Dr. Avi Zinn, PT, DPT, OCS, the owner of Druid Hills Physical Therapy in Atlanta, Georgia has been gradually growing his practice with the goal of giving high-quality care to his patients. Since our last episode, he has procured a PT business coach to reach the goals he has for his business. Today, Nathan Shields checks in with Avi to see how it's going so far, what he's learned, and his experiences since they last spoke. Discover what Avi has learned and the traumatic experience that challenged him as a young owner.
This is episode two of my reality podcast episodes with Avi Zinn, tracking Avi's relationship that he's developed with a coach and consultant over the past few months. If you haven't read the episode, go ahead and do so. That'll give you an idea of where we're coming from because that was prior to Avi starting his coaching. In this episode, we want to focus on simply what his initial experience has been and some of the things that he's had to deal with since we spoke. He had some trauma that happened in his clinic and I hope we pay proper respect to the nature of the issue and how Avi got through it appropriately. It was a difficult situation for him and his clinic to go through. Hopefully, we handle that situation appropriately and understand that Avi had to navigate a ton of emotions while also trying to be the leader and a stalwart of his clinic on behalf of his team, patients, community and families involved. This is an interesting episode, but we got a lot out of it.
The Owner of Druid Hills PT, Avi Zinn. If you read the first episode with Avi, you'll understand that what we're doing here is simply tracking Avi's journey as he brings on a coach, a business consultant, if you will, to help him in his business. We shared a lot of his professional story and what he'd done before that point. Correct me if I'm wrong, Avi, you had hired the consultant as of our last episode but hadn't started doing anything with him formally.
Right, Nathan. I can't remember what month, it was a right around the same time. I may have hired them on, signed up with them, but hadn't gotten anything going.
I wanted to follow along with Avi maybe every quarter or so and see what his progress is like. What he's learning from his coach? What's helping, maybe what's not in some of his experiences as he's taking it on. I started asking you questions already, but thanks for coming on again.
I'm glad to be back.
If you want to follow Avi's story and learn a little bit more about him, read the first episode. Since we talked, tell us a little bit about some of the things that you've done with your coach, some of the things you've learned and some of your experiences.
First of all right from the get-go, things started well. Getting all of my numbers in order, taking all the analytics with WebPT. We had all these analytics but I didn't know what to do with them. We took all of our analytics, all of our metrics and put them all on a dashboard so we can objectively look at the numbers and track them and follow them. Right from the start, we were able to see an increase in efficiency, looking at better utilization. The numbers were able to be tracked. From the start of the coaching, it has been able to get me through a lot of not knowing, being able to like, "I see what that is, now I know what to do."
In relationship to the numbers, there's something to it, but there's a thing out there which is measured, improves, measured, and reported improves exponentially or something like that. What you find is as you start looking at the numbers, even if you don't put a lot of effort into improving the numbers, they start improving somehow. The universe starts pushing you in the right direction if you will. It's simply tracking the objective numbers and your KPIs in your clinic. That exercise alone seems to start improving things.
It feels that is happening by having those numbers on the dashboard and looking at them every month and comparing them, we see positive changes.
The cool thing about it is you're looking at it objectively and I'm not speaking for you, but for myself and maybe some other owners, you might feel things are getting better or you might feel things are getting worse. When you look at the numbers, you have the data right in front of you and you know if it is getting better or how worse it is getting or how much improvement you've made. It's good to have that certainty, if you will.
To get back to the question about how things are going. Having my coach that I speak to every two weeks and we talk about the numbers and see what needs to be changed, how could we change, what can we work on. Going back to the first one we did. Talking about The E-Myth originally and a lot of people read The E-Myth but they don't implement it. Having these numbers, the coach and the accountability is allowing me to stay focused and not get distracted by any of the millions of other little things that anything could happen, accomplish or try to affect and change what we're working on.
Considering you talked about accountability, do you feel a little bit of pressure? As you know that your meeting is coming up with your coach that you go, "I need to get this stuff done," whereas maybe you wouldn't have that before?
That's why it's good to have that person. I'm assuming your coach is a physical therapy owner as well or was or something like that. They can relate to, they can talk about the same language and use the same vocabulary. You started using the metrics, started following your KPIs. You're meeting with your coach. Are you doing anything else on top of that?Always look at the numbers and make sure things are going as you want them to, and then go from there. Click To Tweet
The coaching program, there are also a whole bunch of modules that they have set up for let's say patient engagement or internal marketing or all these different modules. Another good thing that the coaching helps with is you're focusing on those numbers, “Let's talk about what we think can help change that.” If it's making sure that we're focusing on not having the patient drop off or making sure we're more efficient and completing plans of care. There are modules for, "This is what works and this is what you can do." There are all those things that I'm working on. At the end of each call, there's the plan of action and then by the next call, I'm like, "I finished this and I implemented that." That goes back to knowing that is coming up. I’ve got to make sure I get all those things done before the call so that I can say, "I've completed that module and let's work on the next thing."
You've got some homework to do in between. As I'm talking to people who are calling me about doing coaching, this is good to have this real conversation. Because when I tell them we're going to meet bi-weekly and discuss what's going on in their clinics, they think that it's just a call and that's it. What happens is you walk away with a ton of homework to do, sometimes even a little overwhelming if I'm not mistaken.
There's still a lot to be done. It can be overwhelming.
There are many things to do where the coach can help you do it and maybe you've experienced this, help you prioritize what needs to get done more urgently or simply prioritize. “Let's make sure we hit this thing first and if you can get to it, that’s great, but let’s focus our energies.”
My coach, being that he is a PT owner, it comes in handy because he can say, "This is what works for our clinic or proven in the program. These are the things that I can see based on the numbers, based on what you're saying, and based on what we're talking about, that this is what you should work on. If it's time management, then do that mount module and work on chunking your time so that you're efficiently using your time and not being all over the place and getting things done more efficiently. If it's patient engagement, then you start working on these things because that's what we ultimately need to get on to help with that.”
In your program, do you follow a step-by-step process? It’s like, “We're going to focus on number one first and we're not going to stop talking about number two until we get to number one figured out.” Are you able to work with them about things that are of a more urgent nature? Say if there's some disciplinary action that needs to take place, talk about disciplinary procedures and how to handle an employee. If you need to recruit somebody because numbers are going high. Are you able to discuss some of those other things as well in place of the program itself?
There's flexibility within what needs to be worked on and what the priority is. There are the modules which are prerecorded videos, you can watch those at any point in time. We have our coach, we have our call, there's module one through however many, but it doesn't mean that you have to start with number one. “Let's look at what does Druid Hills PT needs?” We're looking at the numbers and visits are fine but maybe there's a poor utilization or I say, "This week, I noticed that we are having problems with cancellations still. Let's focus on that. This week, I noticed that my front desk isn't able to collect as much from the patients. How do we change that?" There's room for flexibility and working on what needs to be worked on, not just following step-by-step through the program.
What's a typical agenda for your meetings with your coach?
We get on the call and talk about some positive things that I've been able to change or implement since we talked. It could be anything, focus on starting on a positive note. It could go 1 or 2 ways but so far, I've had enough to bring up that I wanted to work on. Whereas there were 1 or 2 times where I'm like, "I need your help, what do you think should we work on?" A lot of times, I'm like, "This is what I've been focusing on. I've completed that. That's working pretty well." One of the things originally was working myself out of treatment. I got that under control for a little bit. I was like, "I've done that. How can I use my time better?" My coach says, "You can watch module whatever for time management and then talk about different strategies on what to do with the time and how to utilize it better." There's not necessarily one exact structure of the call other than trying to look at what we think needs to be done. We always look at the numbers and make sure things are going as we want them to and then go from there.
That sounds similar to what I do. It usually starts with what were the wins? What are the successes since we talked? What's top of mind that usually there's something that's happened that you want to talk to out and address? If there's not a whole lot there, then typically the coach will have something that he wants you to maybe consider or focus on as well. Maybe it's the next step or it's something that you might not have looked at, “Have you considered this?” There's some fluidity there based on my experience with coaching. Usually, you want to talk about things that are top of mind, but the coach then also can bring in things that you might not have considered at this stage of your ownership. Does that sound similar?
I only know much and that's why I'm doing the coaching. Hopefully, a good coach can do exactly what you said.
I'm assuming you're progressing fairly well towards the goals that you have set forth already for the year and whatnot?
Yes and no. A few things came up and it's been interesting. One tragic thing happened. One of our PTs was killed in a car accident and it's been crazy. That's what could have been a crazy, downward spiral for the business. It didn't turn out that way. It's ultimately because of the coaching and having that accountability. At first, it was certainly a shock and it was something that I never had to deal with. As a business owner, I had to make sure that the staff was okay. I had to make sure that all the PTs, the patients were okay. Some people didn't want to come back and that's completely understandable. Those are all things and dealing with the PT's family and it was overwhelming.
What a difficult experience and I didn't even think about this because you'd shared that with me but to consider what is expected out of you as the leader in this regard. You're not only responsible for your emotions and handling yourself, but you've got to consider the other team members, the patients that you see, this physical therapist's family and that's involved. Maybe any responsibility you have might have towards them that had to be overwhelming. How did you handle that?
I handled it all right. It was shocking. The first week, I was sitting in my office staring at my computer not knowing what to do. I will say going back to the coaching, you had to separate the emotion from it and then still recognize that this is still a business. Not to be insensitive, but the business needs to continue to move on. That alone that was tough to be able to put aside emotions and focus on the business. It felt insensitive, but it had to be done.
You want to honor them and you want to honor your emotions and your feelings. If you're looking at it from a logical standpoint, the business going down doesn't do anybody a service. You’ve got to keep it up and running because you've got multiple families and your community relying on you to perform still. That's got to be a hard position to be and to find the energy to move forward in that path. Sometimes some of these objective measures helped you out along the way.
The objective measures, having the coaching, having accountability, being able to look at the numbers and at the end of the day everything that happened, I had to jump in and treat more and pick up those patients. At the end of the day, having the numbers and looking at them objectively and being able to look at them rationally and not emotionally and irrationally, allowed me to look and see. The business is not doing anything that different, maybe not growing as much as I was expecting and wanting to, but it wasn't falling apart and becoming this downward spiral. Everything was being able to stay stable. We were looking at the numbers and then having that accountability of talking through it with someone and getting a little bit more direction on what could be focused on more than other things that would be helpful had to have been what allowed me to get through that time.
I can't imagine the support that a third party like your coach provided at that time from the business perspective. The support that they could provide you because you'd laid a foundation, a framework of measurements of policies and procedures that we're able to keep you guys going so you can lean on it. It was a foundation. You could lean on this structure that you'd already built, even though it's not quite finished if you will, but you're able to lean on that and maybe give you space to work on your emotions as you were dealing through this issue.
That's interesting that is what happened in that. Maybe we weren't getting this crazy growth I was anticipating or not even crazy growth, just moving forward. At the same time, because there was that foundation, the integrity of the business was there. Things were able to continue without having to get caught up in losing revenue and whatever. That allowed me to deal with what was going on maybe emotionally. Maybe there would be a time in the day where normally I would be super productive, but that hour I sat in my office and staring at the wall or something. That integrity and that foundation created the space to allow me to do that.
What was the therapist's name?
His name is Tyler Wallace.
It’s a tough situation. I honestly haven't come across a lot of that in my interviews. I had to deal with the death of a longtime PTA that was part of our company. She was amazing. She was with me for fifteen years or maybe more. She was a big part of the company, a real light in our clinics every day. She almost became like a sister to me. It's something that I'm finding and it doesn't go away easily even a fellow employee is still working through their emotions in regards to that passing. It's a tough one. It can be hard because the team members become part of your family. Sometimes you see them more often than you see your family. It can be a difficult experience. I have to commend you for the work that you did ahead of time. You’re creating the foundation of policy and procedures, objective measures, and having the coach. It's hard to say what it would've been like if you didn't have those things in place? Hopefully, we can look back and say, "Some of those things we're able to carry you through."
I believe that is completely what did it. This has been something I've been struggling with, not to be insensitive and not to honor the process. There were a lot of interesting things that happened with the business. By the nature of losing a PT, we had fewer PTs, but because we were implementing all of these different practices and trying to become more efficient and focusing on whatever we're focusing on. The numbers were improving at the same time. We were paying fewer payrolls because we had one less PT to pay and we still see the same amount of visits. The PT schedules were more full and we were becoming more efficient. We were having less drop-off because we are focusing on getting the patients to complete their plan of care. You've got two sides of the thing. This horrible thing happened, but in the end, a lot of ways the business benefited from it. It's hard to say that because of the actual situation but that ultimately goes back to the coaching and the ability to be able to objectively look at the numbers and see that these things work. By looking at the numbers, we can not only get through hard times but grow from them at the same time.
From a larger perspective, I don't want to minimize Tyler's passing, but you had gotten to a point where you weren't treating at all for the few weeks before his passing.
That's true. I was down to no treating.
Focused on business, time with your family, time for hobbies. I see it quite often, not necessarily that someone's going to pass, but obstacles come in the way. Whether that has to let go of somebody or personal issues show up as you're making these steps in progression, life is going to get in the way. It's because you have some of these structures in place that make getting through those difficulties easier. If someone does pass away, we've got these structures in place and we're watching the statistics. Someone who we thought was an integral part of our program and a rock that we couldn't let go of. Maybe they leave for greener pastures or for disciplinary procedures or whatever it might be. You come out the other end, things can improve. Whereas in the state beforehand, if you hadn't measured those things and structures weren't in place, then it would have been complete chaos with a lack of control or power or whatnot. You give yourself to whatever happens. You're simply riding the waves, but you're able to have some power if you're able to structure your business and your management appropriately.
Having those numbers, having that accountability from the coach and having the structure, I was talking about in the last episode that we did, my PT, my first employee, she had reduced her hours. She was doing some home health. I started looking and I hired a new PT full-time and then she decided to do full-time home health. I had this new PT and she had this planned two-week vacation before hiring that we all knew about and it happened at the same time. This went from me backing myself out of treating, having three almost full-time PTs to then having one full-time PT for two weeks. One full-time PT and then me going back into full-time treating all of a sudden. After going through all of that and then looking at the numbers, seeing that at the end of the day, we were 20% more efficient with our utilization.
Our bottom line was in line with what we were even with one less PT. It came back full circle in that when you had asked me about, "How did I decide to hire someone on early?" It seemed out of the norm, usually you don't hire on that early because you want to make sure everything is more efficient, 90% full. It came back for full circle in that. At first, after all this happened, I'm like, "I need to start looking for a new PT because I need to fill that spot." That's not the biggest priority because I realize that we can become as effective as long as we're efficient. That's what the coaching and consulting are helping with is becoming more efficient. Ultimately we're doing the same with the business with fewer PTs, which is what exactly what we're trying to do.It is ideal to build a culture and create a string foundation along with striving for business efficiency. Click To Tweet
What are some of the things that you're looking forward to now going forward? You've been through a tough experience that was his passing. What are you looking forward to as you're moving forward? Where are the things that you're working on as you progress through 2020?
The first mastermind, the group with all the consulting, we all get together quarterly. Right after that, I came back and we had this whole meeting and talk to everyone about the company’s vision and trying to talk to the staff also to see, maybe they have some input on the vision. What do they want to see out of business? What are they looking for? How can we all get on the same page as the vision of this company? I've been thinking about that a lot. What is our vision? What is my vision? How can we include everyone that works here in that? What I am focusing on is I've got two great PTs that are working and I'm focusing on them and trying to get a great team, focus on the staff that I have. Try to get everyone to work together with the same goals in mind.
The vision as simply put is trying to help as many people as possible. We want to be there for the community. I'm telling all my staff that I'm doing the coaching and explaining to them that I'm focusing, anytime I come to the office and say, "We’ve got to do this and this is how we’ve got to change things." It's not because I'm trying to micromanage things. It's because this is what we're doing to try to get to that goal, that vision. This is what we're going to do to get there. I'm focusing in on the staff that I have to build the culture and create a strong foundation of not just the business efficiency, but also the team and the culture of our business.
You say that you're focusing on them, focusing on your physical therapists. What are some of the things that you're doing to focus on them?
I had a meeting with the PTs. First of all, I acknowledged that I appreciate their hard work. That simple thing is probably something that doesn't happen often. Focusing on them, meaning they are my employees, but I also appreciate them and I want them to feel like they're a part of this as well. That is something that will help the business. It's not I'm doing it so that they can feel more appreciated. It's more like if we're all here doing this together, we're going to be able to make this thing work a lot better and help more people. Making it known that they're appreciated, not just tell them that you appreciate them, but asking them what they think we can do better. What is it that we're doing that they see from a different set of eyes that would be different, that would help out? I'm one person and there are a different set of eyes on the business and they see it differently. Their opinions are as valuable. Listening to them and trying to gain that and implement those ideas is going to be super helpful.
What a great way to develop your culture and also get your providers engaged and bought into the company by simply asking their opinions like, "What do you guys think? What should we do?" Recognizing that you don't have all the answers, that maybe they could do some things or have some answers that are better than yours. That's a great exercise that you started and you can continue to do with them to start developing this culture that you have in a new company like that. That's a great step. When I'm thinking about the vision, usually I see it as coming from the top down. It's an essential vision for the company but it sounds like you took them through an exercise where you wanted to see what their vision for the company was as well. Am I right? This is something that your coach has taken you through while you got it from the mastermind but your coaches had been following up with you and seeing how things are progressing
Correct, and giving ideas on how to even bring up the topic or the exercise like my coach was, "What's your vision?" I was like, "To be a good business." He's like, "You need maybe to have a little bit better vision than that." I went home and that was some homework. That was one of our coaching calls. It was like, "Next coaching call, I want you to have your vision." I spent the next two weeks, I watched some TED Talks about people, company visions. I read some stuff and created what I thought would be our vision, not just for the company's growth but also what we're trying to do for the community as well.
The effect in the community, the larger purpose, that stuff and how you want to be seen. You have some other mastermind groups that you're going to go to. You'll have your bi-weekly meetings. Are you going to any conferences then as well?
We have another mastermind coming up. We'll see what new nuggets we get from that.
Based on your initial experience, you've only been with your coach for a few months. What would you tell somebody who's considered it or maybe even not considered? What would you tell our audience about your initial experience with having a coach?
I would say that if you haven't gotten a coach yet, you should go ahead and do it. Even if you're thinking of starting a business, I would say it’s probably better to do it even before starting so that you cannot have to fix what is broken, but start on a much better solid foundation having that. Having that accountability and those calls are helpful to have so you can be focused and committed to what you're trying to accomplish because it's easy to get distracted. There are many millions of things that you could spend your time on but are not important. If you need to get things done, you having that coach and that accountability not just to guide you but also to keep you accountable is instrumental in being able to grow the business.
What would you say your ROI so far on investing in a coach? Maybe you do not see it in sheer numbers, maybe you are, but what would you say are some of the ROIs on what you've invested in so far?
I would say numbers are not the easiest thing to see yet, because of all the things that had happened and we're down a PT. We're at the same as far as the bottom line where we were. Everything else is more solid, more a better foundation. As far as the return, knowing that I have someone to fall back on after going through something like this and able to get through it in such a positive and productive way was more worth more than anything. There's no way that I could've gotten through that without having someone else to keep me focused, keep me rational, keep me objective instead of getting super emotional about it.
I'm glad you had that support. Condolences to you, the families and your team. It’s a horrible, horrific experience to go through. I wish you guys the best and I'm glad to hear that you've got some support and it sounds like you guys are starting to get your footing back and moving forward. I'm sure there are things to work through still, but you have some vision. You're starting to develop a culture and you're starting to get back on track.
We're getting there.
We'll stay in touch. I'll follow-up with you again. We'll see where you are at the time but expect huge changes.
Thanks for your time, Avi.
Thank you, Nathan.
Dr. Avi Zinn, PT, DPT, OCS is the owner of Druid Hills Physical Therapy in Atlanta, Georgia. He opened his practice at the end of 2017 and has slowly built it up—transitioning from a staff of one (himself) to a team of administrative staff and treating therapists. He continues to grow the practice gradually. Avi’s main mission for Druid Hills PT is to provide high-quality, personalized care to each and every one of his patients.
Avi has his doctorate in physical therapy from Touro College, and is a Certified Orthopedic Clinical Specialist. He lives with his wife and three children in Atlanta.
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Jeff McMenamy, OT, and Dr. Sabrina Starling (from the previous episode) join me in a conversation about Jeff's success and how his success is directly related to the business coaching that Dr. Starling provided and continues to provide him. Jeff started his clinic in a two-car garage and now owns four clinics across Wyoming - Teton Therapy. His life changed forever when Dr. Starling asked one question. Take a listen to the episode to find out what it was (mystery sandwich!). Jeff attributes a great measure of his success to the coaching he's received, and I am in complete agreement. Lesson of the day - get a coach!
With this episode, I'm excited because I've got three people on the line. One being myself but also a friend of mine, Jeff McMenamy, a successful physical therapy owner in Wyoming and his coach, Dr. Sabrina Starling. Dr. Starling is the expert in recruiting top talent and has a book called How to Hire the Best, which you should look into. Jeff got me in touch with Dr. Starling and I thought, “I'd like to have Dr. Starling and Jeff on the same episode, so we can discuss the benefits of having a coach in your life as a physical therapy practice owner.” Jeff, not only is inspirational in regard to the fact that the guy started in a two-car garage with his therapy clinic and is now the owner of four physical therapy clinics across Wyoming. A lot of that has been due to some of the consulting he received and the individual business coaching that he received from Dr. Starling. I thought I'd bring the two of them on together to share what it's like to work with a coach and how it helped Jeff go from two-car garage to a four-practice clinic owner.
Jeff is the CEO and owner of Teton Therapy, which provides both physical and occupational therapy services. They have four outpatient clinics in Wyoming. These clinics aren't close together. They're roughly four hours away from each other, but they still see roughly 600 visits per week combined. Jeff has full control of them and continues to succeed and continues to have plans for expansion. He started into private practice on his own in 1999 and joined up with a couple of physical therapists but eventually became the sole owner of Teton Therapy. He's originally from Minnesota, but he has called Wyoming home for years. He loves it because of the outdoor recreational opportunities and the spirit of the people that live in Wyoming. He and his wife, Mic, have three children. They are empty nesters. Jeff retired from coaching ice hockey and is planning to spend his winters in a warmer climate, but still managing his company from a distance. That's the goal of all of us is to be able to have such control that we can manage our businesses from a distance.
Dr. Sabrina Starling has been coaching for years. She's a clinical psychologist and is known as the business psychologist and author of the series How to Hire the Best. She's also the Founder of Tap the Potential business consulting, which essentially focuses on transforming small businesses into highly profitable great places to work. Her experience working with entrepreneurs in rural areas catapulted her into becoming the world's leading expert in attracting top talent in small businesses especially in rural areas and thus brought about the How to Hire the Best series. She also has a podcast called Profit by Design.
In this episode, we're going to focus on some of the benefits that come from coaching and some of the experiences that Jeff had in working with Sabrina that led to his success. I want you to know his story about the one question that Dr. Starling asked him that catapulted him into success. He'll share that question with you. The one question that she brought up that struck a nerve with me was, “What if it's not true, all the fears, all the things that hold you back? What if those ideas and postulates that you have in your head aren't true? What would you do then?” She also asked another question of Jeff that catapulted his growth. These are the some of the things that coaches do for you. They open your mind. They ask open-ended questions and help you come up with the answers from within. It becomes more successful in that way and becomes an eye-opening and mind opening experience.
I'm excited because I've got one of my coaches that I've interviewed, Dr. Sabrina Starling and one of my good friends from my network and a successful physical therapist, Jeff McMenamy with Teton Physical Therapy in Wyoming. Jeff has worked with Dr. Starling over the past number of years. I thought it'd be great to get the three of us and talk a little bit about Jeff's story. Thanks for joining me, Jeff. I appreciate it.
It’s nice to be here.
Dr. Starling, nice to talk to you again. I appreciate you taking the time.
I'm delighted to be back. It is fun to be here with Jeff. Jeff introduced us together, Nathan. I’m glad the three of us are getting to sit down and talk.
Jeff was great. He said, “If you ever want somebody on your podcast, Sabrina would be great.” We talked a lot about attracting recruiting top talent and a lot of that came from her work in this small town. You were in the same small town at the time weren’t you, when you were working with Jeff initially?
Absolutely. Jeff was one of the business owners who inspired that book.
The book that Sabrina is referring to is the book that she wrote called How to Hire the Best. If you're looking to get some strategies and ideas on how to recruit and hire, be sure to look for that book on Amazon or you can go to her website, HowToHireTheBest.com. She's got some extended webinars and training on doing that. Does that sound about right, Dr. Starling?
Yes, that's all good.
Jeff, specifically I want to take this interview to talk about you and your experience working with a consultant. To have both of you at the same time would be a cool thing to do. Jeff, do you want to share a little bit about your story and what got you to where you are now?
I was working for a large corporation back in the early ‘90s. It was roughly about 1999. I had it with big corporations and so forth. Though they treated me well, I felt like I wanted to do my own thing. I'm an occupational therapist by trade. I decided to go into an outpatient setting not knowing anything about what I was getting into. I went ahead and rented some space at a little place and eventually joined up with two other physical therapists. I ended up through time buying both of them out and then becoming the sole owner of Teton Therapy. That's where it all started. I didn't have much of a plan. I knew I wanted to work for myself and create my own life and my own career has taken off from there.If you had all the courage you needed, what decision would you make? Click To Tweet
You've done great. You're the perfect example of a successful small business owner, not just a physical therapy clinic owner but a small business owner. The first thing that came to my mind is how big was your space when you first opened up?
It was a double-car garage that filled in the doorway with a wall and a window and then carpeted it and painted in the sheetrock. That's what it was.
I never heard of a physical therapy clinic inside of the garage.
It was in the back of a doctor's office and that's why we went into it. The doctor was right there and he was willing to rent us some space.
Where are you at now? How many clinics and what are their sizes?
We have four clinics. We've opened up five and one of them went with one of my partners. The current clinic we're in, Riverton, is 5,700 square feet. Lander is about 3,500 square feet. Cheyenne is the same. Sheridan, which opened in 2016 is right at almost 3,000 square feet I believe.
Big changes and big growth from the two-car garage.
After the two-car garage, we were in a racquetball court.
I can verify that, Nathan. When I first met Jeff, he brought me into his office in the clinic that was in the racquetball court and his office was like a closet. He had metrics and numbers all over his wall. That's when I knew that he's not going to be staying in this clinic long this way.
You knew you had a gem to work with at that point, I'm sure?
I was reassured that it’s going to go well from there.
Jeff, when you introduced me to Dr. Starling, you said that she asked you a question that blew your mind and led you down the path that you've gone now. Do you mind sharing what was that question?
She asked, “If you had all the courage you needed, what decision would you make right now that would have the greatest impact on your business and your life?” She discussed more on that, our voices of reason and so forth that they hold us back. That was on a free webinar. I didn't know Sabrina. My wife had set it on my desk and said, “I think you should attend this thing.”
If you had all the courage that you needed, what decision would you make? Is that how it went?We get in our own way all the time as business owners. Click To Tweet
At that time, were you struggling quite a bit or were you looking for something?
I wasn't looking for anything and I was pretty happy with where I was at, but it was a very freeing question because I thought, “If you had all the courage you needed, there wouldn't be any risk.” When she asked that question, I took it in that respect of, “No risk. Big decision.” The follow-up question was, “What's preventing you from acting on that?” It was thrown out there as a group question. It wasn’t to me individually. She asked for anybody in the group if they would be willing to share.
Did you immediately come up with a couple of things that you'd say, “I would do this and I would do that?” Was it pretty obvious?
It was obvious to me that we were facing renting the next racquetball court over trying to figure out how you put a hole in a racquetball court wall because they're very heavy walls. It was evident to me. I was like, “We need to go find some new space and maybe even purchase a building.”
Did you eventually do that?
That day I told Sabrina on the call, “There's a building that had been up for sale for quite some time.” It's on Main Street and it’s the current location that we're in. I said, “I'll go make an offer on that building. I would make a low offer.” I went ahead and I remember I was getting ready to leave the next day for a hockey tournament. I was playing in myself in Las Vegas. I thought, “I'm going to go throw this offer before I leave tomorrow.” I didn’t consult with my wife or my business partner. I told them before I was going to do it. I said, “I'm going to go make an offer on that building on Main Street.” They said, “We haven't talked about this or anything.” I said, “Don't worry, it's going to be a very low offer. What's the worst thing that will happen?” The worst thing that could happen was they would accept the offer.
I assume it ended up being a good thing.
We saw a six-month growth from changing the building, opening our space up.Even coaches need coaches because no one can shine the light on their own dark corners. We need somebody outside of us who can do that. Click To Tweet
You're still there now?
Yes, we still have it but I have another corporate office that we've been in to do more of our administrative stuff.
I have to say when Jeff told me on that webinar that he was going to make an offer on that building, I thought, “What have I gotten this poor guy into?” As Jeff reflects on this, what I'm aware of is that he was playing it safe when he was looking at, “How do I put a hole in a racquetball court and expand that way?” That was him looking at, “Here's where I am, here's the little box I've put myself in and our company and I'm going to keep playing safe. How do I expand from this little box?” We do that to ourselves all the time. We put ourselves as business owners in these little boxes. Much of coaching is about getting out of the box and looking at other possibilities. From Jeff, that question helped expand his possibilities. It put fear on the back burner and it made it not so important to play safe. To hear him say, “We grew from there,” and the level of growth, he did. I remember it was rapid growth from there. Metaphorically, they came out of their box and Jeff and everyone in their business, their mindsets opened up the possibilities.
I don't think that's limited to physical therapy owners. That's something that you see across the board, Sabrina, that is fear gets in the way so much of what we do.
We get in our own way all the time as business owners.
Are there some commonalities that you see among physical therapy, clinic owners in your dealings with them in the past?
Yes. One is working in the business and feeling like I am the one that needs to be delivering the service. “The patients like me, they don't want to talk to anybody else. They want me, so I need to be there or I'm the only one who knows how to do this. It means I have to be doing this.”
How do you break them from that? How do you get someone out of that box?
The, “What if it's not true?” question is a powerful question. We have to listen to ourselves and we're not good at listening to ourselves. It is much better to have other people listening to us and pointing out, “You just said,” and what if that's not true? As a coach, it's always a little precarious to ask the client, “What if what you said is baloney?” You don't want to say it like that, but from a curious place like, “What if this is not true? What if these are beliefs that are limiting you and holding you back? What other alternatives and what other realities could you be operating from that would serve you better?”
I'm sure that leads to all kinds of conversations and ideas that come up as you're coaching these people.
When I threw that question out on the webinar that Jeff was on, I had no idea where he would take it or where anybody on that call would take it. I knew for myself that when I'd heard it, I knew my answers and it got me out of playing safe and looking at other alternatives. I thought, “If it helped me, it's probably going to help people.”
As you've worked with Dr. Starling in the past, Jeff, what are some things that you found that she's been helpful in guiding and directing you as you've worked with her?
When we both have worked with Measurable Solutions and it's all about growing your business and getting other people to get the work done. One of the things that Sabrina started with me was business coaching. The business coaching wasn't just about coaching through business. Probably more of our time was spent coaching me through different life issues because your business and your life is so hand-in-hand. With that coaching, I started to self-coach. I would run into a problem and I would call Sabrina right now, “What would she ask me?” They were always open-ended questions. You were never going to get an answer from Sabrina. I'll tell you that valuable time of contemplating what she was going to ask me and then we would get into our coaching sessions, it taught me how to be a coach. That training that I had with Sabrina, those real-life experiences also going through the coach approach training with her, I use that every day. I have other business partners in some of our other clinics. I see that from that outside perspective. I have to make them get through their barriers and helping to coach them through. It’s a skill. It takes practice. It's definitely a technology and it's so valuable to grow your practice because you're growing other individuals.
It’s so fulfilling when you're able to do that, don't you feel, Jeff?
It's not your answers. It's their answers. They're accumulating the wins when they make the right decision and they experience something new, just like when I experienced purchasing that building and seeing the business take off. That's like winning a big game. Now you're ready to take on stronger opponents. That's what's so fulfilling about seeing some of these other younger partners and younger therapists and so forth that have the same dreams that I had and watching them succeed and take off.
Do you find, as you've done more coaching, that retention of these key and A-players has improved?
Definitely. Some of the executive council that I have around me, they know they're learning more about coaching as well. They may ask a question and they’re like, “I know you're not going to answer it, Jeff, but I'm trying to think of what you're going to ask me.”
You're replicating yourself and that's exactly what you want. I want to turn that over to Sabrina. Is that your goal to help your clients eventually become coaches within their own company?
Not just my clients and the business owners, but their entire teams learning how to be coached as with each other. One of the things that I have come to appreciate coaching and when we ask open-ended questions versus what a lot of people think coaching is, is telling someone what to do. I coached them to go do X, Y and Z. That's very different. If I had been in a conversation with Jeff and he had said, “We're growing and our space is getting cramped in this building.” I would've said, “Jeff, I think you need to place an offer on a bigger building.” Immediately, he would have gone into why that would be not a good idea. He would have told me, “This is crazy.”The Gremlins are the enemy of change. They come up because we're on the cusp of doing something great. Click To Tweet
“I can't do it because of this, that and the other.”
We resist advice giving. That is our human nature. It can be the best advice in the world and we will resist it. That's the hard thing for me as a coach, especially when I'm talking to people about hiring because that's an area where I have a lot of expertise now. Sometimes I absolutely know the answer. I know what they should do and if I say, “You should do it,” I get the resistance. What we've done now is we have our clients in small groups with each other. When other clients share their experiences around hiring or their experiences around, “Here's how I did this in my business or here’s I became more profitable,” that's where people start to pay attention and get curious. It's that combination of experience sharing and asking the powerful questions. I love what Jeff is saying about his executive team when they're all coaching each other because there's that opportunity for those other team members to be sharing experiences and asking the powerful questions. It's not just up to Jeff to be asking those questions.
That's been going on for how many years now Dr. Starling?
Off and on, probably from 2006. Jeff, do you know?
It's probably right at about 2006.
Are there some points where you felt that Jeff needed to make a course correction? From a coach's perspective, how do you go about doing that?
Yes, there were points where I wanted to give him advice. The analogy that I use is like we're going into a dark room with a client and we're trying to shine the light on all the different corners and the exits from that room. When it's dark, you might only see the exit in front of you. The asking the questions helps to shine the light on other alternatives and other possibilities that the client may not be seeing for themselves. That's so important for all of us to be aware of. Even coaches need coaches because I can't shine the light on my own dark corners. We need somebody outside of us who can do that.
Coaches are so huge. One of my recommendations for any small business owners is to get a coach or a consultant. What would your recommendation be then, Sabrina, if someone like Jeff or any small business owner is looking for a coach whether that's you or somebody else? A coach is going to help no matter what, but which ones might work out best and what should a person do to look for the one that does fit?
Ultimately when you're looking for a coach, you want to find somebody that you're going to have a good rapport with. That is first and foremost. Look at the other clients that they have served. Do you look like their other clients in terms of not physical appearance, but the situations that their other clients are in and the results that those clients are speaking to? Do you resonate with those? Do those results match up with what you're trying to achieve? We deliver life-changing business transformations in my coaching company and not everybody wants a life-changing business transformation. They just want to grow their revenue. We're not going to be the coach for them. It comes down to looking at what the results that the coach and the coaching company is promising, your ease and comfort with them and the alignment of the values. The previous clients and the current clients, do you fit with them? Is that the right fit for what you're looking for?
Jeff, from your experience, what were some of the biggest benefits of having a coach on your side?
As a single owner, it was having another perspective and it wasn't somebody that I was paying as an employee who is going to give you lip service of what they thought you wanted to hear. It wasn't somebody like my wife who has the same perspective that I do. Also, it wasn't somebody in my own field that might be steering me in some way. It was somebody who was very neutral and was looking out for my best interests. That's what was key for me. It was a sense of security and also accountability. It was not anything threatening with her accountability. It was like, “If you want to get this to this spot, Jeff, you're going to have to do these things. You're going to have to confront these things and you're going to have to take action.” A meeting with her as often as we did, it felt like a partnership.Be in the business for the right reasons. Don't let anyone else tell you where you want to go with your business. Click To Tweet
I like that you said that it was someone that was outside of the industry. Did you find a lot of benefit from that, the fact that Sabrina was not a physical therapist herself?
I could state things that were beliefs in our world, Nathan, and somebody who's in the outpatient physical therapy might go into agreement with that but that's where Sabrina could ask like, “Why is that true? What are you basing that on? Where's your factual data?” Ask some of those questions that I accepted as truth. You might probe a little bit and get me thinking, “I don't know. I always believed it to be this way.” I might come to the conclusion that it's not true.
One of the best things that I got from having a coach, and maybe you can speak to this a little bit, Jeff, if it resonates with you, but simply dealing with the interactions with the individuals that I was overseeing and working with, it didn't come natural for me to confront them, to hold them accountable, to somehow encouraged greater productivity, help them through situations that you're dealing with professionally, maybe personally. Utilizing a coach, how do you have that conversation and how do you steer it to the best possible conclusion? That was something that I got from having a coach? Is that something that you also noticed?
Yes, absolutely. She would lead me to come to my own conclusion, the best conclusion and I would feel good about that. She would add that little bit of, “What are you going to do?” “I'm going to have a meeting with that person.” “When are you going to have that meeting?” “I'll have it Wednesday.” “When do you want to report back to me how that meeting went?”
We, as owners, don't usually have people holding us accountable. We’re at the top of the totem pole and so there's no one holding our feet to the fire. It's great to have that.
I want to speak a little bit about that accountability piece too because when we decide, “I'm going to play a bigger game with my business. I want more profit. I want more time freedom. I want to take vacations,” that requires us to be different as the leaders in our business. We have to show up as a different person than the person that we are when we're saying, “I'm going to do it all in my business. I'll wear all these hats.” It's very easy to get excited about an outcome or a vision that you're driving towards, but as soon as the rubber hits the road and you have to show up and be the bigger person, the shoes that you're trying to grow into, the gremlins, the self-talk, the negative self-limiting beliefs pop up.
I tell clients a lot of times when we first start working together, “I know you're thrilled. This is exciting. We're going to do great things in your business,” and you want to come to our meeting but a month from now, you're going to be like, “I don't want to show up. I'm going to cancel my coaching. I've got a patient. I need to see that patient. That's more important than my coaching session.” The gremlins are coming up because we're on the cusp of doing something great and that's changed. Our gremlins are the enemy of change. They like the status quo. We need that person holding us accountable to our vision of, “You said you want to grow your clinic. You want to grow your profits this way and you want to be able to take those vacations. What are you going to do about it this week?”
What are you willing to do to make sure you reach those goals? The accountability was huge. The guidance and direction that I received were huge. I can attribute a lot of success that we and our clients had through the coaching we received and the consultants that helped train us. Dr. Starling, anything in particular that you felt would be beneficial for most physical therapists? If they're considering consulting, what would be the benefit of coaching to physical therapy clinic owners specifically as you work with a few of them?
Not having to reinvent the wheel. When you work with a coach, whether it's in your industry or outside your industry, someone who has business expertise, they know what works. I work with so many businesses in different industries. I know what works consistently across the industries. It saves so much pain. I had a client that used the phrase pain puddle. He said, “Working with coaches can pull you out of your pain puddle.”
Jeff, any recommendations on your end, some of the benefits that you’ve had from consulting? For those people who might consider a consultant or a coach in the future, what would you say to physical therapy clinic owners?
The best way for me to tell this is in a story. Sabrina, as you can see when you're talking with her, she's a very nice, caring individual. She's small in stature and so forth, but the results that she gets, she is a pit bull when it comes to seeing that you need to fire this person. She wouldn't ever say that. She would never say, “You need to fire that person,” but she would make me see very clearly that, “You're willing to risk everything for this one employee who's not even serving you well. They're taking you for everything.” She would make me see that, “This person is hurting me and the rest of this company,” or when it comes to a decision of increasing profitability and I would feel worried, “Is that being greedy?” and all this.You got to do what's right by the business before you consider what's right by you. Click To Tweet
She would point out, “Why are you in business? You're in business to build that company and be more profitable.” She was very unrelenting in that way. For me, her as a coach, that passed on right to me, to be that unrelenting, be in it for the right reasons and don't let anyone else tell you where you want to go with your business, mainly your employees who maybe don't have your best interest. They don't have the company's best interest. That's what I see if you’re a physical therapist owning your own business. We're in the business of caring for others. We care for our employees and we definitely care for our patients. We care for the doctors who refer to us. We're always caring for everyone else. It's very hard sometimes for us to take care of ourselves and to take care of our business. It's the last two things will put out there or take care of and that's where I saw Sabrina helped me to keep that focus in.
That's what helped me. I love that you shared that at the very end because that's what one coach helped me and my partner recognize that it wasn't the owner and the business that came last. They actually had to come first. In fact, the business takes priority over the owner. You got to do what's right by the business before you consider what's right by you. If you keep it in that regard, that it's business first followed by owners and then employees, then you'll make the right decision for everybody in that regard. It's the company that's going to run your life and the business than your own. Sabrina, if people wanted to get your book or find you, how would they be able to do that?
The best place to find me and my coaching company is TapThePotential.com. My book is available on Amazon. My book is How to Hire the Best. If you want the free masterclass that goes with the book, you can get that at HowToHireTheBest.com.
Thanks again for joining me on this episode. It's groundbreaking for the Physical Therapy Owners Club podcast to have three people at once. This is awesome. I appreciate, Jeff, you introducing me to Sabrina so that she could share some of her secrets with the world as well.
Thank you, Nathan and Sabrina.
Jeff McMenamy is the CEO and Owner of Teton Therapy operating four outpatient clinics in Wyoming. They offer both Physical and Occupational Therapy services. The clinics are spread out roughly 4 hours away from each other and see roughly 600 visits per week combined. Jeff is an Occupational Therapist by trade and had to adapt to the culture of Private Practice Physical Therapy. Jeff started into private practice on his own in 1999, then joined up with two physical therapists and eventually became the sole owner of Teton Therapy. Originally from Minnesota, he calls Wyoming home after 22 years. He chose the state for it endless outdoor recreational opportunities and the independent spirit of people. He and his wife Mic have three children and are “Empty Nester’s.” Jeff recently retired from coaching ice hockey after 21 years and is set to spend the winter in a warmer climate managing his company from a distance.
Dr. Sabrina Starling is known as The Business Psychologist™ and author of the series, How to Hire the Best, and is the founder of Tap the Potential business consulting. Tap the Potential specializes in transforming small businesses into highly profitable, Great Places to Work, then celebrates by sending business owners on a 4 Week Vacation to celebrate their accomplishment. Dr. Sabrina’s How to Hire the Best series grew from her desire to solve the toughest hiring challenges interfering with her clients’ growth and profitability. What sprang from her experience working with entrepreneurs in rural areas catapulted her into becoming the world’s leading expert in attracting top talent in small businesses, and has earned Tap the Potential the reputation as the go-to resource for entrepreneurs committed to creating Great Places to Work. With her background in psychology, and years of driving profit in small business, Dr. Starling knows what it takes to find, keep and get exceptional performance out of your biggest investment — your team members. Tune in weekly to the Profit by Design Podcast as Dr. Sabrina and her co-host, Mike Bruno, bring you tips, tools, and strategies to grow a sustainably profitable business that allows you to live the lifestyle you desire.