March 17, 2020

The Path To Tripling Production in 1 Year With Ben Larsen, PT, DPT

PTO 88 | Tripling Clinic Production

 

In 2019, Ben Larsen, PT, DPT, co-owner of the Teton Therapy Cheyenne Location, had great goals of increasing his number of total visits per week by year-end to well over 200. Little did he know that by making appropriate, time-honored decisions he would hit well over 300 visits per month come 2020! His path to success wasn't based on a new treatment technique or referral source. Rather, as Nathan Shields and Ben discuss in the interview, Ben hired people that were in alignment and he implemented what he knew he should be implementing (things he learned from his consultants and coaches in the past), and started tracking stats and training his team (future leaders). Suddenly, patients started coming in greater numbers than he had ever seen before and he wasn’t treating most the time! A great story of small and simple actions generating great results.

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Listen to the podcast here:

The Path To Tripling Production in 1 Year With Ben Larsen, PT, DPT

I'm bringing on one of my friends and coaching clients. I hope it doesn't come across self-serving but I had to bring this guy on because he has made incredible gains. I wanted to talk to him about what he's done and what were some of the specific actions that he took that got him to see such significant gains. From what I recall from the discussion is that nothing new came up. We talk about hiring the right people, having the right mindset, figuring out your purpose, stepping out of patient care, taking control of your environment, all things that can be seen in Ben's growth. My guest is Ben Larsen. He's out of Cheyenne, Wyoming, and making great strides and looking to grow and expand. Hopefully, I'm along the ride with him as a coach but he's implemented many great things and made all the right choices so they can see significant growth and hopefully continue to see it going forward. Hopefully, Ben's story is an inspiration to you as well and it gives you some ideas about the next steps that you need to take to see your goals and dreams come to fruition.

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I'm excited to bring on a friend of mine that I’ve known for some time and has become a coaching client, but he's had such tremendous growth. I wanted to share his story and talk about some of the things, especially the successful actions that he's done to double his growth in his clinic. First of all, the guest is Ben Larsen, Co-owner of Teton Therapy in Cheyenne, Wyoming. Ben, thanks for joining me. I appreciate it.

Thanks for having me. I’m excited to share our story and how we've grown this.

I know your story and I’ve had the opportunity to watch you from a distance. If people have checked the previous episodes where I interviewed the Co-owner of your company, Teton Therapy, Jeff McMenamy. He's got a great story starting from working in a racket ball court and starting his physical therapy clinic way back in the day, but he's grown, expanded and brought you on as co-owner in Teton Therapy in Cheyenne but you've done a lot. I want to highlight you and your story and your successful actions. Let's go back a little bit. Do you mind sharing with us a little bit about your professional path?

I went to PT school just like everybody else. I went to a school in North Dakota, the University of Mary. Jeff McMenamy who's my business partner, is an occupational therapist. He's from North Dakota. He was there at a career fair. We talked and it's a funny story. He tells it better than I do. I show up in a full suit and tie and he says, "What do you want to accomplish as being a physical therapist?" I was naive when I looked at him and said, "I want to own my own practice." This is the first time we've talked. At that point, he mentioned how impressed he was with my drive and my determination to expand as a professional. I signed up with him to go ahead and work for him.

I move my way up within two years as a clinical director and then as vice president of operations. In the meantime, I did a lot of training on business techniques and different management techniques through measurable solutions. I got trained in how to run the company from a vice president of operations standpoint. I'd been doing that for several years and he approached me. We had an option to move the clinic down to Cheyenne. He asked me what I thought about doing that and moving my family to a new area. I took my wife and kids down here and decided that this would be a good move for us. We moved down here and opened up the clinic with not knowing anyone in Cheyenne at all.

I put up a sign out by the door that says, “Please call for information and consultations,” a couple of months before we opened. We did a little basic type of stuff to tell people we are coming in town. We opened the door with zero patients on the books. When it hit the pavement hard, it all started with a Parkinson's support group. I met my first patient there. She brought her in. We did a couple of treatments with her. She told her doctor. The doctor was having some issues. She came in for me to treat her because we're getting such good results with her patient. She told her friend, who was another doctor who was having some elbow pain. She came in and I treated her. It expanded from there of initially first treating physicians and then getting the word of mouth out and then expanding the practice.

You've got a nice connection there.

Over the past several years, every year, we've had substantial growth, but 2019 has been a big growth for us. Like most practice owners, when you first start out, you make a lot of stupid decisions and you're trying to fill spots. Your hiring is okay as you're first learning it and then it gets better and better. We've had a complete staff turnover at least once. Within a couple of years, we've brought on some real key players that as we started transitioning people. We've seen significant improvement within the quality of care we're giving first off and then second off in our business growth because of that quality of care. That's been our biggest thing.

If your goal is to be completely autonomous, you got to be able to handle everything. You can't just handle the basic things. Click To Tweet

Finding the right people, hiring the right people, and then helping them to expand in their position in and what they want to accomplish as well. As I sat down with you, we looked and it was more than doubled. We almost tripled based upon having the right staff members in place, expanding the right way, following the right systems, and implementing things that have helped. The basis of my story is starting from about nothing, to where we're getting ready to hopefully get into a new space. It’s finalizing some things on that, to where we'll be able to double our space and hopefully continue to expand our practice and provide good quality care for the city of Cheyenne.

I don't want to go gloss over it too quickly. I do want to get to what some of the specific steps that you've taken that tripled your number of total visits per week. Can you share with us a couple of your bad decisions that when you look back on, you’re like, “That was bad, I should not have done that,” or “I would have done things differently?”

When I started out, I had done all this management training. When I first did the management training, it was more like, "I'm doing this for the company." Most people are going to have executives out there who they bring them on, they do the training, and those people are doing the training because they want to expand the business for that particular owner. When you become your own owner, you get this mindset of, "I’ve done that training. How do I want to do this?" You start thinking about how you'd want to do things and trying things that haven't necessarily been tried or tested.

Are you doing things differently than what you're trained to do?

Yes, because you're trying to make your own way. For me particularly, I’ve had this owner that has developed me into who he thought to be that good physical therapy owner. I had some ideas, some preconceived notions that there were some things I wanted to do differently than what we were doing at the other clinic. I stopped implementing some things that are successful in other clinics that bit me hard. I needed to get back to the basics. That was the one thing that if I could go back, I would stick with the basics of the training and implementing the statistics. The things that we use in our business to make sure we're producing and doing what we need to do. That would be the one thing that I go back on that I would stick with the training that I had and move forward with that. The second thing is sometimes we hire out of desperation instead of hiring out of what we need. Everyone's had it where they want a position filled with someone that can fog up a mirror. They walk in and they've got the proper license and you hire them, but they're not necessarily the right person for your company. There's a couple of times where I wish I would have taken the time and done better with the hiring process like we do now and found that key quality person that fits with our group, team, dream, and purpose, all those things. Those two things are the biggest things. One is sticking with the basic technology of managing the clinic. The second one is to hire based upon what we need not just to fill a position.

You looked back on some of those decisions in terms of hiring out of need and I wonder how much time did I lose by finding a person instead of waiting for the right person. We've had instances where it would have been better for us if we had simply let go of the entire team in a poisonous clinic and started from scratch all over again. It would have saved us a year of headaches if we started from scratch. Sometimes it's that distinct in my head that sometimes you have to wait for the right people. I also want to congratulate you. You said you're going to expand. You're looking at a new 6,000 square foot facility that you're going into. I misspoke. You're not only doubled, but you tripled in productivity. Of course, things didn't happen all of a sudden and I know it wasn't like one new provider started sending to you. You didn't necessarily niche out and do anything in particular. As you look back along the timeline, what started this process of growth if you look back a year and a half ago to lead you to the point where you had such dramatic changes?

Looking back, there is a key event that happened that sucked. It was the worst experience of my life. I had an employee that totally went ballistic on me. He was upset about things. It wasn't a good situation. He reported me to the board saying we were doing an insurance fraud, claims that made me decide what type of a team do I want to have and how do I want to foster this team to do what's best for patient care. It changed the way that I hired after that point because, initially, our HR person would contact them. This is particularly with physical therapists. I would say, "Once we get down to the top five, give me their names and I’ll set up some time to interview them."

This time I said, "Who's your top ten? I want to make personal phone calls to each one of them before I even bring them in and talk to them." I laid out everything on the line. I was very open within these interviews and talk to these individuals to try to find the right people for our team. We looked at is this person the right person for what we need? I got down to one particular candidate where there were two that I liked. I sat down and thought this process out. I didn't make a quick decision. I thought about it and what we needed. There was one thing in particular with the one that made me think, "This one is the one we need. She's going to take our clinic to where it needs to go based upon our conversations and what I saw."

With this particular one, I had some hard times with it because the HR person, our VPA, she was leaning towards another candidate. She's great and I totally trust her completely, but I didn't feel right about that other candidate. We were about ready to pull the cord on the other candidate when I said, "No, I feel there's something with this other candidate." I talked to my business partner. I told him what I thought and he called both of them. He felt the same way with this other candidate that we hired. We pulled the trigger on this. She's been one of our best producers because we followed that gut feeling of what's best for the business and for the clinic. That's been the biggest thing for me, looking at things in terms of what's best for the clinic. Sometimes it's not necessarily what's best for me personally, but it's what's best to expand the business and make things work for the team as a whole. When I started doing this and adding additional therapists, I was very upfront with my expectations.

PTO 88 | Tripling Clinic Production
Tripling Clinic Production: If you don't have somebody to hold you accountable, you will find yourself very scattered.

 

It's a funny story. I have this PTA. We were sitting down at lunch and we were super busy and I said, "I need somebody but I don't know if this is going to be a full-time position. Would you be interested in coming on part-time or coming on as a temp position and then it could go into a full-time position depending on how you do?" During the conversation, I don't remember saying this but she said, "If there is someone who doesn't fit in with this team, I'm going to straight-up fire them." She tells me that. It struck a chord with there that I'm serious about this team needs to be working hard together to get to our purpose, which is taking care of patients.

That's what we need. The biggest key to our success is finding the right team. You've probably seen this as well that when you find that right team, the patients seem to come. When you have that right flow, the patients show up because there's something about it. That's what we've got. In times when we're going to slow down, all of a sudden, we get these boom of patients coming in. It's from word of mouth and it's from people seeing what we're doing. They're happy with the results and sharing it with everybody else. It all starts from that team having that same purpose, working together and working for what is best for the clinic.

It sounds like what you did and unknowingly is try to find people who were in alignment with you. You had the best interest of the company in mind and that goes to show how important it is to have that filter. The company comes first. The owner comes second and then the employees come third. It seems like from your story that you focused on finding people who were in alignment with you. It was cool that you could call Jeff, the co-owner and have him also phone interview these people because you and Jeff are aligned. You two can find the right person who was in alignment with you and that starts creating a culture of like-minded people who share the same purpose, vision and goals. It starts to accelerate the growth process. I've seen it hundreds of times and it happens all the time with people I have on the show.

As you start finding those right people, you start developing a culture. Culture is simply the way you do things at Teton Therapy in your case. People do things the same way. They're saying the right thing, they show the same values, and they treat patients the same way. Not to say that they're the same, but the culture is similar and there's a feeling there that starts to gravitate like-minded individuals to the practice to work with you. That's a sense that patients can get when they come to your clinic. They'll start coming. They'll start returning, they'll start referring friends and telling their doctors. It's almost like you can't stop that as long as you continue to hire the right people. 

On top of that is I got to a point where we were doing well in the last part of 2019. We were getting things in but then the next step is that network out. That's when I approached you about coaching because I needed the next step, which was to help somebody get me to the next step. I'm talking about phase one versus phase two. Being an owner is phase one, you're that clinician, you're in there. You’re handling all the day-to-day stuff. Phase two, you're transitioning out and you're handling the business side of it. It comes down to as a therapist, you have to decide. With my two hands, I can only do much to help people.

I can only see many patients, but if I take my skills and my two hands and teach others how to do the same thing I'm doing, the amount of people I can help is unlimited based upon the amount of people I can train. Those people can then expand their hands to help more people. The whole goal of a therapy clinic is to help as many people as you can possibly. You can't do that if you're doing treatment all the time and you have to make that decision of, "It's time for me to transition to do a greater good." Therapist is a great good, but there's a greater good of training others to do it that you can help more individuals. You can help more people.

To go back into your story a little bit, and I don't want to gloss over this because it's important. When we talked, I was excited to work with you because you said, "I've learned all this stuff. I've learned the management technique. I've read the books. I’ve got the training. I know what I'm supposed to be doing but I need someone to hold me accountable." I remember that sticks out in our conversation that we had back then. As we started training, you recognize that you need to do less treatment on patients and get out of the full-time treating.

I hope you don't mind if I share but then you got Bell's palsy. Physically, you were not capable of seeing patients anymore. Correct me if I'm wrong, that was a turning point where you were able to step back and see what would happen if you physically weren't present and recognizing that, "Now that I’ve got my head out of treating patients because I'm forced to at this point, I can see the things that I can do." Whereas, when you were treating patients, maybe you didn't have a clear vision. It seems like you had to go through that experience to see that.

If the game's easy, it's not worth playing. You've got to have a harder game. Click To Tweet

That was a big part too because at that point, we’re almost 100 less visits than what we're doing just within that last time part of starting this process of the coaching and me stepping out. There's part of you that thinks as a therapist that if I step out, this clinic is not going to do as well. You figure you're going to lose visits. You'll never be going to hit an all-time high unless you're sitting out there treating patients. What I found out was my mindset changed of we're not going to hit an all-time high unless I don't see patients. I can't see patients or we're not going to hit it an all-time high. I have to be doing other stuff. I can't be out there on the floor.

If I am, then my time is not being used for more of that working on the business as not working in the business. That's been a big change. That's been something that's been working with you, working with Jeff. Because we all have that sense when we stop treating patients, it's that timeframe of what do I do now? How do I make this productive? How do I continue to grow the business when I'm not the one who's doing everything? It's a big mindset change and you do need somebody to hold you accountable because if you don't have somebody to hold you accountable, you do find yourself very scattered. What do I do? You find yourself gravitating towards getting back on the treatment floor again, which is not where you need to be.

That's the easiest path and that's what you know. You spent the last 30 years studying to become a physical therapist. Naturally, if you have some free time, you're going to go with what you know and treat patients, but you've got to pull yourself back. It takes a mindset shift. I see this with my coaching clients. There has to be a change in the mind and it doesn't happen immediately. It usually happens over time to the point where they recognize that, “I can do more for the business and for my team, my other providers, my front desk members by not treating patients and focusing on the business to give myself freedom, the bandwidth, the mental freedom and the energy to work on it and make it a better place for my team. Make it a better place for the patients that come in the door and be a greater influence in the community.” It's that mindset shift.

I look at this with my kids. I don't want them to be as good as me. I want them to be better. I want them to do things better. I want them to not have to deal with all the mistakes I have and had to deal with. I don't want it to stay the same. Within the physical therapy profession, I don't think we understand what physical therapy is going to be like in 10 to 15 years. It's going to be different in the way we approach things, the way we do things because we are constantly growing and improving this profession. As business owners and private practice owners, we've got to be at the forefront of training our therapists to be better than we were as therapists. Giving them our basic knowledge and then letting them expand that so that we can continue to expand this field. If our goal is to be completely autonomous, we got to be able to handle everything.

We can't just handle the basic things. We've got to be able to handle everything within the musculoskeletal system and the realm of physical therapy but always pushing those boundaries. That's why, you and I, both involved within hands-on diagnostics because that's what they're doing in Measurable Solutions and another company I'm part of because that's what they're doing. You network with those peoples who are pushing those boundaries because that's what we have to do in this profession if we want to see it succeed. That's what you have to do within your business is pushing the boundaries, not stick in that cookie-cutter box that we have been in the past. The past isn't going to get us to the future. It's the present of working and improving our goals, improving ourselves, improving what we do as professionals.

Did you find it was hard to make that mindset shift? I mentioned that it usually doesn't happen overnight but take some time. What made that switch for you? When did you recognize that, I can't keep seeing patients? I want to go back and reiterate what you said since you stepped out of treating full-time your business has increased 100 visits per week since you stepped out. It did it without you. What was the shift that helped you change your mindset? 

It's deciding where do you get the most gratification. For me initially, it was treating patients but then as I'm treating patients and as most of us know, when you've been treating patients for a long time, it becomes second nature that you're not thinking about. You're doing a good job treating the patient but you can tell that it's not challenging you. You get to a point where treating patients becomes this easy thing. Some people reading this may say, "I don't think it will ever get that way." It gets to a point where it's not the easiest. It's the easier thing to treat. The more gratifying thing for me was bringing on new therapists and watching them succeed. That's where I get my joy from. When I see my therapist totally handle a difficult case and they come out like, "I’ve got this guy better." That's what excites me.

Watching them do that and giving them tools to do that. We brought on an OT and she's got her caseload up to where she's seeing exactly what she needs to do. She's built this amazing caseload and seeing that was huge for me. That was a happy moment for me of seeing somebody push it and work hard to obtain something that a goal she had. That's where it comes from. You step out to work on a higher purpose of helping others, helping your staff see success, seeing them help people. You're in the background going, "This is amazing what these people are doing and these clinicians." Even your front desk staff and other things and other positions you have. Seeing them expand their positions and helping people, that's what's brings you greater joy for me, particularly. Anytime I’ve had treating a patient, that's a huge success.

You came to a point where simply treating patients didn't meet your purpose. My coaching clients who experienced this are people who are like, "I’ve got other things on my mind." They're stressed and torn. They're like, "I need to see patients full-time but I know there's the stuff that I'm learning from Nathan in which I need to implement in the clinic that I'm not getting to. I'm thinking about the business while I'm treating my patients." It's an internal struggle. For me, looking at it from the outside perspective, it's that internal struggle. The purpose that you had up into that point in treating patients had changed. Even without you’re knowing or you recognize, “I have a different purpose in mind now.” It's that transition from one purpose that got you to where you were to a different purpose that's going to get you further. You have to figure out what that greater purpose is like you mentioned.

PTO 88 | Tripling Clinic Production
Tripling Clinic Production: When things start slipping, we start making excuses and figuring out if the situation can be controlled or not.

 

For you, it's to create an environment in which other people can flourish and grow either as providers and hopefully in the future leaders within your own company. Be a greater influence not only in their lives but in their family's lives and in the community that you serve. I see that. We talk about a mindset shift, that's part of it. It's also a change in purpose that you have to come to grips with that as you grow, your purpose isn't being met by treating patients but your purpose is different. For you, it was to grow people. For other people, that greater purpose is meant by having more clinics and growing that way. It can be individual. That shift has to happen and you have to find that greater purpose to go to in order to do let yourself stop treating patients. 

It's finding your greater purpose, playing a different game. That's another concept that is part of it as well. The game gets to a point where it’s easy and you need a harder game. If the game is easy, it's not worth playing. You've got to have a harder game. You've got to challenge yourself or you don't want to get up in the morning and do what you need to do. It's constantly keeping yourself up to playing a bigger game. Maybe you add more clinics and that maybe our next step is we're adding more clinics. I've got some big goals and we've talked about some of those things. Some of them I look and go, "I don't know how I'm going to accomplish this but we're going to try other things." It seems goals that I’ve had in the past that are coming to pass and seeing greater good throughout the community. We all do this profession because we want to help people. It's not a money thing. It's a helping thing.

That's why we put all this time and energy into this. I learned this from Jeff, my business partner that I can only do so much with my two hands but when I train others, I can do so much more. I can see more good done through my company because of that. Because of me not being the one who has to touch everything, I can now step out. The nice thing too is it's a different game because you can step in whenever you want. You can help out your employees. You can help them with handling difficult situations in the clinic, but you can also step out. You're not the main guy anymore but you're that teacher. You're that leader that helps them to develop how they need to develop to be the high-quality clinicians and the high-quality people they're capable of being.

Looking back on your timeline, much of it is similar to what we see in the other physical therapy owners. The successful ones. You started hiring the right people, people who were in alignment with you. I know your timeline as well. Go over it and you can correct me if I'm wrong. You also brought on a marketing person to help you out and take that off your shoulders. You also had some consulting and training. You've also done some networking. You already did two of the three steps that I always promote in that is you already reached out and got some training because that was part of your leadership development. You were also part of networks. You reached out and network. When I started working with you, we started focusing on that third piece, the stepping out process and getting out of treating full-time.

We started working together. You brought on another front desk person and based on my experience, and you can share yours as well. Around 120 to 150 visits per week, you need a second front desk person. They can only handle so much. You're bringing on other providers. You've gone from visits that were in the hundreds per week to over 300 visits per week. You've got great goals to get even busier. It's important to note that timeline that you started hiring other people. A marketing person was beneficial and other front desk person was beneficial. You might say that I helped out a little bit as well, but you made that you made those important decisions after hiring the right people and then you exploded after that.

The biggest thing is we're constantly looking at what's the next hire we need to do because it is growing so fast. This might make some therapists, especially owners on this show a little like, “This guy's nuts, how was he able to do this?” We saw a need. I got to travel to try my caseload by having that intention, having those feelers out within recruiting, traveling agencies, to get somebody on immediately to handle those needs. We're in the process of filling that position with somebody more permanent and then adding more part-time help to offset our schedule. Our biggest issue is space. We don't have space until we get into the new building to expand what we want to. We're expanding hours and looking at other options. That takes into account of, we need to add some part-time help to help with this. It's constantly keeping that mindset of what's the next hire? What's the next step? What do we need to do before we get into this new building? How do we handle that? That's where a lot of my time is spent, being that vision of where we are taking this thing.

The time that you spend is much more intentional looking forward. Instead of fixing what was wrong in the past, you can look forward and look, "At this current growth rate, we need to hire another person. We need to find this person." Looking ahead, you can do that simply because you're not treating much if not at all. You're able to intentionally find those right people and take the time it takes to find the right people. There's so much value in that. As you were treating patients full-time, did you foresee that you could fill up your schedule with all of this administrative/executive work? Were you at the point where you're like, “I don't know what I would do with my time if I wasn't seeing patients?”

Initially, you think that the concept of “What am I going to do with my time if I'm not seeing patients?” Once you step out and you start filling it in with executive functions, you think, “How did I even run this company by treating patients because I’ve got some stuff to do?” What it comes down to is once you stop treating patients and you see all the balls that you're trying to juggle that you weren't juggling. You claimed you were juggling but you're not. You can't because you're so focused on patients or you look in your like, "That visit was okay with that particular patient but I don't feel that my quality is up to par where it needs to be." When you focus on those things, you realize that I can't do things halfway for one thing and be okay doing it halfway for another thing. I've got to be fully focused on one thing. I can't have two things that I'm trying to focus on or I'm not going to be focusing on anything.

Help patients start the process, change the things they need to change and stop the things that are preventing them from getting better. Click To Tweet

If you're focused on two, it's going to go all over the place. With that being said, since I have the time to handle the executive stuff, when there's an issue on the floor and I do need to see a patient, I'm focused on that patient. I know I have the time to handle the other stuff later. This is a part-time thing of me helping out as needed. It helps me focus more because I know I'm going to have the time on the back end to handle the business stuff, to handle the administrative stuff. I'm okay to focus on this patient. I can focus on the administrative stuff because I have that time. When you're treating full-time, you don't have that administrative time. It's always in your head, "I'm not handling this." You're swimming trying to make it and you don't. Eventually, you start drowning and you're like, "I got to handle this." It's a big mindset change but once you make it, it's so freeing. You free yourself up a lot.

One thing that the audience doesn't know also is that Ben is good about having weekly team meetings with his providers and the whole team, not just the providers of his clinic every week. One thing that sticks out to me from our past conversations that is a conversation that you had with them about control. You could see that the numbers were slipping a little bit, whether it was arrival rates, the number of billing units they were billing per visit or the efficiency of care and noticing that people were dropping off. I don't know what triggered that but as you're watching the statistics, they had dropped a little bit. You felt like the need to address the providers about control. Tell me a little bit about that story simply because it's important to give owners and leaders some of the verbiage or ideas to talk to their teams about being in control of their positions.

We get very complacent with things and we try to make ourselves okay with issues in the clinic being okay. For example, so-and-so didn't come in because they're sick or we had a downturn of visits because it was snowing. We can always find excuses for why things aren't happening. Not necessarily, my teams are good about taking control and handling things. They do a great job of taking ownership of when things happen and trying to solve issues. We all tend to do this when things start slipping, we start making excuses and we start figuring out, we can't control this and that. It came up to discuss what the term of control meant. We’re discussing with the team saying, "Let's define control as the ability to start change or stop something. Let's stick with that as our definition of control." I said, "What can we start? What can we stop? What can we change within our patients?" Define that and saying, "What we have to do is control the things we can control and then we'll deal with the other things as they come up." When you look at illness, weather, and all those things, those are minimalistic on the ability of a patient to come into treatment. Most of the time, why a patient won't come in is because there's some other internal reason they're not telling you.

They're claiming it's an illness, weather conditions, a work issue, or all these other things, but most of the time, there is something else going on. A patient is not committed to the treatment plan. The therapist doesn't have control over the treatment plan. Pushing that on the therapists of saying, "You need to control these patients. They're coming to you to be able to handle this situation. You need to be able to help them start this process, change the things they need to change and stop the things that are preventing them from getting better." That's what our focus is. If you're not able to do that, sometimes you have to have hard discussions with the patient. Maybe therapy is not the right answer for them at that time. Maybe tweak a couple of things, get them recommitted and then you've got a patient who's making progress with therapy. That was the biggest thing I talk about with them is making sure we're handling the patients. Making sure that we're getting those things done that the patients need so that they can handle their condition. My therapists do a good job. Our percent arrival rates stay above the 90%.

They do a fantastic job of getting their patients in and committing them to their treatment plans to a point where we have them sign a document and that first part of their treatment is saying, "This is what our plan is. We want you to complete this plan. Please sign this if you're in agreement." Most of them are signing, they're excited, and they’re ready to make these changes. That's the biggest thing when those stats come down. It’s looking at what we can control and focus on that and not focus on the things you can't control. You can't control the weather. We'd like to. You can control how you're treating the patient and helping that patient to see the value of physical therapy. You can work with that patient to make sure that physical therapy becomes a top priority. You can also have those discussions when a patient is not doing what they need to do of it's time to have those tough discussions and physical therapy is not right for them at this point. Maybe you need to part ways. There are definitely some difficult conversations you have to have, but you also have to be willing to do that to control your situation.

As you're talking about it, I love how you defined control and you put the patient's plan of care in the provider's hand. They need to follow up but they also have to be bought into what the provider is selling. Would you go so far as to say that if those numbers are coming down, if the arrival rate is poor, the patients are dropping off and not completing their full plans of care, if they're only coming in one time a week, hit and miss that maybe the provider isn't fully in control of the patient care and they're leaving it up to chance?

That's a big thing and that's an issue that we have within our profession. We tend to get complacent and feel that way of, "I can't control this patient, so move on to the next one." That's where we have to stop and say, "What could I do to better sell this patient on treatment? What do we need to do differently? Do we need to do some more testing? Do I need to have a second therapist look at this person and see if there's something I'm missing?" It brings in that whole team approach of what could we do to make this experience good and to help that patient get better. It's funny because we've done surveys.

Most patients say the reason they liked coming here or they like coming to physical therapy, getting better is low on the list. The first ones are experience with the therapist and how much the therapists cared about me. All these things are more important to them than getting better. When you foster those two where you're focusing on the patient experience, that ultimately gets them better than any physical therapy skill you can put on them, it doesn't matter as long as you're giving them that high-quality experience. You're making the time. You're showing them your vested in this and getting them to be vested in their health, that's what gets them better.

I totally believe that's true. Many patients don't know what quality therapy looks like or feels like. They're coming into it as a blank slate. The experience you provide them is going to color so much of what they know about physical therapy and not necessarily the techniques you can provide. There are many different techniques that can get people to the same place. Your skills only add to the experience. The better they are, the faster they're going to get. Fundamentally, it comes down to developing a solid relationship with the patients. Getting that buy-in to the plan of care and providing a positive experience for them, which I would assume is focused on improving their functional capabilities.

PTO 88 | Tripling Clinic Production
Tripling Clinic Production: Focus on the things you can control and not those you can’t control.

 

As long as you've bought in and in control and not saying, "So and so didn't show up, he's not going to get better. Leave it at that.” A therapist that's in control is going to get on the phone and say, "What happened? We agreed to a plan of care that will get you better. I can't guarantee that you're going to get it better if you don't follow it." Instead of the therapist that forgets that so-and-so fell off and two weeks later says, "What happened to that guy?" Being in control shows up in your statistics as you're measuring them. If the therapists are in more control, then you're going to see a better arrival rate. You're going to see you more completed plans of care, etc.

It's great when a patient gives you cookies and all that stuff. That's great and you know that they liked you. One of my patient was on the final day and this particular patient turned to the front desk and said, "I feel like I'm leaving a family." That's the mentality you want in your clinic. You want them to feel like this is a place that helps them get better. This is family, this is a place they can come to if they have issues. That particular patient would have happily come back if they needed it or they're telling all their friends about it. That's what you want. You want to create that family atmosphere that's light and fun, the patient's getting results, everyone's high toned and well personally. That's what you're trying to foster in your clinic. When you can do that, the success comes.

It was cool that you recognize that based on some of the statistics that you had been tracking and recognize that this is what my providers need to hear. I know that your statistics turned around within the week or two after that in huge uptick because they started to take control. You couldn't have done that if you hadn't been tracking your statistics regularly. Ben, I know we can go on forever but I want to thank you for taking the time, especially as busy as you are. You have more free time to do an interview like this, which is cool. Thanks for sharing your insight. As I said on our coaching call, "I’ve got to have you on." I forgot you tripled your visit totals per week. I was like, "I’ve got to have more people like you on." That's why I interview people like you. It's because there are plenty of successful actions that other owners could gain from. Thanks for coming on. I appreciate it.

You're welcome, it’s a plug for you. Nathan, as a coach, has been extremely helpful for me, giving me that accountability. It's taken my mindset from where it was before is, I got be in training to catching the vision of why I need to be out of treatment. Sometimes you need that outside person looking in versus those people who are involved in the day-to-day. That outside perspective helps. A big part of the reason why we're doing this well is because of the coaching. We talked about the consultations stuff that I’ve had with other companies as well, particularly working one-on-one with you to look at the statistics and decide how do we improve this. We've seen my goals have been met. The first day we talked about getting me out of treatment and doing that over a six-month timeframe and we're already there. It's verbalizing those goals and then having someone to keep you accountable for is important. Someone outside of the business who's not caught up in the day-to-day side of things, that's key. I'll plug you every day because of that because you've helped turn around this business for sure.

I love to hear that and I appreciate it. I get so excited after all of our calls and share it with my wife like, "Ben is killing it. It's exciting to work with him." Thanks for the plug. I appreciate it. If people wanted to reach out to you for whatever reason, are you open to sharing your contact information? 

The best way is email because I'm not the best in answering the cell phone. My email is BLarsen@TetonTherapyPC.com.

Thanks for your time, Ben. I appreciate it.

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About Ben Larsen

PTO 88 | TPTO 88 | Tripling Clinic Productionripling Clinic ProductionBen has been a member of Teton Therapy since May of 2010. He graduated with a Doctorate of Physical Therapy from the University of Mary in Bismarck, ND and conducted his field work primarily in out-patient settings while in school. During his time at Teton Therapy, Ben has taken many continuing education courses on topics such as Dry Needling, Kinesiotaping, neuromuscular re-education, running analysis, and injury prevention—a topic which he immediately found a passion for and has since conducted classes to the community. Ben quickly applied this vast amount of knowledge to the practice and sharpened his therapy craft. His general interests include water sports, running, outdoor activities such as camping, competing in triathlons, and most importantly spending quality time with his wife and children.

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