September 3, 2019

Step Out - Reach Out - Network: The Real Life Formula For Nathan Shields And Sean Miller with Stephen Rapposelli

PTO 63 | PT Clinic Ownership


This week, Stephen Rapposelli, PT hijacks the show and turns the tables on the host! Stephen noted early on in his conversations with Nathan Shields that he hasn’t shared enough of his ownership journey with the audience, thus he pushed to take over the podcast and ask Nathan and Sean Miller exactly how they went from individual clinic owners to selling their clinics to Empower PT last year. Stephen asks some specific questions about the how's, why's, and what's that. Hopefully, in this episode, Stephen fills in some gaps and give you a little insight into the PT clinic sale experience. Sean shared all of his wisdom as well to add some great insight into the cycle of PT clinic ownership.


Listen to the podcast here:

Step Out - Reach Out - Network: The Real Life Formula For Nathan Shields And Sean Miller with Stephen Rapposelli

This is Steve RapposelliI'm a fellow PT owner and I have hijacked Nathan's show because we have turned the tables on Nathan. Nathan needs to have the tables turned on him, so he does not know what I'm about to ask him, but here's a little bit of background. Nathan was nice enough to interview me for his show. You may or may not have read it. That's not important, but as I was talking with Nathan and as he was interviewing me in a very inquisitive, friendly way, I found out that he would not be the guy to say that to you directly. I'm taking it on myself to be the interviewer and to ask Nathan a little bit about his story because quite frankly, it's fascinating. It is a story that you are going to want to hear as a fellow PT owner. This is why think it's important.  

If you're a PT owner like myself, whether you have one clinic or five clinics or 100 clinics, you probably have the same questions in your mind that he did and that I do and that is where are we going here with all of it? What is the next step for me as an owner? Nathan has already walked that path and the story that we're about to reveal is going to be one that you're going to find entertaining, learn a lot from and help you on your journey. You may likely take a different journey than Nathan's and that's okay. Nathan has his own path, but it will help guide us as a way of comparing and contrasting where you may need to be. Without further ado, I'd like to introduce Mr. Nathan Shields. Nathan, are you there? 

Thanks for having me, Steve. I appreciate you having me come on my own show. 

We are glad to have you on your own show and I want to get right down into the end of the nitty-gritty. I know that your story is searchable in the wonderful digital land of Google, but we need to have it lying in your own show archives because it's very interesting and it's very instructive to your audience. With that said, you're a guy who got his training Northern Arizona and upon graduating back in the late ‘90s, you opened up a practice in the Phoenix area. Tell me about the path that you took when you first opened your office in Phoenix. 

I opened up my clinic in 2002 and that was in Chandler, Arizona. My whole goal was to get to two physical therapists, 150 visits a week and afford a TiVo. I thought if I could get two PTs, 150 visits a week and get a TiVo, then I know I've made it and that would be all. Lo and behold, I worked hard for a number of years and I opened up a satellite office in Florence. got a friend to manage that for me. That ended up being my business partner, Will Humphreys. Hmanaged that. He eventually bought that clinic from me. Together, we opened up another clinic in Maricopa, Arizona. We ran like that for a number of years. Each having our own success, we had his and our situation, but we shared common consultants. We knew that we needed help. We shared a similar networking group, a small business networking group. We found out, like most of us do that, I don't know what I'm doing business-wise. I can treat patients all day long and they're happy, they get results, but I hate doing the business stuff. 

You said, “We needed help. How did you know that you needed help? 

If you read my interview with Will, he knew he needed help because he had a breakdown. He had a stack of charts that he was going home with every night. He was driving in the middle of the summer in Arizona at 115 degrees in a little truck that didn't have AC. He was sweating through his clothes. For me, I was the guy that was staying up all night doing charts. I had employees that were upset with me and upset with the company, who didn't know who to talk to. I was upset with them and frustrated that they weren't simply doing what they were supposed to do, even though I didn't tell them what they were supposed to do. There were a lot of frustrations and I knew there's got to be something better. I also knew that if I continued down this path of working 60 hours a week and then trying to run the business on top of that, there was going to be a burnout. I couldn't keep doing that. It was at that point that we figured we needed some help. 

What help does a PT owner seek out when they reach that a-ha moment? 

They can do a number of different things. You can start reading books. You can start googling and looking up webinars and YouTube channels of other PTs that have been successful. You can reach out to a podcast. Nowadays, there are many more resources available to us at our fingertips as PT owners than there was back then I believe. Even the APTA has provided some good materials through PPS to help someone get started in a clinic, but there are many more consultants. There are many more companies. The internet is much more available so you don't have to feel as alone as I did back then in the early 2000s, starting at the clinic. There are many more resources now.  

My mantra is to reach out, step out and network. That's the common formula for success that I've found in not only in my experience, but also the people that I'm interviewing. You got to stop treating full-time. If you're going to be a business owner, you've got to put it on your business owner hat a couple of days a week and act as the leader of your company and that you own a business. Forget that you're a physical therapist almost anymore because more than a physical therapist or an owner, you've got to get some support, some outside perspective. You've got to network. 

Reach out, step out and network is a common formula for success. Click To Tweet

Did you seek out a PT-specific coach consultant? 

We had a personal/business coach, someone who helped us at different times as a parenting coach. When I say us, that's Will and myself. We found this person who was providing parenting seminars because we were new parents as well. That'll add to the stress. She also did some business consulting because a lot of it's about relationships, whether it's parenting or interpersonal relationships with the husband and wife or relationships that you have with your employees. It's about relationships. She did some coaching with us, but then we also reached out to a PT-specific consulting group, Measurable Solutions at the time and got some help in that regard as well to help us organize and establish structure and systems in our company. 

Are cutting-edge PT owners ever done seeking coaching/consulting? 

If you're me personally, I don't believe so. Consider the professional athlete, they're at the top of their game yet they still have coaches. I listened to podcast about The Trillion Dollar Coach or something like that, but Steve Jobs had a coach through most of his existence as the CEO of Apple. It’s the same thing with the guys at Google. They have coaches. They need another perspective. They need some insight. They need someone to hold them accountable if they're going off the rails and not heading towards their goals. I believe that everyone needs a coach. 

In your opinion, one consistent behavior of success of the PT owners that you've interviewed and interacted with is ongoing and regular coaching to help them grow personally and professionally. 

I believe so, yeah. 

That's good to know. Here you are back in the early 2000s. You're running and gunning with Will, everything is going well. For those of us who are not in Arizona, I assume that those cities that you identified are in that whole Phoenix Megalopolis area. Tell me more of your mindset at that time. Were you like, “I got the two PTs, 150 visits a week and the TiVo. Now we have two other offices. Let's just rinse, wash and repeat.” Where did you evolve from there and why? 

The ultimate decision is to get some consulting help. I don't know how to put my finger on it. We have another physical therapist on here with us, Sean Miller, who might've gotten through the same experience. My thinking at that time is, “We can't keep doing this.” When I think about what this is, it’s that I'm treating full time. I'm running my business. I don't have a lot of time with my kids. Maybe financially I'm doing all right, but I'm not able to enjoy it per se. I didn't feel like I had a lot of freedom. I felt like I was a slave to the company. The company didn't work for me, which is the ideal situation. I knew I needed help at that time. You and I both know, everyone knows who's reading this blog, we haven't had any business training, so I also didn't know what I didn't know. I knew I needed some outside help to do that. Did I answer your question? 

That statement you made of, I can't keep doing this,” resonates with a lot of your audience. That’s a very scary place to be because you're leaving a comfort zone of you treating people and making the donuts so to speak. To leave that to then work on your business is not an easy transition for most clinicians/owners. 

I believe a lot of us are high-achieving people. If we've gotten through physical therapy school, that's a common trait for all of us and we are very comfortable in being good physical therapists. Looking at it, if you were to say, “You're not going to do any physical therapy and you own a clinic, what are you going to do?” Most physical therapists might not know what to do to lead their company. They might go over and pay some bills or they might go market some doctors, but what are they going to do to achieve their company goals? That might be hard for us to accept, to set aside the physical therapy hat and put on a business owner's hat, one that we haven't been trained in. It can be an uncomfortable transition. 

PTO 63 | PT Clinic Ownership
PT Clinic Ownership: If you're going to be a business owner, you've got to put on your business owner hat and act like the leader of your company.


Once you had reached that point, Nathan, were you ready, willing and able to make that transition? Did you still have to be dragged into it by an outside person? 

There was definitely some trepidation because if you get down to some numbers, you're thinking, “If I'm not treating on the floor and I hire someone else to take my place, I'm losing money at that point. There's a decrease in profit margin because I'm taking on the extra salary.” I’m no longer “productive. I can't equate my time, which is time with a patient, to an outcome of money. It's hard to go from that to, “Now I need to set up a marketing plan.” You can't make the immediate correlation between my time and the results of that marketing plan.  

You went from considering yourself productive to being one giant expense for your business. 

Yeah, that's where it took a lot of mindset training. Maybe speak to this a little bit too, Sean, since you're on here. If any of you remember Sean Miller, he's one of my first episodes on the show and he went through some training as well. Maybe you can share your experience, Sean, in the same way, but I had to go through that mindset training that, “I'm not a physical therapist anymore. I'm a business owner who happens to provide physical therapy sometimes.” It’s to make that transition, to recognize that if I'm going to grow and make the company do what I want to do, I've got to work on the company to make it do what I want to do. Simply providing more patient care isn't going to get me there. You have to work yourself through that over and over again to wash that all out. 

I couldn't agree with you more, Nathan. I appreciate you guys having me on with you. That was a huge mindset shift for me as well. You're a full-time clinician treating patients. I remember working with a consultant and the first thing he told me was, “You need to block off five hours a week to work on your business.” I was like, I can't do that. There's no way I can do that.” When I did it though, I said, “I'm going to trust this process. I hired this guy to help me for a reason and I'm going to do what he says. Even if I ended up losing money, we're going to do it to see what happens.” As we all know, when you set aside that time and you start working on your business, you are automatically starting to see results and all of a sudden you realize, “That was a good idea.” It is a mind shift change because we're not used to that aspect of thinking we should block off time instead of being with our patients 

Sean, you bring up a very good point. I want to hammer it again. You said something that was key and that is you brought in a consultant who told you what to do. There are so many people out there who then will disregard that advice that they paid good money for. You happened to take the advice that you paid somebody to tell you. How difficult was that? 

I was telling a lot of people in our company this story and it was that when I first started with this consultant and they were recommending all these things that I needed to do in my business to improve it, I was super skeptical. I was like, “No way. This will not work. This is not going to help my business. I had to stop and check myself and be like, “What I've been doing is not working or has given me lots of more work and headaches and stuff.” I told myself, I'm going to go all in. If I totally disagree with what they're saying, I'm just going to do it.” Part of me was like, I'm going to do it to prove him wrong, to prove that what they have here doesn't work.” I've put it in and started doing everything and all of a sudden, my business started growing way more than I ever had done before with this. I've proven myself wrong with it. It's that mind shift change. I love the saying, “When the student's ready, the teacher will appear. There's so much out there that when we're ready, the teachers will be there for us. 

If you're not ready to learn the lesson, it will keep showing itself up on your front door. Nathan, I know that there's a lot of ground in between these two points, but at one point you said to yourself, for whatever reason, “I’m going to end this and I'm going to go to Alaska. I know there's a lot in between there. Here's a guy who is successful in Arizona. He's got Will working with him. He's got a number of clinics and now you have this idea of an exit strategy. 

Going to Alaska wasn't necessarily the exit strategy. There was a goal there that Will and I had that I was going to develop this diagnostics business. We did so in Arizona, we started some in Alaska and it started getting better. We had been doing diagnostics for a couple of years and it wasn't getting any traction. We recognized that we weren't putting that diagnostics business into its own structure. We considered it this small department within our current structure. No one really had any ownership of it and so it didn't go anywhere. We had some ideas around it but we never really focused on it. We decided, “If this is going to do something, one of us needs to take responsibility for it, make it its own business and set up its own entity.” I took over that. The agreement was that Will was going to focus on developing our leadership team so that he could free himself as well up from the day to day of the Rise Rehab at the time. 

If the owner actually owns the company and is not one of the laborers within it, then there's some value to that. Click To Tweet

How many offices did you have at that point? 

At that time, we had merged. We had that his, his and ours and we eventually merged. We had four clinics going. 

I believe it was close to twenty when you partnered with Empower PT? 

We didn't necessarily grow our clinics from four to twenty-plus. We simply gathered a bunch of people together to put ourselves on the market. 

That's the interesting part. Here you are as your own entity, Rise Rehab. You're in the Phoenix Valley, I guess you call it, the area and you say, “I can sell my four clinics to a national company or I can partner with these other independent practice owners and roll it all up and market that out and sell it as a bigger package.” Is that correct? 

Not totally. You make it sound like I was the brains of the operation. I definitely was not. This is why I'm glad we have Sean on, because he was in Arizona when a lot of this was happening. Will and I, we had a number of offers for our clinic over the years. People had approached us maybe three or four times and each time it was some variation of, “We'll give you 70% of what we consider the value of your company in cash. You guys maintain 30% and you become essentially clinic directors or middle management. Keep doing what you're doing.” That didn't sound exciting. We didn't get into it to become employees again per se. We'd said no a number of times. Like I said, this happened over the course of maybe five or six years. 

This is a conversation that a lot of PT owners have and it can be very disheartening after you've spent all your blood and sweat and tears building this baby of yours and somebody comes in and says, “We're going to give you amount,” when you thought it was going to be 3X. That might've been your feeling as well. What then gave somebody the idea to look around the area and say, “If we do this a little differently, it can be more than what the parts are?” 

For sure. We got some of those offers. We were a little bit disheartened. There were some that were better than others, but we're still relatively young. We'll focus on growing more. We're developing a leadership team to take off the day to day and we'll make it their job to grow the next clinic and open it up and that kind of stuff. A few years ago, a friend of ours, Jared in the Valley, he's someone that we talked to about selling our companies in the past. He came to us and said, “I work for a company that has some physical therapy clinics.” He was essentially the business manager, but he's a PT and they wanted to divest their physical therapy stuff. 

He said, I have an offer on the table.” I know I can get more if we essentially increase our value by increasing EBITDA, profit margins and revenues and that stuff. We can attract a bigger buyer who will pay more in multiples and that stuff. He called my partner Will and he was like, “That's a cool idea. Let me think about it. I'll talk to Nathan.” From what I recall, Will sat on it for a little bit and then Jared called him back a month later and said, “What'd you think about it?” He reached out to me. I said, “I think it's a great idea if we can do what he says he's doing. We could get more for our four clinics than we could on our own as the four clinics. 

We started making calls and that's where we reached out to Sean. I reached out to a couple of other people in the valley. Jared did some of his own footwork and reached out to some people. We started collecting some guys who were, and correct me if I'm wrong, Sean, in the mindset of, “If we can take advantage of the current market, it was a hot PT market a couple of years ago, we can get a higher multiple than what we can get on our own. It’s a buyer that we think is cool. We would consider it.” We didn't have any ties to it at the time. We had this loosely-held NDA between us. We formulated things together and got all got on the same page. 

PTO 63 | PT Clinic Ownership
PT Clinic Ownership: Everyone has to think about their legacy when they sell their practices.


Let's use Jared as an example. Your business did not have to have shared resources or procedures or processes as Jared per se. Is that true? 

Per se. Sean, how would you describe that? 

Essentially, we ended up with five different entities with different policies and procedures, but most physical therapy practices were very similarly aligned. We had some that were stronger than others in terms of being organized and structured. It wasn't a unique situation. I've never heard of it happening anywhere else before, but it wasn’t a unique situation for sure. 

Sean, to use a vernacular here, was it like herding cats? 

In the beginning, it was a lot of work. It was like herding cats, but to the point of why we did it as well helps in this discussion, for me anyway. It’s to paint the picture that the market was hot, the timing was good and it was the right concept that if we do come together as a bigger entity, there is more value there, which then increases the sale price of things. 26 clinics are worth more than my four clinics, essentially. For me, something that everyone has to think about when they go to sell their practices or whatever they want is I'm about my legacy. What's going to happen to what I built? Because I was proud of what I built and what I had and what we stood for in the communities and I had a great name in the communities. I didn't want to sell it to some big national entity who then comes in and changes all the paint colors and essentially rips out everything I put together. 

What this became was the opportunity to capture the market and get a great value for what I thought my business was worth, but then to also layout the fact that we could continue our legacy of what we had built. It’s not only to continue but grow it on a larger scale with more help and other people to help us do it essentially. That's what it was for me and how it worked out. With that in mind, we got five other owners and of the five, two of them exited and left out. The three of the other original owner stayed. The three of us then took our cultures, our processes and them all into place and are continuing them. At first it was herding cats to get everybody on the same page, but because we had the same vision of what we wanted to do, it wasn't hard to get the buy-in, if that makes sense. 

I understand. Using totally false numbers, let's say I'm a practice owner and I'm considering this and somebody offered me $100,000 on my own. I then think about making this arrangement, and I won't call it a partnership, but this arrangement. How is it that then I get back $200,000 instead of the $100,000? Should I be thinking of it like that? 

I think you can think about it like that. I want you to add on after I talk, Sean. I talked to a few brokers as we were going through this process and they shared some generalizations. They'd worked with many PT, mergers and acquisitions and they said, “Your typical practice is going to be maybe around $1 million, maybe $2 million if they're doing well.” That could generate maybe two times multiple of your EBITDA, maybe get a little bit more if the market is hot. If you don't know what EBITDA is, it's an acronym. It's essentially your net profits with some of the add-backs. You can get maybe two times a multiple for a small clinic like that. If your net profit is $100,000, maybe you get $100,000 to $200,000, but if you were to increase that EBITDA to a point where now you're talking to some larger buyers, not just some local dudes, but some national guys who want to plan a national scale, then you can get higher. You can get four times the EBITDA or five times maybe. 

I think that's an important distinction to make for your listeners and that is that it's not just gross revenue, but it's EBITDA. The higher it can go, the more there is latitude and a higher multiple for your sale.  

Do you want to add anything to that, Sean? What do you think? 

It's spot on. Now that I'm on the other side where we're trying to acquire people, you hit it on the head. You're a one or two clinic platform. The two, maybe three multiple off of your EBITDA, the bigger your platform, the more that EBITDA goes up, that valuation goes up. If you're a six, seven clinic, you're probably more four or five. Depending on where you're at and how strong your EBITDA is, that can even go above five. The typical PT practice is probably a three to five EBITDA. It’s what you typically see. 

To add a lot of value is to essentially work your way out of your business prior to the sale if your goal is to sell it and not work at anymore. Click To Tweet

Sean, I want to come back to something that you said and dig a little bit deeper in them. That is what you said the timing was right. How would a clinic owner figure out if the timing is right? 

There are a few factors there. One is where are you in your career with your business? I was taught by our consultants a few years ago that you need to start preparing your business for sale now. I was like, “I'm not selling my business for several years,” but I started to do it anyway because back to my point of listening to them. The stronger you are to position your business for sale and there are things you should do to do that, which maybe should be another podcast, there are some key things there. As far as the market side, what I noticed being in the profession for over fifteen years is the first probably eight years of owning my practice. Nobody was knocking on my door. Nobody was sending me any emails wanting to buy my practice. 

All of a sudden, like Nathan said, I started noticing, “We'd like to buy your practice,” or soft reaches, “Will you be interested in selling it?” That's when you started noticing things come around. Then you started getting more and more people hitting you up. It's like selling your house. What's the market doing? Where is the pricing at? We all know when the market is high for selling or house. The PT clinic side was the same thing for me. That was all of a sudden out of the wood where people were coming left and right trying to make offers to come in and made me pause and go, “What's going on here? What is happening?” We can all remember back in these days, but in the 90s, the same type of thing that I saw happening in our profession was happening in our profession in the ‘90s. It has its cycles as the housing market does. It was one of those things like, “Here's the cycle and now's an opportunity. If I'm ready to do this and go on and do different things with it, this would be the perfect timing to do it because the market is so hot.” I hope that helps. 

It certainly does. I think that your audience will have maybe one office or two. They could be a little bit heartbroken right now to think about that the value of their business is two to three times their net profits and, but what you're showing with your journey, Nathan, is that in partnering up with other local independence, your one to two office platform might permutate into a ten, twelve to fourteen-office platform and be much more attractive to a bigger fish. Is that accurate?  

For sure. A lot of the value comes off of the numbers. That's how they're going to value the company. You can add value to your company by not increasing the numbers, but they want to see general growth trends. I had done some episodes on this. I did one with Paul Martin. I did another one with Steve Stalzer of 8150 Advisors. One of my first episodes was with John Dearing who works with mergers and acquisitions. There are a number of things you can do to prepare, but they're going to look at the numbers. They want to see good policy and procedures in place. 

They want to see growth trends over the last few years. Not stagnation, but continued growth and a strategy for continued growth because they want to know that once you sell, you're not going to walk away. There's going to be a focus on increasing what they're buying so they can increase the value of their investment. Another strong aspect is if the owner's not treating. If the owner owns the company and is not one of the slave laborers within it, then there's some value to that. If they take him out, they're going to have to replace him with someone else. That goes back to structure, policy, procedures, organization and all these things that make a company more valuable without necessarily hitting the bottom line. When you do those things, your bottom line improves. 

Back to your question a little bit, maybe they're a little bit disheartened, but I've told a number of people across the country, what we did could be done in other places. If you know any of the other people in your community, some of the other owners, and you're looking at an exit strategy, we called a lot of people. I called a number of friends that weren't ready. They're like, I don't know what I would do if I would sell.” They're like, I'm happy with what I'm doing,” or “What is an EBIDTA?” They're across the board. They weren't interested in selling at the time, and that's fine. If you are looking at an exit strategy or if you want to take advantage of the market, start working your network. 

Talk to some local people, see if you can get some people who are on the same page and then there are opportunities out there. You reach out to some people who might represent you on the market. Yeah, you can get a little bit more for what you're doing. I know you didn't ask this question Steven, but I would say if you're looking to sell any time in the next few years, now's the time to do it because it's going to go through that cycle again. I don't think it's going to be as hot as it is now. I think we're at the tail end of that cycle, honestly. It's not going to come around for a little while. 

PTO 63 | PT Clinic Ownership
PT Clinic Ownership: As owners, we are the goodwill value of the clinic.


Sean, from your perspective, what Nathan did was he got a consortium of local practice owners, probably within 25 to 50 miles of him. Is there any advantage for him to have said, “I'm going to get my pal in Tucson and my pal in Albuquerque and my pal in Colorado Springs. Even though we're not going to have a map or a footprint that's every three to five miles in that geography, I’m placing some pins down in a very large area?” Is that an increased value, a decreased value or a wash from your perspective? 

I think it's an increased value from my perspective. When we did our deal, we ended up with clinics in California and one in Louisiana, which is the off beaten path one and kind of weird. The market share, getting it in multiple states is good. I will say some states are more attractive than other states are depending upon reimbursement rates. Is your market dominated by a hospital-based system? We're in the process of acquiring clinics that are states that we are not even looking at it based upon reimbursement rates and the hospital-based systems that we don't even go into. I do want to go back real quick as well and adjust something that Nathan said about selling your business. 

I think the key thing to learn is that as owners, we are the goodwill value of the clinic. If you look at selling your business down the road, if you're in the business, working it a lot like say 40, 50, 60 hours a week like we all did some times. You go to sell your business and you're telling the people you're selling it to, “I'm going to sell it to you and I'm walking away,” your business is now less valuable because you are a huge integral part of why the business is successful. Another way to add a lot of value is to essentially work your way out of your business prior to the sale if your goal is to sell it and not work at anymore. That's a key point. The way I got my business is it was running where I didn't have to work in the business unless they want it to where it didn't need me. If I wanted to exit, I could've left and left all the key people who were the key to making the business run. There's more value to that if you want to exit out, if that makes sense. 

It certainly makes sense to me and one way you can test your ability to do that is to take a month off. If the prospect of taking a month off makes you want to vomit, then it's likely that you have not put the systems and processes in place to allow you to do that. That's a good stress test. 

Yes, there's more value in a business where you can take a month off because you're no longer the goodwill value of that business. 

It makes total sense. Nathan, looking back on this process, what would you have done differently? 

I don't know. Sean might agree there was an element of timing there. We found a partner and this was something that Sean and Will were definitely a part of as far as they interviewed the interested parties that came through Phoenix. We found a partner that I would say is relatively ideal in allowing Sean and, Matt and Will to carry forth our company values, visions, policy and procedures that we all had some loosely held agreements too and not disrupt that. Empower physical therapy became something that's greater than ourselves and a greater expansive are divisions that we already have. I think I'm speaking for you Sean, but things came together in an opportune way for us to do this because we had a great footprint across Phoenix. We met up with a great partner. We have some great leaders in place. When you talk about Will and Sean and Matt and the CEO that we brought on, there's not a lot I can look at and say, “I would've done things differently. Things worked out well for us. 

You don't think that all the stars were aligned perfectly and it can never happen again. This situation can be repeatable across the country with other practice owners. 

I would think so. The benefit that we had was that Jared had been through this process before. The guy, Jared Bowman, who started this ball rolling, he knew the landscape well. He also knew the people to talk to. We did have that in our favor that other people might not have. Anyone that puts forth a little bit of effort and takes the banner and runs with it could do the same. 

I would agree. It does take a little work. Jared was a huge help because he understands the business acquisition side and understands the power of the equity world better than we did. That was where our strong play was. You would need someone like that, but that's what you definitely could do. What was different about us is that in the beginning, Nate mentioned it and I said it too, people were approaching us to buy our business. What we did that was different was we came together and then we started approaching the private equity firms and shopping them.  

What we realized is that there were people were approaching us whom I'll never sell my business to them. We're like, “Let's find somebody who understands our vision and what we want to do and is excited about it.” We went through that process, which was close to over 30 PT firms that we reached out to interview about ten of them in person. We ended up finding the group that we went with that loved our story and loved what we wanted to do as a profession and was totally on board, so it definitely can be done. 

When you do things that add value, your bottom line improves. Click To Tweet

You’ve brought up a good point there, that maybe we didn't iterate it, but we had an ideal partner in mind. If we're going to exit and we're going to sell our legacy to someone else, this is what they're going to look like and this is how they're going to be. It's not necessarily the best idea to take the highest bidder. It's valuable before you sell to number one, maybe have an idea of the number that you want, but also number two, who do you want to partner with? You want to vet that because that's going to affect your life significantly going forward. You want to make sure you've got the right person with shared alignments in values, vision, growth strategies and whatnot. You want to make sure that you're partnering up with the right person or group. 

There's a lot of due diligence that needs to be done. There’s no doubt about it. Sean, where can our audience contact you? Hopefully from this show, people have a lot more questions now than they did before work. Where do they contact you if they had additional questions for you? 

They could always reach out to me in my email. It’s I love helping people and love showing people what to do and what I've learned from it. I'm a big believer that we're always growing and learning. I've always said, I'm the biggest rip off artist there is. I steal from other people what they've done and implemented it. If that works, I'm going to do that. It’s not to say, “Come steal from me,” but come steal from me. I'd love to share with things that people are interested in trying to do this or what we did and I’ll be more than happy to take time and talk to and discuss it with them about it. 

Going back to what you were asking me about me, Steve, if other owners can do that nowadays what we did, go ahead and try it. Reach out to Sean and say, “I'm thinking about doing this. What are some tips that you have?” Reach out to the guys at Empower PT that did it. We can guide you. If you're looking to sell, Empower PT’s a great place to go. I'll put in a plug right now. 

I've got to say the same thing. If you are looking to sell, we are still looking. We are trying to expand and grow and we have a huge vision belief behind therapists. Our core value is patients first. We’re a PT-centered company focused on the profession, trying to enhance the profession. We're looking for people with that same mindset that want to help us continue that vision out to the public. Come talk to us. We're always open to that as well. 

Sean, I want to thank you for your time and your expertise. Nathan, I want to thank you for being on your own show. That's very nice of you to show up. I'm sure it'll be an interesting listen for yourself and your family and all your friends. I encourage everybody to tune in for every episode because there is a lot to learn. Nathan is spouting out truth bombs left and right and we're all the better for it and everybody in the profession thanks you for it. Thanks again for your time. 

Thank you, Steve.  

Thanks for having me. 

I think it was great to do this little forum. A lot of people could learn from what we did and if they wanted to reach out to us personally and bounce some ideas off of us or ask for some insight or maybe you can help me with this, feel free to do that, whether it's Sean or me, it’s By all means, reach out. Steve, thanks for offering to do this and I'm excited that we got the opportunity to sit down and do it. 

All good things happen when you shoot from the hip and have no script and let it rip. You guys are very good sports and, we came up with something good, don't you? 

Definitely, thank you so much, Steve. 

Enjoy the rest of your day and thanks.  

Thanks for your time.

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About Stephen Rapposelli

PTO 63 | PT Clinic OwnershipStephen Rapposelli, PT, OCS opened his private practice in 1992 at the tender age of 26, because he was told by his previous employer that he couldn't buy into the existing business. He has since grown into 3 clinics and has been voted best PT business in his state for numerous years. H

e also serves as Vice President of the Delaware PT Association, as well as sitting on the IMPACT editorial board. Stephen plans on devoting the rest of his career to promoting independent practices across the country.


About Sean Miller

PTO 63 | PT Clinic OwnershipGrowing up Sean always felt the desire to make an impact in others life. It was in high school when a friend got hurt playing sports that Sean was introduced to the power of physical therapy and the impact it has on people’s lives. From that experience, Sean has set a course in his life to be a Physical Therapist and change lives. Receiving his Bachelors of Science from Brigham Young University in 1999, Sean then pursued his dream of getting his education in Physical Therapy. In 2001 Sean graduated from Texas Woman’s University in Dallas, Texas. Moving to Arizona in 2002 working for others Sean became very proficient as a Physical Therapist.

He now specializes in treating vertigo, balance, and orthopedic cases involving the shoulders, cervical (neck), and knees. After years of treating patients, full-time Sean realized that he was just 1 Physical Therapist and only had the ability to treat so many patients at one time; It was this realization that sparked the dream of owning his own practice. “What if we had multiple therapists all with the same skill and passion? The impact would be even bigger than just 1 therapist”. From this Sean along with his brothers opened Kinect Physical Therapy in 2012. “Opening Kinect Physical Therapy has been one of my greatest challenges, but to see the larger impact we have on the communities and in our patients is why I do this.”

Sean when not making an impact on others life’s enjoys spending his time with his wife and their 4 children. He is often found on the sporting fields coaching his boys teams, at the lake wake surfing or headed to the beach to enjoy the waves and surfing. His favorite quote that he lives by is: “We are what we repeatedly do, excellence therefore is not an act but a habit.” – Aristotle.

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