June 16, 2020

5 Things To (re)Consider While Ramping Up

PTO 103 | Ramping Up


The COVID-19 pandemic has provided many of us a little more time on our hands to assess how our clinics are doing in general. Whether you're reopening, slowly increasing production, or stuck in a holding pattern, it helps to make use of this down time to really consider and reconsider some fundamentals of your business. Host, Nathan Shields, breaks down five of the things that you need to look into now: purpose, responsibilities, goals, marketing, and self-control. Being intentional and specific about how things have changed in your business and taking advantage of the opportunity in front of you may set you to a completely different path than prior to the pandemic—a path that leads to greater freedom, fulfillment, and profits. These things take some effort, but going back to the status quo should not be your future. Make something better for yourself, your family, your employees, and your business with the help of this episode.


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5 Things To (re)Consider While Ramping Up

I don't have a guest to interview. I want to riff on my own here a little bit and talk about the five things that you need to consider as you are ramping back up your clinics. A lot of you may still be closed. A lot of you might be trudging along slowly and gradually building up. Some of you might be ramping up a little bit more quickly. Wherever you're at, I'm assuming that a lot of you have a little bit more time on your hands to assess your business in general and take advantage of the opportunity to work on your business and not just in your business. I talked on a previous episode with Will Humphreys about what to do during the downturn.


As things are starting to get busier, the possibility is that you might get sucked back into doing things the way you used to do them. That was the caution that I wanted to put as I've interviewed and talked with Will is that no, this is an opportunity to make things change. I want you to hold fast to that commitment to change. There are five things that I'm noticing amongst my clientele and the mastermind that I've started that need to be addressed and be considered or at least reconsidered. The first thing I wanted to talk about is purpose. Now is a great time to look at your purpose and consider, “Does this still meet my needs? Does this still excite me, inspire me and my team? Is it time for a change and updating?” That's a possibility because a purpose is like that. You don't change it very often, but in certain circumstances and as you're making changes in life, your purpose will change.

Consider does the purpose still meet the needs of the company? Does the purpose still meet the needs of me personally, as the owner? Does it reflect what I want in terms of my business, how it works, what it stands for? Does it reflect the entire team and the team that I want to develop and build? Does it also reflect my clientele? I have coaching clients that are deciding to shift from one clientele to another or to expand the clientele that they're marketing to. That would significantly change your purpose, change how you advertise things and also how you run things in your business. Now is a good time to consider, does the purpose still meet your needs? Does it still meet the needs of what you want out of your business going forward? Maybe it met the needs of that in the past, but does it meet the needs of what you want to see in your business going forward? Now is the time to consider adjusting your purpose to meet your needs going forward.

Take advantage of this challenge and make it an opportunity. Click To Tweet


Second, as you are considering maybe treating less and working on your business more, then your responsibilities are changing. You need to get comfortable with what those responsibilities are and what they look like. Simply going off of treating patients full-time or a significant amount of your time to doing some administrative stuff and stepping away from treating is going to make you feel uncomfortable, and it's going to make you feel less productive. Don't buy into that. Understand that your responsibilities have simply shifted and that under your new purpose, you have different responsibilities to meet the goals that you have going forward.

A lot of them are typically administrative. Consider what statistics and KPIs do you need to track on a regular and weekly basis? Are you creating battle plans to improve the statistics that are falling? Whether that's frequency of patient visits per week, the number of skilled units per visit, the arrival rates and completed plans of care. Those kinds of statistics need to be tracked, but you also need to create battle plans in order to correct them if they are going down. Are you strategizing appropriately for improving the team around you, for developing leadership on your team, for marketing or for improving the care in your business?

It could be any number of things, but you, as a leader, need to be the person that creates the vision and puts a strategy together with the support of your team. Other things that you could be doing that are more administrative, but less numbers specific and project-related. Are you having one-on-one meetings with your team whether that's weekly, monthly, bi-monthly, bi-weekly or whatever? Holding accountability meetings with those people who might be needing some disciplinary action or simply meeting with your team members to see if things are still going in the right direction and that you are aligned.

PTO 103 | Ramping Up
Ramping Up: Set a sacred time that is not spent on patient care because your business won't grow simply by you treating more patients. You are also limited by your energy, time, and mental capacity.

Also consider that with your administrative time that you have set aside to write down policy. You, as the owner in your clinic, are the most productive, the most efficient in terms of both billing and charging and getting patient results and getting patients to buy into their plans of care. Whatever you're doing successfully in those areas need to be written down so they can be recreated. Inevitably, the therapist that you bring on aren't going to be as productive. They're not going to be able to commit patients to their plans of care like you do, because you are so invested, but that also makes you distinct and an owner.

Because you have those responsibilities of ownership, it forces you to be more productive. Everything's on your shoulders. Take the time to write down a policy of how you do things. How do you treat patients at initial evaluation? What do you say in order to get patient buy-in? Are you scheduling out your full plan of care after the initial evaluation? These are the things that need to be written out as policy for other providers and team members to follow going forward. Writing down policy, although it's a grind is a significant part of your responsibilities at this time.

Also consider how can you top grade? Who needs to be let go because they're not aligned or not producing or simply not acting appropriately in your clinic? How can you improve the situation of your team? If you go back and read my interview with Will Humphreys, he talks about A, B, C and D-players. How can you get rid of the C and D-players and get more A-players? Now's the top opportunity to do that, which is called top grading. Also take the time to meet with your CPA and your billers monthly. You should have reports coming from your billers, the statistics that they follow and track that are reported up to you, projections for upcoming months, billing and how they did in relation to what the projection is worth. All those things need to be met.

It's important to revisit your business goals and make sure that you're strategizing appropriately to achieve them. Click To Tweet


With your CPA, feel free to ask him, “Show me what my P&L is. Show me my expense lines compared month to month and year over year. What is the projection going forward?” Also, ask them to figure out your breakeven point. All of these things are important to do as an administrator. Although you're not getting immediate return on your investment, it will come back to you tenfold as you improve your business. The third thing you want to reconsider are your goals. Is it time to readjust them for 2020? Probably what you had in January needs to be revisited. Revisit your goals and get specific. What I'm finding as I'm talking to owners is that they have goals. I want to gross $500,000 a year. Let's break that down. How many visits does that translate into? In order to get $500,000 a year, how many new patients do you need to have coming through the door? What is your profit margin on that? Is that an acceptable profit margin? Getting specific on some of your goals will drive a lot of your work.

Honestly, if you want $500,000 and it's going to take 1,500 new patients to come in the door and you had only 600 last year, what kind of marketing efforts are you going to have to do in order to do that? It's one thing to simply put the goals out there. It's another thing to then do some reverse mathematics and reverse engineering to determine what do I need to do to actually get to that goal and attain that goal? Furthermore or at least another example is I want to treat part-time and be in a bigger space. Let's work it back. If you have a bigger space, you'll have a greater mortgage. You'll have other providers taking on your patient load. How productive do they need to be in order for you to either maintain or improve your profit margins, such that you have the financial flexibility and freedom to achieve that goal. Will that work if you have those things? It's important to revisit your goals and then also work around those goals to make sure that you're strategizing appropriately to meet those goals. They're realistic and that there achievable.


The fourth thing I want you to consider is what your new marketing programs might be. If you were solely reliant on physician referrals for the health of your clinic, you recognize that now you need to change things in order to survive, at least through this part of the ramping up phase. Honestly, it will benefit you going forward but consider new marketing programs. As you consider them, people ask me, “What should I do? Should I do some social media stuff? Should I do some mailers? Should I do some emails? How should I reach out to past patients?” Before all that, consider what's your budget. If you go back to my interviews with Neil Trickett of Practice Promotions or David Straight of E-Rehab. The first question they have to ask as a marketing vendor is, “What's your budget?” Based on your budget, they can tell you what you can do and how much you can expect on your return. First of all, you need to consider the budget.

PTO 103 | Ramping Up
Traction: Get a Grip on Your Business

One book that I've recommended to a number of people, it's called Traction, and it's not the Traction by Gino Wickman. It's called Traction: How Any Startup Can Achieve Explosive Customer Growth by Gabriel Weinberg. It's a good book to consider if you're wanting to know how to spend your marketing money and what to do first. You might have multiple options. Whether it's marketing to physicians, marketing to the community, doing social media ads, marketing to past patients, marketing to your latest patients. You have all these avenues to put your marketing dollar. Do you want to do all of them at the same time with the same amount of money or should you focus on one avenue, spend a little bit of money and see what your return is like before you put more money into it? Essentially spoiler alert, that's kind of what Traction talks to you about and how to focus your marketing efforts to get the greatest return on any particular avenue. Check it out. It might be able to walk you through how to spend your marketing dollar the best way possible. A great recommendation is to reconsider where you're spending your marketing dollars to begin with and consider new marketing programs that tap into communities and not necessarily physicians.


The fifth thing I want you to also consider is make a schedule that allows for you to do your administrative work, your marketing, and more specifically give you time with your family, your loved ones and your hobbies. Don't let patient care interfere with that time. Make that time sacred. That time is what you need in order to achieve your goals. You have to set aside that time that's not spent on patient care, that is focused on your business to achieve your business goals. Your business won't grow simply by you treating more patients. You are limited. Your energy, time and mental capacity is limited. You need to build your business such that others are treating patients that you want them to and are running the business how you would run the business or even better if you find the right people.

Make a schedule that you are in control of, that you are not reactive to. Many times, as we're growing up as physical therapists, we’re simply looking at the schedule to tell us what we're going to do. You were going to treat that patient at this time. Thus, we become at effect of our schedule instead of being at cause, being the causative factor to our schedule and saying, “This is when I can see patients. This is what I'm going to work on my business. This is when I'm going to be home with my family.” If the patients can't fit into my schedule, then unfortunately I can't see them at those times or they need to work with another physical therapist under my roof to be seen for their malady. It's important that you make those times sacred in which you're working on your business and you've set aside for family loved ones and hobbies. It’s uncommon for so many physical therapy business owners to simply get burned out. You don't want to get to that point.

Make the time sacred now so that you can make the business what you want out of it. Give yourself the energy and space to get revitalized and reenergized on a regular basis. Those are my five considerations as you're ramping back up. I hope you appreciate it. I don't do a lot of these solo podcasts. If you like them, let me know at Nathan@PTOClub.com. I'd be happy to hear from you. If you have any suggestions on topics, speakers or presenters, but we have a lot of great interviews coming up. I also want to thank you again for being a continued audience. I’m proud of the content that we've put out there. I hope you've appreciated it. I'd like to hear from you once in a while. I like getting the positive feedback, simply saying, “It’s great.” I love talking to people who have read the blog wherever you are across the country. Thank you again for being here. Have a great day.

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