We are switching seats. I'm not going to be the host of the podcast. I'm coming up on a year anniversary and in order to celebrate that, we're going to do a little year-end review. I'm going to have my good friend and partner, Will Humphreys, be the host and ask me the questions. He's got some questions to ask me about my experiences with the podcast and some of the guests that stood out. I thought it would be a change of pace. We have some insight to share based on the experiences that I've had and I thought it would be a good way to celebrate. Let's get to the interview of me, your host, Nathan Shields, as the guest.
We're taking a different track and I'm going to be in the hot seat for once and be the interviewee. My friend, Will Humphreys, is going to be the interviewer. Will, thanks for joining me. It's good to have you on again.
Thanks for having me back. It’s an exciting switch of roles. I'm glad to be a part of it.
I appreciate your support. You get to ask your questions, interview me about the podcast or whatever experiences you might want to ask about with what's been going on with the Physical Therapy Owners Club or whatever's on your mind. I'm going to turn it over to you.
I appreciate the opportunity to be with you in this space like this because it's very different than what you've done up to this point. I've had the privilege of sitting on the sidelines as you've done what very few people have done before. There's a huge need, in my opinion, of podcasts and information to help prevent what you and I went through as we started our PT practices. First one, I want to acknowledge that you're coming up on your year mark of having launched this podcast. Congratulations on that first and foremost.
Thanks. It was June that we got started and I thought I'll try this for about six months and see how it goes. Maybe I'll hit a year if I want to but it's been exciting to meet other physical therapy owners, to meet other influencers in physical therapy. I've gotten to meet some great people. It's been a cool experience that I'm excited to continue past this year mark.A lot of people are totally open if you just reach out to them. Click To Tweet
If you go to podcasts in general, you'll see when I looked into them, there are not many in physical therapy to begin with. The ones that are there, there are very few that three to five episodes and they're done. For you to be this long, the first thought I have is what was it that kept you going? What kept you going month after month to doing all the work, to meet people, introduce yourself to them, start new relationships and then create this powerful podcast?
I tapped into my network initially because you and I both know some great owners and I haven't interviewed them all. We know some great owners and we know some great consultants and coaches. I got the opportunity to meet these people. I find myself after every episode getting energized. My family would recognize after each interview that I'd come out and I'd be a little bit happier, fun and excited. I'd come across other people in the PT sphere that I met either as a referral from an interviewee that I had done an episode with or someone who had written an article in the Impact Magazine for PPS.
I'd meet these great people and they'd be willing to join me on the episodes and be amazed at how much knowledge and how many resources are out there for physical therapists. I could share some of this content with people. That energized me as I kept going. During about the six-month mark, I had another question as to whether or not I wanted to continue another six months and my wife was like, “It's obvious, you’re enjoying it. You love it.” The grind is simply finding the interviewees and finding the guests.
There's a lot of energy that you get from meeting powerful people and sharing that with others. I wonder if there is any cathartic healing of the old you when you expose these resources to others that you didn't have when you started?
I'd do a little phone interview with my guests before the recorded interview because some of them are skeptical. They’re like, “Who are you? Why are you doing this and how are you going to monetize yourself on my name?” That's the conversation that's going in my head, but they actually come on and they want to know what's happening. I talked to them, shared a little bit about the podcast and I asked them, “What are you doing? What's top of mind for you? What's inspiring you nowadays or what issues you're coming up against?” They tell me, “I'm working on this. I'm seeing a lot of this with my physical therapy owners.
This is what I'm dealing with in my clinics right now and this is how I'm getting over it.” I think, “We haven't even covered that topic yet. I need to share this with the group because there's obviously a hole in the content that I'm providing and you can fill it.” When you ask if it's cathartic to my younger self, maybe it's because I wish I had that when I was a new owner. I wish I had some insight on this topic. That gets me excited to say, “I can take this person, this resource and connect it to that person over here and they can benefit from each other.” That gets me excited. That's where I find I get a lot of energies when I can be the matchmaker between some of these people.
In your career, you have the initial podcast that talks about how you started your journey and why you became a PT. I don't want to spend too much time on that because the audience can go back to that and dive more in-depth into you. It makes me curious, as someone who's known you for years as to what other parts of your career did you find that same kind of energy? I know there are times when it was gone. As you look back through your journey, at what points do you recognize that energy?
Initially, it was when I was a new owner. It’s when I was actually starting to see it gain some traction and like, “This actually could work. I'm actually supporting my family. Doctors are referring to me, trusting me and patients are referring their friends and family to me.” That gets you excited that’s like, “This concept that I have is coming to fruition. I'm able to capitalize on it and fulfill my purpose and also support my family. Everything's matching up.” You gain greater visions and that becomes run of the mill. Maybe you get busier to the point where I'm treating 50 hours a week. This dream isn't so much a dream anymore.
I’m not living the dream I thought I was, then I get bigger and open up a second location. “I'm a multi-clinic practice owner and here's this new dream that's coming to fruition and it's working great.” You see those little steps here and there as you grow. You and I, then as we partnered and worked together, we'd have sessions where it was exciting to get in the vision, to maybe align our values, create missions, goals for the upcoming year and find that next executive that was going to help offload us. Those things will give us energy. Little steps along the way that were helpful and to see some of those dreams come to fruition are exciting.Learn, earn, and then return. Click To Tweet
It's so powerful to have been a part of that journey, to see you start your clinic, to build it up, ultimately have it merged with others and become a great larger company and Empower Physical Therapy. I look at what you've created in Alaska. I don't think others can hear it because it has to come from someone other than you. Otherwise, it sounds like you're bragging. You've become a thought leader in diagnostic physical therapy, EMGs and diagnostic ultrasounds. You have been a participant in Hands-On Diagnostics Seminars, which is the country's leading authority on all things diagnostics. It's neat to see as you've accomplished these things. You've moved your family up to Alaska with your seven kids, take them on so many great challenges and you've overcome them. It begs the question for me, what was it about the podcast that it was in your head, what was it the itch that you had to scratch around creating the podcast?
It goes back to wishing that I had a resource like this when I was a younger owner. When I listened to podcasts initially for the first time a couple of years ago, I'd heard about them but I didn't know what they were, take the effort to actually push the podcast app on my iPhone and see what that world was. When I finally did that, I immediately tried to see what podcasts could be applicable to me. We were still businessowners at that time down in Arizona, living there, working with you and looking for something that could be a resource for us where we were at that stage and recognizing there's not a lot to see whatever was out there at the time. It was more marketing-based or treatment-based and not entrepreneurial business-minded PT owner based.
They didn't seem to be a lot of that out there and that was years ago. For two years, I stood going, “I wish there was something out there.” I've found other entrepreneurial business podcasts but nothing PT-specific. When I finally figured out how to actually produce a podcast and get it out there, then I was like, “I can finally do this.” It felt like a calling to me to make sure that I introduced these successful industry leaders that a lot of people don't know about and say, “They're doing some great things. They've got some successful actions that you could replicate or you could learn from them. You don't have to recreate and reinvent the wheel. Learn and even reach out to them if you want to.” A lot of these people are totally open if you reach out to them. I felt the need to make sure that the audience and these influential people were connected.
I love how you say that too. As you discovered these people helping get their stories out, a part of that energy was to be able to share those positive messages with others. A lot of your audience are people who are in a similar position. Either they're in the earlier stages of where you were when you started your company or they're down the road a bit and they've played that game. They're still challenged by it but they've wanted it to a certain degree. What would you tell them were some of the challenges you faced as you branched into this new chapter of your life?
It’s trying to find a purpose. Shaun Kirk sticks out because we talked about it quite a bit in his podcast and this is one of the more popular podcasts that I have. With other people as well, it comes up on a routine basis that figuring out your purpose is what will drive you to push through any issues that you're having at any particular time when you get stuck per se. Your purpose is not always the same. Things change in your life. Your purpose as a single male changes when you get married and your purpose change again when you have kids. Your purpose changes when you become a business owner. There could be an underlying general foundation that you have but some of the purposes that you work off of change over time.
The difficult thing for me as we've gone through this transition of selling our practices and living in Alaska is to find the purpose, something that drives me and that pushes me to work towards something higher, push through any problems that I'm having in getting it done. Setting on my mind on something specific back in that is a change. I could see that happening with people who might come up to four or five clinics. They're like, “Now what? I've got an executive team and things are going smoothly and things are great.” It's at that point where they have to find another purpose. What's your next goal? What's your next purpose for doing this? Maybe they're working off that if they've got grander visions, but it is finding that purpose and setting those new goals.
It’s interesting as you're talking because having known your journey, it reminds me of that adage that in our careers it's, “You learn, earn and then return.” You're at that point where maybe the podcast, there was a little bit of a return to others and getting back to that same position you were in.
I feel that for sure. When I think of the person that I'm talking to for the interview or setting it up, I've got him set up. He's a guy with two kids living in Texas. He's got a single clinic and he's working 50 hours a week seeing patients and not necessarily having time that he needs to work on his business, but he's got grand plans. However, he's not experiencing the stability and freedom that he was hoping for as an entrepreneur or as a new clinic owner. Financially, he's doing okay but he doesn't have the time for his kids that he wants and he doesn't have time to maybe do other hobbies that he's looking forward to in those things.
I look at that guy and I'm like, “This is for him. I want to introduce Dee Bills and how she can help you with the front office issues. I want to introduce you to Shaun Kirk and see if you were assessing the six areas of your clinic. I want to introduce you to Christopher Music. Are you setting aside money for your whole household, for your future and is the business making money for you?” All these people that I’ve had on the podcast, I'm thinking, “I wish I had some of these little tidbits of information that could have helped me push to do a little bit more sooner, get there faster and not have to go through the hardships that it takes that a lot of these people experienced because there are resources.”
You’re describing your ideal customer as it were, your ideal audience and they're like, “That's me. Nathan hit it on the head. That's who I am.” You don't get this opportunity very often to speak directly to your core audience. If you had something you could say to them right now, what would you tell them directly?Invest in your business like how you invested in your education. Click To Tweet
I would tell them to invest in their business as they invested in their education. I had this great conversation with Shaun Kirk or it could have been Jamey Schrier. Sorry if I’m not attributing it to the right person. Nonetheless he said we go into physical therapy school, we'll spend $100,000 or maybe more on some of these schools to get an education with no guarantee that we're going to pass the exam, that we're going to be successful at all and that we're going to be able to pay off our loans and that we’ll have a job. There's no guarantee whatsoever of any of that but we're willing to spend six figures on it. When it comes to investing in our business education in terms of coaching and consulting, then it’s like, “$1,000 a month? How am I going to afford that?” You spent six figures on your education with no guarantee at all. Whatever it is, $500, $1,000, $2,000, $5,000, you and I have both spent more than that on coaching and consulting, to let that be a hindrance, to gaining some wisdom from other people who are willing and able to help you be successful.
I am of the belief that almost anybody that you reach out to that I've talked to on my podcast if you joined up with any one of them, would help you be successful and help you get the stability and freedom that you're looking for. I pray that they would simply make that step to reach out, step out and network. That's my mantra. I started my story off thinking that the key to stability, freedom in a physical therapy clinic and owning it is to reach out, step out and network. Those are my three things and there's a hypothesis at the time, but it has actually become a truism for me. It's real. You have to step out of the clinic and work on your business. You can't be treating 50-60 hours a week and think that your business is going to go where you want it to go unless you make a change. You’ve got to step out of the clinic and do something different if you want to meet your goals. Number two, you've got to reach out and find a coach or consultant. You've got to find somebody who's going to hold you accountable when you are the pinnacle of the organization, there's no one to answer to unless your wife's hounding you. There's no one to answer to business wise to make sure you get things done. You’ve got to have a coach or consultant and reach out to one of them.
Number three, you've got to network and find that or recognize that you're not the only one in the world that's having these small business problems. Whether it's reaching out and networking with other physical therapists or other small business owners, you’ve got to be part of some network that allows you to ask questions or get a different person's perspective. Get someone else's perspective, to challenge you on the ideas that you have. Someone to hold you accountable so that you actually get things done and move in a direction that you want. Otherwise, you and I both know there's a lot of burnout in physical therapy. You don't see a lot of 60-year old physical therapy owners out there that are still rocking it and seeing a ton of patients. The reason is because there's a big amount of burnout in our profession. In order to avoid that, you've got to get back to your purpose but follow the mantra, reach out, step out and network.
I know there are lots of people who are hearing that, “I've got a little bit of hope now.” Shifting back to the podcast a little bit, you keep mentioning these many guests. I'd like to do a best of scenario here. In your case, I would like to ask you if you had to pick up a story that you heard that impacted you the most or significantly, what would you pick?
The first one that comes to mind is an interview that I did with Michele Kehrer. She owns Balance Chicago in Chicago and she is full of energy. She is Wonder Woman on crack. Here's a woman who developed talent and expertise, a niche in physical therapy and decided to open up a clinic. She didn't have any referral sources. She didn't have a clientele. She took on 3,000 square feet in the middle of Chicago with nothing. She went out there and her personal life went to crap over the next two years. There was a divorce. She was diagnosed with cancer and coming back from that then a year or two later getting diagnosed again with the same cancer. They're not knowing where it comes from and to the point where she is an incredible arc of personal development growth. I love Michele's story.
The other podcast that sticks out in my mind is interesting simply because he's a newer PT owner. He figured some things out pretty quickly. He thought and he finds that with a lot of these coaches and consultants. You and I might have had the same mindset when we were coming out of physical therapy schools, that if I can improve my skill set and become the best physical therapist, then the success and the money will follow. No one cares about your skill set because you're going to get paid the same in the insurance company's eyes. It’s all about how you develop your systems, your team and how you establish that customer experience.
Roy Rivera is a podcast listener who reached out to me via email. He said, “I really enjoy your podcast. I want to give a shout out. I think you're doing great.” We bantered back and forth via email. I said, “What are you doing?” He's like, “I'm in Houston.” I asked him, “What are you doing? How have you become successful? How are you experiencing success?” He said, “I don't do any marketing. I simply use social media.” I'm like, “I need to do an episode about that right now.” That was a cool story because he's found a niche in Houston and he has a clientele that works for him. He circled the customer experience all around that. To give you a brief quip about what's made him successful, with every discharged patient, whether it's on his schedule or someone else's, he sits with them in a room and says, “How's your experience?” They said, “It was great. I love it.” He said, “Do me a favor. I need you to go to Google and Yelp. I need you to rank or review us. Would you mind doing that?” They say, “Great.”
They'd give them a card on how to do it and that kind of thing. He'd send an automatically generated email three to five days later and say, “Thanks again, please follow these links if you haven't already to review us on Yelp and link in Google.” He said when you look up Yelp or Google reviews for Houston physical therapy, his is the top search. Those are the stories that get me excited to bring those people in front of the audience and give them the energy and know that you don't have to have all the stars aligned to make this thing work for you. You have to remember your purpose, focus on the customer experience and on your company.
Another thing that I heard that you didn't directly say but I want to complete that thought is consistency. You keep going back to the idea of you don't have to be perfect, but do the best that you can. Ultimately, it's those consistent even smaller steps that I've seen you take that have impacted not just your family's life but everyone's. The story that you shared is interesting because I heard from a business consultant I was talking to, she shared with me that usually, businessowners wait until the three D's occur for them to pivot and actually become an owner of a business and not have their business own them. Those three D's are death, divorce and disease. One of those three D's usually shows up before people realize, “I can't keep doing this to myself.” I look at those stories and you've had so many powerful podcasts. There's nothing but value throughout them. Were there any surprises? Was there anything, either in an interview or a person that floored you and took you back?
It’s one thing that comes to mind because I hadn't heard this before. Christopher Music shares it often in his teachings for financial advice to private practice owners. That is to set aside 10% of your revenues for yourself off the top. Not 10% of your profits, 10% of your revenues go into your bank account. When he said that on the podcast, I was like, “What? Are you serious? Are you kidding me?” I thought about if I had done that years ago, I would have a ton of money. His mindset is, “You make it an expense line in your company. It's another line item. That 10% goes to the household and you don't touch it.” The funny thing is the mindset is like, “I need to cover my expenses and a little bit more.” Essentially, you start doing a little bit more to cover that new line item that's 10% of revenues and you make it work. That was one thing that took me off guard and I wish I had done it. Looking back, hopefully someone else is taking advantage of that advice. The other one that I thought was, it wasn’t new to me but I was like, “If we did more of that, it would be so much easier on us as owners.” That was an interview that I did with Craig Ferreira of Survival Strategies.Remember your purpose, focus on the customer experience, and focus on your company. Click To Tweet
When we're talking about improving the productivity of physical therapists in general and talk a lot about stats across the number of the podcast episodes, we’re making sure people are tracking their stats and you're following stats. It's an objective assessment and not subjective but he said, “The expectation for productivity starts in the interview process. It's not part of their training after you've hired them. It's part of the interview process.” It’s like, “This is what our expectations are and this is how you're going to be judged on whether you're being successful physical therapist or not.” Having communication like that with not just your physical therapists but anybody beforehand as you’re going through the hiring process would be so beneficial in helping them understand what it looks like to succeed in our company. What it looks like to not succeed.
This is when you know it's going poorly when you're not meeting these numbers or when you're not fulfilling this goal as a team. Have some of that. It ties into the conversation I had with Jamey Schrier about hiring A players and getting to know what drives them. Of course, you're going to lay out what the expectations are but also find out what's driving them and how can you fulfill their purpose. Maybe they know that their husband might get transferred in a year but they're scared to say it and if you provided an environment of communication where you're discussing what the expectations are but also, “How can we support your end goals?”
Things like that could come up, “I'm only going to be here for a year.” If you knew that and were able to have that conversation before the hiring even occurred, how valuable would that be. This is Jamey’s story. He hired somebody like that and they found out a few months in advance, the year mark came around and her husband was going to get transferred. That employee was able to then help them find her next replacement. It was a win-win for everybody. We're meeting our goals. Communication, I looked at that and thought not that it was a surprise to me but it was like, “I wish I could have done more of that.”
Part of the beauty of this podcast is that by being in this space with these thought leaders and by generating those discussions we’re getting knowledge. As we learn and grow, that knowledge is such a big thing for physical therapy owners to be able to become a little bit more powerful day-to-day, even if it's one step at a time. I look at this and I have been so amazed at the people you've gotten on there and I want to ask you. What’s something that you've learned, not from people but from doing this? Having spent this year interviewing these people and having taken a risk of putting yourself out there. It's not easy to put yourself on a podcast, stamp your name on it and go, “I'm making a stand.” What would you say that you've learned overall from this process?
I went out with this hypothesis and the idea that stability and freedom come from stepping out, reaching out and networking. The one thing that came to mind is I cemented that in my head, that's for sure for certain. The other thing that I learned is there are a lot of people out there that are willing to provide information, support, resource, advice, whatever you want to call it if you know who they are and reach out to them. I was surprised at how easy it was to talk to Jerry Henderson of Clinicient and Heidi Jannenga is a busy woman but she'll make time for the podcast. People that are leaders in our industry are willing to share some of their information and it takes some effort to find them and to look for them.
That's why hoping that this can be a little bit of a one-stop shop to say, “If you're looking for this issue, then here's a consultant over here that can help you out. If you're having this problem, listen to this episode and maybe he'll talk to you about a book that you need to read.” I learned that people are very willing to offer some help. It's been easier to get ahold of people than I thought it might be. I'm reaching out to some of these people who write articles in Impact Magazine and asking if they want to do interviews and they're open to it. Some of them are easier to get ahold of than others but they're willing to talk and share some of their excitement about the industry or what they're passionate about.
Let's talk about the future. What are your plans? What is the future for the PT Owners Club?
The Physical Therapy Owners Club, it's been a grind to make it work. We’re dropping an episode every week. We're going over 50 episodes. I'm probably not going to be dropping them as frequently. They are going to be coming two to three times a month and sometimes we'll get four out a month but it's not easy to get guests. I'll have some people that come back around. Shaun Kirk will be another one that comes up here again and he's my most popular podcast in terms of listens.
I've got Heidi Jannenga coming on again. I've got an interview coming up with Jerry Durham. He's been in the private practice room for years and a successful consultant as well. I've got him coming up here also. It's been a little bit more of a grind, so I'm going to have fewer guests. However, I'm going to take a stab at doing some podcasts where it's me talking and that'll be new for me. That's taking a step out on the ledge. Doing the podcast itself, it takes a little bit of risk because I hated hearing my voice. Getting past that and putting myself out there, I'm very proud of the content that I've created. That content has to be created from within me and then expressed out to the audience.
That's a different level and that's somewhere I haven't gone before. I'm going to try my best to do some episodes where it's me talking and I don't have someone to interview and go back and forth with. I'm going to start doing some coaching. You'll hear more of that in future episodes where I'm making myself available based on my experience and what I've learned both personally and professionally and by doing the podcast where I can help other physical therapy owners achieve their goals, hold them accountable. Maybe even provide some advice here and there as they need it to say, “Have you considered doing this and why aren't you doing that?” I’ll provide some of that to also return and give back.We've made a year! Yay, PT Owners Club! Click To Tweet
I am excited for what's coming next. The foundation you've built is obviously speaking for itself, all the people who have listened to who have been benefited. Thank you for making the decision to be bold and to do something totally different. On a personal note, I want to say it's such a privilege to work with you, validate and give that external proof that whatever you do is going to be successful. People need to learn from honestly your mistakes and being able to grow. The thing I love most about you, Nathan, is that your heart is genuine. You're one of the most authentic people I know. As you move forward into the future, I see nothing but a benefit and value as you move forward being yourself. I know firsthand all your strengths, all your weaknesses and people will be fortunate to be able to spend time with you, whether it's a podcast or a coaching relationship. With all you've experienced, if I hadn't gone through it, I would want to sign up with you immediately as a mentee. Is there anything you would like to share?
I've shared a lot. I'm excited about physical therapy in general because we meet such a huge need out there, whether it's filling the void for opioids and the opioid crisis, to the number of Baby Boomers that are coming out on a daily basis that are going to need our services. I'm excited about that. I worry that physical therapy owners if they aren't pulling their head out of treating patients every day and seeing what's happening in the landscape, they might get blindsided by some of the changes that will come with healthcare. I only say that because you can look at other parts of the medical healthcare spectrum and maybe extrapolate to what we'll be having with physical therapy. What I see in people that I talk to you is that it's going to be hard for the individual practitioner to stay the course, treat and survive as we did several years ago.
There's going to be more consolidation to these ACOs. Hospitals are going to acquire physical therapists like they're acquiring family practices. That's where I'm talking about. They're doing this in other parts of the healthcare spectrum. We can extrapolate it to us because you can see how hospitals are requiring family practices. They're acquiring physiatrists and orthopedic groups. When they do that and bring in physical therapy, then they can keep it all under one house. You can see that with Banner Network in Phoenix. Now, it has its own insurance. It all stays under Banner and they don't have to network with any other outside physical therapy groups. The consolidation of insurance companies are the same. If you don't know your statistics, if you don't know your niche, if you don't have a solid footing in the community and have your head up and looking forward, you could get run over.
I'm hoping that some of these guests that I bring can shed some light on that. I did a little bit of that with Jerod Bowen and Jerry Henderson, we talked about some of the future of physical therapy and where that's headed. There's still an opportunity there to do that and you can have a seat at the table but you can't do it if you're treating patients 50 hours a week. There's an opportunity out there not to mention the diagnostics. You throw in some diagnostics on top of the PT that you're doing, then you're setting up a different type of value that you bring to the community that other physical therapists don't. It’s not only for your community but also for the profession because the other healthcare practitioners will look at you like, “I didn't know physical therapists could do that.” We can do EMGs, we can do ultrasounds and we can be diagnostic. If we want to be the gatekeepers to musculoskeletal healthcare, then we need to have some diagnostics in our pocket in order to do that appropriately.
I know you're so passionate about what you're doing. This is Will Humphreys interviewing the great Nathan Shields. This is the guy you want to reach out to if you're stuck on anything. If he doesn't have the answer, he knows somebody who does. Feel free to reach out to him anytime, day or night.
I am a father of 4 boys, married 20 years and a part-time comedian. I am passionate about physical therapy and startups in my field. I am also fascinated by culture and team building in health care companies.