A topic we’ve never discussed on the Physical Therapy Owners Club podcast: Meetings. Feelings about meetings can tend to be negative. Some even avoid them as much as possible. But what you’ll learn in this episode is that is only because people have not witnessed what a good and successful meeting looks like. Today, Will Humphreys and Nathan Shields break down why meetings are important, what makes for good meetings, and how to make them an integral part of the culture you want to create in your PT clinic. Join in on this conversation and rediscover the power of good meetings.
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The Power Of Good Meetings With Will Humphreys Of Rockstar Admins
I got my good buddy here, Will Humphreys. Thanks for joining me again.
Thank you, brother. Always a pleasure to be with you, Nate.
It was good to have you on a couple of episodes ago and talk about rockstar admins and how to utilize virtual assistants. One thing we wanted to talk about now that I’m semi-excited about because I’ve never talked about it before on the show has little to do with physical therapy but more to do with entrepreneurism. That is about meetings. Never would I consider meetings to be exciting, but there was a huge benefit that we noticed over time as we nailed down our meetings and the agendas and whatnot, which I believe, is a huge benefit to our company.
It’s interesting because oftentimes those simple things are the most impactful. Since we don’t understand the benefits of them or how to execute them correctly, we don’t do them because we’re so busy. In the PT world, we’re so busy that we don’t take the time because we don’t feel like we have the time to learn about them and understand them. That’s why I love this episode too. I love talking about meetings because of what they did for us.
One of the reasons people maybe don’t do meetings is because they haven’t witnessed what successful meetings look like. A lot of us have gone through the meeting cycles and most of the time, would you say maybe a majority of the time you come away from the meeting like, “I don’t know exactly what happened right there. I don’t know if it was very productive.” People haven’t experienced what successful meetings look like. Once we got to a point where I feel like our meetings were successful per se, productive, essentially, then it would make a huge difference in our company.
Without a doubt. They are a part of the lifeblood of the company culture, which we’ll get into in a little bit. At the end of the day, it’s the main tool that we leverage for communication. When people talk about why they don’t like the company they work in, the number one answer is always communication. The hard thing as business owners is that we understand concepts like Death by Meeting by Patrick Lencioni’s book. Meetings held the wrong way are counterproductive and drain the living soul out of people.
When we don’t know what to do, we get people in a room for an hour. For some reason, every meeting is an hour when it doesn’t have to be any specific length. It can be twenty minutes or an hour and a half depending on what’s needed and wanted. We go in there, we get people together for an hour, and then we overwhelm and burn leaders out, especially merging leaders with meetings because we don’t know how to leverage them. Frankly, even in those cases, we’re grateful to have them just because some touch points give us a little bit of clarity and reality as leaders, even if it doesn’t move the needle as much as some meetings could. I love this topic. It’s one that most people wouldn’t see as an exciting topic.
What would you say were some of the benefits that came out of the meetings that we eventually developed into? What made them so successful? What were some of the results?
This isn’t my opinion as much as what’s been documented. Meetings held correctly within any business, especially a physical therapy practice, are the number one cause of driving culture. What does that mean to drive culture? Remember that culture in a company is the experience that people have when they’re there. It’s what they feel and think. When a good company leverages productively meeting rhythms at the beginning, the first thing they always do is create connection.Meetings held correctly within any business, especially a physical therapy practice, are the number one cause of driving culture. Click To Tweet
A bad meeting is where you have one person in front of a group of people talking. A productive meeting is where you have a leader facilitating connection and collaboration. That was the first thing that came to mind when you asked what would be one of the greatest things that occurred in our company. Once we start meeting correctly every single week in our weekly meetings, we’ll talk about what types of meetings they have in a minute. In our weekly meetings, there was always a dedicated spot for someone to give a 2 to 5-minute thought about a company value or the company purpose.
That’s what we do at In the Black now. We have upwards of 50 employees at this point. Every single week, someone talks about our company’s purpose or value. It’s so cool because that is how the values and the purpose start evolving. That’s how they can recite them from memory because they live in these meetings. The meeting rhythm or structure create the space for connection through the culture of the company.
The only way you can maintain excitement, engagement, and remembrance of the values and purpose of the company is through reiteration. Many times, I’ve gone through with owners generating a purpose and values, and if left to their own devices, they’re just going to collect dust on a shelf or maybe they’ll paint them on the wall or a hanging of some kind. They see them once in a while but the beauty of implementing that as part of a meeting agenda and every meeting agenda, honestly, whether it was a leadership team or a full staff meeting, entire clinics is what by that, whatever it is, would start with a recitation of the purpose and values.
Even small 2 to 5-minute thoughts like you mentioned where it wasn’t upon the owner to talk about the value, but one of the team members to talk about the value. If they wanted to take it to the next level, how they’ve seen that value lived out within the clinic or company within the past period. That’s where the rubber meets the road. That’s where people who are misaligned roll their eyes and have poor body language during those period of time. Those people who are aligned love it. They love that portion of the meeting. They like to talk about the feel-good stuff and how it’s more than the technical aspect of treating patients.
It’s so cool that you said like it’s a filter. It’s a definite filter for our teams. When we have people who roll their eyes on it, it’s either because we haven’t been as a company living it. It’s not necessarily a bad thing if we’re introducing it and it’s new, and maybe as owners, we haven’t been integral in terms of what we said we stand for. I also want to highlight that maybe your values and purpose need to be reworked, in which case you need to work with Nathan Shields, Michelle Bambenek, or whoever to talk about better defining that. Those weren’t things I figured out on my end or on your end. We figured that out with the help of Scott Fritz together.
We have the right coach to help us create the right language. That can be a driver but once that language is created, then it serves as a filter, like you said. What’s cool about that is it filters both ways. You get people that you think are pretty cool who roll their eyes and you’re like, “They’re not buying into this.” You have other people who are quiet and start lighting up when they see that. When they share their 2 to 5-minute value, it moves you. They talk about how in their review and they love the values.
It’s a natural segue, I would say, into the next benefit of having meetings. When we create connection in culture, I highly emphasize doing it in a fun way too. There are games that we play in that first half of the meeting, but after the connection is done, it’s time to get to work. We can then talk about metrics and production. It no longer comes across like a stat push because when we’ve spent time honoring the humanity of our team, celebrating each other, and connecting on this interpersonal level, now is the time we can talk about numbers.
If you’re a business owner and you’ve always wondered why you feel like you can never talk about metrics, production, or production standards without resistance, it’s either because your people aren’t in the right mindset or it’s because it’s not being balanced with the correct amount of culture or purpose. When we develop that purposeful why, we talk about metrics, then it makes sense why we’re talking about it. That’s when the bleeding heart physical therapist can understand why there’s a minimum standard of production and why we want to keep growing because it’s about driving that company’s purpose.
Making that back-to-back in any meeting builds upon exactly what you’re talking about. A forward-thinking owner can talk about the numbers and reflect on the values and the purpose. If they were to take advantage of that opportunity and say numbers are down and when numbers are down, what value are we not aligned with? Are we fulfilling our purpose if our numbers are down and making that connection?
There are many times that the team listens to the leader is doing the thing. They are reciting the values and the purpose, and they are showing the metrics that they’ve performed. Maybe they’re not making the connection and getting the two brain cells to rub together. A leader does that once or twice and starts creating that connection for them. They can start thinking for themselves, “I see why we’re talking about it now. I see why it’s important.” We’re falling short based on what we say we believe in. That makes it a lot easier for those leaders to make that connection and get buy-in.
Once they have buy-in, that’s when the meeting structure starts to become a platform like a container that holds water. The second we have a team that buys into the culture because we are living our purpose and our values, we’re celebrating the team as a result of that. By the way, they’re contributing to the idea of how to develop our company culture and the charities that we sponsor in the name of culture. Once that’s established, we start talking about production and they buy into that.
The third benefit so far is that the structure of the properly held weekly meeting allows for group accountability instead of individual accountability. Once we’re talking about production on the back end of values and purpose, then we can have everyone show their graph of production of how many visits they’ve done. It’s no longer about the owner or the clinic director. It’s about me and my integrity with the company and my team, the people that I care about and love working with. I don’t want to be left out as the person not pulling their weight and helping drive this very altruistic purpose of helping other people.
My numbers become a reflection of the greater purpose, and I don’t want to be deficient. That was when things took off for us when we started having teams of people who believed that their numbers represented something greater than money. In a group sense, they were holding each other accountable, then the leader became a mentor and a coach versus an accountability holder. That right there leads to the for-worth benefit of the owner stepping away. That’s the only way I was able to step more into the recruiting space in Alaska. It was because we had these amazing leaders, but we built it first to where they were containers unto themselves that held the water of the production of that company. That’s an important piece to recognize group accountability changes the game.
There’s something to be said when a team can show their statistics. The team has group accountability and not a singular authority or supervisor over them. Honestly, if it’s a supervisor over them who’s holding them accountable for that particular statistic, then there could be a lot of emotion and, “What about this and that? I didn’t do that. You didn’t give me this. What about that patient? How am I supposed to control that?” When you’re in a group setting, it’s hard to get past everybody or pull the wool over everybody’s eyes. When you’re held accountable to a full team, that’s a different story. Especially if that’s seen week after week, it becomes rather objective and less emotional.
It becomes more about praising the people who are exceeding. The people who are bonusing. It’s like, “Mark, look what you did. We’re so excited for you. Everyone, give him some applause. He’s crushing it this week. Mark, how did you do that?” Mark shares how he did it, and he’s getting all this praise. We’re like, “We want to thank you for driving our company purpose of being the light and hope in the lives of others today. Thank you for sharing the light and growing it in that way. Thanks to you, our company has a strong future.” Mary is sitting over there with her graph that’s below everyone else’s, and we don’t call Mary out loser.
Everyone has down statistics. It’s nothing personal. It’s objective. When Mary gets there when she sees all this, nothing even needs to be said. There’s no extra time taken away between the director or owner and the therapist who’s below production. Mary is sitting there feeling like the dorky kid in a group of cool kids and she knows it’s important. She’s going to do everything she can. When we get to Mary, it’s like, “Mary, we can see your statistics. What would you like to say about it?” We don’t kick into it. What we’re expecting from Mary is to be like, “I’m down, and here’s what I’m doing about it. I’m down and I don’t know what else to do about it. Can someone please help me? I’m trying to figure this out.” We can do magic with that mindset.
Stop the meeting and let’s focus on helping Mary.
She feels love and support. It’s like, “Mary, we want you to be successful. By the way, we want to acknowledge you for asking for help. We do want you to come up with your solutions next time, but regardless, you asking for help is what matters most.” How nice is that, Nathan? For people tuning in, what would it feel like to have somebody come to you after a week or even better, before the week is over and going, “I’m looking at my stats. I’m predicting my stats are going to be below my minimum expectation. Here’s what I’ve done about it and I’m stuck. Can you help me?” Who wouldn’t want to go help that person? That’s when we stop becoming dictators and managers and we become real leaders. We’re inspiring the willing, not motivating the complacent.
You brought up the next point. That is they can be leveraged as a tool to develop future leadership. One of the easiest things I’ve noticed with myself and with clients is to hand over some leadership responsibilities. An easy, simple initial handoff is, “I want you to run the meeting.” Our agenda is pretty fail-safe because more than likely you’re still going to be present, but they’re going to lead out and you’ve already set up the successful agendas, hopefully. You know how they’re run. They need to run them and assess how well they’re engaging with the team. Are they asking good questions?
When you get one-on-one in the back room, you can give them feedback as to how they did, how they could’ve responded better or taken a different tact, or praise them in front of everybody. You can start developing team members and see how they respond to their peers or how the peers respond to them in some of those meetings as well.
It’s so true. One of the coolest things we did that year was in our big group director meeting every clinic meeting was run like this too. The clinic director was the person who was presiding over that meeting, just like the CEO was presiding over our director meeting. Every week, it rotated who was in charge or who would run the meeting. In a clinical setting, there’d be a technician who would run the weekly meeting. Katie, our finance director, is over billing. She’s in the director meeting so she’s running the team meeting. Now she’s a CEO of a company. She would never have had the skills to do what she’s doing now if we hadn’t been selfishly offloading to her. It’s not a big deal, but it still takes work to run a meeting.
I loved having other people run the meetings and watch how nervous they got. The coolest thing is when they run the meeting and they all take turns running the meeting, they start showing up a lot more connected to that meeting and buy in because they know what it’s like to be in charge. No one to answer a question, “Guys, what do you think we should do about this problem?” No response. The next time someone else is running it, they’re like, “I’m going to help them out because that sucks.” It creates group accountability but also creates group empathy in that regard.
There’s a lot of opportunity to build on the culture. We’ll talk about some of the structure of our meetings in a little bit, but once you get past the recitations of purpose and values and talking about statistics. You’re going to go through your calendar of upcoming items. Who’s got a birthday this month? It’s October right now as we’re doing this and it’s National Physical Therapy Month. What are we going to do in October for National Physical Therapy Month? How do you guys want to celebrate? Have those conversations but you also get to talk about real training.
For example, our cancellation rate was high. What are some of the reasons why our cancellation rate went up? What do you guys think? What’s happening? What are you seeing? This is what our policy states. If you have a written policy, this is how we could address it. Role play is a great way during these team meetings to develop the capabilities within the individual team members to address problems as they come up. Someone says, “This patient said this last time. This is why they can’t show up. How do you guys think we should address it?” There’s a great opportunity there to do training is what I’m trying to say. Address some of the common issues that are coming. Where else are you going to do training on an ongoing basis if not in some of these team meetings?
The training piece is a wonderful way to create connection too. It’s like learning and connecting. At the end of the meeting, you hit it perfectly. The first third is about connection and the middle third is about culture and celebrating wins and all that. If the middle third is about statistics and identifying points, the last third is about education, improving, and dealing with specific problems. They say every week you want to move 1 or 2 rocks. We have maybe 20 things we’re focusing on, but that’s when we move 1 or 2 rocks in that last part.
It could be a training thing because we’ve had a consistent trend of a specific issue or it could be a matter of like, “Staffing for vacations is a real problem. Let’s address that as a group and figure out collectively how we’re going to do this over the next three months.” Whatever those issues are. In that last part, we want to encourage the team to write them down and put their items in a parking lot. There’s a whole thing around prioritizing them that we can’t get into now. Essentially, there’s a way to prioritize the issues that people put on the parking lot. Usually, we only get to 2 or 3 of those based on what’s going on.
When we can effectively address the top priority issues every week, 1, 2, or 3 items every 52 weeks out of the year, you’re looking at least over 100 significant issues in that company that have been addressed by the team within that year. When you’re starting this out, as someone who’s tuning in, the owner of the meeting, the director, or the physical therapy owner typically is the one driving the entire parking lot at first. When the group accountability kicks in, it’s surprising how quickly the team members start putting their items in the parking lot. They start adding. It’s funny because when they start doing it, everything is a 10 out of 10. The urgency and importance are because they wouldn’t put it on there unless they wanted some help with it.
When you teach them how to take their issues and compare them to what’s the bigger issues at play, then they start to deal with their issues. It’s a little bit more proactively and understand how to prioritize them effectively so that they’re not always knocking on your door, which is what happens when you don’t have any meetings. When people have issues, they come straight to the owner. It’s like, “Nate, what about this?” When there’s a meeting and structure, they have a place to put something somewhere and then they can weigh that against other issues and realize, “That isn’t that important. I feel stupid for even bringing it up.”
The beauty of having that opportunity in those weekly meetings is they can be addressed by the team and not just the owner. They can ask the owner, “What are we going to do about blank?” The owner can very easily kick it back to the team, “What do you guys want to do about it?” You have veto authority over everything, but within reason, if they follow certain parameters and it’s within their values, there’s a lot of leeway that can be given to the team to come up with their own decisions. If it’s not going to ruin the company, they can try something that maybe you wouldn’t have recommended to begin with because it’s something that you haven’t had experience in and they can try it.
You can always pivot and say, “How did that work last week when we implemented blank? If it worked out great, let’s keep doing it. If it didn’t, what do you guys want to do? How do you want to change that?” There’s a great opportunity there to get the buy-in from the rest of the team. It’s not just the owner coming down from the mountain with the Ten Commandments and listening, but it’s them creating their own culture and having a say in what happens in their company. That can go a long way.
I would say that was one of the life-changing moments in our journey. It was so cool because if I was running the meeting, my experience of that on my end was like, “Team, how do you want to handle this issue?” They would work it out. I’m like, “This is so great.” Normally what would happen is if it was one of my teams and I was going to go in there and make an adjustment to the team, it’s like, “This is what it is. Here’s why we’re doing it.” This whole process, they’re figuring it out. They’re making a decision.
We as owners, Nate, are like, “Let’s give that a try.” What was so cool about it is that immediately, they knew it was a pilot. They were less critical of it because it wasn’t being mandated from on a high and they got all the credit. That was the greatest thing. They did all the heavy lifting and they got all the credit, which ironically keeps people engaged in the company and keeps them working with you longer. It’s the most ironic thing. We’re giving them the work to solve their problems and they love us for it.
When we do the opposite, the opposite happens. When we solve their problems for them, their failures are our fault and then they hate us for it. If we solve it, there’s no acknowledgment of that either. From their perspective in that relationship, then we’re doing our job at a minimal level. When we’re like, “What do you guys think? We believe in you.” Not “I’m lazy and I don’t want to have to deal with this.” It’s ironic because they solve it better.
Most of the coolest things Rise Rehab, our old company, created was this weird accumulation of multiple ideas that merged. It was almost hard to know who started the idea. This idea had so many facets to it because someone would go, “That’s good, but what about this?” Someone would go, “We could do this for that.” “That’s a good idea.” There were so many times, it was like standing up and going, “I don’t know how you guys came together and did this. You guys must be an amazing team.”
After a while, they start believing it. What’s cool is the day when we can say to them, “I am confident that this team can figure anything out.” They believe it. That day is the day that the owner doesn’t have to be present because on that day, not only do they own it, they love it and they are grateful to you for trusting them with it. It’s crazy.The day when we can say to them, “I am confident that this team can figure anything out,” and they believe it is the day that the owner doesn't have to be present. Click To Tweet
I can’t tell you how many times I was surprised that they would come up with a solution to a problem. I honestly would say, “You guys came up with the solution. I’m cool with it. I don’t want anything to do with it.” In terms of, “I don’t want to be the one tracking that statistic. I don’t want to be the one calling and making sure this and that gets done. Who’s responsible for getting it done and by when?” People you wouldn’t think of would raise their hands, “I’ll take care of that.” It’s no big deal to them. I didn’t want to do it. I was like, “I guess you’ll report next week at the meeting or whatever due date.” They’re like, “Yeah, no problem.” “Okay, let’s go.”
They hit out of the park and we get to be like, “Holy crap. You did such a great job. How did you figure that out?” “I don’t know, I’m just great.” They walk away feeling so validated and so acknowledged. Honestly, so many times, they have come up with better solutions than I could have ever come up on my own. No question.
Since it is that time of year, National Physical Therapy Month, at our clinics was a big deal. We had inter-clinic competitions going on that were not our idea. We had costume days every Friday, quizzes, games, raffles, and Minute To Win It games for the patients. It was a party in the clinics that entire month. The patients looked forward to it. The clinicians looked forward to it. It was a lot of fun. None of it was any of our ideas.
That’s why it worked. If we had had the same idea, just because of the nature of our position in the company, especially without meeting rhythms, our culture would perceive that position as authoritative. Who wants to be told to have fun? No one can mandate fun and culture but group pressure can mandate that. It’s not singular to an individual. It’s not the hierarchy anymore or the patriarchy. It’s us. It’s our family that wants to connect. It’s like, “That’d be cool.” People buy in and the experience becomes amazing, and then the next year, they build on it and repeat.
We talked about the benefits of having these meetings and how they might look. We didn’t get into too many details just yet. Let’s do that now before we talk about the meetings that we’re going to have. This is a skeleton structure of what we’ve used in meetings before. Maybe it evolved a little bit with what you’ve been doing In The Black. I remember them starting. We always had the one word open. Get a gauge of where everyone is at. In one word, how are you feeling today as you’re coming into the meeting? That gets the temperature of the room as to what the tone is for everybody. We do that at the beginning and we could do it at the end. We have a one-word close.
We’d recite our motto, production is the basis of morale. We’d recite the purpose and values. We’d have a 2 to 5-minute thought about one of the values. We look immediately at our statistics. We’d look at it as a group, as a clinic, as a whole, and also as individuals, especially if there were department heads or individual providers. We’d look at the individual statistics and we’re only looking at one key stat that we chose for each patient.
Every role had one key stat and there’s a graph over a six-week trend that we would all show it. The curve of the graft determined if they were growing flat or dying, it was black and white.
They would essentially talk about what their battle plan is for the next week. Are they going to continue doing what they’re doing? Are they going to do something new? Do they need to do something different? They’d share their battle plan for the next week. It was expected that they come prepared for the meeting. They needed to come with a little bit of thought. We talked typically about calendar items.
We used to do the announcements towards the beginning. After the one word open, there would be the meeting rules. Our culture was meeting rules where it’s like being the first to share and own your own experience. Remember who our customers are. Sometimes we’d take time just to talk about that. One of the big meeting rules I wanted to punch real quick was no pink elephants. This is a big one because what that means is if someone doesn’t feel complete or safe in a meeting, they have to speak up. This became a game-changer early on. Everyone’s connected with the one word open. We’ve gone through the meeting rules and the pink elephant. People would say clearly or they would bring up their issue.
At first, it was like, “I’m just tired.” When the team safety grew, it was, “Josh, I set up this marketing wheel. I went into the clinic and it wasn’t there. I appreciate all that you do and I’m curious why that’s not up. I’m worried about it. Did I do something wrong?” They’re calling each other out in that meeting and we’ve had whole meetings where people are clearing pink elephants.
Those are the best meetings you’ve ever had because they’re not like a reality TV show calling each other out. It’s a real respectful debate, but you’re debating and people are like, “I don’t get the point of the wheel.” I remember that meeting. “I didn’t put it out there. I should have. I’m out of integrity. If I got to be honest, I don’t get it. I don’t see why we’re supposed to do that.” Stacy, our marketer would be like, “Scott or Josh, we talked about it.” They’d go back and forth.
The CEO was like, “Why do we do this? Josh, is there another way to have handled that?” By the end of it, everyone feels so much more connected and we move the needle. The announcements are usually you can do them in the middle like that or you can do them in the beginning, it doesn’t matter. It’s not like there’s one way. I love what you talked about the stats in the battle plans because that was a big deal. They had to come prepared. What we started to do was take your advice, Nate, on the one thing. People will use that time to talk about their battle plans and just politic, “It’s the slow season.” My one thing is I’m going to call past patients and get my visits up because I’m below staff.
There’s opportunity. That’s where the leaders of course have to be prepared going into the meeting. Are we going to talk about an issue, vacations coming up, the holidays, or a policy that’s falling out and we’re seeing that it’s not being followed at this time? It’s a key issue. This is something that usually comes up because of prior meetings where there’s been an issue or there’s an outstanding issue that’s not being addressed regularly.
There are opportunities to train in there. If you have students, they’re going to have to present during the course of their internship. That can be put in there somewhere. it’s some kind of continuing education if necessary. Consider all your OSHA and HIPAA training that you’re supposed to do on an annual basis, even documentation training. I guess if you’re doing documentation training, you want to do that more provider-specific. If there’s time then time for parking lot issues like you mentioned. What are some of those things?
That’s a great overview. When we’re closed, like you said, and you move a couple of needles, you review the statistics. People walk away a little bit more clearly as to where they are in the company. It’s amazing how much power those meetings can generate. When we would do reviews, hands down, the number one reviewed part of our company that people said they loved the most was the meetings at Rise Rehab. It’s true for In The Black as well. They say that the meetings are the best part of the company and their experience in the company.
It’s impressive when we did what we did, which was give it to them. When we used it as a tool the right way to empower them and let them solve problems and offload us. They thank us for it.
Some of the meetings that I would imagine on a smaller scale, of course, there are your whole clinic meetings that involve anybody who’s in the clinic. I have had some clients who do provider-specific meetings, maybe separately, weekly or biweekly, where it is about the providers and issues that are specific to them. That can or doesn’t have to happen. If you have any form of leadership, then you’re going to want to have a leadership team meeting between those top 2 or 3 people weekly as well to make sure you’re all on the same page.
In that meeting, you can focus on what are some of the topics of our upcoming team meetings. What are some of the issues that need to be addressed? Is that a team meeting worthy or is that a one-on-one conversation with somebody? What are some of the key statistics we need to drive? It follows a similar agenda. The agenda is not much different but the conversations are more global instead of specific unless necessary.
Some people will call that meeting the executive council meeting. Organically, we’ve hit the main meetings in the right order. If people are looking to put meetings into their practice, the weekly team meeting like you and I have been talking about is number one. The clinic-by-clinic weekly team meeting. The second meeting would be the executive council. Depending on your size, you might need to put that in first if you’re a multi-location business. I don’t think you get multi-location if you haven’t already been doing the weekly team meetings.
You get to that point where you have the executive council meeting and it’s a very similar agenda. The key difference is introduction like we ended up doing Tony time. Tony, who used to be in charge of recruiting, would come in and do a five-minute update on what’s been requested for hiring, what she’s working on, and where she’s at. All the directors knew here are the open positions and here’s what we’re filling. There was the marketing minute with Stacy, where Stacy would come in and go, “Here are the events we’re scheduled. Here’s the doctors I’m working on.” There was a Katie moment as well where she would come in over financials. That wasn’t really with the executive council that was specific to the owners.
That was the clinic director meeting where we had the multi-clinic directors come together.
I’m combining the director meeting and the executive council. The executive council was you and me and Michelle and Stephanie. There was the director meeting with all the clinic directors with us. When you were working in AK, you wouldn’t have to be in those as much. There were the clinic-by-clinic meetings. There were three weekly meetings. It sounds like a lot of meetings but this information gets brought up to the top, how decisions get made, and how it gets disseminated.
When you think about it, in a four-location company, you count every single weekly meeting. There were six hours of meetings across 50 people. I only had two hours of meetings a week. The directors only had two hours of meetings a week. It wasn’t as much as it sounds. When it starts flowing, you wonder how you lived without it. That’s for sure.
People who say that’s a lot of wasted time when they could be out on the clinic floor producing. I can understand that because that’s my driver. I want to see production and money and I’m going to judge my self-worth on my bank account. However, when we looked at our financials compared to the others that we sold with at the time, we were head and shoulders above on profit margins compared to other companies. A lot of that had to do with the fact that we had built a culture and an accountability system through the meetings in which we could drive productivity.
As I like to say, this isn’t a brag on us. It’s a brag on the people. When we merged with those four other companies, we weren’t the biggest. We weren’t even the second biggest in terms of patient volume or number of locations. We had two other companies that were bigger in both of those regards. We had the highest net margin and the highest net profits, meaning we didn’t see as much gross volume, but we had more profits than anyone else. That means we worked smarter, not harder. Magnification is delegation and delegation requires space. That’s where the meetings come in. We come in to collaborate, delegate, and any other word that rhymes with delegate like commiserate, don’t be late, try not to hate. Do you remember that in Excess song?Magnification is delegation and delegation requires space, and that's where the meetings come in. Click To Tweet
Yeah. That’s a good one.
Anyway, it’s like that. The meetings are everything in that regard.
The one meeting that we didn’t discuss was the quarterly town halls. I wasn’t around when you started implementing those. I had moved by that time. The quarterly town halls were a great opportunity to bring all the teams together, cast a vision, and do some vision-sharing and training on a greater level. It’s magnifying that training. Tell us about the benefit and how you ran those quarterly town halls.
There are three extra chapters that you download on the website. What we talked about is like bare bones. Once you get your executive council director, depending on your size, maybe all you need is a weekly clinical meeting. If you’re a single location provider, you need one meeting an hour a week. Once you get your regular meetings in place, then you can escalate things to a quarterly town hall.
At the quarterly town hall, we would shut down the entire company. Usually, we were open to about 3:00 or 4:00 in the afternoon. We still ended a little bit earlier on those Fridays, but we shut down at four locations. It’s almost twenty providers. We shut down patient care per provider for three hours on a Friday once a quarter. Think about that. That’s almost 50 visits a week. Let’s say 100 visits a week, that’s $5,000. We were “losing” in that regard.
Smartest investment in growing our profits ever because when you shut down, you get your tribe together and you connect at the deepest level. It was a tear fest every time. It wasn’t because of one person. We would give space to acknowledge each other over the company values and the purpose. One of the main things we did was we would stand up and go through one of our companies. We’d go through four of our values and say, “We’re going to talk about accountability. Close your eyes. Everyone here can think of someone in the company that exemplified this value. You can think of someone, raise your hand, don’t even worry about it.” From day one, people would raise their hands. We’d have 3 to 5 people per value stand up in front and recognize each other.
Susan would stand up and say, “I want to talk about Carrie and how her accountability changed my life.” Things would come up that we didn’t know about like people losing family members or having to deal with cancer. All these things would come up that we had no idea about as we grew until it was brought up by the team members. The love was so palpable that people would know that we were committed to each other. That commitment was thickened over time. The trust grew to the point where we would walk away from those quarterly town halls knowing that we were risers. That was unique when we merged as well. Everyone loved their company and thought it was the best.
Our company to this day, those people who used to work together still refer to each other as risers or the rise way. I hear that all the time. When we talk to people, “So and so do it the right way.” That’s when that’s when things go from this cool company that is being run by wonderful people. It’s not like this burden. That’s when it becomes this thing bigger than any one of us. We start to look at it as a movement. That’s why when we exited, there was so much heartbreak over that.
We have to give credit where it’s due. This isn’t something that you just pulled out of nowhere. A lot of it came from Verne Harnish’s Scaling Up. Am I wrong?
No. I said that at the beginning. It’s a free chapter. It’s all in there. It was a play in the playbook that we took out. Even if I took that play out of the playbook, it was Michelle Babin, Stacy Sullivan, and Stephanie Borland. It was the directors we had at the time who took that and said, “Let’s do this. Let’s do it right.” It wasn’t one of us. It was this collaboration. The way the town halls worked was that we would get together.
First of all, it was Thursday morning that the four people would get together and there’d be planning over the next quarter. It’d be a review of the previous quarter’s planning for the next quarter. It’d be a kickoff dinner Thursday night where all the directors came in and we’d all have dinner. It was usually at Bocca di Bacco. Friday is when we’d bring in a facilitator like Scott Fritz or Corwin. We would in a room map out the next quarter. The week from that Friday was the town hall, so we had time to create target goals.
In those town halls, there was a lot of love, but there was also a lot of like, “Here’s the red, yellow, and green focus for next quarter. We want everyone to write down how their commitment and role is going to move the needle.” You have technicians writing down how they’re going to break the record of visits in the next quarter in the summer months when it usually slows down.
The first thing you would do in the town hall after you warm up is you would recognize if we hit red, yellow, and green, and there was always a sexy prize to it. If it was green, it was something really big. It was such a collaboration to get there. Anyone can do it. It’s a matter of starting small with the meeting rhythms that gripped the most. The weekly meetings have to be in place. They have to be bought into metrics and that has to be in place before you throw a town hall out. Once that’s there, you can accelerate it to this huge degree by using those quarterly pushes to connect and move the needle.
If people hadn’t bought into the culture by that point, they did or solidified that culture, that environment, and all the feel-goods prior to that. It solidified the team as a whole.
Agreed. It was cool too because, at that point, that’s when recruiting and hiring became a non-issue.
It became a lot easier.
The hard thing to teach in Rockstar Recruiter is that you first have to have those things in place to create the magnet draw for people to want to come work, but it’s a chicken and egg thing. You can’t create that culture unless you hire those people. You keep fighting. You fight the battle. We hire people. We don’t have the culture to keep them long enough, so we hire again, and we don’t get quite as good of people. We work them out. We bring a better person in and on we go. Over time, if we don’t give up and we are willing to let go of the fact that our treating is everything, we can let go of that one core limiting belief. We can get there. You and I are living proof of that. The fact that you and I got to that place with our team is more of a reflection of it being possible for anyone than anything else.
I’m usually afraid talking about culture because people think that there might be a switch or a certain thing that needs to be done, and within a couple of months, my culture’s going to be better. You’ve got to look at culture as a long play. It’s going to be a long game. I would say it took us a couple of three years before we could have said that our culture had a significantly positive impact on our business.
To your point, about those first years, it got way worse before it got better. When we first reconnected and created Rise after having our whole journey of the pinnacle, affinity, and all those different companies we used to own together and whatever. We got all of them together and created Rise. That first bit, we had a lot of cleanup to do. That first connection and drive for culture stirred the hornets’ nests in such a bad way. Some of the worst professional memories of my life occurred on that journey.
With one location in particular, whose name will not be mentioned because it turned out to be great after we got that cleaned out. It was hell and miserable. If I could go back in time and talk to myself then, I would’ve loved to have taken a video of one of those leader town hall meetings and be like, “This is the price you’re paying to build. It wouldn’t have been hard.” What would you have told yourself going back in time in those days?
Similarly, I would’ve said, “What you’re doing is going to pay off. Even though you’re losing people now who you think are valuable, the people that are going to come in their place are going to be aligned and you’ll get more fulfillment from them than you ever have before.”
You’ll be so fulfilled by what’s coming that whatever price you pay now is more than worth it.You'll be so fulfilled by what's coming that whatever price you pay now is more than worth it. Click To Tweet
That’s what we saw, especially as those who were not value-aligned shipped off. People who were more closely value-aligned came on then pushing production, pushing accountability, and getting people to see the visions that we saw, and the desire to do more and be better became so much more easier. It was easier to talk about numbers, get things done, get volunteers for projects, and find people who wanted to join leadership development programs. All these things as we gained more people who were aligned with us, and we had a culture that supported those same people, then leaders started bubbling up. People wanted to take on more and more off of our plates. Leadership became so much more easy.
It’s that flywheel concept. You’re cranking at first so hard and then the wheel starts picking up momentum and then it starts pulling you. It’s an amazing thing that happens. I would say as you’re talking, it made me realize that the one thing that we did right from the beginning was we knew our job. What I mean by that is you and I knew that we were not going to serve anybody treating. We weren’t going to ever grow any of that if we were treating. I’m not bagging on treating, but I do want whenever possible to mention to the many wonderful, talented PT owners who are tuning in that there is greatness on the other side of treating that if you could see, it would make you put down your goniometer right now and step into leadership full-time.
It is one of the most amazing rewards. It blows out any patient care experience I’ve ever had out the water. I loved my patient care. For years, just like you, I never thought I’d ever be anything other than a passionate provider. Building a team to help thousands of people at that level of commitment and trust is indescribable. If you and I were still trying to treat patients and do that, it would’ve never happened. We would’ve stayed in our routine. If people are like, “What am I doing that’s keeping me stuck?” you’re treating. “What do I do?” Go get a coach and figure it out but you’ve got to be committed to step one, getting to work on your company full-time. Little by little at first, but then getting full-time because it took Nathan and I being full-time on the business for years to get to that point.
The people who are stuck, I don’t think they recognize that they are the limiting factor. Once you say you need to go treat, they’ve already got these self-limiting beliefs or false postulates. If I’m not treating, who’s treating? They can’t treat as well as I can and they don’t care as much. How are you going to get them to care as much? How are you going to train them? Even if you do hire them and find them, how are you going to keep everything in and do things the way you want them done according to the values and purpose that you’ve already iterated? How are you going to do that?
Do you think these people are going to naturally fall in your lap and stay fully aligned all the time and run all your policies and procedures without you telling them how to run policies and procedures? What systems are you going to use to keep everything humming? What else can you use besides well-planned and thought-out meeting rhythms? How are you going to spread your message?
Giving a lot of people who are tuning in the benefit of the doubt, the reason they still treat isn’t because they’re safe in treating. There’s legitimate not fear and not understanding what to do if they weren’t. They might lean on the excuse of like, “If I don’t treat, then we’re going to lose money or not even exist.” That might be the case in some rare cases, but in every case, it’s possible to work yourself out of treating into leadership full-time. That’s why it goes back to coaching again, hiring you or Adam. Talk about how to build yourself out of the day-to-day in a way that they can put in meetings. That’s the thing. Once you’re out of treating, you start putting these meetings in. It takes work. This is not easy, but it is doable. Anyone can do it. It just takes time. That’s it.
There’s no other way to develop that culture than what we’re talking about. I can’t think of it. You could do one-on-one accountability meetings all the time and have your annual reviews, but there’s no other way to bring a team together.
I used to do all of those. I used to do one-on-one. I have question interviews with every director, every key player, and every biller. It was exhausting. There are still a lot of people in my network who still do that in my business network outside of physical therapy. I want to say, “Go to a group accountability thing. They love it more. You get so much of your own time back.”
What books do you recall were influential in helping us develop some of these meetings and recognize the importance of them? We talked about Scaling Up. Any others?
That’s the best for structure. That’s the skeleton’s anatomy of it. If you think about comparing a business to learning how to treat patients, the anatomy of the meeting structure and most things businesses are in Scaling Up. It’s a bible so it’s a heavy read. It took years to go through that because you’d have to read it and implement it and so on. When it comes to the culture of what you want to build within the structure, The Five Dysfunctions of a Team by Patrick Lencioni is number one, hands down.
An overall cultural builder would be Leadership And Self-Deception by the Arbinger Institute is incredible. If you want to learn about those types of things, those are the best three resources I would recommend. If those three things are hit, then it does help create the structure and then fill it with content that will be valuable.
One of the first ones that we read was Mastering the Rockefeller Habits also by Verne Harnish. A smaller read than Scaling Up and the precursor to Scaling Up.
I thought Scaling Up was Rockefeller Habits 2.0. Is it a separate book?
It is. Mastering the Rockefeller Habits was first. It was smaller from what I recall.
Another thing that you brought to the table, a book that I loved that became part of the meeting rhythms was The ONE Thing. We went from battle plans, which came from measurable solutions to, “Create your battle plan but tell us the one thing that matters most from your battle plan for simplicity.” It eliminated all the politicking and it was what we were talking about. That’s a good book to fill the content in the meetings.
I like that idea, too. Really good books. Anything else you want to say about meetings?
I hope people can see the power of it. We’ve been going off on this and it is such a cool thing because it’s something that we all have at our disposal. It takes a little bit of organization. The impact is exponential. I hope that people, as they’re tuning into this, can feel that the possibility of what they could do if they started the meetings or improved them. Remember, most of all, to not negate yourself. PT owners are the worst at this. I put myself in this category of beating myself up. It’s like, “I’m not doing that. I should do that.” No, just take one step. If you don’t have a coach, start with a coach. Don’t worry about meetings. Get a coach, step one. Step two, talk to the coach about meetings.
If you want to start meetings, don’t look for the best times in which to put them down every week. We had ours every Tuesday at lunch. It wasn’t a surprise to anybody. They start at lunch, 11:58 or 12:05 every Tuesday. We come prepared so it’s not a surprise for anybody. It takes a little bit of effort to do that. Once you do it, then it’s on the schedule for every week.
Consistency alone creates value in a way that if you don’t have the perfect structure, the perfect culture, or the right people, doing it every week is going to get better.
If it ends up only being 40 minutes, great. People would love the extra twenty minutes, I’m sure.
End the meeting if you feel like it’s going sideways, “That’s it for today.” Let it go. It doesn’t have to be an hour. If we feel the need to fill the hour whenever the meetings take off, you’ll be doing the opposite. You’ll be cutting things out of the meeting because you have so much content that you are feeling like you have to get through.
We’ve got a lot of stuff that we’ve handled these past years. I remember in one of our meetings, we talked about how to handle the holidays every year. Christmas falls on a Wednesday or a Friday. What are we going to do when Christmas falls on a weekend? I remember we spent one meeting that took us about 10 or 15 minutes to set up a policy for how we handle holidays all the time so we never have this conversation ever again.
You find yourself talking about the same things in the meetings. Maybe we should do something different.
Let’s make one decision that affects every conversation going forward regarding this topic. Some people are going to act out during these meetings. That’s a good opportunity, like you said, to shut it down or, “I guess we need to have a one-on-one conversation. Let’s go. Let’s do that. Let’s set that up for some other time and we talk about it.” Those things come up, but you can handle them and that’s fine. I’d rather handle them there or know that that came up during the pink elephant conversation instead of letting it brew and then you get a two-week notice or someone does not show up for the job.
After having powerful meeting structures and review structures, both of those things in place, when someone quits and you’re surprised, 99% of the time, it’s on them at that point. It’s like, “I wasn’t happy here.” Every week, we’re asking if you’re not happy about something. Every so often, we’re checking in personally with you. That’s on you. That still happens but it happens so much less. That’s one of dozens of problems that are resolved by simply having meetings.
Thanks for your time. It was awesome talking about meetings.
Thank you for having me. I hope all of your audience are safe in their cars as they’re driving home.
Thanks. We will catch up again later I’m sure.
Talk to you soon.
- Will Humphreys
- Death by Meeting
- Scaling Up
- The Five Dysfunctions of a Team
- Leadership And Self-Deception
- Mastering the Rockefeller Habits
- The ONE Thing
About Will Humphreys
Will is the founder of the Healthcare Business Academy. He is a serial entrepreneur, health care provider, speaker, and author. At 17, he fell off of a mountain breaking both arms and legs. His exposure to the medical field led him to becoming a physical therapist. Later, he became a private practice owner and built a company to multiple locations prior to exiting at 3 times the national average. Today, he teaches others the lessons he learned from decades of practice and hundreds of interviews, hires, and fires. His greatest joy is his wife of 20 years and four sons.
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