Your Cash Flow Issues Have Nothing To Do With Money With Adam Robin

[00:00:00] The reason why we're not creating change is because you're not being who you truly want to be. And that's hard. 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.

[00:00:25] 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. Hello, and welcome to the Private Practice Owners Club. Nathan Shields here with my buddy, Adam Robin. How are you doing, man?

[00:00:55] Charged. Ready to roll. What's up? I love your one word open. Charged. Charged, man. Let's go. That's great. Yeah. Cool. Very cool. Well, I'm excited about talking about this today because it's in my wheelhouse. I like talking about money. Mm-hmm. Me too. You know how I get excited about that. So today we're talking about financials and cash flow in particular and the fears related to it and why we're having cash flow issues, et cetera, et cetera. But I think it's a good place to start with.

[00:01:24] You're talking to a number of owners, right? And talking to them about our coaching program, what we can do for them. And I'm assuming you're talking to a number of owners who might be having cash flow issues. Is that about right? For sure. Yeah. Yeah. Absolutely. Right. And rather common? Yeah. I'd say it's probably, I mean, it's really either comes down to time or money. It's really the two big bottlenecks for people. For investing in coaching, right? Correct. Correct.

[00:01:54] Yeah. Yeah. Yeah. Yeah. And not uncommon, right? There's plenty of owners out there that are struggling a little bit financially. They want to get through payroll next week or they're having, they've extended themselves on equipment or simply the purchase of their practices, et cetera, et cetera. And so I know you brought this up in particular because the lack of cash flow isn't the issue, right? That's what you're recognizing as you're talking to them. Yeah. Go ahead.

[00:02:48] Not the problem, but it's really the symptom to the problem. Yeah. People are going to be like, well, I don't have cash and that's a problem. Yeah. So it's like, okay, right. It's like, why don't we have cash? Yeah. Let's go a little. And we look at like, and our instinct is to blame it on exterior circumstances. Like, oh, because I can't hire people or because the insurance rates or because of this or because of that. Because I can't get referrals. Right. And more new patients. So it's a very, it's a very limited mindset. Right.

[00:03:17] Which keeps people trapped in this hopeless situation that they've kind of created for themselves. But it's like, well, what if you recognize that there is, there's like a whole lot you can actually do. You can, you can fix the root cause of this problem. And that is the thing that will generate the cashflow. Right. And so like, I felt like it would be cool to have that conversation today.

[00:03:36] Yeah. For me back in the day in that mindset was I have a lack of cashflow, so I need more new patients. So simply I need to go market more physicians. That was the only perspective that I had. I need to get more referrals from more physicians so that I can generate more patient visits and thus make more money. And it was almost like I see a nail. I hit it with a hammer. That's all. That's all.

[00:04:02] I knew how to do. And that perspective has changed now. Now that I learned more about business. Same. Right. And been through enough experiences where it's easy for us now to tell people, yeah, it goes deeper than that. And have a conversation like this today and bringing up my presentation at the last conference about pretty easy ways that you can increase your revenues 10% without a single new patient coming in the door. Yeah.

[00:04:28] And those are some of the things we're going to talk about today. So, but maybe it goes a little bit deeper than that sometimes too. Like I know I've been burned. You've probably been burned by buying something thinking this is going to solve XYZ problem. And it didn't solve the problem. And now I'm out X amount of dollars.

[00:04:48] Right. So there's the fear of that. There's the fear of man, they're telling me I can do this. I've never done it before. So maybe I don't have a lot of confidence in myself to get it done. Or that sounds like it's going to take some time. It's going to take some effort. And time is one thing that I don't have when I'm seeing 40 to 50 hours of patient care each week and trying to run my practice on top of that. Right. It can go deeper. Yeah. And so I think those are some of the things that we want to talk about today.

[00:05:18] Yeah. It really is. Change is hard. That's what it really comes down to. Change is hard. And it's not the hard thing isn't necessarily doing changing what you're doing. That's the outcome. But the hard thing to change is the identity that you have. It's like, hey, it's not hard to drive to the gym and go to the gym.

[00:05:38] But it's hard to become the person who prioritizes their health and fitness, which will require me to sacrifice something so that I can prioritize the new thing. So it's just shift in identity. That's hard. That's really hard. I know how to do this thing. Right. But like this thing is like, I don't know what that is. It's like, it's scary. It's vulnerable. Like, well, what would happen if I let this go? Right. That's that psychological shift. That's hard for most people.

[00:06:03] Well, we're talking about deeper stuff because the lack of cash flow is like you said, before we push recorded as a symptom of the problem. And to what you're talking about here is there's many of us. And this is how I was, frankly, back in the day was I wanted to own my clinic, but I didn't want to take ownership of the clinic. Wow. That's great.

[00:06:27] I didn't want to look at myself as the reason why I liked cash flow. I didn't want to look at myself as the reason that people that I lost people by attrition. Right. Because then I have to focus inward and it's easier to put the blame externally, right, on something or someone else and just say, I'm a victim of XYZ.

[00:06:49] And I saw this week talking to one of our clients and he's had, he had this PTA that's just been a negative force in his clinic since, I don't know. He's been, I think he's been on the team like nine months. Come to find out nobody likes this guy. He's a 10 year veteran in physical therapy and has a hard time seeing eight patients a day. Right. And I think they do 40 minute visits or something like that. So now, and he's always late.

[00:07:15] And when his feet are held to the fire accountability wise, he's like, well, if I'm not getting paid extra for coming in five to 10 minutes early, then I don't want to be five, 10 minutes early. That's tough. I mean, all these things that are going against the guy's values. Right. And he's like, I don't, the owner said, I don't want to see this guy's face ever in my clinic again. I'm like, you're the owner. You don't have to. Say that one more time. Real slow.

[00:07:42] You are the owner. You don't have to work with the people that you're working with. If you don't like them, you are the owner. You don't have to barely break even every week because you're the owner and you are the change agent. Right. It's almost like, what am I supposed to do if I don't like this guy? And he's a negative influence. Well, what, what kind of blowback is that going to get?

[00:08:03] And when I find out that nobody likes the guy, he has plenty of reasons to fire him. He still wanted to run it by legal, but get on the phone with legal right now and fire him tonight. And thankfully he did. Thankfully he fired him after we got off the phone because I'm like, cause he told me how many sleepless nights he's had over this guy, how to approach him, how many times he's held him accountable. I'm like, dude, fire him right now and sleep better tonight, please. Yeah.

[00:08:30] Right. But it goes back to some of us want to be owners without taking on the identity. Like you're talking about, we want to see change come about. We want to see insurance companies pay us more, right? We want our employees to provide and produce more, do better, be better without changing ourselves. Hmm.

[00:08:52] Once you become that change agent and take on the identity, the identity of a true owner. Like I am responsible for everything that's happening running in this, everything, everything. If something goes wrong, it's up to me to recognize what the issue was. Right. Or empower my team to recognize what the issue is. Right. There's different ways where you can exert ownership and it doesn't have to be you on top of the problem. You can empower other people to do that.

[00:09:20] Yeah. But that starts with you empowering them. Right. And so to your point, you got to change who you see yourself as in order to really take changes and make massive changes in your clinic. And as it goes to today, if you want to make more money that requires you to take ownership of all the things that generate money. Of the money stuff. Right. Right.

[00:09:44] Yeah. I've had Eric Miller on plenty of times from Econologics. And I shared this with our group call with, with our coaching clients. This, I think it was this last week, but he said the first thing that he noticed when, when there is a cashflow issue in your company, the first thing you need to look at is your purpose. Man, that's so good.

[00:10:05] You would think he's the financial advisor. He's going to say, know your numbers, talk to your billing company. What are kind of over the counter transactions that are happening at the front desk? What is their over the counter collections rate? He's like, no, no, no, no, no. We got to go back to purpose. Are we really truly living our purpose in the way that we do things? And get clear on that. What is our purpose? What is our reason for being here? And it's everyone on the team bought into that. Right.

[00:10:33] Have some discussions, vet it out, talk about it, make sure we're all on the same page. And if we have that foundation off of which to work from now, we can move forward and institute changes appropriately. Right. Yeah. He sounds like a smart guy. Eric knows some things.

[00:10:50] I mean, it's so true, man. And it gives me kind of chills thinking about it. And it just affirms so many things that I've, so many experiences that I've had in my practice, in my business, in my life as a leader. It's like every time I choose to take ownership of the thing, it improves every time. And I like the word purpose, but I've been, for whatever reason, my language has shifted more to identity. Okay. Just like, who do you want to be? Or, which is a similar concept. Sure. Maybe there's some subtle differences. Yeah.

[00:11:19] Right. But really it's like the reason why we're not creating change is because you're not being who you truly want to be. And that's hard. Right. It's like, if you ask anybody, so like everybody that's listening, I want you to stop and I want you to envision yourself five years from now. And you are this elevated version of yourself. You're a more powerful leader. You've solved bigger problems for people. You've created the life of your dreams. You've created the practice of your dreams.

[00:11:47] And now that person is going to come down and he's going to give you advice and how to make more money. What is he going to tell you? Or she going to tell you? Okay. What are you waiting on? So like, who do you want to be? Like, is that the identity that you want to be? Or do you want to continue to keep the identity that you have today? And who's the only person in the world who can make that decision? You. So what do you want to do? Right. It's like, it doesn't get any simpler than that people. You know what I mean? Like we've got to stop the victim and the blaming and the looking in the like.

[00:12:17] It's on you, man. It's on you. Like you can create change. All you have to do is decide that that's what you want to be. I've got a friend, Billy, who really exemplifies what you're talking about when you're talking about envision where you want to be. And from what I'm after going through that exercise, what I'm hearing you say is don't wait to become that kind of owner until you get there. You need to become that kind of owner now in order to get there. I heard this from someone else. Like if you want a million dollar practice, you don't

[00:12:47] start acting like a million dollar practice owner when you hit a million dollars. Right. You, when you're making 200 and $300,000 a year, you make decisions as if you were a million dollar practice owner and you act like a million dollar practice owner at that stage, which will accelerate and get you to a million dollars. Right. And so I bring up Billy because he said this before. I said, man, you're making some really good decisions that really impress me because you're not where you want to be.

[00:13:15] But in his language is such that I need to do this in order to get to where I want to go. I need to do this because when I'm at the five clinic level, I'm going to need this in place. I'm needed. This needs the scale. My decision now needs to be scalable. Right. So he's like, he could do the financials. This is his real bugaboo. Shout out to Billy, if you're listening, but his bugaboo is like, like paying bills and running the numbers. And he like hates that. He's like,

[00:13:45] I can't keep doing this. This is taking energy away from me. He could do it, but he says this isn't scalable. I number one, great question. And it is not scalable. So who do I need to find to guide me, direct me, do this for me so that it's just part of the process and gets me to scale faster.

[00:14:09] Yeah. So yeah, I bring on a bookkeeper and now I need to just vet bookkeepers. So I do this for the right way. Right. Right. What kind of software do I need so that I can scale this company and not just get by for a one or two clinic company? I need for my one and two clinic company. I need the five clinic software program. Right.

[00:14:31] Yeah. You want to make the decisions for where you're going for five years from now. Right. Not five days or five hours. Right. Correct. Like, so I've had these same, I'm sure you've experienced something like this with your team, but it's like, you know, it's, it's kind of like, Hey, we need to onboard a new person next week. We got to fix this piece of the onboarding process. It's like, okay, well, what if we had to onboard a hundred people next week? What would we

[00:15:00] do? Hmm. Okay. Let's do that. Let's build the onboard process like that. So that way we don't ever, we can put this onboarding process on the shelf for the next five years and it's going to work. If we're going to fix it, let's fix it. Right. You know what I mean? And so like taking bold, courageous action towards where you're going or who you want to be usually wins, usually scales. Right. And that's going to take some scary stuff. Like you're going to have to invest time, money, and energy towards things that you really believe in. Even if it's scary,

[00:15:30] Even if you're not sure how you're going to get there, just do it anyway, do it scared. Yeah. Shout out to Billy. So coming back to the initial, to the beginnings of our conversation about financials and how, and you, you said it, it is a symptom of other problems, right? So when someone is having a cashflow issue, where are some places that you recommend they start looking?

[00:15:53] So I try to look at this from, obviously it's like, we have to build the foundation, right? It's all about like, let's build a strong foundation. I can tell you what not to do. Don't immediately buy a shockwave machine and try to go and go sell cash pay services. Don't do that first. Yeah. Let's invest some more money in a piece of equipment that costs five, six figures.

[00:16:20] Again, that's the thing is like, Hey, I'm going to throw this money at this thing, right? That's going to solve. Right. So like what I would recommend is like, let's just take your current model and let's like bulletproof it first.

[00:16:31] Right. Because what we want to do is not make money next month. We want to make money for the next, for the rest of our life. Right. So my goal with owners is to assuming that cashflow is one of their biggest concerns is the first, one of the first things that we do is go through that, that profit accelerator piece, which is looking at over-the-counter collections, the four touch points, over-the-counter collections.

[00:16:51] And my goal is to double your over-the-counter collections. But even if we were only able to increase them by 10 or 15%, like transformative financial, like transformative difference. And those of you that are listening, I know what you're thinking right now. You're thinking, yeah, we do a pretty good job at that. And I'm going to look you right. If I could look at you right in your eyes, I'd look at you in your eyes and I'd say, no, you're not. You think you are, but I promise you, you're not.

[00:17:14] If you can't give me an exact percentage of your over-the-counter collections rate, then you don't know how well you're doing. There's levels to this thing. Totally. Verifying the insurances and asking your front desk to do that is not enough. Even measuring isn't enough anymore. There are more things you can do. So double your over-the-counter collections. And the other three touch points are A, your fulfillment piece, so how you're delivering care. And that comes down to things like, how are you scheduling? What are your productivity expectations? How are you billing?

[00:17:43] The number of units and the quality of units you're billing, right? So there's some elements there. Then it's your billing and collections team. What does your AR look like? What's your denial rates? What are your clean pass-through rates? And what is your average number of days before you get paid? Those are like the big ones.

[00:18:00] But we need to front load the heck out of that stuff. So you're getting cash instantly hitting your bank account. And then the last thing is your financial management piece, which is like how you're managing your cash inside your practice via budgeting, bookkeeping, managing profits. Knowing your financial KPIs. Knowing your financial KPIs. But what you could do is you could build guardrails around the way money moves in your business such that it all funnels down to the bottom line.

[00:18:27] So there's some structure you can build there. And if you just make like 2% to 5% dense in each of those buckets, you will transform the financial health of your practice. Transform. Now, are you going to get rich? Probably not. But are you going to be predictably profitable and have a scalable model? Absolutely. Right? So that's where I start. I started like, let's build the foundation first. I think that that's key. And you can see how the cause is you're not doing those things.

[00:18:56] You don't have the scalable financial systems in place such that generates the cash flow. Right? So you fix those symptoms. Either the systems aren't there or they're not being executed on. Period. Well, they're not efficient. Right. Yeah. Right? And so if you fix those things, you will create a model that's profitable. Right. Like if you're going to generate more cash, you need to do more and better cash producing things in terms of systems. Right? Yeah.

[00:19:24] Like I mentioned Eric Miller in his presentation on when there's a cash flow crunch. And I did the podcast with him like four years ago, probably three, four or five years ago. So you can look at it. Go to our website, pplclub.com. There's a podcast tab and it gives you an opportunity to search by keywords for previous episodes. And you could put in cash flow. And I'm sure his would pop up pretty quickly.

[00:19:47] You got to track your money lines. Like where's the money going? And this is your bloodlines of your clinic. This is how you survive. And you need to have a touch point on where the money's flowing and how it's flowing and where it's getting constricted, where it's getting taken out, where it's being minimized. Right.

[00:20:05] And that's what you're talking about here. Right. When we're talking about the money comes in, chronologically, it comes in through the front desk first before it goes anywhere else. And are you collecting all of the coinsurances, co-pays and deductibles at the time of service? Like if I were to go back to my clinic now, no way would I let deductibles just linger out there until they come through the insurance company. You can't do it. You can't do that. I mean, you can do whatever you want.

[00:20:35] But like, yeah, good luck. This episode is brought to you by Empower EMR, a modern AI driven EMR that not only keeps owners in control, it keeps billers happy, PTs, OTs and speech therapists productive without burnout and keeps your patients happy as well. Empower EMR lets you automate workflows so you can focus on delivering quality care profitably. We are happy to have empower EMR as a sponsor of the private practice owners club.

[00:21:04] And you can learn more at empower EMR.com. Yeah. Yeah. I saw a statistic by McKinsey, which is a super powerful accounting firm that said that money that is not collected at the date of service, usually you lose about 50 to 60% of each dollar if it's not collected upfront. Right.

[00:21:27] And so if you get really hardcore and improve that over the counter system with the front desk, like you said, that's a pretty easy 10 to 15% increase in your revenues. Right. Right. Cause you're no longer taking the risk of it, not getting paid, frankly, but you also don't have to waste the billers time to send out the bills and you name it run. It saves money. Right. That can be hard for people to do if they haven't set up their clinics like that from the very get go.

[00:21:57] Most therapists aren't good at asking for money. That's why you get a front desk person that has no issues talking money. Like they're the type of people that are like, I don't care. This is your insurance. It's not mine. You owe us $80 today. And they're like, yeah, we need a, your credit card on file. Yeah. Yeah. Sure. If we're going to do this right. Like we need your credit card on file. Cause I don't want to ask permission every time you come in. I'm just going to charge your card. And you know what? Someone brought this up.

[00:22:26] They're like, well, doesn't that mean you have to, you might have to send out a lot of refunds after a while. And I'm like, I would be more than happy to write a hundred checks a month. Than to be asking people for money. Yeah. With their bills in the mail or sending out texts or emails or however you're collecting right now. I'd be more than happy to send them refunds if it, if it came to it. And that's easily, I mean, if you did that today, like you said, immediate changes. Yeah. For real transformative.

[00:22:53] The other thing that people get bogged down with is they don't understand their metrics. So they're honestly, their providers are just underproductive. That's a big one as well. And that's, I think there is some, maybe a leadership gap that causes that. Maybe like they're usually the most productive person in the clinic, right? The owner themselves. The owner, right? They're very productive. They're the biggest revenue generator. Yep. Right.

[00:23:19] Therefore they can't escape the clinic because if they do, they'll run out of money. So how will we empower our team to be as productive as we are? And that's usually a leadership skill. It's either like a training issue. True. Yeah. Or a leadership issue, which is around like, I don't know how to deliver, hold that standard, or I don't know how to help the team see why this is in the benefit of everyone and not just the company. Well, you had to go through this yourself. Yeah, for sure.

[00:23:47] Much, much more recently than I have. And yeah, I think there's two parts to it. Like they lack the clarity on what that training looks like to get everyone else to do, be more productive. For you and me, it was almost natural. I don't know what my secret sauce is, but I can see a ton of patients and I can bill for them appropriately. And yeah, thus I am the greatest revenue generator in my clinic. And now you, you're my coach. You're telling me I need to step out of patient care. Yeah.

[00:24:17] Tell me how that makes sense. Tell me how that makes financial sense. So you go, having gone through it, what was your experience? It was scary. I think for me, it was that I never avoided it, but it was scary for me because I had honestly, like I had limiting beliefs around money, you know, like I didn't want my team to think that I was all about the money because I would scared of how they might judge me or how they might think of me.

[00:24:45] So I would kind of like speak ambiguously around that topic and kind of be like passive aggressive around it, sort of. And I ended up sounding like a jerk when I didn't mean to. And it was because I was really, I didn't know how to step into that place boldly and unapologetically because I didn't truly even believe it myself. You know what I mean? Yeah. So it was really more of a me thing that held me back.

[00:25:10] But through doing that and through challenging your own limiting beliefs, you realize a new truth through the hard thing. And now I can be like, Hey, Nathan, welcome to the team. We need you to build this many units. Are there any problems? Like I can just be very bold around that, you know? And by the way, like this is why it's important. And like, this is how we do it here. Do you want to do this? Well, you don't even have to, like you can go work somewhere else if you need to, but like, this is how we do it here.

[00:25:39] We'd love to have you. What do you say? You know? And when you can get really clear and explicit and have that belief about it, then you can communicate it clearly. And people are like, Oh yeah, this makes sense. You know, that's what really helped me when I, when I had a coach to get through some of these sticking points for me, and this is me, I wanted to talk about those things, but for the same reason you had a fear is like, how are they going to judge me? I'm going to be all about the numbers, all about the money.

[00:26:04] But when my coaches were able to guide me on proper scripts, you know what I mean? So maybe the conversation isn't about the metrics. Maybe the conversation is more about fulfilling our purpose. How do these metrics match up with our values? Correct. How does improving the financial status of our organization improve the opportunities for each provider? And the profession. And the profession, like bringing it back to them.

[00:26:32] And like, if, do you recognize that if you bill absolute maximum that you can bill for the services you ethically provided, that you're worth more in my organization and you can make more money, you recognize that? And if it wasn't just you doing that, but if, what if, what if, what if the rest of the physical therapy profession build the maximum they could for all the ethical care that they provide? Don't you think it'd be easier for us to then say, listen, we provide X amount of services

[00:27:01] and no, we're not going to take less. Yeah. We expect to get paid for that. We expect to get paid for that. And we're not going to take the contract because we've already matched our salaries accordingly. Right. And then you're coming from a position of power, but having conversations like that, giving what the coach did for me was give me a perspective and or a verbiage to use. And that was super helpful for me. Yeah. Because now I could have these conversations and it wasn't about these objective measures, which are super important. And we're going to measure it to me that the point became these measures.

[00:27:30] The metrics are representative now of how well we have lived out our values, how well we are living up to our purpose and how well we are providing care. Right. Because I believe that my care worth much more than a therapeutic exercise unit, because I actually put some thought into my, my treatment. Right. So I'm going to bill and I'm going to document for a therapeutic activity unit of care, which will pay me significantly more. Right.

[00:27:56] And if I do that three times over in the same visit, then now my care is worth $13 more in that visit. And you spread that out, multiply that. Now my care is worth significantly more. And I'm worth more as an individual because I can do that and I can document it and I can provide great care and get results. Yeah. Right. And that's when, like you said, they have to step into leadership, which means they have to go into areas that they are unsure of, especially when it comes to billing.

[00:28:24] Like you need to know the codes, need to know the difference between AMA guideline, billing guidelines and Medicare billing guidelines. And if you don't know what they are, that's your job as the owner to go figure it out. And there's a ton of resources out there. Go Wenda BCMS web PT has blogs on it. I mean, you can find that you can chat GPT, chat GPT. I mean, find the stuff. That's what your job is as the leader. And as you do that, guess what? You make more money. You make way more money.

[00:28:53] Because if all your team's billing Medicare billing guidelines, I'll tell you what, you're making a lot less money than you could. And if all of your providers are billing three Theraxes and one manual therapy each visit, guess what? You're making a lot less money than you could. Right. And so getting training on that is imperative. I tell my team all the time, it's not what you're doing. It's who you're being. Catherine, shout out, Catherine. She's awesome. She's freaking awesome. You know, rebuilding our leadership development program.

[00:29:22] We've got some evolving leaders into in the company and we're in, we're in. And I'm kind of playing her run with it. But she's like, oh, my, how are we going to do this? And how are we going to do that? How are we going to structure this on the first call? And sometimes I have to remind her. It's like, hey, it's not about what we do. It's about who we decide to be when we get there. Remember? And coming back to the purpose and the values. Right. Right. It's like, why don't we just go all in on that? And then let's see what happens. You know? And maybe learn along the way. Yeah. And learn along the way. And so you mentioned the purpose and values.

[00:29:51] It's like, hey, owner who is kind of timid and scared to approach your team. I'm wondering if you haven't fully bought into your purpose and values yet. Mm-hmm. Right. Or your value. Or maybe you have a little, but there's more potential for you to really commit to them. And I'm wondering if that gap in commitment might be the thing that inspires your team to actually commit with you. And so it's like, you have to really get a stronger identity so that you can invite others to join you.

[00:30:20] That's what leadership is, you know? Once you do that and you can start, that's what a culture is, right? You start shaping up your culture and then your team starts to believe and they will perform. Yeah. You mentioned in our coaching program, we have a profit accelerator that goes through these four stages, right? And it's a lot of that. Like there is a lot of knowingness that needs to take place, right? But it starts with saying, this is who I am. I'm an owner. And what do owners do?

[00:30:48] Like what are the, don't think about the owners around you. Think about the world renowned owners. What are they doing, right? If you're thinking about Elon Musk, of course, or Jeff Bezos. Or Bill Gates. No matter what you think of all the politics that's going around, man. Shark Tank guys. The Shark Tank guys. Yeah. Do you think some of them have therapists, coaches, advisors, mentors? Yeah. Yeah, they do.

[00:31:17] Michael Jordan had a coach throughout his career, right? And because when you're in it, you really can't see everything that's going on around you. But these coaches also give them guidance, direction. They give them kudos, you know, a pat on the back when they needed it. They're also a sounding board, right? I remember a Tim Ferriss episode that had, that was interviewing a coach and he coached Steve Jobs. I want to say Steve Jobs and Bill Gates at the same time. Oh, that'd be cool. Yeah. To like opposing companies.

[00:31:46] Right, right, right. Right. And guess what? He didn't take any salary. He's like, I have no stock in this. I'm just giving you guys the straight, you know what? And I don't care because I have no stock in either of your companies. Right. And they leaned on it big time all the time. And so that's what the benefit of the coaching was. And it was for me, it was, I can go back to the fundamental changes I made as an owner were when someone gave me just a little bit of guidance.

[00:32:14] Hey, maybe let's just open up this window where we're here. And see what kind of light it produces in your room. And maybe it's better. What do you see there? Right. Now what do you see? I'm thinking about the guy who fired his employee that was talking about it there in the earlier conversation. I had to follow up with him like, Hey, what's your work day like now that you've actually taken ownership of the people that work for you? Maybe a little bit better. Yeah. A little bit better. Actually funner.

[00:32:43] I am inspired by the young therapist who's open, who's starting, who's starting a new clinic. You know what I mean? Like, I'm like, oh man, go for it. You know what I mean? I'm like, I got you. Like, how can I help? So I'll get on these calls with these people just to kind of coach them up and be like, Hey, what are you working on? How can I, how can I support you? Spoke with a young guy named Garrett out of Idaho today. Shout out Garrett. He's starting his practice in April. And you know, he's like asking me about units and billing and over the counter collections and all this stuff. And I said, here's the trick.

[00:33:12] I said, you need to surround yourself with people and resources such that you enter each day with an optimistic state, a place of like encouragement, possibility, and optimism, minimize the overwhelm. And we need to try to keep you there often. Right. And if you can stay in that state often, you will become the thing that can make this thing work. But what happens is we get stuck in our own limiting beliefs. And we've all experienced that where we're like lost, depressed, anxious, overwhelmed.

[00:33:41] It's kind of spiraling. And we put ourself in a box and nobody wins. Right. So like, we need you guys to win. We need entrepreneurs to win because when you win, the profession wins, the providers win, the patients win, everybody wins. Yeah. There's a lot of excitement there when you can step out of that box and have the opportunity to like see things for what they really are and not be emotionally caught up in it. Yes. Clarity, right? Usually it's like, ah, like the emotion is just gone. Yeah.

[00:34:11] And you see it clearly. You see it as it is. I can be a little bit more creative. Right. Right. Right. Right. Right. From my creative side of my brain instead of the reactionary side of my brain. Right. Because the emotions and the money go so closely together. For sure. For sure. When there's a cashflow crunch, that's emotional. Yeah. For most people. Yeah. I tie, frankly, I tie a lot of my self-worth, right? My image of my self-image to the money I'm making.

[00:34:39] Maybe that's a very male thing to do because we are providers at heart. But that's a big blow when money's tight. Like it's almost all you can think about. And so to be able to step outside of that, even though you're in the situation, to be able to step outside of it is where others come into play. The positive people like you're talking about, when you can have interactions with them, whether it's a fellow team member, mentor, coach, et cetera. And they can help you step out of that for a second and say, well, what are some other

[00:35:09] possibilities? Solution-based thinking. Yeah. That's what I like. We want to stay in solution-based thinking. Yeah. Exactly. I coached once and I'll never forget what she said. She's like, so you're saying a lot of your self-worth is dependent upon your production. And I'm like, yeah, kind of. It's kind of where I live. And she's like, so are you telling me that if you were on a ventilator and not productive, that your wife and your children would love you less? No. She's like, so you're telling yourself a lie?

[00:35:36] I mean, without going through the words, I'm telling myself a lie because I'm willing to let myself go into that emotional state. You're like, yeah. You've attached to that thing. And now it's like, how do I let go of it? Yeah. And that was probably 12, 13 years ago. I still have to think through that process, man. A hundred percent. How do you feel like that mindset impacted you in your decision-making along the way, like with money and hard conversations and leadership and marketing and growth?

[00:36:02] Like that monster in front of you, like if you can't get around that, like you can see how that would, that would impair everybody. Oh yeah. Yeah. Exactly. And it affects everybody else. If my emotions are running hot. Yeah. It's going to affect my wife, my kids, my fellow employees, right? My team members, my leadership team. So trying to stay out of that, like you said, the more you can be in that rather more optimistic, creative state, the better for you and everybody. For sure, man. Yeah. Good stuff.

[00:36:31] Anything else you want to share on the topic, man? I think we covered a lot. I mean, and what's interesting is we didn't really talk about a lot of the, I mean, I gave some steps on how to improve cashflow. Yeah. I mean, you could go down, like search the podcast. There's all kinds of stuff. Obviously you want to improve your billing and collections. You want to improve your counting. Like we can beat that horse to death. Like we've talked about that until we're blue in the face. But I think the main point I hope people got is that those, the lack of cashflow is really just the symptom of the bigger problem.

[00:36:59] And this bigger problem is really tied to the identity or the purpose and values that you're choosing to hold onto, or you're choosing to live out or the lack of systems or the execution of those systems within your organization. Yeah. It can go back to identity. It can go back to knowingness. Yeah. Yeah. It can go to lack of clarity. It's a lack of commitment. It's a lack of you, lack of the owner. It's a lack of you, right?

[00:37:25] Because the way I've started to frame this up is like the business becomes so complex. It's like, we work really hard and we build up this complexity around us, this chaos around us. And the business just consumes us such that we have nothing left to give to our team, our patients, our family, the things that we value. And we're definitely not giving enough to ourself. So we're not learning. We're not growing. We're not acquiring new skills. We're not elevating our leadership.

[00:37:54] We're not having the hard conversations in a productive way. We're not building the onboarding, right? Like, and that is the thing that is keeping you stuck. Right. And so once we can clear your plate and give the hero of this journey, which is you, once we give you the tools and resources you need, you will transform your life. Yeah. I shared with you just to wrap it up. I shared with you the testimonial that we got from Christy. Pretty cool. Man. That just made my day. Yeah. Sent a text over to me and it was out of the blue. It was really.

[00:38:25] And she said, Hey, by the way, looking at my, looking at last year's financials, I have increased my revenues by over 20% year over year. And my profit margin is well over 17% this year. Highest ever. Wow. Right. And I'm shooting to get to 20% in the next couple of years. And I chalk it up to you guys. I was like, what? That is amazing. That was so cool. Because when I first met her, like, I think that was two and a half years ago, maybe three, not much cash. Right.

[00:38:54] Was kind of frustrated with her team and her, and the production of the team overrun by HR issues. Didn't have time for herself. Young mother who had a young baby at the time. I want to say she baby that was less than a year, somewhere in the one zero to two year age range and didn't have a lot of time for the baby and like, didn't know what to do. COVID was a huge hit. And to see her transformation now, she has time for herself. She still wants the treat.

[00:39:24] So she treats maybe 12 visits a week. Yeah. She's in control of that. Right. Right. That's her decision that she wants the baby 12 visits. I'm doing this for fun. Yes. She could step out of that at any time. And she has a team that's productive and she has leadership in place. So thankfully she was willing to share the testimonial. She was, and it was awesome to see because she transformed her life. I would invite the audience.

[00:39:50] Last thing I'll say is I'd invite you to, as you hear Christie's story, like imagine the type of impact something like that would have on your, on your family, on the people and the things that you know, that you care most about. It could be transformative for you. So I would invite you guys to kind of think about that because you're worth it and people are counting on you. That's right. If people, where are you nowadays? If people want to get in touch with you, how do they find you then? I've been spending a lot of time on social media. So obviously I'm on LinkedIn. I'm on Facebook, Dr. Adam Robin.

[00:40:20] I'm on Instagram now. I'm actually creating a little Instagram following. That's been fun. So you guys can check me out. I have a YouTube channel. We have PPO Club YouTube channel. So yeah, you can check me out there. Always shoot me a DM if I can support you. If you ever want to talk shop, you can email me, adam at ppoclub.com. Join the Facebook group, Private Practice Owners Club Facebook group. We're doing live trainings every Thursday. I have a ton of free things to give you guys. So yeah, anything I can do to support you, let me know. Plenty of resources. Yeah. All right. Thanks for sharing today, man.

[00:40:50] Yes, sir. All right. Talk to you later. Bye-bye, brother. 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. And visit our website, ppoclub.com, to find more resources and connect with us.