For many owners making the transition out of (some) patient care and into more management/administration is a huge hurdle but one that, once they experience it, leads to more growth as a company. Jacob Pollard, PT has made that transition and has now taken the NEXT step. Now, instead of him being the go-to guy for all questions, the resolver of all problems he has developed a leadership team that follows policy and procedure. His team is able to follow policy and handle issues without his involvement! What is simply a dream for most owners Jacob is now experiencing because he spent the time developing his team and training them on the policy. Learn how this all came to be in this conversation with Nathan Shields.
I've got a friend, a coaching client, and also a business owner nearby me in Wasilla, Alaska. He also has a clinic in Anchorage. He's the Founder and CEO of Empower Physical Therapy. Jacob Pollard is joining me on the episode to talk about some of the growth that he’s had that I wanted to highlight and share with the audience.
Jacob, thanks for coming on. I appreciate it.
Thank you, Nathan. I appreciate you asking me to be on. I'm excited to talk to you.
Before we get into what we want to talk about, which is developing your leadership team and creating, implementing and utilizing policy procedures in your clinic, share with the audience a little bit about you and what you've done up until this point to get to where you are.
I live here in Wasilla, Alaska. We have a clinic out here in Wasilla but we also have a clinic about 40 miles south of here in Anchorage, Alaska. We started Empower at the end of 2016, the beginning of 2017. We're excited about having it and being around. Nathan talked to me and introduced me to a coach that helped me but as most practice owners, I’m working 45 to 50 hours a week of treating and then trying to fit in. In addition to that time, hours to try and do marketing, admin trainings, business management and grow the business, anything and everything else that most clinic owners do. It was right around that time in October, I had my second child with my wife and I was exhausted. You know how that is with a new baby. I thought, “There's got to be a better way. This can't keep going this way.” Nathan is the one who introduced me to a man named Jamey Schrier. Jamey's program is the Practice Freedom U. I got introduced to him first. I started down with some coaching and consulting. Nathan also reached out to me when he started coaching to become a coaching client of his.
I quickly jumped on board because I realized, through Jamey's program, that I had no idea what I was doing as far as running a business. I needed people who knew how to run a business to show me what to do. That's a big thing that prompted me to get started into taking control of my business and deciding I needed to do something different. Through a lot of that coaching, consulting and education, I started to turn around things with my business and say, “This is a business. It's not a job for me to come in and do every day.” It changed me and my family's life and where I am.
Before, I was still treating full-time. I had a couple of admin blocks here and there. We made the transition and I started carving out more time to work on the business. Now, I'm completely out of treatment and I've built a management team that helps me run all the day-to-day operations of the business. As Jamey said, we've implemented a lot of policies and standard operating procedures that helped guide who we are and what we do. I've been able to take a step away and focus on the business. That's where I've come from and what I've done. It's been years of a journey here.
First of all, congratulations. I remember when you first started opening up your clinic in town and I had met you and I thought, “Here's a guy who's opening a clinic like I did years ago. He probably doesn't have a lot of business training.” I remember I sent you a book or two because I'm like, “You're going to need some help.” I had Jamey Schrier on the podcast a couple of times and I was like, “I'll throw some contact information on Jacob’s way and see if he could use some help.” That seemed like a real turning point for you where you started getting a handle on how to run your business and what you needed to be doing.
When I started working with you some time ago, it's cool to see where you are from December of 2019 to 2020 and the changes that have evolved in your company. Part of it is like what you said that you developed some policy and procedure and standardized operating procedures. You've also started to build out a real leadership team, which is vital to take some of the burden off of every owner. I wanted to go down that path a little bit. When we first got started working together, you didn't have a designated office manager. If you follow the traction and rocket fuel organizational structures, there's the visionary at the top and the integrator. She was essentially your integrator but you didn't have well-established clinic directors of both places, it didn't seem like. You were the clinic director for both locations while you're also trying to treat patients. Am I right?
I want to talk a little bit about your successes and some of the things that you've done right, some of the things you've done wrong, or what you would have done differently. In talking about that, share with us a little bit about how you started working in developing a leadership team. At this time, they're doing a lot of stuff on their own. What was that transition looked like? What did your leadership development program look like per se?
The leadership team and the management team has been the biggest thing that's allowed me to step out of the business as far as working in the business and start to work on the business. It wasn't an overnight thing. One big thing was I was hoping I could turn to my office manager and say, “Now you're the practice manager, make it run.” It didn't work that way. Same with the clinic directors, I gave them the title. At first, this was talking about those mistakes, I said, “You're the clinic director.” I expected them to know what I meant when I said, “You're the clinic director.” Looking back, those were big mistakes on my part that I didn't provide any clarity for what I meant by that. I didn't provide direction and a clear outline of, “This is what I need you to do and expect.” I didn't set those outcomes for them from the beginning.
You didn't have a job description. That's essentially what you're talking about. A clinic director has these traits, these are their responsibilities, these are the product, or these are the KPIs that are measured by or are responsible for.
I didn't have that. I had written down a few things I wanted them to take over. It was, by no means, a clear job description. That was a huge mistake on my part. From your coaching and Jamey’s coaching, I knew I needed a management team. I started there. On one hand, it was good that I jumped in. I said, “We're going to build a management team.” I used to sit around and kept thinking about, “I’ve got to get it perfect before I do.” On the bad side of that, it did come with some headaches and a learning curve. That would be something I would have done differently. I would’ve got clear on what I expected from them and written it all out before I made them the clinic director or the practice manager.
When did you see some traction as far as their growth and taking on the responsibilities that you expected? When did you start seeing some of that? Did certain things start happening? Did you implement certain trainings or something like that?
To be honest, it was during COVID. When we got hit with COVID, I relied on them and leaned on them. At the same time, I had some more time to flush out a lot of these things. At that point, we had 4 or 5 months of struggling through like, “I expected you to run those reports and they didn't get done. Make sure you do it next time.” It's me telling them here and there instead of having it all written up to this and move on. I was realizing like, “I've got to get this all organized so they know what to expect.” It was during that time, end of March, beginning of April and May when COVID was at its worst up here as far as shutdowns and all that stuff. We banded together. We spent some more time training with each other. They got to see more of what I was doing because I was there with them more. On top of that, I had more time to sit down. It’s almost going through that trial together and build some managers. I’m not saying everybody needs a COVID to build their managers but it forced me. I realized, at that point, I need these things or I'm not going to have a business. In the future, I hope COVID never happens again. That drove me to say, “If I don't figure this out, in a couple more months we're not going to have a business.”
COVID might have forced it. If someone is not going through that stage of a pandemic, recognize you've got to dedicate and set aside training times. I'm assuming you sat shoulder-to-shoulder with them, looked at reports, talked to them across the table about how to handle things, “This is what we do and this is how we handle this.” If people are outside of the pandemic and they feel like they're too busy, I even told a client, “You've got to take time away from them being on the floor to train them or else you're going to be spinning your wheels.”
That was the scariest thing for me as a new business owner. Cutting my hours or cutting other therapists' hours to train them or to work on creating a job description. I couldn't see past like, “I'm going to make a couple of hundred dollars if I'm out there and my PTs are out there.” I couldn't see past that. By taking a few hundred dollars that we would make by being out there for these two hours, training, going through this and writing this up, it's going to pay huge dividends into $1,000 down the road. Out of everything you said, taking the time was the scariest thing for me.
I remember you and Jamey told me, “You've got to start blocking some time and working on the business.” That concept was hard. It took me a couple of months to do it. It took me a full year before I got out of treatment. I was working with you for over a year before I was like, “I’ve got to get out of treatment.” It was cutting hours back-and-back. It's still a scary thing to do once you've trained for it for so long in your life is to treat patients. That's what you want to jump back into doing because it's easy and you feel comfortable with it. I can step out there, treat these people and make some money. Taking time is vital. No question, that would be huge advice for someone down the road.
It's a mindset that every PT owner I work with has to get over. The first one is taking themselves off the floor. Even though they know that's what they need to do, there's some mental barrier in there or whatever it is that keeps them from doing that. To take another provider off the floor, I'm paying them for me to train them, how does that work? They can't flush that out psychologically. It's a hurdle they have to get over. Inevitably, every time they do it, there's a positive response. They're like, “Why didn't I do this earlier? Now, I can see that.” You have to go through that experience to figure it out.
I knew this was going on. The thing that stuck out to me in our mastermind meeting was when you talked about your wins. One of your wins is your management team was able to resolve a problem without your personal intervention. You might have discussed it, whatever the problem was, but they handled it without you. That's another level of ownership where they follow policy and procedure to resolve an issue without you. That's next level ownership and something to get excited about to try to replicate over and over again. Share with us a little bit about your win there.
The incident that we're talking about, in particular, we have a policy or a procedure in place on how to handle patients that are no show and patients that miss an evaluation or miss a follow-up visit. We have different ones for what they miss. This was an exception in their mind. Usually, those exceptions in the past would come to me like, “What do you think about this person? They did this, but then their dog got sick. They should give him leeway on this one.” Inevitably, they would come to me as what do I think? I was supposed to decide and tell them, “Go do this for this case. In this case, let's do this.” We got a lot clearer lately. We wrote up in a policy and procedure, “This is what we're going to do and this is the procedure.”
I had come back into the clinic the next day or later in the afternoon. They said, “We tried sending you an email or calling you and we didn't get ahold of you. Ignore it because we figured it out. We went back to the procedure and followed it. That patient is taken care of.” I don't even remember what happened honestly. They either booked out or they told them they're not coming back. That's the thing that was nice. When they told me that, I sat back like, “I didn't have to do anything with that. They took care of the issue and they resolved it.” I’m not even sure who the patient was or what happened. It’s exciting for me to say that.Look at your business as a business, not as a job for you to come in and do every day. Click To Tweet
That's a new experience for you.
It was, it's the next level. You can write up those SOPs but then the training and getting people to do them, that's next level. It was exciting to see.
Number one, you weren't necessarily involved. I was joking you need to turn off your email a little bit more often or not answering the phone. Number two, the policy worked. That's like, “Something that I wrote about worked. That's cool.” That being a new experience is what you're looking for. Back in the day, we got to a point with our leadership team and our clinic directors, if they came to us with a question like you had, our response was supposed to be, “What does the policy and procedure manual say about it?”
Even though we knew the answers in our heads, our job and our leaders’ job if they were talking to the clinic directors was, “What does the policy and procedure manual say?” It's too easy for them to send out an email or make a call and get the answer than it is for them to do some footwork, look through the paperwork and try to find it. If you're going to make that policy and procedure manual, live, breathe and have some meaning, you have to guide them back to that over and over again until they get a clear message and then say, “If the policy procedure manual doesn't give you the answer or you try it and it didn't work, then come talk to me. Don't come and talk to me until you’ve followed the procedure.”
Another cool story, I did an out-of- office visit at the surgery center. I went down and did an eval for a new patient. We document those a little differently and the way we get it to our biller is a little different. We updated the procedure of how we do these things. I wasn't even sure how we did it because I wasn't the one that updated the SOPs. Something cool was my practice manager was the one who updated and how we do it, “This is the system.”
You're telling me that people besides you are making policies?
Now, they are. That's another big thing that we've started doing. My practice manager has done several of these procedures.
I wanted to gloss over that. I want to make sure that stood out.
Another big thing for me in the beginning was I felt like I had to do all of these procedures and write down all the systems that we do. It was overwhelming. I can't even tell you everything we do. I couldn't write it all down, let alone the whole team. Once you had said it or someone is like, “There's no reason why my new patient coordinator and the practice manager can't write her own procedures and systems.” They've been writing them out.
Back to the story. I was the lazy one and I was looking around and saying, “Where are these supposed to go?” My practice manager pulled out the SOP binder and said, “Right here.” She's the one that pointed, “Here's what the system says.” I was laughing about it. They were all making fun of me. You can tell I was fish out of water in my own clinic. I went and put it where it needed to be. It was too easy to ask around than it was to go to the manual. It was good. She brought me back to it and said, “This is what we do.” It was a cool experience.
That's been their MO this entire time and not any fault of theirs. That's how they've been trained to get answers. As you start implementing these policies and procedures, it's going to take a learning curve and a redirection regularly before they get the message. If you have a question, figure it out through the manual first and then talk to your supervisor if that doesn't answer the question or if you don't get the result that you want. That's what is super exciting about it. I assume that all that grinding and hard work feels like it's paying off.
Not only is it paying off in the sense of my overall workload has dropped dramatically. I've been able to hand off a whole bunch of different things and tasks that I was doing. It's paying off in the stress level of my life and the time I get to spend with my family. I'm not working every night anymore like I was. I would get home and put my kids in bed. By 9:00, I was back on the computer. Every practice owner knows what I'm talking about. If I was doing notes or I was writing emails, I was on the computer from 9:00 until 12:00 or 11:00 PM. I'm not doing that anymore. My wife pointed that out and she said, “It's been awesome that we can be together, not have to worry about me being on the computer.” It's paid off in the overall profits of the company. Financially, it's paid off. We've had some huge growth. No way I could have done it without growing my management team and bringing on other people too.
We didn't even mention that. You were striving to hit 800 visits a month and now you're up to over 1,100 visits a month if I'm not mistaken.
We went over 1,300.
Over 50% increase in one year.
It was nuts.
We had some big growth. Thank you.
In a pandemic no less, right?
Yes, it was.
Your leadership team, new clinic directors and practice manager, how do you think they feel now that you've given them these responsibilities and they've made this progress?
They feel a lot more ownership of their position. Before, it was obscure and vague of what they were supposed to be doing in that role that they reverted to what they feel comfortable in, treating or running payroll. That was a big thing Bree did. Bree would go back into authorizations or something that she felt comfortable with like, “I know I can do this. I'm going to go do it.” Like we do when I don't know what to do but I know how to treat someone, so I'm going to jump back into treating. This has given them some clear direction and I know that they feel more comfortable with their abilities to lead and manage and their ability to own what they do in their positions.
I feel like you're now becoming a coach to them.
I have a quick half-hour sit down with each one of them once a week and we model a coaching call like, “What are some wins from the last week? Let's review it. What are some challenges we're working on? What are some things I could do to help?” We model a coaching call through that. It's been awesome and fun to do.
You've made this great progress, you've got the beginnings of a management team in place, your policy and procedures are starting to come together, and they're starting to gain some traction. What do you think the next steps are that you're going to be working on?
That's the role of the owner. It's always looking ahead, looking to the visionary of, “What's next? What's down the road?” Before, I was always like, “Let's look what's down the road.” Instead, I would put my head down and see what was right in front of me. I didn't want to trip over that tree branch and so I could never see what was coming up to the horizon. What this has allowed me to do is look to that and say, “This is what I see in our future.” A new building for example, bringing on a new service line. We did bring on massage therapy. We'll bring on occupational therapy. It’s allowed me to step into that role of, “How else can we empower our community?” That's a phrase we say and our clinic being Empower. How else can we do that? By me, working on the business, we can reach more people that way. That's exciting for us.If I want to get from A to B, it's a process, a road to go on. There's no secret sauce to make it happen overnight. Click To Tweet
Were there some books that were influential not just for you? Have you shared any books with your management team?
We read a book now. We try it once a month. It's been once every two months or so. I had them all read with me the E-Myth so they can understand what I was going to be doing. It’s like, “This is where I'm moving to and what I'm going to be spending a lot of my time on.” A lot of the Mike Michalowicz books were influential for me. Profit First was awesome. Clockwork was a great book. I've read most of them, The Pumpkin Plan and a couple of others. Those are influential. Jamey Schrier’s book, The Practice Freedom Method, that's a good book. My management team is reading that too because we're talking about marketing, active appreciation and a couple of things along that line.
If you can look at your leadership development program, if you will, some of it was shoulder-to-shoulder training and there were some books involved. Was there anything else that you did to help them learn and grow whether it was leading out on meetings or heading up other programs and stuff like that?
There are a couple of things. One is I did end up giving them some responsibilities and said, “I want you to do it.” They took it over even if it was rocky to start. Bree runs our team meeting now. Before, I always did it all. She took that over. Even if it was rocky in the beginning, she's run with it and does a great job with it. The other big thing, we also sit down all together once a week for 30 minutes. When I say all together, I mean the management team, the four of us. That helped a lot because there was no real coordination between us. I would be going one way, Bree would be trying to do something else, the other two clinic directors had no idea what we were doing, and that didn't help them. This at least got us coordinated and said, “This is what we're going to work on and this is how we're going to get these things done.”
It's simple things like that. When I talk to clients about developing leaders in their clinics, they have a deer in the headlights looking and understandably so. It simply goes back to having opportunities for communication and a meeting rhythm works. What did you learn to make you a leader? What books did you read to make you a leader? What is your agenda for leading out on a team meeting? How do you remind them of the values? It's little things like that. If you took 30 minutes and wrote down what you did as a “clinic director,” then that's what you would train the other guys on and that becomes your development program.
I've had a couple of PT owners that we've talked to that have asked, “What did you guys do that last a little bit?” Honestly, I've told everyone, “Nothing complicated, out of the box, obscure or crazy things.” Mainly, it’s been a lot of simple processes and they've started to get traction to where they're finally taking off. Part of it was the fact that we kept doing it during that time when they weren't getting traction. We could have turned back and said, “This isn't working. Let's scrap this whole procedure thing. Let's scrap the management team. I'm going to take back over.” It’s like he says in the E-Myth like, “Fire everyone and I'm going to do it again myself. This is a headache.” I knew that I didn't want to do that. Sticking with it, eventually it paid off. A big thing for people to think about is it's not going to change overnight. It’s been years for me to get here. Even then, I don't feel like I'm there. It's not like, “I'm done.” At the same time, I'm in a way better place now than I was years ago. It’s important for people to look at that and say, “If I want to get from A to B, it's a process and it's a road to go on. There's no secret sauce that tomorrow or next month, I'm going to now be all of a sudden done with treating and out of all this.”
It's great to hear your experience and you can share some of the details about it. That's why I was excited about having you on to show owners that it can happen. It can happen within a couple of years. You’ve got to start doing some of the hard work, start putting some intention and development behind it, and it starts coming around.
In Jamey's group, we talk about something we call the deep work. The deep work that the owner needs to do and that's vision planning, value building and culture creation. It's all those things that, a lot of times, you don't do because you're busy treating or managing the fires. Taking the time and doing that deep work pays off huge in the end.
Thanks for spending a little bit of time with me and sharing your experience. It's great to have that experience and see that happening in real-time. Number one, congratulations. Number two, keep it up. You're doing great things.
Thank you. I wouldn't be anywhere now if it wasn't for Nathan and Jamey's group. You've helped me a ton to get where I am. It's a huge difference from where I was before. I'll put a shameless plugin for Nathan's coaching. He's helped me a ton and it's been awesome. You may have even talked about some coaching when we first met and I blew it off because I was like, “I'm too busy for coaching.” It's one of those things I would now say, “I would never start a business without a coach and without this type of training.” For anybody out there that's considering, “Should I pay for a coach? Should I pay for some extra education or training?” It’s more than worth your money to do that. I would have never got to where I am without that.
It's the formula. I don't think I've interviewed an owner yet, a successful owner at least, that hasn't stepped out of treating full-time, got some coaching or consulting and continues to network. Whether that's in a mastermind, PPS or small business organizations, they're doing all three of those things on a routine basis. It's a formula that hasn't been proven wrong so far. If you want the stuff that you're talking about growth, freedom and the ability to develop what you want in a business, then that's the formula right there. Thanks for sharing your experience.
Thanks for having me. I'm happy to be on.
Thanks for your time. Thanks for coming. I look forward to hearing more about your growth in the future.
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