PTO 154 | Steps To Success


Everyone wants their business to succeed, but what does it take to run a successful physical therapy clinic? In this episode, we find out the key steps to success for PT clinic owners. Nathan Shields takes a look at eight key steps that you need to take for your clinic to succeed. He analyzes each key step and tells you what you need to know and do. Tune in and learn the secrets to a successful PT clinic here.


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8 Key Steps to Success as a PT Clinic Owner

I want to talk about the Eight Steps to Success as a Physical Therapy Owners Club member. Some of you may be thinking, “I’m not a member. I didn’t join anything.” Let’s say you are a member because you are an audience of the show and/or a Facebook Group Member and you are passively engaged in the club so you are a club member.

I want to take this time to talk to you about what that pathway looks like for success as a Physical Therapy Owners Club member. In essence, what are the eight steps to becoming a successful physical therapy clinic owner? They are one in the same thing. The whole purpose behind the Physical Therapy Owners Club is to help you as an owner generate more profits and freedom in your business.

PTO 154 | Steps To Success
Profit First: Transform Your Business from a Cash-Eating Monster to a Money-Making Machine

I want to take some time to talk about what those steps are. Some of you definitely are further along in the process. I would love to talk these out with you and see where you are and how far you have gotten. Also, look back and say, “What things do I need to do to shore up my ownership in my clinic?” Bear with me. There are a number of things that we could be talking about. I'm looking at things from a larger perspective as to what it takes to become a successful PT owner.

Let's talk about the first step. The first step that I have to encounter with most of my coaching clients is obtaining an ownership mindset. What I mean by that is many physical therapists, I included, opened up a clinic thinking, “I’m a physical therapist that now owns a clinic.” Taking on an ownership mindset flips that script and helps you recognize that, “I am a business owner that happens to own a physical therapy clinic.” I am also a physical therapist. However, what comes first if you want to be successful in your business is to recognize that you are an owner of a business, the business requires you to think that way and what is in the best interest of the business at any and all times.

As a successful business owner, your job is to give the business quality time. If we were to talk about love languages and if your business had a love language. That love language would be quality time. You must take the time that the business needs for it to run successfully. If you are treating 50 hours a week and trying to fit in business/administrative tasks in-between visits and on the weekends, inevitably, you are either going to burn out. Number two, your employees are going to get frustrated. Three, you are going to have limited growth. You might obtain some measure of financial, security or goals but you are not going to have a lot of freedom to go along with it.

If you want to take the first step towards successful business/PT clinic ownership, that is to obtain an ownership mindset and recognize that your business comes first. What do I do? How do I become a business owner? That's the second step. A lot of your training has been in physical therapy or working towards a physical therapist for twenty-plus years of your life throughout your education so you can become a physical therapist. Now I'm telling you, don't be a physical therapist anymore, essentially. What do you do to get that business training? That begins with listening to me and others. Also, reading books related to business ownership.

If your business had a love language, that love language would be quality time. Click To Tweet

I’m going to toot my own horn and say we’ve got a ton of great resources over the past years at the Physical Therapy Owners Club show. Tons of great interviews from successful physical therapists and industry leaders that can teach you different aspects of successful business and administrative actions that you can take to improve your business. That’s one, but I’m not the only one out there to help physical therapists. There are others.

Paul Gough is one that I have appreciated many times. I know Devin DeBoer has one for cash-based businesses. Check them out. Listen to them. Gain what you can from them and use those as resources. It also goes toward the idea is to read more. Read the books that we have recommended here in the past that many times. Read E-Myth Revisited, Think and Grow Rich, Profit First, Traction, and Who Not How, is a great one that I read. These are all books that are number one important to read. Number two, it’s important to implement.

PTO 154 | Steps To Success
Who Not How: The Formula to Achieve Bigger Goals Through Accelerating Teamwork

Many people have read all the books, done all the things but haven't taken the time to implement them. Thus, they haven't progressed in their ownership path. Take the time to read the book once, twice, maybe three times, come back and implement, and take the time to implement those recommendations in those books and those shows. How do you do that if you are treating full-time? That's the third step. You've got to cut back on your treatment time.

You’ve got to take the time to implement the strategies that are recommended. If you are not taking any time now to do administrative tasks, it's got to start with at least half-day a week. I recommend two half days per week to start with. During that time, you will implement these strategies. You will plan appropriately, hold people accountable, develop policy and procedures, which we will talk about later on. These are the things that you do with your administrative time. Even though you haven't had any business training, you can start doing some of these things.

Taking the time to implement business practices and improve your business will take you a long way. I didn't see a lot of gains in my business until I stepped out of treating a significant amount of time so that I could work on my business, not just in my business. That's the third step. Take the time to step away from treating and putting the time to work on your business.

The fourth step, leverage your network. What do I mean by that? Number one, you have to be a part of a network. That could be the Facebook group of the Physical Therapy Owners Club. That could be a peer-to-peer network from the private practice section of the APTA where you meet with other physical therapy owners that could be joining entrepreneurs' organizations, which is a small business network that Will and I joined, and had a ton of success with when we recognized that we needed more training in business. This is another group.

You could even join local Rotarians or Lions Club. These are networks that you can use to interact with other business owners and share some of your concerns, issues, ask questions, if you will, especially on the Facebook group. We had a lot of great questions on there from private practice owners. That's where you can leverage your network, ask questions and get advice.

Many times, as an owner, you can feel like you are alone on an island dealing with things that no one else has dealt with. That's not the case. Even people in other industries are dealing with similar issues. You must recognize and lean on their experience to overcome the obstacles you are dealing with. That's the fourth step.

Training is invaluable and helps you generate physical therapists that are both value-aligned and part of the clinic's culture. Click To Tweet

The fifth step, hire a coach or get a consultant. Whatever you need to have someone to guide you, hold you accountable or give you feedback and support on a routine basis. It might be somewhat self-serving of me to do that because I am a coach for PT Owners at this time but I can tell you that I'm not here in this place. I have not gained the success that I have without the help of coaches, mentors and consultants in the past, who have helped me. In fact, even now, as I'm coaching others, I have a coach of my own because I know their value.

I have spent hundreds of thousands of dollars on coaches in the past and it has gotten me to the point where I am. I wouldn't trade a single dollar for any of that experience that I have had, the training that I’ve got and the wisdom that I learned. I find that a majority of owners out there, I would say 96% to 99% if I had to put a number to it of successful owners out there have had some coaching or consulting in the past to get them to the level that they are successful. Hire a coach or a consultant.

The sixth step, develop policy and procedure. This is how we do, blank. This is how we collect copays, maintain a higher arrival rate, treat patients, treat shoulders, order supplies and clean. That policy and procedure manual that you develop on how we do things is something that lives beyond you and allows others to do those things the way you would do them if you did them and do that at a successful level without your physical presence. That’s the magic of policy and procedures. It gets you to a point when instituted, followed and utilized to a point where you don’t have to be there. That gives you freedom.

Traction: Get a Grip on Your Business

If you have read to any of my reality show with Avi Zinn in the past. I followed him for the past couple of years in his ownership journey from a young owner. His success thus far to the point where he hardly steps into the clinic more than once or twice per week is all due to the fact that he spent a significant amount of time establishing policy and procedure for his therapist, front desk, managers to follow.

As they follow that, his involvement is less and less necessary because they stick to the policy and procedure manual, and rely less on Avi to be the answer man for everything. Developing policy and procedures for the front desk, training and onboardings, recruitment, treatment, you name it. Policies and procedures for all those things take time but when you do them, it starts to organize the chaos and give you the freedom that you need to be the visionary for your clinics.

The seventh step, find your next physical therapist. You have stepped out of treatment. You have done all these things to organize and progress your clinic. You need to find a physical therapist to take over some of those patients and come on full-time. Most importantly, hire physical therapists and train them appropriately. Train them how you would treat patients.

They don't have to use the same techniques. I shouldn't say that many times, they do prefer you have certain techniques or training if you are going to treat certain patient populations. Train them on how you greet patients, how we keep patients all the way through their full plan of care, how we discharge patients, how we ask patients for referrals a family and friends, how to interact with the front desk, how to schedule patients and how to do their EMR. All of that training is invaluable and helps you generate physical therapists that are both value-aligned and part of the clinic's culture.

PTO 154 | Steps To Success
Think and Grow Rich

Not only hiring the physical therapists but training them accordingly. The eighth step, work on building up that business more. In most of your situations, if you can get to 4 to 5 physical therapists running full time, you are in a magical profitability state and a place of freedom. As you grow from 1 to 2, you are increasing in size, essentially, 100%. 2 to 3, you are growing at 50%. 3 to 4, that's a 25% increase.

The pain is less as you add more physical therapists. On top of that, whereas you get to the 4th and 5th physical therapists, your fixed expenses, rent utilities and EMR systems stay about the same outside of salaries. Once you get past that third physical therapist, the revenue generated by the 4th and 5th therapists goes straight to the bottom line outside of their salaries because all other fixed expenses are fixed.

Getting to that place where you can get to 4, maybe 5 physical therapists will require some effort. That's where you need the time to spend on marketing strategies to the four buckets, physicians, community, past patients and current patients. Have a marketing strategy for each bucket to generate the new patients necessary for 4 or 5 physical therapists.

Also, what you need to do to generate a culture that breeds a patient-friendly environment, keeps the patients engaged and keeps the physical therapists engaged will require a lot of work. You can't be treating patients full-time if you are going to do that. As you get to the 4 and 5 physical therapists, make that your goal because the profitability is great.

Considering you have done all of this. Maybe you have reached all these steps, you are well on your way or you are at the 7th and 8th steps. What do you do after that? Essentially, it comes down to duplicating what works and eliminating what doesn't. When it comes to policy procedure and personnel, you’ve got to duplicate what works and eliminate that, and those that don't, then you can start looking at expansion either in terms of square footage or another location. Again, duplicate what works in that first clinic, take that marketing strategy, take the therapists and the personnel that are aligned with you, take the policy and procedures that work, cut and paste into the next clinic and you do that over again.

PTO 154 | Steps To Success
The E-Myth Revisited: Why Most Small Businesses Don't Work and What to Do About It

That's what you see a lot of successful multi-clinic or large clinic owners do. Duplicate what works and eliminate what doesn't. I could have spent a lot of time in these eight steps talking about the importance of establishing purpose and values, KPIs or stats, reviewing stats and establishing battle plans based on those stats. We spend a lot of time on necessary meetings.

To get to this point, I wanted to give you an overall picture of what those eight steps look like because along the way, you are going to have to address those things anyways. Purpose and values being foundational aspects. Statistics are necessary to know when to grow next. Those are the things that a coach can teach you and you can learn from your networks and books. Inevitably, you have to establish those things along the way but they are super important.

I want to look at from a global perspective, a higher-level perspective as to what it takes to become a successful PT Owner/Physical Therapy Owners Club member. Remember, you are already one because you are an audience. You are well on your way because you are an audience and taking advantage of the resources that are out there for you.

I recommend you follow this path to success. If you are along the path already, keep moving and know what your next step is. My goal for each of you that are reading is to obtain the freedom and the profits that you want from your clinic so that you can fulfill your personal purpose and goals for yourself and your family. I hope you do so by following this path to PT clinic ownership. Have a great day.

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