Dr. Avi Zinn, PT, DPT, OCS, the owner of Druid Hills Physical Therapy in Atlanta, Georgia has been gradually growing his practice with the goal of giving high-quality care to his patients. Since our last episode, he has procured a PT business coach to reach the goals he has for his business. Today, Nathan Shields checks in with Avi to see how it's going so far, what he's learned, and his experiences since they last spoke. Discover what Avi has learned and the traumatic experience that challenged him as a young owner.
This is episode two of my reality podcast episodes with Avi Zinn, tracking Avi's relationship that he's developed with a coach and consultant over the past few months. If you haven't read the episode, go ahead and do so. That'll give you an idea of where we're coming from because that was prior to Avi starting his coaching. In this episode, we want to focus on simply what his initial experience has been and some of the things that he's had to deal with since we spoke. He had some trauma that happened in his clinic and I hope we pay proper respect to the nature of the issue and how Avi got through it appropriately. It was a difficult situation for him and his clinic to go through. Hopefully, we handle that situation appropriately and understand that Avi had to navigate a ton of emotions while also trying to be the leader and a stalwart of his clinic on behalf of his team, patients, community and families involved. This is an interesting episode, but we got a lot out of it.
The Owner of Druid Hills PT, Avi Zinn. If you read the first episode with Avi, you'll understand that what we're doing here is simply tracking Avi's journey as he brings on a coach, a business consultant, if you will, to help him in his business. We shared a lot of his professional story and what he'd done before that point. Correct me if I'm wrong, Avi, you had hired the consultant as of our last episode but hadn't started doing anything with him formally.
Right, Nathan. I can't remember what month, it was a right around the same time. I may have hired them on, signed up with them, but hadn't gotten anything going.
I wanted to follow along with Avi maybe every quarter or so and see what his progress is like. What he's learning from his coach? What's helping, maybe what's not in some of his experiences as he's taking it on. I started asking you questions already, but thanks for coming on again.
I'm glad to be back.
If you want to follow Avi's story and learn a little bit more about him, read the first episode. Since we talked, tell us a little bit about some of the things that you've done with your coach, some of the things you've learned and some of your experiences.
First of all right from the get-go, things started well. Getting all of my numbers in order, taking all the analytics with WebPT. We had all these analytics but I didn't know what to do with them. We took all of our analytics, all of our metrics and put them all on a dashboard so we can objectively look at the numbers and track them and follow them. Right from the start, we were able to see an increase in efficiency, looking at better utilization. The numbers were able to be tracked. From the start of the coaching, it has been able to get me through a lot of not knowing, being able to like, "I see what that is, now I know what to do."
In relationship to the numbers, there's something to it, but there's a thing out there which is measured, improves, measured, and reported improves exponentially or something like that. What you find is as you start looking at the numbers, even if you don't put a lot of effort into improving the numbers, they start improving somehow. The universe starts pushing you in the right direction if you will. It's simply tracking the objective numbers and your KPIs in your clinic. That exercise alone seems to start improving things.
It feels that is happening by having those numbers on the dashboard and looking at them every month and comparing them, we see positive changes.
The cool thing about it is you're looking at it objectively and I'm not speaking for you, but for myself and maybe some other owners, you might feel things are getting better or you might feel things are getting worse. When you look at the numbers, you have the data right in front of you and you know if it is getting better or how worse it is getting or how much improvement you've made. It's good to have that certainty, if you will.
To get back to the question about how things are going. Having my coach that I speak to every two weeks and we talk about the numbers and see what needs to be changed, how could we change, what can we work on. Going back to the first one we did. Talking about The E-Myth originally and a lot of people read The E-Myth but they don't implement it. Having these numbers, the coach and the accountability is allowing me to stay focused and not get distracted by any of the millions of other little things that anything could happen, accomplish or try to affect and change what we're working on.
Considering you talked about accountability, do you feel a little bit of pressure? As you know that your meeting is coming up with your coach that you go, "I need to get this stuff done," whereas maybe you wouldn't have that before?
That's why it's good to have that person. I'm assuming your coach is a physical therapy owner as well or was or something like that. They can relate to, they can talk about the same language and use the same vocabulary. You started using the metrics, started following your KPIs. You're meeting with your coach. Are you doing anything else on top of that?Always look at the numbers and make sure things are going as you want them to, and then go from there. Click To Tweet
The coaching program, there are also a whole bunch of modules that they have set up for let's say patient engagement or internal marketing or all these different modules. Another good thing that the coaching helps with is you're focusing on those numbers, “Let's talk about what we think can help change that.” If it's making sure that we're focusing on not having the patient drop off or making sure we're more efficient and completing plans of care. There are modules for, "This is what works and this is what you can do." There are all those things that I'm working on. At the end of each call, there's the plan of action and then by the next call, I'm like, "I finished this and I implemented that." That goes back to knowing that is coming up. I’ve got to make sure I get all those things done before the call so that I can say, "I've completed that module and let's work on the next thing."
You've got some homework to do in between. As I'm talking to people who are calling me about doing coaching, this is good to have this real conversation. Because when I tell them we're going to meet bi-weekly and discuss what's going on in their clinics, they think that it's just a call and that's it. What happens is you walk away with a ton of homework to do, sometimes even a little overwhelming if I'm not mistaken.
There's still a lot to be done. It can be overwhelming.
There are many things to do where the coach can help you do it and maybe you've experienced this, help you prioritize what needs to get done more urgently or simply prioritize. “Let's make sure we hit this thing first and if you can get to it, that’s great, but let’s focus our energies.”
My coach, being that he is a PT owner, it comes in handy because he can say, "This is what works for our clinic or proven in the program. These are the things that I can see based on the numbers, based on what you're saying, and based on what we're talking about, that this is what you should work on. If it's time management, then do that mount module and work on chunking your time so that you're efficiently using your time and not being all over the place and getting things done more efficiently. If it's patient engagement, then you start working on these things because that's what we ultimately need to get on to help with that.”
In your program, do you follow a step-by-step process? It’s like, “We're going to focus on number one first and we're not going to stop talking about number two until we get to number one figured out.” Are you able to work with them about things that are of a more urgent nature? Say if there's some disciplinary action that needs to take place, talk about disciplinary procedures and how to handle an employee. If you need to recruit somebody because numbers are going high. Are you able to discuss some of those other things as well in place of the program itself?
There's flexibility within what needs to be worked on and what the priority is. There are the modules which are prerecorded videos, you can watch those at any point in time. We have our coach, we have our call, there's module one through however many, but it doesn't mean that you have to start with number one. “Let's look at what does Druid Hills PT needs?” We're looking at the numbers and visits are fine but maybe there's a poor utilization or I say, "This week, I noticed that we are having problems with cancellations still. Let's focus on that. This week, I noticed that my front desk isn't able to collect as much from the patients. How do we change that?" There's room for flexibility and working on what needs to be worked on, not just following step-by-step through the program.
What's a typical agenda for your meetings with your coach?
We get on the call and talk about some positive things that I've been able to change or implement since we talked. It could be anything, focus on starting on a positive note. It could go 1 or 2 ways but so far, I've had enough to bring up that I wanted to work on. Whereas there were 1 or 2 times where I'm like, "I need your help, what do you think should we work on?" A lot of times, I'm like, "This is what I've been focusing on. I've completed that. That's working pretty well." One of the things originally was working myself out of treatment. I got that under control for a little bit. I was like, "I've done that. How can I use my time better?" My coach says, "You can watch module whatever for time management and then talk about different strategies on what to do with the time and how to utilize it better." There's not necessarily one exact structure of the call other than trying to look at what we think needs to be done. We always look at the numbers and make sure things are going as we want them to and then go from there.
That sounds similar to what I do. It usually starts with what were the wins? What are the successes since we talked? What's top of mind that usually there's something that's happened that you want to talk to out and address? If there's not a whole lot there, then typically the coach will have something that he wants you to maybe consider or focus on as well. Maybe it's the next step or it's something that you might not have looked at, “Have you considered this?” There's some fluidity there based on my experience with coaching. Usually, you want to talk about things that are top of mind, but the coach then also can bring in things that you might not have considered at this stage of your ownership. Does that sound similar?
I only know much and that's why I'm doing the coaching. Hopefully, a good coach can do exactly what you said.
I'm assuming you're progressing fairly well towards the goals that you have set forth already for the year and whatnot?
Yes and no. A few things came up and it's been interesting. One tragic thing happened. One of our PTs was killed in a car accident and it's been crazy. That's what could have been a crazy, downward spiral for the business. It didn't turn out that way. It's ultimately because of the coaching and having that accountability. At first, it was certainly a shock and it was something that I never had to deal with. As a business owner, I had to make sure that the staff was okay. I had to make sure that all the PTs, the patients were okay. Some people didn't want to come back and that's completely understandable. Those are all things and dealing with the PT's family and it was overwhelming.
What a difficult experience and I didn't even think about this because you'd shared that with me but to consider what is expected out of you as the leader in this regard. You're not only responsible for your emotions and handling yourself, but you've got to consider the other team members, the patients that you see, this physical therapist's family and that's involved. Maybe any responsibility you have might have towards them that had to be overwhelming. How did you handle that?
I handled it all right. It was shocking. The first week, I was sitting in my office staring at my computer not knowing what to do. I will say going back to the coaching, you had to separate the emotion from it and then still recognize that this is still a business. Not to be insensitive, but the business needs to continue to move on. That alone that was tough to be able to put aside emotions and focus on the business. It felt insensitive, but it had to be done.
You want to honor them and you want to honor your emotions and your feelings. If you're looking at it from a logical standpoint, the business going down doesn't do anybody a service. You’ve got to keep it up and running because you've got multiple families and your community relying on you to perform still. That's got to be a hard position to be and to find the energy to move forward in that path. Sometimes some of these objective measures helped you out along the way.
The objective measures, having the coaching, having accountability, being able to look at the numbers and at the end of the day everything that happened, I had to jump in and treat more and pick up those patients. At the end of the day, having the numbers and looking at them objectively and being able to look at them rationally and not emotionally and irrationally, allowed me to look and see. The business is not doing anything that different, maybe not growing as much as I was expecting and wanting to, but it wasn't falling apart and becoming this downward spiral. Everything was being able to stay stable. We were looking at the numbers and then having that accountability of talking through it with someone and getting a little bit more direction on what could be focused on more than other things that would be helpful had to have been what allowed me to get through that time.
I can't imagine the support that a third party like your coach provided at that time from the business perspective. The support that they could provide you because you'd laid a foundation, a framework of measurements of policies and procedures that we're able to keep you guys going so you can lean on it. It was a foundation. You could lean on this structure that you'd already built, even though it's not quite finished if you will, but you're able to lean on that and maybe give you space to work on your emotions as you were dealing through this issue.
That's interesting that is what happened in that. Maybe we weren't getting this crazy growth I was anticipating or not even crazy growth, just moving forward. At the same time, because there was that foundation, the integrity of the business was there. Things were able to continue without having to get caught up in losing revenue and whatever. That allowed me to deal with what was going on maybe emotionally. Maybe there would be a time in the day where normally I would be super productive, but that hour I sat in my office and staring at the wall or something. That integrity and that foundation created the space to allow me to do that.
What was the therapist's name?
His name is Tyler Wallace.
It’s a tough situation. I honestly haven't come across a lot of that in my interviews. I had to deal with the death of a longtime PTA that was part of our company. She was amazing. She was with me for fifteen years or maybe more. She was a big part of the company, a real light in our clinics every day. She almost became like a sister to me. It's something that I'm finding and it doesn't go away easily even a fellow employee is still working through their emotions in regards to that passing. It's a tough one. It can be hard because the team members become part of your family. Sometimes you see them more often than you see your family. It can be a difficult experience. I have to commend you for the work that you did ahead of time. You’re creating the foundation of policy and procedures, objective measures, and having the coach. It's hard to say what it would've been like if you didn't have those things in place? Hopefully, we can look back and say, "Some of those things we're able to carry you through."
I believe that is completely what did it. This has been something I've been struggling with, not to be insensitive and not to honor the process. There were a lot of interesting things that happened with the business. By the nature of losing a PT, we had fewer PTs, but because we were implementing all of these different practices and trying to become more efficient and focusing on whatever we're focusing on. The numbers were improving at the same time. We were paying fewer payrolls because we had one less PT to pay and we still see the same amount of visits. The PT schedules were more full and we were becoming more efficient. We were having less drop-off because we are focusing on getting the patients to complete their plan of care. You've got two sides of the thing. This horrible thing happened, but in the end, a lot of ways the business benefited from it. It's hard to say that because of the actual situation but that ultimately goes back to the coaching and the ability to be able to objectively look at the numbers and see that these things work. By looking at the numbers, we can not only get through hard times but grow from them at the same time.
From a larger perspective, I don't want to minimize Tyler's passing, but you had gotten to a point where you weren't treating at all for the few weeks before his passing.
That's true. I was down to no treating.
Focused on business, time with your family, time for hobbies. I see it quite often, not necessarily that someone's going to pass, but obstacles come in the way. Whether that has to let go of somebody or personal issues show up as you're making these steps in progression, life is going to get in the way. It's because you have some of these structures in place that make getting through those difficulties easier. If someone does pass away, we've got these structures in place and we're watching the statistics. Someone who we thought was an integral part of our program and a rock that we couldn't let go of. Maybe they leave for greener pastures or for disciplinary procedures or whatever it might be. You come out the other end, things can improve. Whereas in the state beforehand, if you hadn't measured those things and structures weren't in place, then it would have been complete chaos with a lack of control or power or whatnot. You give yourself to whatever happens. You're simply riding the waves, but you're able to have some power if you're able to structure your business and your management appropriately.
Having those numbers, having that accountability from the coach and having the structure, I was talking about in the last episode that we did, my PT, my first employee, she had reduced her hours. She was doing some home health. I started looking and I hired a new PT full-time and then she decided to do full-time home health. I had this new PT and she had this planned two-week vacation before hiring that we all knew about and it happened at the same time. This went from me backing myself out of treating, having three almost full-time PTs to then having one full-time PT for two weeks. One full-time PT and then me going back into full-time treating all of a sudden. After going through all of that and then looking at the numbers, seeing that at the end of the day, we were 20% more efficient with our utilization.
Our bottom line was in line with what we were even with one less PT. It came back full circle in that when you had asked me about, "How did I decide to hire someone on early?" It seemed out of the norm, usually you don't hire on that early because you want to make sure everything is more efficient, 90% full. It came back for full circle in that. At first, after all this happened, I'm like, "I need to start looking for a new PT because I need to fill that spot." That's not the biggest priority because I realize that we can become as effective as long as we're efficient. That's what the coaching and consulting are helping with is becoming more efficient. Ultimately we're doing the same with the business with fewer PTs, which is what exactly what we're trying to do.It is ideal to build a culture and create a string foundation along with striving for business efficiency. Click To Tweet
What are some of the things that you're looking forward to now going forward? You've been through a tough experience that was his passing. What are you looking forward to as you're moving forward? Where are the things that you're working on as you progress through 2020?
The first mastermind, the group with all the consulting, we all get together quarterly. Right after that, I came back and we had this whole meeting and talk to everyone about the company’s vision and trying to talk to the staff also to see, maybe they have some input on the vision. What do they want to see out of business? What are they looking for? How can we all get on the same page as the vision of this company? I've been thinking about that a lot. What is our vision? What is my vision? How can we include everyone that works here in that? What I am focusing on is I've got two great PTs that are working and I'm focusing on them and trying to get a great team, focus on the staff that I have. Try to get everyone to work together with the same goals in mind.
The vision as simply put is trying to help as many people as possible. We want to be there for the community. I'm telling all my staff that I'm doing the coaching and explaining to them that I'm focusing, anytime I come to the office and say, "We’ve got to do this and this is how we’ve got to change things." It's not because I'm trying to micromanage things. It's because this is what we're doing to try to get to that goal, that vision. This is what we're going to do to get there. I'm focusing in on the staff that I have to build the culture and create a strong foundation of not just the business efficiency, but also the team and the culture of our business.
You say that you're focusing on them, focusing on your physical therapists. What are some of the things that you're doing to focus on them?
I had a meeting with the PTs. First of all, I acknowledged that I appreciate their hard work. That simple thing is probably something that doesn't happen often. Focusing on them, meaning they are my employees, but I also appreciate them and I want them to feel like they're a part of this as well. That is something that will help the business. It's not I'm doing it so that they can feel more appreciated. It's more like if we're all here doing this together, we're going to be able to make this thing work a lot better and help more people. Making it known that they're appreciated, not just tell them that you appreciate them, but asking them what they think we can do better. What is it that we're doing that they see from a different set of eyes that would be different, that would help out? I'm one person and there are a different set of eyes on the business and they see it differently. Their opinions are as valuable. Listening to them and trying to gain that and implement those ideas is going to be super helpful.
What a great way to develop your culture and also get your providers engaged and bought into the company by simply asking their opinions like, "What do you guys think? What should we do?" Recognizing that you don't have all the answers, that maybe they could do some things or have some answers that are better than yours. That's a great exercise that you started and you can continue to do with them to start developing this culture that you have in a new company like that. That's a great step. When I'm thinking about the vision, usually I see it as coming from the top down. It's an essential vision for the company but it sounds like you took them through an exercise where you wanted to see what their vision for the company was as well. Am I right? This is something that your coach has taken you through while you got it from the mastermind but your coaches had been following up with you and seeing how things are progressing
Correct, and giving ideas on how to even bring up the topic or the exercise like my coach was, "What's your vision?" I was like, "To be a good business." He's like, "You need maybe to have a little bit better vision than that." I went home and that was some homework. That was one of our coaching calls. It was like, "Next coaching call, I want you to have your vision." I spent the next two weeks, I watched some TED Talks about people, company visions. I read some stuff and created what I thought would be our vision, not just for the company's growth but also what we're trying to do for the community as well.
The effect in the community, the larger purpose, that stuff and how you want to be seen. You have some other mastermind groups that you're going to go to. You'll have your bi-weekly meetings. Are you going to any conferences then as well?
We have another mastermind coming up. We'll see what new nuggets we get from that.
Based on your initial experience, you've only been with your coach for a few months. What would you tell somebody who's considered it or maybe even not considered? What would you tell our audience about your initial experience with having a coach?
I would say that if you haven't gotten a coach yet, you should go ahead and do it. Even if you're thinking of starting a business, I would say it’s probably better to do it even before starting so that you cannot have to fix what is broken, but start on a much better solid foundation having that. Having that accountability and those calls are helpful to have so you can be focused and committed to what you're trying to accomplish because it's easy to get distracted. There are many millions of things that you could spend your time on but are not important. If you need to get things done, you having that coach and that accountability not just to guide you but also to keep you accountable is instrumental in being able to grow the business.
What would you say your ROI so far on investing in a coach? Maybe you do not see it in sheer numbers, maybe you are, but what would you say are some of the ROIs on what you've invested in so far?
I would say numbers are not the easiest thing to see yet, because of all the things that had happened and we're down a PT. We're at the same as far as the bottom line where we were. Everything else is more solid, more a better foundation. As far as the return, knowing that I have someone to fall back on after going through something like this and able to get through it in such a positive and productive way was more worth more than anything. There's no way that I could've gotten through that without having someone else to keep me focused, keep me rational, keep me objective instead of getting super emotional about it.
I'm glad you had that support. Condolences to you, the families and your team. It’s a horrible, horrific experience to go through. I wish you guys the best and I'm glad to hear that you've got some support and it sounds like you guys are starting to get your footing back and moving forward. I'm sure there are things to work through still, but you have some vision. You're starting to develop a culture and you're starting to get back on track.
We're getting there.
We'll stay in touch. I'll follow-up with you again. We'll see where you are at the time but expect huge changes.
Thanks for your time, Avi.
Thank you, Nathan.
Dr. Avi Zinn, PT, DPT, OCS is the owner of Druid Hills Physical Therapy in Atlanta, Georgia. He opened his practice at the end of 2017 and has slowly built it up—transitioning from a staff of one (himself) to a team of administrative staff and treating therapists. He continues to grow the practice gradually. Avi’s main mission for Druid Hills PT is to provide high-quality, personalized care to each and every one of his patients.
Avi has his doctorate in physical therapy from Touro College, and is a Certified Orthopedic Clinical Specialist. He lives with his wife and three children in Atlanta.
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