective numbers say it's time.
[00:38:17] Yeah, these are our expectations.
[00:38:20] And hopefully on the front end, you've shared you've set up productivity standards
[00:38:24] even in the interview process like, hey, are you cool with seeing
[00:38:27] so many visits per week and billing so many units?
[00:38:30] And they agree to that, but then they can't follow through it
[00:38:32] with it on the back end or things slip and or maybe they go against your values
[00:38:36] or a values based firing makes it so much easier.
[00:38:40] Hey, we talked about this.
[00:38:42] You're falling through on our values, so we have to let you go.
[00:38:45] I find that the decision is easy.
[00:38:47] Oh, yeah, the conversation sucks.
[00:38:49] But the conversation is like kind of tough.
[00:38:52] Yeah, exactly. Exactly.
[00:38:54] Yeah. So as you're looking then out at number four,
[00:38:58] what are you recognizing?
[00:38:59] What do you think needs to be in place for a fourth clinic to open up?
[00:39:03] So we're going to rebuild our systems this year.
[00:39:05] Oh, rebuild everything, start from the ground, build it all the way back up.
[00:39:09] Reassess everything. Reassess every system we have.
[00:39:12] That's probably number one.
[00:39:13] We're also going to implement a few cash pay things in the clinic
[00:39:16] and make sure our profit margins can withstand some of the changes.
[00:39:20] Medicare cuts and whatnot.
[00:39:21] We're going to add some cash pay services.
[00:39:22] We're also looking into some improved automation, particularly in the front desk
[00:39:26] and with documentation with Comprehend PT.
[00:39:29] Ooh, yeah. Yeah, yeah, I like that, guys.
[00:39:31] So we're looking at making things better and more efficient throughout the company.
[00:39:36] And then the next thing that, you know, I'm really I'm the recruiter.
[00:39:41] I'm good at it. I like it.
[00:39:44] I like the marketing and sales piece.
[00:39:46] I like the chase, so I have to get rid of that.
[00:39:48] I have to figure out a way to like build out a full blown
[00:39:52] marketer recruiting program and not just that, but like a sales interview
[00:39:57] process with all of our directors.
[00:39:59] Like, I got to build that out this year.
[00:40:01] And then I don't know what I'll be doing after that, but that's what I got to do.
[00:40:04] Yeah, I got to.
[00:40:05] Man, this sounds like a lot of work.
[00:40:07] Nah.
[00:40:08] So what you signed up for?
[00:40:09] Dude, you know, it's like you got good people around you
[00:40:13] and you start building out those trainings and you want to build one out
[00:40:17] and build two out and, you know, they're all the same.
[00:40:20] You just kind of change up the template.
[00:40:22] And what I found is those trainings don't have to be perfect.
[00:40:26] They shouldn't be.
[00:40:27] They should be they should be guidelines.
[00:40:31] You know, there's some objectivity to it.
[00:40:32] But like as long as you can give people the vision with the product
[00:40:36] with tools to get there and their value aligned,
[00:40:38] it really just comes down to like plugging the right person into that seat.
[00:40:41] Right. And it's going to get they're going to make it better than you did.
[00:40:44] Do you find war fulfillment with what you're doing now,
[00:40:47] then what you did with clinic number one at the very beginning?
[00:40:50] Oh my God, yes.
[00:40:52] Did you ever? Well, you always had that vision for yourself
[00:40:54] that you were going to be a business owner, clinic owner of multiple clinics,
[00:40:58] right? Mm hmm.
[00:40:59] Even before you opened your first.
[00:41:00] Yeah, even when I was in school.
[00:41:02] Yeah. I think I felt the same, but I had no idea
[00:41:05] what I would have to learn in order to get there.
[00:41:07] Like I thought my vision was I'm going to be treating full time
[00:41:11] and there's going to be other physical therapists also treating full time,
[00:41:15] not thinking about the multiple clinic aspect.
[00:41:18] Right.
[00:41:19] And what I found was as I started doing more of the business stuff,
[00:41:23] setting aside time to work on the business instead of treating,
[00:41:27] I started find myself really enjoying and loving the business side of things.
[00:41:32] And that really took the place of the joy that I had in treating patients.
[00:41:37] Yeah, you see the same thing.
[00:41:39] Yeah, I do miss treating patients at times.
[00:41:43] I don't miss the documentation.
[00:41:44] I can tell you that much.
[00:41:45] I don't miss treating patients.
[00:41:46] I missed the interaction.
[00:41:48] I miss the personalizing.
[00:41:49] Yeah. And I missed the like, you know, like just making them feel good
[00:41:53] and like get by getting that trust and then they refer you people
[00:41:56] and you make them feel good and I miss that piece.
[00:41:59] But I still do that.
[00:42:00] I just do it with my team and like the people I'm recruiting, you know?
[00:42:04] So it's it's the same game.
[00:42:05] It's just pointed in a different direction.
[00:42:07] Yeah, I get it.
[00:42:08] I do find myself, unfortunately, sitting behind a computer
[00:42:11] a little bit more than I would like to.
[00:42:13] Oh, true.
[00:42:14] You know, sometimes I'm like, man, I just need to get out of this room.
[00:42:19] Yeah, I get it.
[00:42:19] But you know, there are seasons.
[00:42:21] I could tell you the thing that doesn't change is it's always going to be hard.
[00:42:25] You're always going to be learning something new that is going to demand
[00:42:30] something new from you, and it's always going to be harder than you think it is.
[00:42:35] So just get just settle in.
[00:42:37] It's kind of what you signed up for when you open up.
[00:42:39] This is what business is all about, right?
[00:42:41] Yeah.
[00:42:42] Well, thanks for sharing your experience.
[00:42:43] It was cool for sure, brother.
[00:42:44] I'm excited.
[00:42:45] I'm excited about this year.
[00:42:46] I'm excited about what we're doing with PTO Club as well.
[00:42:49] We've got some man.
[00:42:50] I tell you what, we had a group call today just fired up.
[00:42:52] Everybody's winning.
[00:42:54] Everybody's gearing up for February and going into the end of Q1.
[00:42:57] And, you know, if you have any desire to grow your clinic significantly this year
[00:43:02] and you need any help, any tips, tricks, please let me know.
[00:43:05] Shoot me a message.
[00:43:06] Happy to jump on a call with you or just conversate in the DMs
[00:43:10] or connect you with somebody who can't help you.
[00:43:11] Right.
[00:43:12] That's what I do.
[00:43:13] Well, adamantptoclub.com, Nathan at ptoclub.com.
[00:43:17] Don't be afraid to reach out to us.
[00:43:18] We'd love talking to you about your business.
[00:43:20] Thanks for joining me today, dude.
[00:43:22] Sounds good, brother.
[00:43:22] Have a great evening.
[00:43:24] All right, you too.
[00:43:25] Peace out.
[00:43:29] Thanks for joining us today in the Physical Therapy Owners Club,
[00:43:32] the resource for stability and freedom in your PT practice.
[00:43:36] Reach out and join the network today.
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